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1019 Regional > Wrist and Hand > Flashcards

Wrist and Hand Flashcards

1
Q

The scapholunate joint line is aligned just distal to the

A

Radiocarpal Joint/ Scaphoid bone

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2
Q

The trapezium has a tubercle for attachment of the

A

Triangular Fibrocartilaginous Complex

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3
Q

What is the function of the TFCC?

A

Primary stabiliser of the Distal Radioulnar joint

Reinforces ulnar side of the wrist

Binds the distal ends of the radius and ulna while simultaneously allowing the radius to pronate and supinate around a fixed ulna

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4
Q

What are the structures that stabilise the ulnar side of the wrist?

A

TFCC

Ulnar collateral ligament

Flexor and extensor carpi ulnaris

Palmar ulnocarpal

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5
Q

What structures make up the TFCC?

A

Radioulnar joint capsular ligament
Palmar Ulnocarpal ligament (Ulnotriquetral and Ulnolunate)
Ulnar Collateral ligament

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6
Q

What ligament is attached to the hook of hamate?

A

Pisohamate ligament

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7
Q

Which carpal bone is the easiest to fracture and how?

A

Scaphoid through excessive hyperextension

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8
Q

The radius articulates with which 2 carpal bones?

A

Scaphoid and Lunate

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9
Q

Which carpal bone has the most contact with the radius?

A

Scaphoid

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10
Q

What is the structural classification of the radiocarpal joint?

A

Synovial Ellipsoid Joint

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11
Q

Do you have greater range of flexion or extension

A

Flexion (There is volar tilt at 10-15 degrees)

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12
Q

Do you have greater range of abduction or adduction? Why?

A

Adduction, due to the volar tilt as well

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13
Q

Which row of carpals exhibits a greater amount of movement between adjacent carpal bones?

A

Proximal row

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14
Q

Which row generally moves as a unit? Which bone is most commonly used as the reference in measurement of ROM?

A

Distal row (Trapezium, Trapezoid, Capitate and Hamate)

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15
Q

Structural classification of 1st CMC

A

Biaxial Synovial Saddle joint

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16
Q

Movements that occur at the 1st CMC

A

Flexion Extension

Adduction Abduction

Opposition (Conjunct rotation)

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17
Q

What ligaments stabilise the 1st CMC joint in the hand and when are they taut?

A

Anterior oblique (Abduction, Extension, Opposition)

Flexor Retinaculum (Abduction, Extension, Opposition)

First intermetacarpal (Abduction and Opposition)

Posterior oblique (Abduction and Opposition)

Radial collateral (All movements except extension)

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18
Q

Structural classification of 2nd to 4th CMC

A

Biaxial Synovial Plane Joint

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19
Q

Movements that occur at the 2nd to 4th CMC

A

Flexion/Extension, Abduction/Adduction,

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20
Q

Structural classification of 5th CMC

A

Biaxial Synovial Plane Joint

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21
Q

Movements that occur at the 5th CMC

A

Flexion/Extension, Abduction/Adduction, Rotation/Gliding

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22
Q

Structural classification of 2nd to 5th intermetacarpal joint and its movement

A

Biaxial Synovial Plane Joint

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23
Q

What are the primary restraints to the dislocation of the 1st CMC?

A

Dorsal ligaments

24
Q

Describe the screw home mechanism of the thumb

A

Abductor Pollicis Brevis, Opponens Pollicis, Adductor Pollicis and Flexor Pollicis longus compresses joint and positions the volar peak of the 1st MC into the recess of the trapezius and forms a pivot

Rotation of metacarpal occurs, functioning like a screw and tightening the dorsal ligament

Provides stability for power grasp and pinch

25
Q

Why is the trapezium not just stabilised onto the scaphoid?

A

Scaphoid is very mobile and hence would not provide enough stability

26
Q

Structural classification of 1st to 5th MCP joints and their movements

A

Synovial Ellipsoid

Flexion/Extension
Abduction/Adduction

27
Q

Structural classification of 1st to 5th IP joints and their movements

A

Synovial Hinge joint

Flexion and Extension

28
Q

What collateral ligament of the 1st MCP resists the force that is produced by pinching thumb and index

A

Radial Collateral Ligament

29
Q

Which IP joint has a greater range of flexion?

A

Proximal interphalangeal joints

30
Q

What structures are attached to the transverse carpal ligament (Part of carpal tunnel)

A

Scaphoid, pisiform, trapezium and hamate

31
Q

Describe the force transfer in the hand

A

MCP 2 and 3 -> Capitate-> Trapezoid->Scaphoid-> Lunate-> Distal radius and Ulna-> Interosseous membrane->Proximal Radius and Ulna->Humerus

32
Q

What is the function of the Transverse Carpal Ligament?

A

Acts as a stabiliser for ulnar aspect of the wrist

33
Q

What are the 2 collateral ligaments at the wrist?

A

Radial and Ulnar collateral ligaments

34
Q

What is the function of the RCL?

A

Strengthens articular capsule of radiocarpal joint and provides stability between radius and carpal bones

35
Q

What structures are attached to the RCL?

A

Styloid process of radius and scaphoid

36
Q

What structures are attached to the UCL?

A

Styloid process of ulna and triquetrum

37
Q

What is the function of the UCL?

A

Supports radiocarpal joint

38
Q

What are the extrinsic wrist ligaments?

A

Palmar radiocarpal ligament, Dorsal radiocarpal ligament, Palmar ulnocarpal ligament

39
Q

What is the function of the PRCL?

A

Ensures hand follows radius during supination

40
Q

What movement does the PRCL resist?

A

Excessive wrist extension

41
Q

What ligaments make up the Palmar Radiocarpal Ligament?

A

Radio-scapho-capitate

Radiolunate

Radio-scapholunate (most lateral, blends with radial collateral ligament)

42
Q

What is the function of the Dorsal RadioCarpal Ligament?

A

Ensure hand follows radius during pronation

43
Q

What movement does the Dorsal Radiocarpal Ligament resist?

A

Excessive wrist flexion

Anterior dislocation of lunate

44
Q

What movement does the PUCL resist?

A

Excessive wrist extension

45
Q

What are the intrinsic ligaments at the wrist?

A

Palmar midcarpal ligament and Dorsal midcarpal ligament

46
Q

Function of the Palmar Midcarpal Ligament

A

Stabilise carpal bones on midcarpal joint to allow limited gliding movement

47
Q

Function of the Dorsal MidCarpal Ligament

A

Stabilise proximal row carpal bones on midcarpal joint

48
Q

What muscles travel through the carpal tunnel?

A

4 Flexor Digitorum profundus, 4 Flexor digitorum superficialis and Flexor Pollicis Longus

49
Q

What nerve travels through the carpal tunnel

A

Median nerve

50
Q

What causes carpal tunnel syndrome?

A

Compression of the median nerve and causes loss of sensation of the lateral 3.5 digits

51
Q

What is the function of the extensor retinaculum?

A

Keep extensor tendons aligned during movement

52
Q

What muscles contribute to making a fist?

A

Flexor digitorum superficialis and flexor digitorum profundus as they do finger flexion, Flexor pollicis longus helps with flexion-extension, and adductor pollicis

53
Q

What is the advantage of the extensor hood mechanism?

A

Being able to flex and extend fingers at the same time, allows for isolation of each digit and dexterity

54
Q

What are the borders of the Guyon’s Canal?

A

Pisiform, Flexor carpi Ulnaris Tendon (Medial), Hook of hamate (Lateral), Transverse carpal ligament (Dorsum), Volar carpal ligament (Volar)

55
Q

What structures pass through the Guyon’s Canal?

A

Ulnar nerve and Ulnar artery

56
Q

What are the borders of the anatomical snuffbox?

A

Tendons of Abductor Pollicis Longus and Extensor Pollicis Brevis (Lateral), Tendon of Extensor Pollicis Longus (Medial), Scaphoid and Trapezium and tendons of Extensor Carpi Radialis Longus and Brevis

57
Q

What goes through the anatomical snuffbox?

A

Radial nerve and artery

1019 Regional (9 decks)

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