Wrist and Hand Bones,Joints and Movements

Question 1

Features of distal radius and ulna

Answer 1

Radial and ulna styloid process
Dorsal tubercle of radius
Head of ulna
Triangular fibro cartilage complex

Question 2

What are the bones in the carpus proximal/distal row

Answer 2

Proximal row (lateral-medial-thumb to 5th finger)
- Scaphoid 
- Lunate 
- Triquetral 
- Pisiform 
Distal row (lateral-medial)
- Trapezium 
- Trapezoid 
- Capitate 
- Hamate

Question 3

Describe the scaphoid

Answer 3

Scaphoid tubercle (palpable)
Tubercle - responsible for blood supply
Avascular necrosis is a common problem for post fracture

Question 4

Describe the lunate

Answer 4

Articulates with the scaphoid and triquetral in the proximal carpal row

Question 5

Describe the triquetral/pisiform

Answer 5

Palpable - medial aspect proximal carpal row

Pisiform is a sesamoid bone in the tendon of flexor carpi ulnaris lying on the palmar surface of triquetral

Question 6

Describe the trapezium

Answer 6

Palpable tubercle
Forms the first carpometacarpal joint with the base of the first metacarpal
It’s important for the mobility of the thumb

Question 7

Describe the trapezoid

Answer 7

Base of index finger metacarpal

Question 8

Describe the capitate

Answer 8

Largest of the carpal bones

Articulates distally with the base of MC3 (middle finger)

Question 9

Describe the hamate

Answer 9

Large hook palpable in the muscles on the medial side of the proximal palm (the hypothenar eminence) - hook of hamate.
It articulates distally with the bases of MCs 4 and 5 (ring and little fingers)

Question 10

What are the joints in the wrist region

Answer 10

The radiocarpal joint - the wrist joint 
The carpal joints - mid carpal and inter carpal joints 
CMC
MCP
PIP
DIP

Question 11

Describe the radiocarpal joint/wrist joint

Answer 11

Synovial ellipsoid joint 
- flexion/extension 
- ABD/ADD
close pack 
- full extension 
- radial deviation

Question 12

What are the ligaments, articular surfaces and movements in the radiocarpal joint

Answer 12

Articular surfaces - distal radius, triangular fibrocartilaginous disc, scaphoid, lunate and triquetral
Synovial ellipsoid joint
Capsule
Ligaments - dorsal/palmar radio carpal, radial/ulnar collateral
Movements - flexion/extension, ulnar/radial deviation

Question 13

Describe the mid carpal joint

Answer 13

Synovial complex saddle
Between the proximal and distal rows of carpal bones
Capsule
Ligaments - intercarpal-Palmer/dorsal, collateral
Movements - flexion/extension and ABD/ADD

Question 14

Movements of the R/C and mid carpal joints

Answer 14

Flexion - 85degrees
Extension - 85degrees
Radial deviation - 15degrees
Ulnar deviation - 45degrees

Question 15

What stabilises the wrist

Answer 15

The many tendons crossing the joints (plus pronator quadratus).
Ligaments anteriorly,posteriorly, medially and laterally.
Tendons bound by extensor and flexor retinaculum.
Radiocarpal, inter carpal ligaments
Close pack position: extension with radial deviation

Question 16

Active movements of the wrist and hand

Answer 16

Flexion occurs and mid carpal joint > radial carpal joint
Extension occurs at radio carpal joint > mid carpal joint
Radial and ulnar deviation occur mainly at radio carpal joint

Question 17

What accessory movements at the radio and mid carpal joint

Answer 17

A-P and P-A
Ulna glide
Radial glide
Longitudinal caudad

Question 18

Describe the carpometacarpal (CMC) joint

Answer 18

Articulate surfaces - trapezium and base of the 1st metacarpal.
Ligaments - radial CMC, anterior/posterior oblique
Movements - flexion/extension, ABD/ADD, opposition

Question 19

Classify the 1st carpometacarpal joint

Answer 19

Synovial saddle - biaxial

Loose capsule - supported by ligaments

Question 20

Classify the inter carpal joint

Answer 20

Synovial plane joints
Between individual carpal bones
Ligaments - dorsal and Palmer inter carpal and interosseous
Movements (slight) - small glides, only significantly capitate

Question 21

Classify the metacarpophalangeal MCP joints

Answer 21

Synovial ellipsoid joint
Articular surfaces - round metacarpal head with the base of phalanx
Ligaments - palmar, collateral, transverse metacarpal (4 fingers), deep transverse.
Movements - flexion/extension,ABD/ADD

Question 22

Classify the inter-phalangeal (IP) Joints

Answer 22

Synovial hinge joints
Proximal/distal
Ligaments - collateral and palmar
Movements - flexion/extension

Question 23

Function of hand

Answer 23

Communication 
Manipulation 
Sensation 
Protection 
Stability