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템 > UE Joints II - Wrist And Hand > Flashcards

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
Q

What muscle connects to the palmar aponeurosis?

A

Palmaris longus m.

26
Q

What condition is caused by overuse of the wrist joint causing swelling and compression of the median n., leading to associated neuropathy?

A

Carpal tunnel syndrome

27
Q

What anatomical changes occur with chronic carpal tunnel syndrome?

What are some treatments?

A

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
Q

What are the 2 most common wrist fractures?

A

Most commonly caused by falling forward onto hands, leading to scaphoid or radial fracture

29
Q

What artery may be damaged with a scaphoid or radial fracture?

A

Radial a.

Can lead to avascular necrosis if untreated

30
Q

Why is the ulna not usually fractured at the wrist?

A

Weight is generally transferred to radius

31
Q

If a patient complains of pain in the anatomical snuff box, what bone might they have fractured?

A

Scaphoid

32
Q

What are the 2 types of distal radial fractures? Which one is more common?

A

Colle’s fracture (most common, associated with osteoporosis)

Smith’s fracture

33
Q

Colle’s fracture is associated with what motion at the wrist? What does this lead to?

A

Hyperextension

Leads to distal radius being displaced dorsally, “dinner fork” presentation

34
Q

Smith’s fracture is associated with what motion at the wrist? What does this lead to?

A

Hyperflexion

Leads to distal radius being displaced anteriorly, “shovel deformity” presentation

35
Q

What ligaments are associated with joints of the hand?

A

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
Q

What condition is characterized by the PIP stuck in flexion and the DIP in hyperextension?

What are some causes of this deformity?

A

Boutonniere Deformity

Causes:
Rupture of central slip of extensor tendon at PIP due to trauma

Ehlers-Danlos Syndrome

Rheumatoid arthritis

37
Q

What condition is characterized by extensor tendon damage, causing a disruption of digit extension, and presents as DIP flexion?

A

Mallet Finger (baseball/basketball finger)

If left untreated can progress to swan neck deformity

38
Q

What causes mallet finger?

A

Blunt force trauma to finger

39
Q

Describe the swan neck deformity of the finger including potential causes

A

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
Q

What ligament is ruptured in Skier’s Thumb? What are some causes of Skier’s thumb?

A

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
Q

What injury is characterized by sprain of radial collateral ligament and avulsion fracture of the lateral proximal phalanx of the thumb?

A

Bull Rider’s thumb

Caused by trauma or sports

42
Q

What is the boxer’s fracture?

A

Fracture of 5th metacarpal often due to punching with a closed and abducted fist

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