Lecture: Wrist & Hand Flashcards
Carpus (or wrist) comprises of __ bones, __ ligaments
- 8
- 26
hand accounts for: \_\_% of upper limb fxn thumb: \_\_% index (2nd digit): \_\_% middle (3rd digit): \_\_% (3rd digit is \_\_\_ finger)
- 90%
- 40-50%
- 20%
- 20%
- strongest
what kind of joint is the distal radio-ulnar joint?
what does it unite?
- double pivot joint
- distal radius, ulna and an articular disc (TFCC)
Colle’s Fracture, aka?
fracture of?
__ angulation of distal fragment?
- dinner fork fracture
- radius
- posterior
Smith’s Fracture, aka?
fracture of?
__angulation of distal fragment?
- reversed colle’s & garden spade
- radius
- anterior
TFCC?
b/w?
- triangular fibrocartilage complex
- the medial proximal row & the distal ulna within medial aspect of wrist
primary fxn of the TFCC is to improve __ __ & to cushion against __ __.
- joint congruency
- compressive forces
proximal carpal row from lateral to medial:
- scaphoid
- lunate
- triquetrium
- pisiform
distal carpal row from lateral to medial:
- trapezium
- trapezoid
- capitate
- hamate
which carpal is a sesamoid bone?
-pisiform
which carpal takes up 2 metacarpal bases?
-hamate
which carpal is the most commonly fractured and largest in the proximal row?
-scaphoid
radius articulates directly with?
-lunate & scaphoid
which carpal is the largest of all carpal bones?
-capitate
which carpal is the 2nd most commonly fractured, and why?
- lunate
- b/c its in the middle, is takes the brunt of stress in the arch
lunate, capitate and base of 3rd MC are covered by the __ __ __ __ tendon.
origin:
insertion:
- extensor carpi radialis brevis
- lateral epicondyle
- base of 3rd metacarpal
what kind of articulation is the mid carpal joints (lying bw the two rows of carpals) and why?
- compound
- bc each row has both a concave & convex segment
the proximal row of carpal is __ laterally & __ medially
- convex
- concave
stability of the CMC (carpometacarpal) joints is provided by:
-palmar and dorsal carpometacarpal and intermetacarpal ligaments
the MCP joint allows for __ & __ and __-__ deviation, associated with a slight degree of __ __.
- flexion & extension
- medial-lateral
- axial rotation
First Carpometacarpal joint is what kind of joint?
- is the most __ joint of the thumb &
- consists of the articulation bw the base of the __ MC and the __ __ of the trapezium.
- sellar (saddle-shaped)
- important
- 1st & distal aspect
Bennet’s fracture= fracture thru the __ of the 1st metacarpal neck with __ & __ displacement of the __.
(aka?)
-base
-dorsal & radial
-shaft
(post/lat. frx)
metacarpophalangeal joint is what kind of joint?
-hinge
Bar Room Fracture= fracture of the __ or __ MC neck with __ displacement of the head.
- 4th or 5th
- anterior
Boxer’s Fracture= fracture of the __ or __ MC neck with __ displacement of the head.
- 2nd or 3rd
- anterior
the PIP joint is a __ joint, capable of __ & __.
- hinge
- flexion & extension
the DIP joint (similar to PIP) but is less __ and allows some __.
- stable
- hyperextension
heberden’s nodes: found on what fingers & where?
size?
nodules are?
- all except the thumb, DIP
- 2-3mm in diameter
- painless and motion is unlimited
heberden’s nodes: localized?
several joints more common in? during? mostly from?
single joint more common in? mostly from?
- OA
- women, menopause, hereditary
- males, trauma
bouchard’s nodes: which joint?
may indicate: primary & secondary?
- PIP
- 1*=synovitis
- 2*=RA (bilateral)
swan neck deformity: MOI?
PIP is?
DIP is?
- RA
- deforms into hyperextension
- is flexed
boutonniere deformity: what happened?
PIP is?
DIP is?
- slip of the extensor digitorum communis tendon is avulsed from insertion into the base of the middle phalanx
- is flexed
- is extended
the major ligaments of the wrist (carpal ligs) include the:
- palmar intrinsic ligs
- volar extrinsic
- dorsal extrinsic
- & intrinsic ligs
which carpal ligaments provide the majority of wrist stability?
-extrinsic palmar ligaments
which carpal ligaments serve as rotational restraints, binding the proximal row into a unit of rotational stability?
-intrinsic ligaments
(1) medial &
(2) lateral collateral ligaments of the fingers are named?
- Grayson’s
- Cleland’s
Radiocarpal joint is formed by the large articular __ surface of the __ __ of the __, and __, and __ of the proximal carpal row, and the TFCC.
- concave
- distal end
- radius
- scaphoid
- lunate
Antebrachial Fascia is a __ __ tissue, “__”, that encases the __ and maintains the relationships of the tendons that cross the __.
- dense connective
- bracelet
- forearm
- wrist
Extensor Retinaculum prevents the tendons from “__-__”, when tendons turn a corner at the wrist.
-bow-stringing
the tunnel-like structures formed by the extensor retinaculum and the underlying bones are called:
-fibro-osseous compartments
the extensor retinaculum compartments, from lateral to medial, contain the tendons of:
- abductor pollicis longus & extensor pollicis brevis
- extensor carpi radialis longus & brevis
- extensor pollicis longus
- extensor digitorum & indicis
- extensor digiti minimi
- extensor carpi ulnaris
the flexor retinaculum transforms the carpal arch into a tunnel, through which pass the __ __ and some of the __ of the hand.
- median nerve
- tendons
Jersey finger is avulsion of the __ __ __ tendon.
moi=finger gets caught in an object and the actively __ __ joint is suddenly & forcibly __ resulting in a __.
- flexor digitorum profundus
- flexed DIP
- extended
- rupture
proximally the flexor retinaculum attaches to the __ of the __ and the __.
- tubercle
- scaphoid
- pisiform
distally the flexor retinaculum attaches to the __ of __ and the __ of the __.
- hook hamate
- tubercle
- trapezium
carpal tunnel serves as a conduit for the __ nerve & __ __ tendons
- median
- nine flexor
what makes up the floor of the canal of the carpal tunnel?
-palmar radiocarpal ligament &
-palmar ligament complex
(palmars make up the roof!)
what makes up the roof of the canal of the carpal tunnel?
-the flexor retinaculum (transverse carpal tunnel)
what are the ulnar (medial) and radial (lateral) borders of the carpal tunnel?
- trapezium
- hook of the hamate
Tunnel of Guyon is a __ superficial to the __ __, located b/w the __ of __ and the __ bones.
- depression
- flexor retinaculum
- hook of hamate
- pisiform
the roof of the tunnel of guyon is formed by:
- palmar (volar) carpal ligament
- palmaris brevis muscle
- palmar aponeurosis
the floor of the tunnel of guyon is formed by:
- flexor retinaculum (transverse carpal ligament)
- pisohamate ligament
- pisometacarpal ligament
Cyclist Hand= __ __ & __ compression injuries b/w the __ and __ of __.
other activities to elicit similar probs?
- ulnar nerve & artery
- pisiform
- hook of hamate
- crutch use & weight lifting
Palmar aponeurosis: __ fibrous structure, continuous with the __ __ tendon & fascia covering the __ & __ muscles.
- dense
- palmaris longus
- thenar & hypothenar
Dupuytren’s contracture is a __ condition of the __ __ that results in __ formation or __ of the __, and which may ultimately cause finger __ __ (usually the _ or _ digit).
- fibrotic
- palamar aponeurosis
- nodule
- scarring
- aponeurosis
- flexion contracture
- 4th or 5th
palpation during Dupuytren’s contracture reveals a __ __ over the __ tendon; __ extension of the finger raises the __ taut where it can be readily seen.
- hard cord
- flexor
- passive
- cord
