Week 4 - The Hand & Wrist Flashcards
What are the movements of the wrist?
Extension, Flexion, Abduction (radial deviation), Adduction (ulnar deviation)
These movements allow for a wide range of motion in the wrist.
What are the movements of the thumb?
Extension, Flexion, Abduction, Adduction, Opposition, Reposition
These movements are crucial for thumb functionality and grip.
What are the movements of digits 2-5?
Extension, Flexion, Abduction, Adduction
These movements enable various hand functions and dexterity.
What type of joint is the distal radioulnar joint?
Pivot Synovial Joint
This joint allows for pronation and supination of the forearm.
What is the function of the Triangular Fibrocartilage Complex?
Binds DRU joint & absorbs shock
It includes the articular disc that facilitates movement and stability.
What does the articular disc of the TFCC allow for?
Pronation/supination on a relatively static ulna
This disc is crucial for wrist mobility.
What type of joint is the radiocarpal joint?
Condyloid Synovial Joint
It is formed between the radius, articular disc of TFCC, and carpal bones.
What ligaments are associated with the radiocarpal joint?
TFCC, Palmar & Dorsal Radiocarpal ligaments, Ulnar & Radial collateral ligaments
These ligaments provide stability to the wrist.
What type of joints are the midcarpal and intercarpal joints?
Compound joint and Plane Joints
They consist of several intercarpal joints that facilitate wrist movement.
What is the role of the palmar/volar plates/ligaments?
Limit hyperextension
They are thick ligamentous structures that provide stability.
What is the function of collateral ligaments in the MCP joints?
Reinforce laterally and prevent abduction when flexed
These ligaments are essential for joint stability.
What structures form the carpal tunnel?
Deep: Carpal bones; Superficial: Flexor retinaculum/Transverse carpal ligament
This tunnel houses important tendons and the median nerve.
What are the contents of the carpal tunnel?
Flexor digitorum superficialis & profundus, Flexor pollicis longus, Median nerve
These structures are vital for hand movement and sensation.
What is Skier’s Thumb?
Hyperabduction/extension of 1st MCPJ rupturing Ulnar collateral MCPJ ligaments
This injury results from excessive stress on the thumb joint.
What are the symptoms of Skier’s Thumb?
Weak grasp with thumb, Pain, Swelling, Instability
These symptoms indicate a possible ligament injury.
What causes Carpal Tunnel Syndrome?
Median nerve compression due to swelling/tumour, inflammation, or arthritis
This condition affects hand function and sensation.
What are the risk factors for Carpal Tunnel Syndrome?
> 50yrs, Female, Repetitive movements, Pregnancy
Certain demographics are more prone to this condition.
What are common symptoms of Carpal Tunnel Syndrome?
Tingling, pain, numbness, Dropping things, Thenar muscular atrophy
These symptoms typically worsen over time without treatment.
What are the treatments for Carpal Tunnel Syndrome?
Steroid injections, Splinting, Open/endoscopic carpal tunnel release
These treatments aim to relieve pressure on the median nerve.
What is Tinel’s Sign?
Percussing nerve lightly at wrist -> paraesthesia
This test helps diagnose nerve compression issues.
What is Phalen’s manoeuvre?
Hold wrist flexion position for 1-3mins -> paraesthesia
This test indicates potential Carpal Tunnel Syndrome.
What is Ehlers-Danlos Syndrome?
Genetic disorder of collagen that weakens volar plates
This condition can lead to joint instability and increased injury risk.
What is the forearm also known as?
Antebrachium
What are the three osseofascial compartments of the forearm?
- Anterior Compartment
- Lateral Compartment
- Posterior Compartment
Which nerve supplies the muscles in the anterior compartment of the forearm?
Median nerve (except 1.5 muscles supplied by the ulnar nerve)
What structure divides the forearm into compartments?
Deep fascia, interosseous membrane, and fibrous intermuscular septa
Name one muscle from the superficial group of the anterior compartment of the forearm.
Pronator teres
What artery supplies the anterior compartment of the forearm?
Radial artery and Ulnar artery
Fill in the blank: The _______ is a ligamentous band that unites the shafts of the radius and ulna.
Interosseous membrane
What is the primary function of the flexor retinaculum?
Holds the long flexor tendons in position at the wrist
What forms the carpal tunnel?
The concave anterior surface of the wrist converted by the flexor retinaculum
True or False: The extensor retinaculum holds the long flexor tendons in position.
False
What structures pass superficial to the flexor retinaculum?
- Flexor carpi ulnaris tendon
- Ulnar nerve
- Ulnar artery
- Palmar cutaneous branch of the ulnar nerve
- Palmaris longus tendon
- Palmar cutaneous branch of the median nerve
Which nerve passes deep to the flexor retinaculum?
Median nerve
What is the clinical significance of the anatomic snuffbox?
Scaphoid bone palpation and radial artery pulsation
What type of skin is found on the palm of the hand?
Thick and hairless
What is the palmar aponeurosis?
A triangular structure occupying the central area of the palm
What is the function of the extensor retinaculum?
Holds the long extensor tendons in position
Name one structure that passes deep to the extensor retinaculum.
Extensor carpi ulnaris tendon
What is the primary action of the hand facilitated by the thumb?
Pincer-like action
What type of glands are present in large numbers on the palm of the hand?
Sweat glands
Fill in the blank: The wrist is a common site for _______.
Injury
What does the deep fascia of the wrist and palm form?
Flexor retinaculum and palmar aponeurosis
True or False: The skin on the dorsum of the hand is thick and hairless.
False
What is the function of the palmar aponeurosis?
To give firm attachment to the overlying skin and so improve the grip and to protect the underlying tendons.
True or False: The palmar aponeurosis is triangular and occupies the central area of the palm.
True
What are the boundaries of the fascial spaces of the palm important for?
They may limit the spread of infection in the palm.
Fill in the blank: Dupuytren contracture is a localized thickening and contracture of the _______.
palmar aponeurosis
What are the names of the two spaces divided by the fibrous septum from the lateral border of the palmar aponeurosis?
- Thenar space
- Midpalmar space
What is the treatment for Dupuytren contracture?
Surgical division of the fibrous bands followed by physiotherapy or injection of collagenase.
Describe the contents of the thenar space.
Contains the first lumbrical muscle and lies deep to the long flexor tendons to the index finger.
What is the clinical significance of the fascial spaces of the palm?
They can become infected and distended with pus due to infections like acute suppurative tenosynovitis.
Fill in the blank: The pulp space of the fingers is a closed fascial compartment situated anterior to the _______.
terminal phalanx
What type of infection is commonly associated with the pulp space of the fingers?
Pulp Space Infection (Felon)
What can happen if a pulp space infection is left untreated?
Infection of the terminal phalanx can occur.
True or False: The digital artery branch to the epiphysis of the distal phalanx runs through the pulp space.
False
What is the anatomical relationship between the proximal end of the pulp space and the digital synovial sheath?
The close relationship accounts for the involvement of the sheath in the infectious process when the pulp space infection has been neglected.
What does the deep fascia of the pulp of each finger fuse with?
The periosteum of the terminal phalanx.
How is the palmar aponeurosis structured at the base of the fingers?
It divides into four slips, each of which further divides into two bands.
What clinical condition may begin at the root of the ring finger and draw it into the palm?
Dupuytren contracture
What are the two major components of the deep fascia of the wrist and palm?
- Flexor retinaculum
- Palmar aponeurosis
What occurs in the midpalmar space?
Contains the second, third, and fourth lumbrical muscles.
Fill in the blank: The function of the fascial spaces of the palm is to provide ________ for the hand.
potential spaces filled with loose connective tissue
