The Wrist And Hand Flashcards
What is the most frequently fractured bone in the wrist? Most disclocated?
Scaphoid - Most fractured
Lunate - Most dislocated
What s the thickened band of CT on the posterior wrist?
Extensor retinaculum
What tunnel follows the anterior carpal concavity?
Carpal Tunnel
What structures pass through the carpal tunnel?
- Median nerve
- FDS Tendon
- FDP Tendon
- FPL Tendon
What are the most commonly fractures bones when some falls directly on their extended hand?
- Wrist
- Forearm
- Clavicle
What is Barton’s dislocation/fracture
Intraarticular fracture of distal radius/dislocation of the radiocarpal joint
What is carpal tunnel syndrome?
- Parasthesias, pain, numbness, and loss or impairment of function of hand over distribution of median nerve
- affects skin over lateral 2/3 hand and digits 1-3 and half of 4
What is the effect of nerve damage to Ulnar nerve?
“Claw Hand”
Inability to extend fingers at IP joints resulting in permanent flexion
What is the effect of nerve damage to Median nerve?
“Ape Hand”
Inability to oppose thumb
What is the effect of nerve damage to
Radial nerve?
“Wrist Drop”
Inability to extend hand and fully extend forearm
What is Colles Fracture?
Fracture of distal forearm where radius is bent backwards which overrides rest f the bone
“Dinner fork deformity”
What is Smiths fracture?
Fracture of distal radius from falling on flexed wrist displacing fracture ventrally
What is AVN?
Avascular necrosis
Common complication of scaphoid fracture
Which eminence follows the ulnar side of the hand?
Hypothecate eminence
Describe the Palmar aponeurosis.
• This is a triangular, well defined structure that covers the soft tissues of the palm overlying the flexor
tendons.
• Its proximal end is continuous with the flexor Retinaculum and the palmaris longus muscle tendon.
• Its distal end divides into 4 bands that go the base of
the proximal phalanges of the medial 4 digits.
What is Dupuytren’s contracture?
- Fibrosis of the palmar aponeurosis with shortening of digital bands, especial 4/5
- Associated it’s EtOH and epilepsy
What are the muscles of Thenar?
What are their innervation?
APB - Median
FPB - Median and Ulnar
OP - Medial
AP - Ulnar
What are the muscles of the hypothenar? What are the innervation?
Abductor Digiti Minimi
Opponents Digiti Minimi
Flexor Digiti Minimi Brevis
All supplied by Ulnar Nerve
What are the attachments and actions of the lumbricals?
Tendon of FDP -> Base of proximal phalange of medial 4 digits with extensor expansion and interossei muscles
Flexion of MPJ
What is the innervation of the lumbricals?
Lumbricals 1/2 - Median
Lumbricals 3/4 - Ulnar
What are the attachment and actions of the Palmar Interosseous muscles?
Innervation?
Arise by one head from metacarpals 2,4,5 —> Bases of proximal phalanges of each corresponding digit
Adducts fingers to midline of hand
All supplied by Ulnar nerve
What are the attachment and actions of the Dorsal Interosseous muscles?
Innervation?
Two heads of adjacent metacarpals —> side of proximal phalanx
Abduct finger away from midline of hand
All supplied by Ulnar nerve
What is the blood supply of the hypothenar and Thenar eminences?
Hypothenar - Deep palmar arch via ulnar artery
Thenar - superficial palmar arch via radial artery
What is Boxer’s Fracture?
Fracture of the 5th metacarpal
