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BOC > WHF - structure, function, anatomy > Flashcards

WHF - structure, function, anatomy Flashcards

1
Q

Mechanical purpose of shoulder, elbow, WFH

A

shoulder - mobility and gross placement of handelbow - stabilityWHF - strength and precision

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2
Q

How may carpals, metacarpals, and phlanges

A

8 carpals, 5 metacarpals, 14 phalanges

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3
Q

name the carpals

A

scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate

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4
Q

1st Metacarpal lines up with

A

Trapezium

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5
Q

2nd metacarpal lines up with

A

trapezoid

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6
Q

3rd MC lines up with

A

Capitate

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7
Q

4 and 5 MC lines up with

A

Hamate

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8
Q

Pisiform floats on

A

triquetrum

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9
Q

commonly fractured

A

scaphoid

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10
Q

commonly dislocated

A

lunate

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11
Q

proximal articulating surfaces of long bones

A

concave

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12
Q

distal articulating surfaces of long bones

A

convex

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13
Q

purpose of sesamoid bones on first MC

A

improve mechanical line of pull of the flexor pollicis brevis, abductor pollicis brevis, adductor pollicis muscles

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14
Q

Distal radioulnar joint - degrees of freedom - movements

A

ulnar head/ulnar notch
1 degree of freedom
pronation and supination

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15
Q

Radiocarpal joint

A

ellipsoid joint
2 degrees of freedom
flexion and extension
radial and ulnar deviation

fibrous capsule formed by distal radius and the scaphoid and lunate

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16
Q

RCL

A

radial collateral ligamentlimits ulnar deviation becomes taut when the wrist is at the extreme ranges of flexion and extension

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17
Q

Palmar radiocarpal ligament

A

controls motion and wrist stability

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18
Q

Dorsal radiocarpal ligament

A

limits flexion

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19
Q

TFCC

A

triangular fibrocartilanginous complex-articular disc-dissipates stress imposed on forearm during loading-stabilizes distal radioulnar joint

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20
Q

Intercarpal joints

A

allow for gliding movements

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21
Q

First CMC joint

A 
2 degrees of freedom
synovial saddle joint
flexion and extension,
 abduction and adduction
accessory motion: opposition and reposition
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22
Q

CMC joints 2-4

A

plane synovial joint
1 degree of freedom
flexion and extension

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23
Q

CMC joint 5

A

2 degrees of freedom
flexion and extension
abduction and adduction

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24
Q

MCP joints

A

condyloid joints
2 degrees of freedom
flexion and extension
abduction and adduction

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25
Q

collateral ligaments at fingers

A

protect against valgus and varus forces make gripping less dependent on dynamic stability

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26
Q

IP joints

A

1 degree of freedom

flexion and extension

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27
Q

natural position of hand

A

slight flexion

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28
Q

Extensor muscles

A

Extensor muscles
location: posterolateral forearm
6 compartments
radial nerve innervation

extensor carpi radialis longus/brevis
extensor carpi ulnaris
extensor digitorum communis
extensor pollicis longus
extensor pollicis brevis
abductor pollicis longus
extensor indicus

all secured by extensor retinaculum
increase efficiency of the muscles’ pull and prevents “bow stringing” when the wrist is extended

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29
Q

Flexor muscles

A 
Flexor Muscles
Location: anteromedial forearm
2 compartments
flexor carpi radialis, 
palmaris longus (absent in 12-15% of population)
flexor carpi ulnaris
flexor digitorum superficialis
flexor digitorum profundus
flexor pollicis longus

median nerve innervation
(fourth and fifth - ulnar nerve)

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30
Q

Palmar muscles groups

A

thenar central, hypothenar, adductor interosseous compartments

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31
Q

muscles of thenar eminence

A

abductor pollicis brevis, flexor pollicis brevis, opponens pollicis

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32
Q

muscles of hypothenar eminence

A

abudctor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi muscles

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33
Q

To prevent bowstringing

A

series of pulleys restrain and guide the tendonsduring flexion and extension of the fingers

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34
Q

flexor tendons require how much more excursion than extensor tendons

A

4x

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35
Q

annular pulleys

A

tunnels for tendons

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36
Q

cruciate pulleys

A

pliable, allow annular pulleys to move towards each other in flexion

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37
Q

4 Lumbrical muscles

A

flex MCP, extend PIP and DIP

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38
Q

Palmar aponeurosis equals

A

volar plate

39
Q

Ulnar

A

passes through tunnel of guyon.palmar/dorsum - 1/2 ring finger, pinky finger.

40
Q

median

A

runs through carpal tunnellateral palm, 1/2 ring finger, fingers 3-1.dorsum - fingers 1,2 and half of ring finger

41
Q

Radian nerve

A

base of thumb, back of hand near thumb below 1st and 2nd fingers

42
Q

Carpal tunnel

A

fibro-osseus structurefloor formed by proximal carpal bonesroof - transverse carpal ligaments

43
Q

PVD

A

peripheral vascular disease (Raynaud’s)

44
Q

Russell’s signs

A

abrasions, small cuts, callosities over dorsal surface of MCP or IP joints-outward signs of bullimia

45
Q

Drop wrist associated with

A

radial nerve

46
Q

Trigger finger

A

stenosing tenosynovitisnodule in flexor tendonaffects MCP flexion and extension

47
Q

Ape Hand

A

median nerve pathologyweakness in thenar eminencepulls thumb medially

48
Q

Bishop’s Deformity

A

ulnar nerve, hypothenar muscles, flexion in PIP and DIP joints, extension limited

49
Q

Claw Hand

A

ulnar and median nerveextension of MCP, flexion of PIP and DIP

50
Q

Dupuytren’s Contracture

A

excessive flexed resting positioncan’t extend MCP and PIP jointsshortening or adhesion of palmar fascia

51
Q

Swan Neck Deformity

A

flexion of MCP and DIPhyperextension of PIPvolar plate injuries,malunion, trauma, arthritis

52
Q

Volkmann’s Ischemic Contracture

A

flexion contraction of wrist and fingers,limited extensiondecreased blood supply

53
Q

Jersey Finger

A

avulsion of extensor digitorum longus tendon-can’t actively extend distal phalanx

54
Q

Mallet Finger

A

avulsion of extensor digitorum longus tendoncan’t actively extend distal phalanx

55
Q

Boutonniere Deformity

A

rupture of central extensor tendonrupture of volar plate-extension of MCP and DIP joints-flexion of PIP joint

56
Q

Hard end feels

A

radial deviation, MCP flexion, PIP flexion

57
Q

Soft end feels

A

thumb flexion, thumb adduction

58
Q

numbness on dorsal hand correlates with what nerve pathology

A

ulnar nerve in elbow

59
Q

numbness on palmar side of hand correlates with

A

ulnar nerve near tunnel of guyon

60
Q

distal forearm fractures common in

61
Q

Colles fracture

A

any fracture of distal radius

62
Q

scaphoid fracture common in

A

15-30 year olds and younger males

63
Q

concerns with scaphoid fracture

A

blood supply from radial artery compromised - necrosisPreiser’s disease - osteoporosis of scaphoidnonunion

64
Q

MOI of schaphoid fracture

A

foosh, land on palm, hyperextension of wrist

65
Q

Hamate fractures, MOI

A

hook of hamateMOI - foosh or trauma from golf club or bat,axial loadcould compress ulnar nerve - symptoms in fingers 4 and 5.

66
Q

concerns with hamate fractures

A

nonunion, vascular supplycan be removed

67
Q

Lunate dislocation

A

lunate is disassociated from other carpals

68
Q

perilunate dislocation

A

proximal carpal row being stripped from around the lunate

69
Q

Lunate MOI

A

high energy forced hyper extension of wrist

70
Q

Murphy’s sign

A

depressed third knuckle - lunate dislocation

71
Q

Wrist sprains

A

scapholunate ligaments - most commonly sprained

72
Q

Watson test

A

positive for tear - clunk with pain

73
Q

TFCC injury

A

traumu, or repeated injury

74
Q

MOI of TFCC

A

forced hyperextension w/ pronating force; rotary force, repeated weight bearing

75
Q

Carpal tunnel syndrom

A

compression of median nerve-fibrosis of the synovium of flexor tendons secondary to tenosynovitis-repeptive microtraumau-caused by poor biomechanics, poor posture, obesity, pregnancy, typing, work related activities, diabetes,

76
Q

CTS signs and symptoms

A

numbness or pain and thumb, index, middle, lateral half of ring finger (median nerve)

77
Q

Boxer’s fracture

A

common in young men, punching somethingfracture of 5th MC

78
Q

Collateral ligament injuries

A

unilateral stress applied to extended finger

79
Q

Dequeravain’s syndrome

A

finkelstein’s test-tenosynovitis of the extensor pollicis brevis, abductor pollicis longus tendonswomen 20-40repetitive radial deviation

80
Q

UCL sprain

A

limits opposition and decreases grip strengthhyperabduction or hyper extenstion”gamekeeper’s thumb”pain on ulnar side, can’t pinch or grasp

81
Q

Bennett’s fracture

A

base of first MC

82
Q

Splinting jersey finger

A

DIP joint in flexion

83
Q

Splinting mallet finger

A

dIP joint in extension

84
Q

Splinting boutonniere finger

A

PIP and DIP joints in extension

85
Q

radial collateral and ulnar collateral ligament stress tests

A

UCL - test with valgus stressRCL - test with varus stress

86
Q

Valgus and Varus IP tests

A

tests for collateral ligament sprainavulsion fracture

87
Q

Laxity of thumb MCP collateral ligaments

A

valgus stress to thumb UCLsprain or avulsion fracture

88
Q

Watson’s test

A

arm in arm wrestling position-apply dorsal pressure with thumb at scapholunate area-move hand from ulnar deviation to radial deviationtests for: scapholunate dissociation

89
Q

Phalen’s Test

A

test for carpal tunnel-tingling from irritation of median nerve-patient is standing-overpressure applied though wrist flexion for 1 minute

90
Q

Finkelstein’s

A

dequervain’s syndrome

91
Q

the pisiform improves what?

A

mechanical efficiency of the flexor carpi ulnaris

92
Q

history

A

where is the painMOIprevious historygeneral medical healthSounds or sensationshow long?type of pain, pain scalechanges in activity

93
Q

keystone of carpal group

BOC (49 decks)

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