Wrist

Question 1

strength of skeleton and lig/muscles

Answer 1

skel: weak

lig/musc: moderate

Question 2

prox row of carpels left to right

Answer 2

• naviuclar
• lunate
• triquetrum/triquetral
• pisiform

Question 3

distal row of carpel left to right

Answer 3

• trapezium
• trapezoid
• capitate
• hamate

Question 4

jnts of wrist (4)

Answer 4

• radial carpel: most lfex here
• mid carpel: most exten here (btwn 2 rows)
• carpel-metacarpel
• radial ulnar: not in wrist

Question 5

ligs of wrist

Answer 5

• transverse carpel lig (palmar side)
• interosseous lig: btwn carpels
• radial collateral lig: radius -> navicular
• ulnar collateral: ulna -> pisiform/triquetral

Question 6

mechanism of navicular fx

Answer 6

hyperextension

Question 7

what is important w/ naviuclar fx

Answer 7

• blood supply

- will not heal and bone will die if do not have blood supply to prox/distal portion

Question 8

what is preisers disease

Answer 8

aceptic necrosis to prox protion of navicular bone due to fracture

Question 9

signs/symptoms of presiers diease

Answer 9

• no swell
• pain on radial devation
• pain in snuff box

Question 10

mech of colles fx

Answer 10

fall on outstretch arm/ hyperextension

Question 11

signs/symptoms of colles fx (4)

Answer 11

• distal end of radius moves distally
• finger/hand move limited
• difficult radial deviation/abduct
• posterior displacement of hand and wrist

Question 12

mech of smiths fx

Answer 12

hyperflex = rare

Question 13

what way does the radius displace in smiths fx

Answer 13

ant/volar/palmar

Question 14

what borders the carpel tunnel

Answer 14

• post: carpel bones

- ant: transverse carpel lig

Question 15

what does the carpel tunnel contain

Answer 15

• median nerve
• blood supply
• bursa
• finger flexor tendons

Question 16

mechnism of carpel tunnel (4)

Answer 16

• overuse
• trauma
• swelling of tendons/synovial sheaths
• dislocation of lunate into tunnel

Question 17

waht does carpel tunnel result in (3)

Answer 17

• entrapment of median nerve=
• burn/tingle/numbness
• thenar eminence atrophy

Question 18

what does phalans test test for?

Answer 18

carpel tunnel

Question 19

how do you perform the phalans test?

Answer 19

• flex both wrists
• place back to back (hold)
• pain = pos = pressure on nerve

Question 20

mechanism of dislocation of lunate

Answer 20

fall on outstretched hand/hyper extension

Question 21

what does lunate dislocation result in (4)

Answer 21

• displace bone to palmar side
• lodge under capitate
• displace into carel tunnel = obstruct the structures in this
• ant blood supply gets cut off

Question 22

what can lunate dislocation cause?

Answer 22

kienbocks disease = aceptic necrosis from DISLOCATION

-carpel tunnel

Question 23

what doe sthe murphys test test for?

Answer 23

lunate dislocation

Question 24

how do you perform the murphy test?

Answer 24

make fist

pos = 3rd met head lines up with 2nd/4th met

Question 25

mechanism of tunnel of guyan syndrome

-what does is it result in?

Answer 25

chronic over use

-entrapment of ulnar nerve (like carpel tunnel)

Question 26

where is the tunnel of guyan

Answer 26

• btwn hook of hamate and pisiform

- contain ulnar nerve

Question 27

mechanism of dequervians disease

Answer 27

overuse of thumb/wrist

Question 28

two tendons involved in deque disease

Answer 28

• abductor pollicus longus

- extensor pollicus brevis

Question 29

anatomical results of deque disease

Answer 29

• tendosynovitis (synovial inflammation)

- stenosing of tunnel (narrowing)

Question 30

what does the finkelstein test test for?

Answer 30

dequervians disease

Question 31

how do you perform finkelstein test?

Answer 31

• make fist w/ thumb inside
• ulnar deviate (adduct)
• pos = pain

Question 32

for navicular fx how long should you wait to re xray if there is no response?

Answer 32

2-3 weeks

Question 33

how long should you immobilize for presiers disease

Answer 33

4-6 months

Question 34

definition of aceptic and necrosis

Answer 34

• aceptic: w/o infection

- necrosis: death to bone/tissue surrounded by healthy tissue

Question 35

where does a navicular fx occur?

Answer 35

waist of the navicular bone

Question 36

where does a colles and smith fracture occur?

Answer 36

distal end of the radius

-btwn shaft and styloid process

Question 37

what does the tinel sign test for?

Answer 37

tunnel of guyan syndrome

Question 38

how do you perform the tinel sign?

Answer 38

• tap on transverse carpal lig

- pos = numbness/tingling intesifys