Wrist anatomy

Question 1

what is the site of De quervain’s syndrome

Answer 1

Tenosynovitis of Abductor pollicis longus and Extensor pollicis brevis

Question 2

Tunnel of Guyon

Answer 2

Pisiform (Flexor carpi ulnaris insertion), Hook of the Hamate, Pisohamate ligament (Ulnar nerve and artery - pulse felt proximate and lateral to pisiform bone)

Question 3

Anatomy snuff box

Answer 3

Lateral border = abductor pollicis longus and extensor pollicis brevis
Medial border = extensor pollicis longus
Floor = scaphoid
Radial artery

Question 4

most important ligament in the hand

Answer 4

radioschapholunate ligament, most commonly injured, maintains carpal stability
Injured with wrist extension, ulnar deviation and intercarpal supination

Question 5

parlmar and dorsal ligaments, which are stronger?

Answer 5

parlmer

Question 6

what gives stability for wrist?

Answer 6

triangular cartilaginous disc

Question 7

which bone is the central keystone for proximal transverse arch

Answer 7

capitate

Question 8

where is the stability point for distal longitudinal and transverse arch

Answer 8

2 and 3rd metacarpophrangeal

Question 9

no man’s land in the hand

Answer 9

region between the distal palmar crease and the mid portion of the middle phalanx of the fingers. Damage to this region has very poor prognosis

Question 10

reflex neurovascular syndrome is also called

Answer 10

complex regional pain syndrome, reflex sympathetic dystrophy, shoulder-hand syndrome and sudeck atrophy

Question 11

Bouchard nodes

Answer 11

osteoarthoritis swelling of proximal interphalangeal joint

Question 12

Heberden nodes

Answer 12

osteoarthoritis, swelling of distal interpharangeal joint

Question 13

Ulnar drift

Answer 13

common deformities occuring in rheumatoid arthritis

Question 14

Swan neck deformity

Answer 14

RA. Flexion of the metacarpohalangeal and distal interphalangeal, but extension of the proximal interphalangeal joint

Question 15

ape hand

Answer 15

wasting of thenar eminance of hand. Median nerve palsy

Question 16

Bishop’s hand or benediction hand defority

Answer 16

wasting of the hypothenar mm of the hand, ulnar nerve. Felxion of the 4th and 5 fingers

Question 17

Butonniere deformity

Answer 17

extension of metacarpophalangeal and distal interphalangeal joint and flexion of the proximal interphalangeal joint. Result of a rupture of the central tendinous slip of the extensor hood and is most common for RA

Question 18

Myelopathy hand

Answer 18

inability to extend and adduct the ring and little finger despite good function of the wrist, thumb and index finger. Exaggerated triceps reflex. Due to cervical spinal cord pathlogy in conjunction with cervical spondylosis

Question 19

trigger finger

Answer 19

digital tenovaginitis stenosans
result of a thickening of the flexor tendon sheath (notta’s nodule) which causes sticking of the tendon when the patient attempts to flex the finger

Question 20

zig zag deformity of the thum

Answer 20

flexed carpometacarpal joint and hyperextended at the metacarpophalangeal joint. Raptured extensor pollicis longus

Question 21

volkmann ischemic contracure

Answer 21

typical of a compartment syndrome after a fracture or dislocation of the elbow (wrist flexion and clawed fingers)

Question 22

4 types of power grips

Answer 22

hook, cylinder, fist, spherical

Question 23

3 types of precision (prehension)grips

Answer 23

chuck or three fingered pinch (digital prehension)

Lateral or key pinch (lateral prehension)

Tip pinch (tip to tip prehension)