The Wrist and Hand

Question 1

What are the names of the carpal bones?

Answer 1

1st row (lateral to medial): HCTT
- hamate, capitate, trapeziod, trapezium

2nd row (lateral to medial):
PTLS
- Pisiform, triquestrium, lunate, scaphoid

Question 2

What is the wrist ‘carpus’ joint?

Answer 2

Radiocarpal joint

• no participation by ulna!
• Pisiform does not articulate with distal radius (TLS do)
• Synovial Ellipsoid joint

Question 3

What do the radicarpal ligaments do?

Answer 3

Strengthen the joint capsule anteriorly and posteriorly.

Question 4

What is Colle’s Fracture

Answer 4

= fracture at distal end of radius.

• most common in middle aged and elderly, particularly in women due to osteoporosis
• FOOSH
• ulnar styloid process may be avulsed

Question 5

What is a Scaphoid Fracture?

Answer 5

• results from FOOSH when hand abducted
• scaphoid bone has a narrow ‘waist’ that is most likely to fractures
• common injury in YA
• tenderness in anatomical snuffbox between Extensor Pollicis Brevis (EPB inferiorly) and Extensor Pollicis Longus (EPL) tendons.

Question 6

What can be palpated in anatomical snuffbox?

Answer 6

Radial pulse.

Question 7

What is unique about blood supply to scaphoid?

Answer 7

Via the palmar carpal branch of the radial artery.

• blood enters the scaphoid distally to proximally.
• if fractures, blood supply to proximal region may be disrupted and lead to necrosis of the bone.

Question 8

What is Boxer’s Fracture?

Answer 8

• (disputed which finger) fracture of neck of metacarpals.

- usually occurs when striking an object with a clenched fist.

Question 9

What are movements of the wrist?

Answer 9

1. Abduction and adduction
2. Extension and flexion
3. Circumduction

Question 10

What are the anterior flexors of the wrist?

Answer 10

• innervated by median and ulnar nerves