Wrist and hand Flashcards

1
Q

What type of joint is the wrist joint?

A

the Radoiocarpal joint is a synovial joint

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2
Q

The articular disc can be found

A

between the ulna and the wrist joint

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3
Q

What muscles are in the superficial layer of the anterior forearm?

A

FCU
FCR
Palmaris longus
Pronator teres

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4
Q

What muscle is in the middle layer of the anterior forearm?

A

FDS

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5
Q

What muscles are in the deep layer of the anterior forearm?

A

FDP
Flexor pollicus longus
Pronator quadratus

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6
Q

What muscle adducts the wrist?

A

FCU

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7
Q

What muscle abducts the wrist?

A

FCR

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8
Q

What does the median nerve supply in the anterior arm?

A

All muscles apart from FCU and the medial half of FDP

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9
Q

What muscles are in the superficial layer of the posterior forearm?

A
Extensor carpi ulnaris 
Extensor carpi radialis longus
Extensor carpi radialis brevis 
Extensor digitorum 
Extensor digiti minimi
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10
Q

What muscles are in the deep layer of the posterior forearm?

A
Supinator
Abductor pollicus longus
Extensor pollicus brevis 
Extensor pollicus longus 
Extensor indicis
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11
Q

Which intrinsic muscles are not supplied by the ulnar nerve?

A

Thenar muscles

Lumbricals 1&2

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12
Q

What are the thenar muscles?

A

Flexor pollicus brevis
Opponens pollicus
Abductor pollicus brevis

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13
Q

Where do the lumbricals originate from? What do they do

A

The tendons of FDP

Flex the MCPJ whilst extending the IPJ

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14
Q

What are they hypothenar muscles?

A

Opponens digit minimi
Abductor digiti minimi
Flexor digiti minimi brevis

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15
Q

What muscle in the thenar region is innervated by the ulnar nerve?

A

Adductor pollicis

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16
Q

What do the dorsal interossei do? How many are there?

A

abduct

4

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17
Q

What runs through the carpal tunnel?

A

FDP
FDS
Median nerve
Flexor pollicus longus

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18
Q

What is Guyon’s canal?

A

Where the ulnar nerve (and artery) run through before splitting into sensory and motor components

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19
Q

what gives the main branch of the superior palmar arch?

A

the ulnar artery

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20
Q

what gives the main branch of the deep palmar arch?

A

the radial artery

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21
Q

What UL nerve lesion is obvious when the patient is asked to make a fist?

A

median nerve lesion

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22
Q

Which vein is found on the lateral side of the wrist?

A

Cephalic

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23
Q

Klumple’s palsy will cause paralysis to

A

the majority of the intrinsic muscles of the hand

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24
Q

decreased active and passive movement in the shoulder points to a

A

joint problem

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25
Q

decreased active movement only points to a

A

muscle problem

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26
Q

The painful stage of frozen shoulder tends to last

A

2-9 months

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27
Q

Wartenburg syndrome is due to

A

entrapment of the radial nerve

28
Q

Why is the dens more prone to fracturing?

A

It is less dense

The dens is a feature of CII

29
Q

Is the nucleus pulposus or annulus fibrosus a shock absorber?

A

Nucleus pulposus

30
Q

What does the anterior longitudinal ligament do?

A

Prevents hyperextension of the vertebral column

31
Q

What prevents posterior herniation of IV discs?

A

Posterior longitudinal ligament

32
Q

What ligament can be injured in whiplash?

A

anterior longitudinal ligament

33
Q

What does the pubofemoral ligament do?

A

prevent excessive abduction

34
Q

What does the iliofemoral ligament do?

A

prevents hyperextension during standing

It is the strongest ligament

35
Q

What is the weakest ligament around the hip?

A

The ischiofemoral ligament

36
Q

What occurs to the hip when there is posterior dislocaition?

A

It is internally rotated, flexed and adducted

It commonly occurs when an accident occurs in a seated position in a car

37
Q

What is the blood supply to the head of the femur?

A

Medial circumflex and lateral circumflex arteries

The primary supply to the joint is from the medial circumflex

38
Q

What are examples of congenital abnormalities of the hip?

A

Subluxation
Low dislocation
High dislocation

39
Q

What are the adductor muscles innervated by?

A

Obturator nerve (L2-L4)

40
Q

what does g. maximus do at the hip?

A

powerful extensor

innervated by the inferior gluteal nerve

41
Q

What are the hip flexors?

A

Iliopsoas
Sartorius
Rectus femoris

42
Q

What are the short hip flexors? What do they do

A

Piriformis
Obturator internus
Gemelli
Quadratus femoris (L5-S1)

Lateral rotators of the hip

43
Q

Name the hamstrings. What are they innervated by?

A

Biceps femoris
Semitendinous
Semimembranous

Sciatic nerve (L4-S3)

44
Q

How does the PCL travel?

A

Supero-anteriorly

It inserts onto the medial femoral condyle and restricts posterior displacement of the tibia

45
Q

How does the ACL travel?

A

Supero-posteriorly

It inserts on the lateral femoral condyle and restrict the anterior displacement of the tibia

It is weaker than the PCL

46
Q

Is the tibial collateral ligament attached to the menisci?

A

Yes, the medial meniscus

It prevents abduction of the leg at the knee

47
Q

What is the ‘unhappy triad’?

A

Lateral twisting of the flexed knee that causes a tear of:

  • ACL
  • tibial collateral ligament
  • medial meniscus
48
Q

When is the knee joint most stable?

A

When extended

At full extension, the femur undergoes medial rotation on the tibia

49
Q

Why is patellar dislocation more common in women?

A

Larger Q angle due to a wider pelvis and strong quad contraction

50
Q

In genu varum, what occurs to the tibia?

A

It is adducted with respect to the femur

51
Q

What type of back pain is made better by lying flat?

A

Mechanical backache

52
Q

Backpain with nerve root involvement will often lack what reflex?

A

Ankle jerk

Foot drop may also be present

53
Q

What are ‘Looser Zones’ seen on Xray?

A

pseudofractures associated with osteomalacia

54
Q

Where is the COG located in the body?

A

Anterior to S2 vertebra, posterior to the hips and anterior to the knee and ankle

55
Q

Damage to what nerve can cause a Trendelenberg gait?

A

Superior gluteal nerve

the pelvis drops to the side of the raised foot

56
Q

What can cause pes cavus?

A

Charcot Marie Tooth

Freidreich’s ataxia

57
Q
In the supine position, what is the maximum
hip flexion
hip abduction 
hip adduction 
internal/external rotation
A

HF- 120
HA- 45
HAd- 30
IR/ER- 45

58
Q

What is important about Ilazarov frame?

A

It uses 3 dimensions
It has 4 fixation elements per segment
It is a powerful tool in bone healing

59
Q

How do statins work?

A

HMG-CoA reductase inhibitors lower levels of LDL to stabilise plaques

60
Q

How is limb ischaemia classified?

A

Fontaine classification

  1. asymptomatic
  2. intermittent claudication
  3. ischaemic rest pain
  4. critical ischaemia
61
Q

What are signs of critical ischaemia?

A

Pain on rest
Ulceration
Gangrene

62
Q

What are the 6 Ps of acute limb ischaemia?

A
pain 
pale
perishing cold
pulseless
paralysis
parasthesia
63
Q

what are the boundaries of the femoral triangle?

A

inguinal ligament
adductor longus
sartorius

64
Q

What are risk factors for DVT?

A

OCP containing oestrogen
immobility
pregnancy!!!
IVDU

65
Q

What types of imaging of the vascular system have no ionising radiation?

A

Duplex scanning

MR angiography

66
Q

What type of Xray contrast is less nephrotoxic?

A

CO2