Test 2 Wrist and Hand Flashcards
The hand accounts for about __% of upper limb function. The thumb is involved in __-__% of hand function. The index finger is involved in about __% of hand function.
90%
40-50%
20%
The middle finger is the strongest and accounts for about __% of all hand function. It is important for both __ and __ functions
20
precision
power
DIstal radio-ulnar joint is a __ joint that unites the distal radius and ulna and an ___ ___. The rounded head of the ulnar head contacts both the ___ of the radius laterally and the ____ distally.
double pivot
articular disc
ulnar notch
TFCC
The ulnar styloid process is about __ inch(es) shorter than the radial styloid process, resulting in more __ deviation. (30 vs. 20)
1/2
ulnar
Colles’ fx aka ___ ___ fracture is a fx of the radius within __-__mm of the wrist joint with ___ angulation of the distal fragment.
Dinner Fork
20-35
posterior
Reversed Colles fx. (2 AKAs __ and __) is a fx of the radius within __-__mm of the wrist joint with __ angulation of the distal fragment.
Smith’s fx
Garden Spade deformity
20-35
anterior
Triangular fibrocartilage complex is in between the __ __ row and the distal ___ within the __ aspect of the wrist. Primary function is to improve joint congruency and to cushion against __ forces.
Medial Proximal
Ulna
medial
compressive
The TFCC transmits about __% of the axial load from the hand to the forearm.
20
__ is the most commony fractured bone of the wrist. __ __ helps to slide it out from under the radial styloid process for palpation.
Scaphoid (Navicular)
ulnar deviation
__ is the largest and most prominent of the MCP bases as well as largest of all carpal bones.
Capitate
__ is the 2nd most often fractured and most commonly subluxated wrist bone.
Lunate
What 3 things are covered by the extensor carpi radialis brevis tendon? Where does the tendon insert?
Lunate, Capitate, base of 3rd metacarpal
Inserts into base of 3rd metacarpal
The ___ joint lies between the two rows of carpals. The proximal row of carpals is __ laterally and __ medially.
Midcarpal
convex
concave
The proximal row of carpals presents with a __ surface to the distal row. The distal row of carpals presents with a __ surface to the proximal row.
Concave
Convex
What provides stability to the carpometacarpal joints?
Palmar and Dorsal carpometacarpal and intermetacarpal ligaments
The 2nd-5th metacarpals articulate with the
respective proximal phalanges in __ joints
Biaxial
The MCP joints allow __/__ and __/__deviation associated with a slight degree of __ rotation
flexion/extension
medial/lateral
axial
Functionally, the ___-shaped ___ joint is the most important joint of the thumb
sellar (saddle)
carpometacarpal
ROMs at the thumb
Flex/Ext
Abd/Add
Opposition
Bennett’s Fx is through the base of the __ metacarpal neck with __ and __ displacement of the shaft
first
dorsal
radial
Bar Room Fx is in the __ or __ metacarpal neck with __ displacement of the head
fourth
fifth
anterior
Boxer’s fx is the __ or __ metacarpal neck with __ displacement of the head
second
third
anterior
The PIP joint is a hinged joint capable of __ and __. The DIP is similar but is less stable and allows some ___.
flexion
extension
hyperextension
Heberden’s nodes are found on one or more fingers, except the ___. Distal joints are enlarged by 2 nodules, __ to __ mm in diameter, one on either side of the __ midline.
thumb
2-3
dorsal
Hebdeden’s nodes are painless, process is a localized __. Involvement of several joints is more common in __ in whom they appear at the __ age.
OA
women
menopausal
Herberden’s nodes in women is usually ___ and a single joint is usually involved in __. Condition on men is usually the result of __
hereditary
men
trauma
What is swan neck deformity?
PIP jt deforms into hyperextension and the DIP jt is flexed
In Boutonniere deformity,The central slip of the ___ tendon is avulsed from the___ to the
base of the __ phalanx, the PIP is __ and the DIP is __.
Extensor Digitorum Communis insertion middle flexed extended
The extrinsic palmar ligaments provide the majority of the __ __.
wrist stability
The intrinsic ligaments serve as __ __, binding the proximal row into a unit of rotational stability
rotational restraints
Medial and Lateral collateral ligaments of the fingers are named __ and __ ligaments
Cleland’s
Grayson’s
Radiocarpal is formed by the large articular __ surface of the distal end of the radius , the __ and __ of the proximal carpal row, and the __
concave
scaphoid
lunate
TFCC
Antebrachial fascia is a __ ct bracelet that encases the forearm and maintains the relationships of the __ that cross the wrist
dense
tendons
Extensor Retinaculum serves to prevent the tendons from “__ __” when the tendons turn the corner at the wrist. The tunnel-like structures formed by the retinaculum and the underlying bones are called __-__ compartments
bow-stringing
fibro-osseous
Extensor retinaculum from lateral to medial, contains tendons of…
- Abductor pollicis longus and extensor pollicis brevis
- Ext. Carpi radialis longus and brevis
- Extensor Pollicis longus
- Extensor Digitorum and indicis
- Extensor DIgiti Minimi
- Extensor Carpi Ulnaris
Flexor retinaculum transforms carpal arch to tunnel, through which pass the __ nerve and some tendons. Proximally, the retinaculum attaches to the tubercle of __ and __. Distally, it attaches to ___ and tubercle of __
median scaphoid pisiform hook of hamate trapezium
Jersey finger is an avulsion of the ___ tendon. MOI- finger gets caught in an object and actively flexed __ joint is suddenly and forcibly __ resulting in a __
flexor digitorum profundus
DIP
extended
rupture
What makes the floor of the carpal tunnel?
Palmar radiocarpal ligament and palmar ligament complex
What makes up the roof of the carpal tunnel?
Flexor retinaculum (transverse carpal ligament)
What are the ulnar and radial borders of carpal tunnel?
Trapezium and hook of hamate
Tunnel of Guyon is a depression __ to the flexor retinaculum, located between the __ and the __ bones
superficial
hook of hamate
pisiform
Whats forms the roof of the Tunnel of guyon?
Palmar (volar) carpal ligament, palmaris brevis muscle, palmar apopneurosis
What forms the floor of the tunnel of guyon?
Flexor retinaculum, pisohamate ligament, pisometacarpal ligament
Tunnel of guyon serves as a passageway for the __ nerve and artery into the hand
ulnar
Cyclist hand is __ nerve and artery compression injuries between __ and __. What other activities could elicit similar problems?
ulnar
hook of hamate
pisiform
-Crutch use and weight lifting
Palmar apopneurosis is a dense fibrous structure continuous with ___ tendon and fascia covering the __ and __ muscles.
palmaris longus
thenar
hypothenar
Dupuytern’s contracture is a fibrotic condition of the ___ that results in __ formation or __ of the apopneurosis, and which may ultimately cause finger __ contractures
palmar apaopneurosis
nodule
scarring
flexion
In Dupuytren’s contracture, palpation of the palm reveals a __ __ over the __ tendon. Passive __ of the finger raises the cord taut where is can be readily seen
hard cord
flexor
extension
Extensor hood is a complex tendon, which covers the __ aspect of the digits and is formed by a combination of the tendons of insertion from __(3)__
dorsal
Extensor difitorum
Extensor Indicis
Extensor Digiti Minimi
Extensor hood creates a “__” system that provides a mechanism for extending the ___ and __ joints, and allows the __ and possibly __ muscles to assist is __ of the MCP joints.
cable MCP IP Lumbrical Interosseous flexion
Mallet finger is when __ phalanx of finger is permanently flexed at the __ joint. Cannot be voluntarily extended.
terminal
distal
Mallet finger is caused by rupture of the __ tendon that inserts on the __ phalanx. Possibly a fx of the __ phalanx
extensor
terminal
distal
Synovial sheaths are long narrow balloons filled with synovial fluid, which wrap around a __ so that one part of the balloon wall (__ layer) is directly on the tendon, while the other part of the balloon wall (__layer) is separatet
tendon
visceral
parietal
Annular and Cruciate pulleys restrain the __ tendons to the ___ and __ and contribute to fibro-osseous tunnels through which the tendons travel
flexor
MCP’s
Plalanges
Where is surgical no man’s land?
Distal palmar crease to the pip joints
The surgical no man’s land is where 2 __ tendons run into 1 __
flexor
sheath
Trigger finger usually occurs in __ or __ finger. __ feels normal but __ is accompanied by a painful snap that may refer to the __ of the hand
4th 5th Flexion Extension Dorsum
There are __ muscles that arise and insert into the hand
19
There are __ extrinsic muscles that originate in the forearm and insert within the hand
24
What makes up the floor of the anatomic snuff box?
Deep branch of radial artery and tendinous insertion of extensor carpi radialis longus
Scaphoid and trapezium are under these
What is ulnar border of anatomic snuff box?
Extensor pollicis longus tendon
What is radial border of anatomic snuff box?
Abductor pollicis longus