Topic 4: BONES AND JOINTS OF THE WRIST AND HAND Flashcards

1
Q

Which bones make up the “wrist joint complex”?

A
  1. carpal bones
  2. radius
  3. ulna
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2
Q

Which bones does the radius articulate with?

A

the proximal carpal bones

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3
Q

What does the ulna articulate with?

A

doesnt directly articulate with carpals

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4
Q

Order of carpal bones

A

Some, Lovers, Try, Positions, THat, THey, Cant, Handle
scaphoid, lunate, triquetrum, pisiform
Trapezium, trapezoid, capitate, hamate

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5
Q

2 joints of the wrist complex

A
  1. Radiocarpal

2. Mid carpal

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6
Q

Articular surfaces of the radiocarpal jt

A
  1. scaphoid, lunate, triquetrum
  2. distal surface of radius
  3. distal surface of Inf RU jt disc
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7
Q

Articular surfaces of the Midcarpal jt

A
  1. scaphoid, lunate, triquetrum
  2. trapezium, trapezoid, capitate, hamate
    (between the 2 rows of the carpals)
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8
Q

Classification of the radiocarpal joint

A

synovial, biaxial, ellipsoid

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9
Q

Movements of the radiocarpal jt

A
  1. flexion - extension (palmarflexion- dorsiflexion)
    - transverse axis
  2. abduction - adduction (radial deviation- ulnar deviation)
    - anteropostierior axis
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10
Q

Articular surfaces of the Radiocarpal jt

A
  1. distal surface of scaphoid, lunate, triquetrum

2. proximal surface of radius & of inferior RU disc

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11
Q

Where does the articular capsule of the RC jt attach?

A

to the articular margins of the bones involved

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12
Q

What is the RC jt capsule reinforced by?

A

by capsular ligaments at sides and anteriorly & posteriorly

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13
Q

Synovial membrane of the RC jt

A
  • usually restricted to RC jt space

- sometimes communicates with synovial cavity of the inf RU jt

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14
Q

What is the Triangular Fibrocartilage Complex?

A

Ligamentous & cartilaginous complex of structures

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15
Q

What are the components of the TFCC?

A
  1. triangular fibrocartilage (articular disc)

2. ligaments

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16
Q

Ligaments of the TFCC

A

ulnotriquetral, ulnolunate, palmar and
dorsal radioulnar ligaments, ulnar collateral
ligament

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17
Q

Functions of the TFCC:

A
  1. stabilizes distal radioulnar and ulnocarpal joints
  2. transmits & distributes loads from carpals to ulna
  3. helps facilitate complex movements of the wrist
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18
Q

How is the TFCC commonly injured (lateral)

A

by acute/ repetitive loading in an extending wrist position (FOOSH)

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19
Q

Ligaments of the RC jt

A
  1. collaterals

2. dorsal & palmar radiocarpal

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20
Q

Radial collateral ligament of the wrist limits:

A

adduction

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21
Q

Ulnar collateral ligament of the wrist limits:

A

abduction

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22
Q

Fibres of the dorsal & palmar radiocarpal ligaments

A
  • run inferiorly & medially –> ensure that carpals move with the radius and ulna during pronation & supination
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23
Q

Dorsal radiocarpal ligament of the wrist limits:

A

flexion

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24
Q

Palmar radiocarpal ligament of the wrist limits:

A

extension

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25
Q

Midcarpal joint classification

A

synovial, biaxial, condyloid

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26
Q

midcarpal joint movements

A
  1. flexion - extension (palmarflexion - dorsiflexion)
    - -> transverse axis
  2. abduction - adduction (radial deviation - ulnar deviation)
    - -> anteroposterior axis
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27
Q

Articular surfaces of the MC joint

A
  1. distal surface of scaphoid, lunate, triquetrum

2. proximal surface of trapezium, trapezoid, capitate, hamate

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28
Q

What does the articular capsule of the MC joint attach to?

A

the articular margins of the bones

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29
Q

What is the articular capsule of the MC jt reinforced by?

A

Capsular ligaments at sides and anteriorly & posteriorly

30
Q

Synovial membrane & cavity of the MC jt

A
  • cavity = complex: extensive & irregular

- may extend distally between bones of distal row

31
Q

Ligaments of the MC jt

A
  1. collateral ligaments of the wrist

2. dorsal and palmar ligaments of the wrist

32
Q

Collateral ligaments of the wrist (MC jt)

A

From the radiocarpal jt

  1. radial collateral
  2. ulnar collateral
33
Q

MC JT

radial collateral ligament limits:

A

adduction

34
Q

MC JT

ulnar collateral ligament of the wrist limits:

A

abduction

35
Q

MC JT

Dorsal intercarpal ligament limits:

A

flexion

36
Q

MC JT

Palmar intercarpal ligament limits:

A

extension

37
Q

MC JT

Fibre orientation of the palmar intercarpal ligament:

A

converge on the capitate

38
Q

Contribution of both the RC and MC jts in movements

A

Both contribute to flexion & extension range

39
Q

contribution of RC & MC jts in adduction (ulnar deviation)

A

RC&raquo_space; MC

40
Q

contribution of RC & MC jts in abduction (radial deviation)

A

MC&raquo_space; RC

41
Q

Classification of the Intercarpal (IC) joints

A

synovial, mostly multi-axial, plane jts

–> only slight movement

42
Q

What are the IC jts connected by?

A

extensive array of ligaments – not all named

43
Q

What is the feature that acts as an accessory IC ligament?

A

flexor retinaculum

44
Q

What is the most commonly injured IC ligament?

A

Scapholunate ligament

45
Q

Function of the scapholunate ligament

A

functions to prevent lunate dislocating from scaphoid (most common in FOOSH)

46
Q

Classification of the Common Carpometacarpal jts

A

synovial, multiaxial, plane

47
Q

Movements of the common CMC jts

A
  • increasing mobility as move lateral to medial (less articulation between the bones/ articular surfaces)
  • 2nd CMC least mobile, 5th CMC most mobile
  • observe rotation of 5th CMC
48
Q

Articular surfaces of the Common CMC jts (2-5)

A
  1. base metacarpal 2 with trapezoid
  2. base metacarpal 3 with capitate
  3. base metacarpal 4 with hamate
  4. base metacarpal 5 with hamate
49
Q

where does the capsule of the common CMC jts attach to?

A
  • attaches to articular margins

- one common cavity, usually communicates with MC jt cavity

50
Q

Ligaments of the common CMC jts

A

Dorsal and palmar carpometacarpal ligaments

  • from carpals to base of metacarpal
  • commonly 2 bands to each MC
51
Q

Dorsal carpometacarpal ligament limits

A

flexion

52
Q

Palmar capometacarpal ligament limits:

A

extension

53
Q

CMC jt thumb classification

A

synovial, biaxial, saddle

54
Q

CMC jt thumb movements

A
  1. flexion - extension
    - –> anteroposterior axis
  2. abduction - adduction
    - -> transverse axis
  3. opposition (conjunct –> combination of abduction, adduction; rotates the thumb)
    - -> longitudinal axis
55
Q

What is the rule of THUMB

A

the thumb doesn’t follow the normal rules that the common CMC jts do. i.e. planes of mvmt & type of joint

56
Q

Where does the articular capsule of the CMC thumb jt attach to?

A
  • attaches to articular margins

- relatively loose (allows for increased mobility)

57
Q

Ligaments of the CMC thumb jt

A

Posterior & anterior oblique ligaments of the thumb

58
Q

What do the posterior & anterior oblique ligaments do?

A

Tension in these ligaments helps pull the thumb into/ out of conjunct rotation

59
Q

Classification of the metacarpophalangeal joints (MCP)

A

synovial, biaxial, condyloid

60
Q

Movements of the MCP jts

A
  1. flexion - extension

2. abduction - adduction (axis of movement = middle finger)

61
Q

Articular surfaces of the MCP (knuckle) jts

A
  1. head of the metacarpal

2. base of the adjacent phalanx

62
Q

Ligaments of the MCP jts

A
  1. collateral ligaments
  2. palmar ligaments
  3. deep transverse metacarpal ligaments
63
Q

What do the collateral ligaments of the MCP jts limit?

A
  1. flexion

2. prevents add and abd in flexion (direction of fibres downwards)

64
Q

What are the palmar ligaments of the MCP jts?

A
  • fibrocartilaginous plate

- form part of the articular surface

65
Q

What do the palmar ligaments of the MCP jts limit?

A

extension

66
Q

What do the palmar ligaments house?

A

Long flexor tendons (grooved)

67
Q

What do the deep transverse metacarpal ligaments do?

A

Keep the MC heads together –> particularly important in weightbearing

68
Q

IP jts

PIPs and DIPS classification

A

synovial, uniaxial, hinge

69
Q

IP jts

PIPs and DIPS movements

A

flexion & extension

70
Q

IP jts

PIPs and DIPS ligaments

A
  1. collateral ligaments –> limit flexion

2. palmar ligaments –> limit extension