Wrist/hand

Question 1

What is the angulation of the wrist joint?

Answer 1

palmar tilt and radial inclincation (11 and 23 degrees)

Question 2

What is significant of Lister’s tubercle?

Answer 2

pulley for EPL tendon

Question 3

What is positive ulnar variance?

Answer 3

when ulna lies distal to radius

Question 4

What is negative ulnar variance?

Answer 4

when ulna lies proximal to radius

Question 5

What is complication of positive ulnar variance?

Answer 5

increased risk to TFCC degeneration

Question 6

What is complication of negative ulnar variance?

Answer 6

spontaneous lunate necrosis (Kienbock dsease)

Question 7

What is the most commonly fractured carpal?

Answer 7

Scaphoid

Question 8

What is typical shape of lunate on imaging?

Answer 8

Quadrangular AP, crescent laterally.

triangle on AP indicates potential pathology

Question 9

How would you palpate the triquetrum?

Answer 9

medial border of wrist during radial deviation

Question 10

What runs under hook of hamate?

Answer 10

ulnar artery/nerve

Question 11

What function does longitudinal arch of hand serve?

Answer 11

contributes to powerful gripping

Question 12

Which bone transmits more force through wrist during gripping?

Answer 12

radius (80%)

Question 13

What motions does the radius undergo during pronation?

Answer 13

anteromedial and proximal.

-ulna corresponds by moving (slightly) posterolateral and distal

Question 14

How much of TFCC disc is vascularized?

Answer 14

15-20% near apex

Question 15

Where is TFCC disc thicker?

Answer 15

peripheral region

Question 16

Is degenrative or traumatic TFCC injury more common?

Answer 16

degenerative

Question 17

How common is degenerative TFCC injury?

Answer 17

50-60% of people over 50 years old have it

Question 18

Which row of the carpals is more stable?

Answer 18

Distal-firm ligaments, with little independent movement

Question 19

Where do most wrist dissociations occur

Answer 19

Proximal row, less stable

Question 20

Which motion causes collateral ligaments of MP joints to become taut?

Answer 20

flexion

Question 21

When splinting MP joint, which position should joint be splinted in if possible?

Answer 21

as much flexion as possible

Question 22

What helps keep extensor tendons over metacarpal heads?

Answer 22

sagittal bands and dorsal hood

Question 23

What motion does volar plate limit?

Answer 23

hyperextension

Question 24

Which position should IPs be splinted in if possible

Answer 24

full extension to prevent contracture of collateral ligaments and volar plates

Question 25

Why are collateral ligaments taut in different positions for MP and IP joints?

Answer 25

Metacarpal heads are cam shaped, phalangees are not

Question 26

What is in first extensor compartment at wrist?

Answer 26

APL and EPB

Question 27

Which extensor compartment does De Quervain’s occur in

Answer 27

1st

Question 28

What is in second extensor compartment of wrist?

Answer 28

ECRL and ECRB

Question 29

What is in third extensor compartment?

Answer 29

EPL

Question 30

What is in 4th compartment?

Answer 30

ED and EI tendons

Question 31

What is in 5th compartment?

Answer 31

EDM

Question 32

what is in 6th compartment?

Answer 32

ECU

Question 33

How do extensor tendons connect to proximal phalangees

Answer 33

sagittal bands.

This connection allows extensor tendon to extend MTP joint

Question 34

Laxity of what contributes to swan neck deformity?

Answer 34

lateral bands

Question 35

What is swan neck deformity?

Answer 35

PIP extension with DIP flexion

Question 36

What is primary action of FDS

Answer 36

PIP flexion

Question 37

What flexes DIP?

Answer 37

FDP

Question 38

What does FDP do?

Answer 38

flex DIP primarily.

Secondary: flex PIP and MP

Question 39

Which finger flexor performs most unloaded movements, and is stronger?

Answer 39

FDP

Question 40

What happens during parodoxial extension?

Answer 40

FDP is detached/too long. Extends DIP via lumbricals