Wrist/hand Flashcards

1
Q

What is the angulation of the wrist joint?

A

palmar tilt and radial inclincation (11 and 23 degrees)

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2
Q

What is significant of Lister’s tubercle?

A

pulley for EPL tendon

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3
Q

What is positive ulnar variance?

A

when ulna lies distal to radius

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4
Q

What is negative ulnar variance?

A

when ulna lies proximal to radius

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5
Q

What is complication of positive ulnar variance?

A

increased risk to TFCC degeneration

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6
Q

What is complication of negative ulnar variance?

A

spontaneous lunate necrosis (Kienbock dsease)

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7
Q

What is the most commonly fractured carpal?

A

Scaphoid

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8
Q

What is typical shape of lunate on imaging?

A

Quadrangular AP, crescent laterally.

triangle on AP indicates potential pathology

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9
Q

How would you palpate the triquetrum?

A

medial border of wrist during radial deviation

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10
Q

What runs under hook of hamate?

A

ulnar artery/nerve

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11
Q

What function does longitudinal arch of hand serve?

A

contributes to powerful gripping

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12
Q

Which bone transmits more force through wrist during gripping?

A

radius (80%)

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13
Q

What motions does the radius undergo during pronation?

A

anteromedial and proximal.

-ulna corresponds by moving (slightly) posterolateral and distal

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14
Q

How much of TFCC disc is vascularized?

A

15-20% near apex

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15
Q

Where is TFCC disc thicker?

A

peripheral region

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16
Q

Is degenrative or traumatic TFCC injury more common?

A

degenerative

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17
Q

How common is degenerative TFCC injury?

A

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

18
Q

Which row of the carpals is more stable?

A

Distal-firm ligaments, with little independent movement

19
Q

Where do most wrist dissociations occur

A

Proximal row, less stable

20
Q

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

21
Q

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

A

as much flexion as possible

22
Q

What helps keep extensor tendons over metacarpal heads?

A

sagittal bands and dorsal hood

23
Q

What motion does volar plate limit?

A

hyperextension

24
Q

Which position should IPs be splinted in if possible

A

full extension to prevent contracture of collateral ligaments and volar plates

25
Why are collateral ligaments taut in different positions for MP and IP joints?
Metacarpal heads are cam shaped, phalangees are not
26
What is in first extensor compartment at wrist?
APL and EPB
27
Which extensor compartment does De Quervain's occur in
1st
28
What is in second extensor compartment of wrist?
ECRL and ECRB
29
What is in third extensor compartment?
EPL
30
What is in 4th compartment?
ED and EI tendons
31
What is in 5th compartment?
EDM
32
what is in 6th compartment?
ECU
33
How do extensor tendons connect to proximal phalangees
sagittal bands. This connection allows extensor tendon to extend MTP joint
34
Laxity of what contributes to swan neck deformity?
lateral bands
35
What is swan neck deformity?
PIP extension with DIP flexion
36
What is primary action of FDS
PIP flexion
37
What flexes DIP?
FDP
38
What does FDP do?
flex DIP primarily. Secondary: flex PIP and MP
39
Which finger flexor performs most unloaded movements, and is stronger?
FDP
40
What happens during parodoxial extension?
FDP is detached/too long. Extends DIP via lumbricals