UE Joints II - Wrist And Hand Flashcards

1
Q

Describe the 3 joints associated with the radius and ulna?

A

Proximal: pivot type with radial head articulating with radial notch of ulna

Middle: interosseous membrane

Distal: round head of ulna articulating with notch of radius

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2
Q

What ligament is associated with the proximal joint between the radius, ulna, and humerus?

A

Annular ligament

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3
Q

What ligament is associated with the distal joint between the radius and ulna (aka the round head of the ulna articulating with the notch of the radius)?

A

Radioulnar ligament

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4
Q

What motions are present via the 3 radioulnar joints?

A

Pronation and supination

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5
Q

During pronation and supination of the radioulnar joints, what is the bone that rotates?

A

Radius

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6
Q

Supination of the radioulnar joints is primarily driven by which 2 muscles?

A

Supinator m.

Biceps brachii m.

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7
Q

Pronation of the radioulnar joints is primarily driven by which 2 muscles?

A

Pronator quadratus m.

Pronator teres m.

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8
Q

What are the 3 joints of the wrist?

A

Radiocarpal joint
Intercarpal joint
Carpometacarpal joint

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9
Q

Wrist movements include flexion, extension, abduction, adduction, and rotation (a combination of the first 4 movements).

Which motion is more prominent at the mid-carpal joint?

A

Flexion

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10
Q

Wrist movements include flexion, extension, abduction, adduction, and rotation (a combination of the first 4 movements).

Which motion is more prominent at the radiocarpal joint?

A

Extension

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11
Q

Wrist movements include flexion, extension, abduction, adduction, and rotation (a combination of the first 4 movements).

Which motion is considered radial deviation?

A

Abduction

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12
Q

Wrist movements include flexion, extension, abduction, adduction, and rotation (a combination of the first 4 movements).

Which motion is considered ulnar deviation?

A

Adduction

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13
Q

How is the wrist joint classified?

A

Condyloid synovial joint

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14
Q

What are the bones involved in the wrist joint?

A

Radius

Styloid process of ulna

3 carpal bones: scaphoid, lunate, triquetrum

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15
Q

What 2 ligaments are associated with the wrist joint?

A

Intercarpal ligament

Metacarpal ligaments

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16
Q

What are the roles of the palmar and dorsal transverse metacarpal ligaments in the wrist joint?

A

Stabilize metacarpal heads

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17
Q

What 2 ligaments contribute to wrist stability?

A

Ulnar collateral ligament of wrist

Radial collateral ligament of wrist

18
Q

The ulnar collateral ligament of the wrist connects what 2 bones?

A

Ulna styloid process to triquetrum

19
Q

The radial collateral ligament of the wrist connects what 2 bones?

A

Radial styloid process to scaphoid

20
Q

What ligament forms the carpal tunnel?

A

Transverse carpal ligament (aka flexor retinaculum)

21
Q

What are the contents of the carpal tunnel?

A

Median n.

9 flexor tendons of digits

22
Q

Aside from the carpal tunnel, what other anatomical “tunnel” is associated with the wrist joint?

A

Ulnar tunnel

23
Q

What ligaments are involved in forming the ulnar tunnel

A

Palmar carpal ligament

Transverse carpal ligament

24
Q

What are the contents of the ulnar tunnel?

A

Ulnar n.

Ulnar a.

25
What muscle connects to the palmar aponeurosis?
Palmaris longus m.
26
What condition is caused by overuse of the wrist joint causing swelling and compression of the median n., leading to associated neuropathy?
Carpal tunnel syndrome
27
What anatomical changes occur with chronic carpal tunnel syndrome? What are some treatments?
Muscle wasting of much of the thenar group and lumbricals 1 and 2 Initial approach is rest and change in ergonomics Lastly, surgical approach by cutting transverse carpal ligament
28
What are the 2 most common wrist fractures?
Most commonly caused by falling forward onto hands, leading to scaphoid or radial fracture
29
What artery may be damaged with a scaphoid or radial fracture?
Radial a. | Can lead to avascular necrosis if untreated
30
Why is the ulna not usually fractured at the wrist?
Weight is generally transferred to radius
31
If a patient complains of pain in the anatomical snuff box, what bone might they have fractured?
Scaphoid
32
What are the 2 types of distal radial fractures? Which one is more common?
Colle's fracture (most common, associated with osteoporosis) Smith's fracture
33
Colle's fracture is associated with what motion at the wrist? What does this lead to?
Hyperextension Leads to distal radius being displaced dorsally, "dinner fork" presentation
34
Smith's fracture is associated with what motion at the wrist? What does this lead to?
Hyperflexion Leads to distal radius being displaced anteriorly, "shovel deformity" presentation
35
What ligaments are associated with joints of the hand?
Transverse metacarpal ligament Palmar (valor) plate or ligament (around DIPs) Metacarpophalangeal collateral ligaments (around MCPs) Phalangeal collateral ligaments (around PIPs and DIPs) [extensor hood attaches to outside of collateral ligaments]
36
What condition is characterized by the PIP stuck in flexion and the DIP in hyperextension? What are some causes of this deformity?
Boutonniere Deformity Causes: Rupture of central slip of extensor tendon at PIP due to trauma Ehlers-Danlos Syndrome Rheumatoid arthritis
37
What condition is characterized by extensor tendon damage, causing a disruption of digit extension, and presents as DIP flexion?
Mallet Finger (baseball/basketball finger) If left untreated can progress to swan neck deformity
38
What causes mallet finger?
Blunt force trauma to finger
39
Describe the swan neck deformity of the finger including potential causes
Extension at PIP Flexion at DIP Caused by RA, untreated mallet finger, or trauma (tear of middle palmar plate ligament leading to damage to extensor hood)
40
What ligament is ruptured in Skier's Thumb? What are some causes of Skier's thumb?
Collateral ligament of the first MCP joint; if bad it may be accompanied by avulsion fracture of the metacarpal head Caused by trauma, FOOSH, commonly seen in skiers
41
What injury is characterized by sprain of radial collateral ligament and avulsion fracture of the lateral proximal phalanx of the thumb?
Bull Rider's thumb Caused by trauma or sports
42
What is the boxer's fracture?
Fracture of 5th metacarpal often due to punching with a closed and abducted fist