TBL 12 Flashcards
Functional anatomy of wrist and hand
1
Q
unique feature of hand
A
pincer-like action of thumb (grasp objects)
2
Q
anterior (ventral) side of hand
A
palmar (volar) surface
3
Q
posterior aspect of hand
A
dorsal (back) surface
4
Q
digit 1
A
thumb (pollux)
5
Q
thin, hairy, freely mobile skin of hand
A
dorsum
6
Q
thick and hairless skin of hand
A
palm
7
Q
sites of skin movement identified via
A
flexure creases
8
Q
present in large numbers on hand
A
sweat glands
9
Q
palm of the hand has a ___ that separates two eminences: ___
A
central concavity;
thenar eminence; hypothenar eminence
10
Q
lateral, larger eminence in the base of the thumb
A
thenar eminence
11
Q
medial, smaller eminence, proximal to base of 5th finger
A
hypothenar eminence
12
Q
the fascia of the palm is continuous with the
A
antebrachial (forearm) fascia and dorsum fascia
13
Q
palmar fascia is thick centrally where it forms the
A
palmar aponeurosis
14
Q
the proximal end (apex) of the palmar aponeurosis is continuous with the
A
flexor retinaculum and palmaris longus tendon
15
Q
articulation is between the radius and the articular disc and the scaphoid, lunate, and triquetral bones
A
radiocarpal (wrist) joint
16
Q
the radiocarpal joint articulates between the ___ and the ___ and the ___
A
radius;
articular disc;
scaphoid, lunate, triquetrum
17
Q
does the ulna directly participate in the joint surfaces
A
no
18
Q
forms a concave surface, which is adapted to the distal convex surface
A
proximal articular surface of the wrist joint (radiocarpal)
19
Q
the proximal articular surface of the radioulnar joint forms a ___ which is adapted to the ___
A
concave surface; distal convex surface
20
Q
encloses the joint and is attached above to the distal ends of the radius and ulna and below to the proximal row of carpal bone
A
radiocarpal joint capsule
21
Q
the wrist joint capsule is attached above to the ___ and below to the ___
A
distal radius and ulna;
proximal row of carpal bones
22
Q
lines the capsule and is attached to the margins of the articular surfaces
A
synovial membrane of the radiocarpal joint
23
Q
synovial membrane of the wrist joint is attached to the __
A
margins of the articular surfaces
24
Q
the joint cavity does NOT communicate with the
A
distal radioulnar joint or the joint cavities of the intercarpal joints
25
nerve supply of the wrist joint
anterior interosseous nerve (from median) and the deep branch of the radial nerve
26
ligaments of the wrist joint
anterior (palmar radiocarpal) and posterior (dorsal radiocarpal), ulnar collateral (medial), radial collateral (lateral)
27
strengthens the radiocarpal joint capsule
anterior (palmar) and posterior (dorsal) radiocarpal ligaments
28
attached to the styloid process of the ulna and to the triquetral bone
ulnar collateral (medial) ligament
29
attached to the styloid process of the radius and to the scaphoid bone
radial collateral (lateral) ligament
30
the carpal bones form an arch that is convex on the ___ and concave on the ___
dorsal; palmar
31
palmar groove is called the
sulcus carpi
32
sulcus carpi is covered by the
flexor retinaculum
33
attached radially to trapezium and on the ulnar side to the pisiform and hook of hamate
flexor retinaculum
34
the flexor retinaculum is attached radially to the ___ and ulnarly to the ___
trapezium; pisiform and hook of hamate (hamulus)
35
the 9 tendons that pass through the carpal tunnel
flexor digitorum profundus (4) and superficialis (4) and flexor pollicis longus (1)
36
courses between the tendons of the flexor digitorum profundus and superficialis
median nerve
37
the recurrent branch of the median nerve innervates
the thenar muscles
38
the thenar muscles are innervated by
the recurrent branch of the median nerve
39
the median nerve bifurcates after the nerve
exits the carpal tunnel
40
in 5-10% people, the median nerve bifurcates
more proximally in the carpal tunnel, wrist, or forearm
41
ulnar canal / tunnel
Guyon's canal
42
space between the pisiform and hamate bone through which the ulnar artery and the ulnar nerve travel into the hand
Guyon's canal
43
Guyon's canal is the space between the
pisiform and hamate bone
44
ulnar neuropathy is caused by
entrapment of ulnar nerve at the ulnar canal (Guyon's canal)
45
guyon canal syndrome
rare peripheral ulnar neuropathy
injury to the distal portion of the ulnar nerve
46
movements of radiocarpal joint include
flexion, extension, abduction, adduction, circumduction
47
why is rotation of the radiocarpal joint not possible
articular surfaces are ellipsoid shaped
48
what allows rotation ??
radioulnar joints
49
movements that compensate for the lack of rotation in the wrist joint
pronation and supination of the forearm
50
flexion of the wrist joint is performed by
flexors of the forehand
51
the flexors of the forehand attach to the
metacarpal bones
52
extension of the wrist joint is performed by
the extensors of the forehand
53
abduction of the wrist joint is performed by
the flexor carpi radialis and the extensor carpi radialis longus and brevis
54
adduction of the wrist joint is performed by
the flexor and extensor carpi ulnaris
55
deep fascia of the wrist and palm is thickened to form
the flexor retinaculum and the palmar aponeurosis
56
triangular space occupying the central area of the palm
palmar aponeurosis
57
apex of the palmar aponeurosis is attached to
the distal border of flexor retinaculum
58
the apex of the palmar aponeurosis receives insertion of
the palmaris longus tendon
59
the base of the palmar aponeurosis divides at ___ into ___
the bases of the fingers; 4 slips
60
the medial and lateral borders of the palmar aponeurosis are continuous with the ___ covering the ___
thinner deep fascia; hypothenar and thenar muscles
61
from the medial and lateral borders of the palmar aponeurosis, ___ pass deeply into the ___ and take part in the formation of the ___
fibrous septa; palm; palmar fascial spaces
62
function of the palmar aponeurosis
gives firm attachment to the overlying skin, improves the grip and to protect the underlying tendons
63
potential spaces filled with loose connective tissue
fascial spaces of palm
64
boundaries of the fascial spaces of the palm are important clinically because
limit the spread of infection in the palm
65
passes from the ulnar border of the palmar aponeurosis and attaches to anterior border of the 5th metacarpal bone
medial fibrous septum
66
passes from the lateral border of the palmar aponeurosis to the anterior border of the 3rd metacarpal bone
lateral fibrous septum
67
passes between the long flexor tendons of the index and middle fingers
lateral fibrous septum
68
what limits the spread of infection in the palm
boundaries of the fascial spaces of palm
69
the medial fibrous septum passes from the ___ and attaches to the ___
ulnar border of the palmar aponeurosis;
| anterior border of the 5th metacarpal bone
70
the lateral fibrous septum passes from the ___ to the ___ and between the __
lateral border of the palmar aponeurosis;
anterior border of the 3rd metacarpal;
long flexor tendons of the index and middle fingers
71
between the 1st and 3rd metacarpal
oblique septum
72
the oblique septum lies between the ___
1st and 3rd metacarpal
73
the palm of the hand is divided into:
medial, midpalmar space, thenar space (misnomer), lateral
74
part of the palm that contains the hypothenar muscles
medial compartment
75
part of the palm that lies between the oblique and lateral septa
thenar space (misnomer)
76
part of the palm that lies between the medial and oblique fibrous septum
midpalmar space
77
part of the palm that contains the muscles of the thenar
lateral compartment
78
fascial spaces of the palm: proximally, the ___ are closed off from the forearm by the ___
thenar and midpalmar spaces;
| carpal tunnel
79
fascial spaces of the palm: distally, the thenar and midpalmar spaces are ___
continuous with the appropriate lumbrical canals
80
continuous with the appropriate lumbrical canals
distal thenar and midpalmar spaces
81
part of the palm that contains the first lumbrical muscle
thenar space
82
the thenar space lies deep to the ___ and superficial to the ___
long flexor tendons to the index finger;
| adductor pollicis muscle
83
part of the palm that lies deep to the long flexor tendons to the index finger and superficial to the adductor pollicis muscle
thenar space
84
part of the palm that contains the second, third, and fourth lumbrical muscles
midpalmar space
85
the midpalmar space lies posterior to the ___ and superficial to the ___
long flexor tendons to the middle, ring, and little fingers;
| interosseous muscles and the third, fourth, and fifth metacarpal bones
86
part of the palm that lies posterior to the long flexor tendons to the middle, ring, and little fingers and superficial to the interosseous muscles and the third, fourth, and fifth metacarpal bones
midpalmar space
87
a potential space surrounding the tendon of each lumbrical muscle
lumbrical canal
88
the lumbrical canal is normally filled with
connective tissue
89
is proximally continuous with one of the palmar spaces
lumbrical canal
90
the lumbrical canal is proximally continuous with ___
one of the palmar spaces
91
the muscles of the thumb include:
abductor pollicis brevis,
flexor pollicis brevis,
opponens pollicis,
adductor pollicis
92
which of the thumb muscles are innervated by the median nerve
abductor pollicis brevis,
flexor pollicis brevis,
opponens pollicis,
93
which of the thumb muscles are innervated by the ulnar nerve
adductor pollicis
94
muscle located superficially and laterally in the thenar eminence
abductor pollicis brevis
95
the abductor pollicis brevis is located ___
superficially and laterally in the thenar eminence
96
the origin of the abductor pollicis brevis
scaphoid, trapezium, flexor retinaculum
97
the insertion of the abductor pollicis brevis
lateral aspect of the base of the proximal phalanx of the thumb
98
muscle that originates in the scaphoid, trapezium, and flexor retinaculum and inserts in the lateral aspect of the base of the proximal phalanx of the thumb
abductor pollicis brevis
99
innervation of the abductor pollicis brevis
recurrent branch of the median nerve
100
action of the abductor pollicis brevis
abduction of the thumb at the carpometacarpal and metacarpophalangeal joints
101
muscle located medially and below the abductor pollicis brevis
flexor pollicis brevis
102
the flexor pollicis brevis is located ___
medially and below the abductor pollicis brevis
103
the origin of the flexor pollicis brevis
flexor retinaculum and trapezium
104
insertion of the flexor pollicis brevis
lateral aspect of the base of the proximal phalanx of the thumb (with the abductor PB)
105
muscle that originates in the flexor retinaculum and trapezium and inserts in the lateral aspect of the base of the proximal phalanx of the thumb
flexor pollicis brevis
106
innervation of the flexor pollicis brevis
recurrent branch of the median nerve
107
action of the flexor pollicis brevis
flexion of the thumb at the carpometacarpal and metacarpophalangeal joints
108
muscle located deep to the abductor pollicis brevis
opponens pollicis
109
the opponens pollicis is located ___
deep to the abductor PB
110
origin of the opponens pollicis
flexor retinaculum and trapezium
111
insertion of the opponens pollicis
lateral border of the shaft of the 1st metacarpal
112
muscle that originates in the flexor retinaculum and trapezium and inserts in the lateral border of the shaft of the 1st metacarpal
opponens pollicis
113
innervation of the opponens pollicis
recurrent branch of the median nerve
114
action of the opponens pollicis
opposition of the thumb
115
origin of the adductor pollicis
oblique head from the bases of metacarpals 2 and 3 and adjacent carpal bones
transverse head from the shaft of the 3rd metacarpal
116
muscle that originates in the oblique head from the bases of metacarpals 2 and 3 and adjacent carpal bones and inserts in the medial aspect of the base of the proximal phalanx of the thumb
adductor pollicis
117
muscle that originates in the transverse head from the shaft of the 3rd metacarpal and inserts in the medial aspect of the base of the proximal phalanx of the thumb
adductor pollicis
118
insertion of the adductor pollicis
medial aspect of the base of the proximal phalanx of the thumb
119
innervation of the adductor pollicis
deep branch of the ulnar nerve
120
action of the adductor pollicis
adduction of the thumb at the carpometacarpal and metacarpophalangeal joints
121
movements of the thumb
abduction, adduction, extension, flexion, opposition, reposition
122
hypothenar muscles include:
abductor digiti minimi,
flexor digiti minimi brevis,
opponens digiti minimi
123
innervation of the hypothenar (pinky) muscles
deep branch of the ulnar nerve
124
muscle located superficially and medially in the hypothenar eminence
abductor digiti minimi
125
the abductor digiti minimi is located
superficially and medially in the hypothenar eminence
126
origin of the abductor digiti minimi
pisiform bone
127
insertion of the abductor digiti minimi
medial side of the base of the proximal phalanx of the little finger
128
muscle that originates in the pisiform bone and inserts in the medial side of the base of the proximal phalanx of the little finger
abductor digiti minimi
129
action of the abductor digiti minimi
abduction of the little finger at the metacarpophalangeal joint
130
muscle located under the abductor digiti minimi in the hypothenar eminence
flexor digiti minimi
131
the flexor digiti minimi is located
under the abductor digiti minimi in the hypothenar eminence
132
origin of the flexor digiti minimi
pisiform bone
133
insertion of the flexor digiti minimi
medial side of the metacarpophalangeal joint
134
muscle that originates in the pisiform bone and inserts in the medial side of the metacarpophalangeal joint
flexor digiti minimi
135
action of the flexor digiti minimi
flexion
136
location of the opponens digiti minimi
deep to the abductor and flexor digiti minimi
137
muscle that is located deep to the abductor and flexor digiti minimi
opponens digiti minimi
138
origin of the opponens digiti minimi
flexor retinaculum and hook of hamate
139
insertion of the opponens digiti minimi
medial border of the shaft of the 5th metacarpal
140
muscle that originates in the flexor retinaculum and hook of hamate and inserts in the medial border of the shaft of the 5th metacarpal
opponens digiti minimi
141
action of the opponens digiti minimi
flexion and lateral rotation of the 5th metacarpal at the carpometacarpal joint
helps to bring the pinky into opposition with the thumb
142
intrinsic muscles of the hand include:
```
lumbricals (4)
palmar interssei (3)
dorsal interossei (4)
```
143
lumbrical muscles act on the
2nd to 5th fingers
144
muscles that act on the 2nd to 5th fingers
lumbrical (4)
145
origin of the lumbrical muscles
tendons of the flexor digitorum profundus
146
insertion of the lumbrical muscles
lateral side of the extensor expansion of the corresponding finger
147
muscle that originates from the tendons of the flexor digitorum profundus and inserts on the lateral side of the extensor expansion of the corresponding finger
lumbrical muscles
148
innervation of lumbricals 1 and 2
median nerve
149
innervation of lumbricals 3 and 4
deep branch of the ulnar nerve
150
action of the lumbrical muscles
flexion of the metacarpophalangeal joints
extension of the interphalangeal joints
151
essentially, the only extensors of the fingers
lumbrical muscles
152
when lumbrical muscles contract, they pull the ___ towards the ___ and simultaneously pull the ___ to extend the ___
proximal phalanx;
palm;
extensor tendon;
middle and distal phalanges
153
the palmar interossei muscles act on the
index, ring, and little fingers
154
action of the palmar interossei muscles
adduction of the fingers at metacarpophalangeal joints
(PAD)
flexion at metacarpophalangeal joints
extension at interphalangeal joints
155
origin of the palmar interossei muscles
metacarpals of the corresponding finger (2, 4, 5)
156
insertion of the palmar interossei muscles
proximal phalanx and extensor expansion of the corresponding fingers (lateral and medial side, respectively)
157
muscles that act on metacarpal 2, 4, 5
palmar interossei muscles
158
muscles that originate from metacarpal 2, 4, 5 and insert on the proximal phalanx and extensor expansion of the corresponding fingers
palmar interossei muscles
159
innervation of the palmar interossei muscles
deep branch of the ulnar nerve
160
action of the dorsal interossei muscles
abduction at metacarpophalangeal joints (DAB)
flexion at metacarpophalangeal joints
extension at interphalangeal joints
161
muscles that act on the index, middle, and ring fingers
dorsal interossei muscles
162
dorsal interossei muscles act on the
index, middle (2 muscles), and ring fingers
163
origin of the dorsal interossei muscles
2 heads from adjacent sides of 2 metacarpal bones
164
insertion of dorsal interossei muscles
side of base of proximal phalanx (2 lateral, 2 medial) and extensor expansion of corresponding finger
165
muscle that originates from the adjacent sides of 2 metacarpal bones and inserts in the side of base of proximal phalanx and extensor expansion of corresponding finger
dorsal interossei muscles
166
innervation of the dorsal interossei muscles
deep branch of the ulnar nerve
167
key differences between lumbrical and dorsal interossei muscles
lumbrical - superficial, originate from tendon
dorsal interossei - deeper, originate from metatarsal bone
168
each tendon of the flexor digitorum superficialis divides into:
two halves at the level of proximal phalanx
169
each tendon of the ___ divides into two halves at the level of proximal phalanx
flexor digitorum superficialis
170
the flexor digitorum superficialis tendon attaches to the ___
borders of the middle phalanx
171
the tendon of the flexor digitorum profundus passes through the ___ and continues to insert into the ___
division of the superficialis tendon;
| anterior surface of the base of the distal phalanx
172
the long flexor tendon of the flexor digitorum superficialis inserts into the ___ while the long flexor tendon of the flexor digitorum profundus inserts into the ___
middle phalanx;
| distal phalanx
173
innervated by the median nerve
lumbricals 1 and 2
174
innervated by the deep branch of the ulnar nerve
lumbricals 3 and 4, dorsal interossei (1-4), palmar interossei (1-3)
175
flexes metacarpophalangeal joints
lumbricals 1-4, dorsal / palmar interossei
176
extends interphalangeal joints of digits 2-5
lumbricals 1-4, dorsal / palmar interossei
177
abducts digits 2-4 from axial line
dorsal interossei (1-4)
178
adducts digits 2, 4, 5 toward axial line
palmar interossei (1-3)
179
extensor expansions of digits 2-4
palmar interossei (1-3)
180
extends from the metacarpal heads to the base of the distal phalanges
fibrous flexor sheaths
181
fibrous flexor sheaths extend from the ___ to the ___
metacarpal heads;
| base of the distal phalanges
182
attach to the sides of the phalanges and arch over the long flexor tendons
fibrous flexor sheaths
183
fibrous flexor sheaths attach to ___ and arch over the ___
the sides of the phalanges;
| long flexor tendons
184
osteofibrous tunnels for the long flexor tendons and their synovial sheaths are formed by the
fibrous sheaths, anterior surfaces of the phalanges and interphalangeal joints
185
formed by the fibrous sheaths, anterior surfaces of the phalanges and the interphalangeal joints
osteofibrous tunnels for the flexor tendons and their synovial sheaths
186
osteofibrous tunnel for the thumb contains the
tendon of the flexor pollicis longus
187
contains the tendon of the flexor pollicis longus
osteofibrous tunnel for the thumb
188
osteofibrous tunnels for the medial 4 fingers contain the
tendons of flexor digitorum superficialis and profundus
189
contains the tendons of flexor digitorum superficialis and profundus
osteofibrous tunnels for the medial 4 fingers
190
fuses with the periosteum of the terminal phalanx just distal to the insertion of the long flexor tendons
deep fascia of the pulp of each finger
191
the deep fascia of the pulp of each finger fuses with the ___ and closes off the ___
periosteum of the terminal phalanx just distal to the insertion of the long flexor tendons;
pulp space
192
supplies the terminal phalanx
terminal branch of the digital artery
193
runs through the pulp space
terminal branch of the digital artery
194
the terminal branch of the digital artery supplies the ___ and runs through the ___
terminal phalanx;
| pulp space
195
the pulp space is filled with
fat
196
synovial joints that comprise the hand and fingers include:
```
midcarpal,
carpometacarpal,
intermetacarpal,
metacarpophalangeal,
interphalangeal
```
197
articulation of the midcarpal joint
between the individual bones of the proximal and the distal row of carpal bones
198
ligaments of the midcarpal joint that unite the bone
strong anterior, posterior, and interossei ligaments
199
synovial membrane of the midcarpal joint is attached to
the margins of the articular surfaces
200
nerve supply of the midcarpal joint include:
anterior interosseous nerve, deep branch of the radial nerve, and deep branch of the ulnar nerve
201
movements of the midcarpal joint
small amount of gliding movement
202
articulates between the individual bones of the proximal and the distal row of carpal bones
midcarpal joint
203
synovial plane joints that possess anterior, posterior, and interosseous ligaments
carpometacarpal and intermetacarpal joints
204
have a common joint cavity separated by the cavity of the intercarpal joint
carpometacarpal and intermetacarpal joints
205
carpometacarpal and intermetacarpal joints have a ___ separated by the ___
common joint cavity;
| cavity of the intercarpal joint
206
movements of the carpometacarpal and intermetacarpal joints include:
flexion, extension, small amount of gliding in the intermetacarpal joints
207
articulation of the carpometacarpal joint of the thumb
between the trapezium and the saddle-shaped base of the first metacarpal bone
208
articulated between the trapezium and the saddle-shaped base of the first metacarpal bone
carpometacarpal joint of the thumb
209
the carpometacarpal joint of the thumb is a ___ joint
synovial saddle-shaped joint
210
the capsule of the midcarpal joint
lines the joint
211
the capsule of the carpometacarpal joint of the thumb
surrounds the joint
212
movements of the thumb include:
flexion, extension, abduction, adduction, opposition
213
flexes the thumb
flexor pollicis brevis, opponens pollicis
214
extends the thumb
extensor pollicis longus and brevis
215
abducts the thumb
abductor pollicis longus and brevis
216
adducts the thumb
adductor pollicis
217
opposition (medial rotation) of the thumb is performed by
opponens pollicis
218
articulation of the metacarpophalangeal joints is
between the heads of the metacarpal bones and the bases of the proximal phalanges
219
metacarphophalangeal joint is a type of
synovial condyloid joint
220
ligaments of the metacarpophalangeal joint include:
palmar metacarpal ligaments
221
palmar metacarpal ligament is associated with the ___ joint
metacarpophalangeal
222
strong and contain from fibrocartilage
palmar metacarpal ligament
223
palmar ligaments of the 2,3,4,5 joints are united by the
deep transverse metacarpal ligaments
224
ligaments that hold the heads of the metacarpal bones
deep transverse metacarpal ligaments
225
the deep transverse metacarpal ligaments unite the ___ and hold the ___
palmar ligaments of the 2,3,4,5 joints;
| heads of the metacarpal bones together
226
present on each side of the metacarpophalangeal joints
collateral ligaments
227
each collateral ligament passes from the ___ to the ___
head of the metacarpal bone;
| base of the phalanx
228
taut when the metacarpophalangeal joint is in flexion
collateral ligaments
229
lax when the metacarpophalangeal joint is in extension
collateral ligaments
230
collateral ligaments are ___ when the mcp joint is in flexion and ___ when the mcp joint is in extension
taut; lax
231
movements of the mcp joints include:
flexion,
extension,
abduction,
adduction
232
flexion of the mcp joint is performed by:
lumbricals and interossei,
| assisted by flexor digitorum superficialis and profundus
233
extension of the mcp joint is performed by:
extensor digitorum,
extensor indicis,
extensor digiti mini
234
abduction of the mcp joint is performed by:
dorsal interossei (DAB)
235
adduction of the mcp joint is performed by:
palmar interossei (PAD
236
flexion of the mcp joint of the thumb is performed by ___, while extension of the mcp joint of the thumb is performed by ___
flexor pollicis longus and brevis;
| extensor pollicis longus and brevis
237
anastomotic arterial arches form from branches of the radial and ulnar arteries and include:
superficial palmar arterial arch (palmar);
deep palmar arterial arch (palmar);
dorsal carpal arch (dorsal)
238
dorsal, deep, and superficial arches send proper ___ to supply the fingers
digit arteries
239
each digit gets 4 arteries:
2 dorsal digital from dorsal carpal arch;
| 2 proper palmar digital from the superficial arterial arch;
240
the radial artery gives rise to the ___ arteries which supply blood to the ___
princeps pollicis and radialis indicis;
| thumb and ring finger
241
normal range of motion for flexion
70-90 degrees
242
normal range of motion for extension
70 degrees
243
normal range of motion for ulnar deviation
30-50 degrees
244
normal range of motion for radial deviation
20 degrees
245
normal range of motion for forearm supination
80 degrees
246
normal range of motion for forearm pronation
80 degrees
247
bony landmarks on the volar surface include:
pisiform, hook of hamate, palmaris longus, scaphoid tubercle
248
ulnar side of palm just proximal to palmar crease
pisiform
249
hypothenar wrist, 1 cm distal to flexor crease
hook of hamate
250
absent in 15% population; corses above hamate
palmaris longus
251
palpable at extensor carpi radialis at palmar crease
scaphoid tubercle
252
bony landmarks of dorsal surface include:
anatomic snuffbox, radial tubercle, scapholunate joint / interval
253
located at anatomic snuffbox
scaphoid pole
254
lister's tubercle
radial tubercle
255
distal radius prominence on wrist dorsum
radial tubercle
256
lines up with 3rd metacarpal
radial tubercle
257
palpate radius dorsum when patient flexes wrist
radial tubercle
258
most common carpal dislocation
scapholunate joint / interval
259
most commonly fractured carpal bone
scaphoid
260
swelling of flexor tendon and sheath with difficult passage of swollen tendon through the sheath
Trigger Finger
261
snapping the affected finger at the MCP joint, tenderness to palpation, swollen
Trigger Finger
262
Tigger Finger gets ___ after rest, ___ with active finger use, and the ___ may lock
worse;
improves;
entire finger
263
Trigger Finger occurs with the swelling of ___ with difficult ___
flexor tendon and sheath;
| passage of swollen tendon through sheath
264
treatment of Trigger Finger could include
NSAIDs, immobilization, avoid offending activity, moist heat as needed, steroid injection, surgical correction if refractory to above management
265
median nerve entrapment between transverse carpal ligament and underlying carpal bones
Carpal Tunnel Syndrome
266
Carpal Tunnel Syndrome is caused by ___ between ___
median nerve entrapment;
| transverse carpal ligament and underlying carpal bones
267
median nerve is entrapped from the
inflamed and enlarged flexor tendons
268
conditions associated with carpal tunnel syndrome
hypothyroidism,
diabetes mellitus,
pregnancy
269
proximal radiation into forearm (may radiate into shoulder and neck)
carpal tunnel
270
may be confused with chest pain
carpal tunnel
271
carpal tunnel: increase in wrist swelling with ___
inactivity
272
testing carpal tunnel:
direct pressure over ___ for 30 seconds
transverse carpal ligament
273
Tinel's sign
tap over the palmaris longus tendon
274
Phalen's maneuver
elicits pain by compressing the median nerve
275
a localized thickening and contracture of the palmar aponeurosis, which limits hand function and may eventually disable the hand
Dupuytren Contracture
276
commonly starts near the root of the ring finger and draws that finger into the palm, flexing it at the metacarpophalangeal joint
Dupuytren Contracture
277
nodules and pitting may appear in the hand, rope-like cord forms in the palm, fingers bend toward the palm
Dupuytren Contracture
278
In long-standing cases of Dupuytren Contracture, the pull on the ___ of these fingers results in ___ of the ___ joints
fibrous sheaths;
flexion;
proximal interphalangeal
279
The distal interphalangeal joints are not involved and are actually extended by the pressure of the fingers against the palm
Dupuytren Contracture
280
Dupuytren Contracture is a localized thickening and contracture of the ___ which limits hand function and commonly starts near the ___ and draws that finger into the ___, ___ it at the ___ joint; the ___ joints are not involved and are ___ by the pressure of the fingers against the ___
```
palmar aponeurosis;
root of the ring finger;
palm;
flexing;
metacarpophalangeal;
distal interphalangeal;
extended;
palm
```
281
usual form of treatment for a Dupuytren Contracture of the palmar fascia include
surgical division of the fibrous bands, physiotherapy to the hand
282
alternative form of treatment for a Dupuytren Contracture of the palmar fascia include
injection of enzyme collagenase into the contracted bands of fibrous tissue
283
injury to the median nerve near the elbow
Hand of Benediction and Ape Hand (Pronator Syndrome)
284
unable to flex the index and middle fingers when the patient tries to make a fist
Hand of Benediction and Ape Hand (Pronator Syndrome)
285
caused by loss of lateral lumbrical action, leading to unopposed action on the finger extensors (radial nerve)
Hand of Benediction and Ape Hand (Pronator Syndrome)
286
wasting of thenar muscles due to loss of abductor pollicis and unopposed extensors
Ape Hand
287
Hand of Benediction and Ape Hand (Pronator Syndrome) is caused by injury to the ___ near the ___ leading to the loss of ___, leading to ___ on the ___; patient is unable to ___ when the patient tries to ___
```
median nerve; elbow;
lateral lumbrical action;
unopposed action; finger extensors (radial nerve);
flex the index and middle fingers;
make a fist
```
288
the lesion location of ulnar claw is a ___ or ___ leading to clawing of the ___ due to weakness of the ___
medial epicondyle fracture;
Guyon canal compression;
3rd and 4th fingers;
ulnar-supplied lumbrical muscles
289
medial epicondyle fracture or Guyon canal compression can lead to
Ulnar claw (clawing of 3rd and 4th fingers)
290
Erb-Duchenne Palsy (Waiter’s Tip) is caused by damage to the ___ leading to deficits in ___, weakness of the ___, and the upper limb is ___
cervical nerve roots of the upper trunk (C5-C6);
abduction (Axillary),
lateral rotation (Suprascapular, Axillary),
flexion (Musculocutaneous), and supination (Radial);
extensors of the hand (radial);
medially rotated, extended, pronated, and hangs by the patient's side in adduction
291
caused by birth injury or fall on the shoulder in adults
Erb-Duchenne Palsy (Waiter’s Tip)
292
Lower trunk injury (Klumpke paralysis) is caused by injury to the ___, affecting the ___, and leading to ___
C8-T1 / ulnar nerve / 3rd and 4th lumbrical;
intrinsic muscles of the arm and unopposed extensors;
hyperextension of the metacarpophalangeal joints, flexion of interphalangeal joints
293
caused by birth trauma or extreme abduction of the arm, waste of the interossei
Lower trunk injury (Klumpke paralysis)
294
most often injured in the axilla
radial nerve
295
weakness of hand extensors and sensory loss of the dorsal surface of the hand, forearm, and arm
Radial nerve injury (Saturday Night Palsy)
296
Radial nerve injury (Saturday Night Palsy) is caused by injury to the ___, leading to weakness of ___, and sensory loss of the ___
radial nerve;
hand extensors;
dorsal surface of the hand, forearm, and arm
