Upper limb 3 - Wrist and Hand Flashcards

1
Q

How many radioulnar joints do we have?

A

2

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2
Q

What movements occur at the radioulnar joints?

A

pronation and supination

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3
Q

What bones articulate at the radoiocarpal joint?

A

distal radius with scaphoid, lunate and triquetrum

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4
Q

What type of synovial joint is the radiocarpal joint?

A

condyloid synovial joint

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5
Q

what are the 2 planes of movement at the radiocarpal joint?

A

flexion-extension and adduction-abduction

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6
Q

What are the points of attachment of the medial collateral ligament of the wrist?

A

Ulnar styloid process - triquetrum

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7
Q

What are the points of attachment of the lateral collateral ligament of the wrist?

A

Radial styloid - scaphoid

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8
Q

What could result in avascular necrosis in the hand?

A

A FOOSH that fractures the scaphoid

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9
Q

Where would you feel tenderness as a result of a scaphoid fracture?

A

Tenderness in the anatomical snuffbox

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10
Q

What is Bennett’s fracture?

A

A fracture of the base of the first metacarpal bone which extends into the carpometacarpal joint

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11
Q

What is Colle’s fracture?

A

Dorsal displacement of distal radius

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12
Q

What is Smith’s fracture?

A

Ventral displacement of distal radius

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13
Q

What are the borders of the anatomical snuffbox?

A

Medial border - Abductor pollicis longus & Extensor pollicis brevis
Lateral border - Extensor pollicis longus

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14
Q

What structures are found in the anatomical snuffbox?

A

Radial artery
Radial nerve
Cephalic vein

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15
Q

What is the function of the palmar aponeurosis?

A

A tough fibrous layer limiting movement of the palmar skin (allows grip)

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16
Q

What is Dupuytren’s contracture?

A

Progressive condition that causes shortening and thickening of the palmar fascia. Aponeurotic thickening causes passive flexion.

17
Q

What is the function of the intrinsic hand muscles?

A

Bring about precise control of digit movement

18
Q

What do both the thenar eminence and hypothenar eminence contain?

A
  • A flexor muscle
  • An abductor muscle
  • An opposer muscle
19
Q

What is the golden rule of hand muscle innervation?

A

Everything is C8 & T1 supplied​

Everything is ulnar nerve supplied except:​
​ - Thenar muscles​
​ - Lumbricals (1& 2) which go to digits 2 & 3​

20
Q

What would muscle wasting of the thenar eminence suggest?

A

Median nerve damage

21
Q

What is the function of the lumbricals?

A

Flex the MCP joints and extend the PIP & DIP joints

22
Q

What do the palmar interossei muscles do?

A

Adduct the digits

23
Q

What do the dorsal interossei muscles do?

A

Abduct the digits

24
Q

What is Froment sign?

A

A loss of functioning of adductor pollicis ​

(e.g. in Ulnar nerve lesion) leads to excess thumb flexion whilst pinching (pinching normally requires thumb adduction)​

25
What travels through the carpal tunnel?
- 4x Flexor digitorum superficialis - 4x Flexor digitorum profundus - Flexor pollicis longus - Median nerve
26
Where does the flexor retinaculum of the carpal tunnel attach to?
Pisiform, hook of hamate, scaphoid tubercle and trapezium tubercle
27
What is the surface anatomy marking of the entrance to the carpal tunnel?
Carpal tunnel passes ~2cm distal to the distal wrist crease
28
Where does the palmar (cutaneous) branch of the median nerve travel?
Runs superficial to the carpal tunnel
29
Where is Guyon's canal?
More superficial than carpal tunnel, runs just lateral to pisiform
30
Give some examples of things that can cause carpal tunnel syndrome
Ganglion cyst, giant cell tumour, neuroma, lipoma, soft tissue thickening, fluid retention