MSK Wrist Flashcards
Normal ROM for wrist Flexion: extension: Ulnar deviation radial deviation
F: 80
E: 70
UD 30
RD 20
Name the carpal bones radial —> ulnar
proximal - scaphoid, lunate, triquetrum, pisiform
Distal - trapezium, trapezoid, captitate, hamate
Name the 6 wrist flexors
- FCR (median from MC/LC C6/7)
- FCU (ulnar from MC C8/T1)
- Palmaris longus (Median from MC/LC C7/8)
- FDS (Median from MC/LC C7-T1)
- FDP (median from MC/LC C7-T1 2nd and 3rd digit; ulnar from MC C7-T1 to 4th and 5th digit)
- Flexor Pollicis longus (median from MC/LC C8/T1)
name the 7 wrist extensors
- ECR-L (radial from PC C6/7)
- ECR-B (radial from PC C6/7)
- ECU (radial from PC C7/8)
- Ext dig communis (radial from PC C7/8)
- Ext Dig Minimi (ulnar from MC C8/T1)
- Extensor indicis (radial from PC C6-8)
- Extensor pollicis longus (radial from PC C6-8)
Name the two muscles responsible for ulnar deviation of the wrist
- FCU (ulnar from MC C8/T1)
2. Ext Carpi ulnaris (radial from PC C7/8)
Name the two muscles responible for radial deviation of the wrist
- FCR (median from MC/LC C6/7)
2. ECR-L (radial from PC C6/7)
Name the six tendon sheath compartments of the dorsal wrist
from radial to ulnar
1st - Abductor pollicus longus, Extensor pollicis brevis
2nd - ECR-L, ECR-B
3rd - Extensor pollicus longus
4th - Extensor digitorum communis, extensor indices proprius
5th - extensor digiti minimi
6th Extensor carpi ulnaris
OA is common in ______ of the thumb
1st Carpal-metacarpal joint of the thumb (CMC joint)
In the hand
OA affects ____ and ____
RA affects ____ and ____
OA affects DIP (heberden) and PIP (Bouchard)
RA affects MCP and PIP joints
in RA \_\_\_\_ wrist deviation occurs \_\_\_\_ MCP deviation occurs \_\_\_\_ subuluxation of the ulna \_\_\_\_ at end stage
radial deviation at the wrist
ulnar deviation of the MCPs
Dorsal subluxation of the ulna
erosion of the ulnar styloid at end stages
Describe swan neck deformity (4)
- shortening an dcontracture of intrinsic muscles of the hand
- Flexion at MCP
- hyperextension of PIP
- Flexion at DIP
describe boutonniere deformity (4)
- tearing of extensor hood
- hyperextension of MCP
- Flexion at PIP
- Hyperextensino of DIP
_____ is repetitive or direct trauma to the sheath of the extensor pollicis brevis and abductor pollicis longus tendons, causing a tenosynovitis and inflammation
de quervains tenosynovitis - will have pain and tenderness in radial side of wrist
involves tendons of the 1st compartment of the wrist
what is the provocative test for de quervains tenosynovitis
finkelsteins test - flex the thumb into the palm of the hand with the fingers, making a fist over the thumb. Then passively ulnar deviate the wrist. test is positive if pain is elicited. May also be positive in RA
Treatment of De Quervains tenosynovitis (3)
- thumb spica splint to immobilize the thumb
- NSAIDs
- CSI
surgical release of the tight sheath eliminates the friction that worsens the inflammation, thus restoring the tendon’s smooth gliding capability
ganglion cyst is a fluid filled cyst which arises from ____
synovial sheath of the joint space - typically a small smooth mass on the dorsal or volar aspect of the wrist that occurs on the dorsal apsect in 60% of cases
90% of ganglion cysts are treated by
aspiration of the cyst