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MD2002 Arvin > Wrist, Hand, Ankle and Foot > Flashcards

Wrist, Hand, Ankle and Foot Flashcards

1
Q

Describe the main features of the distal radio-ulnar joint ?

A
  • Interosseous membrane
  • Fibrous capsule
  • Anterior and posterior Radio- ulnar ligaments (weak)
  • Sacciform recess facilitates movement
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2
Q

Which joint do pronation and supination involve a movement of ?

A

Proximal radioulnar joint

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3
Q

Describe the main features of the tibio-fibular joint ?

A
  • Interosseous membrane

- Tibio-fibular ligaments (strong), including the anterior, posterior and inferior transverse tibio-fibular ligament N

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4
Q

What types of joints are the radio-ulnar and tibio-fibular joints ?

A

Syndesmoses

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5
Q

Which movement moves the tibio-fibular joint ?

A

(Very slight movement) during dorsiflexion

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6
Q

What is the major role of the tibio-fibular joint ?

A

Stability of the ankle

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7
Q

Where is the inferior transverse tibio-fibular ligament found ?

A

Forms the posterior wall for the talus (trochlea)

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8
Q

What are the groups of bones of the hand ?

A

Carpals
Metacarpals
Phalanges

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9
Q

Name all the carpals, lateral to medial.

A

Proximal: Scaphoid, Lunate, Triquetrum, Pisiform
Distal: Trapezium, Trapezoid, Capitate, Hamate

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10
Q

How many metacarpals are there ? How are they named ?

A

Five

Using roman numerals

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11
Q

Name all the phalanges.

A

Proximal and distal phalanges in the thumb

Proximal, middle and distal phalanges in other 4 fingers

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12
Q

What are the groups of bones of the foot ?

A

Tarsal bones, metatarsals and phalanges

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13
Q

Name all the tarsals, medial to lateral.

A

Proximal row: Talus, Calcaneus
Intermediate row: Navicular
Distal row: medial cuneiform, intermediate cuneiform, lateral cuneiform, cuboid

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14
Q

What is the only bone to link leg with foot ?

A

Talus bone

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15
Q

Which bones form the wrist joint ?

A

Distal end of radius and articular disc (NOT ulna) articulate with proximal carpal bones (but NOT pisiform)

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16
Q

Which bones form the ankle joint ?

A

Distal end of tibia (medial malleolus) and fibula (lateral malleolus) articulate with the talus.

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17
Q

What are the main features of the wrist joint capsule ?

A
  • Loose fibrous capsule
  • Synovial folds within capsule
  • Strong ligaments reinforce joint
    1. Radial and ulnar collateral ligament
    2. Palmar and dorsal radiocarpal ligament
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18
Q

What are the main features of the ankle joint capsule ?

A
  • Loose fibrous capsule
  • Synovial folds within capsule
  • Collateral ligaments of ankle all originate at malleoli and fan out to tarsal bones:
    1. Medial (deltoid) ligament
    2. Lateral ligament
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19
Q

What is the role of the two collateral ligaments of the ankle ?

A
  1. Medial (deltoid) ligament: Prevents dislocation during eversion of the foot
  2. Lateral ligament: Resists over-inversion
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20
Q

What type of joint are the wrist and ankle respectively ? Which of these two is a weight bearing joint ?

A

Wrist: Condyloid joint
Ankle: Hinge Joint (weight-bearing)

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21
Q

What is the actual name of the ankle and wrist joints respectively ?

A 
Radiocarpal joint (wrist) 
Talocrural articulation (ankle)
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22
Q

What movements are allowed at the wrist ?

A
  • Flexion, extension
  • Abduction, adduction
  • (Some) Circumduction
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23
Q

What movements are allowed at the ankle ?

A
  • Extension (dorsiflexion)

- [Plantar] Flexion

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24
Q

Which one of dorsiflexion or plantar flexion is more stable at the ankle ?

A

Plantar flexion is less stable because of narrow trochlea

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25
What are the flexors of the wrist ?
Main: Flexor carpi ulnaris, Flexor carpi radialis, Palmaris longus Also: Flexor digitorum superficialis, Flexor digitorum profundus, Flexor pollicis longus:
26
What is the origin and insertion of the main flexors the wrist ?
FLEXOR CARPI ULNARIS -Origin: Humeral head: Medial epicondyle of humerus Ulnar head: Olecranon and posterior border of ulna (via aponeurosis) -Insertion: Pisiform, hook of hamate, 5th metacarpal FLEXOR CARPI RADIALIS - Origin: Medial epicondyle of humerus - Insertion: Base of 2nd (3rd) metacarpal PALMARIS LONGUS - Origin: Medial epicondyle of humerus - Insertion: Distal half of flexor retinaculum, palmar aponeurosis
27
What is the common flexor origin of the wrist flexors ?
Medial Epicondyle
28
What are other functions of flexor carpi ulnaris and radialis in addition to flexing the wrist ?
FLEXOR CARPI ULNARIS -Adducting the hand FLEXOR CARPI RADIALIS -Abducting the hand
29
How are the flexors of the wrist innervated ?
- Flexor carpi ulnaris: ulnar nerve - Flexor carpi radialis, palmaris longus, flexor digitorum superficialis, Flexor digitorum profundus, Flexor pollicis longus: median nerve
30
At the wrist, where are the ulnar vessels and the ulnar nerve located relative to the tendon of the flexor carpi ulnaris ?
At the wrist, ulnar vessels and the ulnar nerve is immediately lateral to the tendon of the flexor carpi ulnaris
31
Where does the ulnar nerve pass relative to the flexor carpi ulnaris ?
Ulnar nerve passes between the two heads of the flexor carpi ulnaris
32
What are the flexors of the ankle ?
Main: Triceps surae (Gastrocnemius, soleus and plantaris), and Tibialis posterior Also: Flexor digitorum longus, Flexor hallucis longus
33
What is the origin and insertion of the main flexors of the ankle ?
``` GASTROCNEMIUS -Origin: Lateral head: lateral condyle of femur Medial head: medial condyle of femur -Insertion: Posterior surface of calcaneus via calcaneal tendon ``` SOLEUS - Origin: Posterior aspect of head of fibula, superior quarter of posterior surface of fibula, soleal line, and medial border of tibia - Insertion: Posterior surface of calcaneus via calcaneal tendon PLANTARIS - Origin: Inferior end of lateral supracondylar line of femur and oblique popliteal ligament - Insertion: Posterior surface of calcaneus via calcaneal tendon TIBIALIS POSTERIOR - Origin: Interosseous membrane, posterior surface of tibia inferior to soleal line, and posterior surface of fibula - Insertion: Tuberosity of navicular, medial cuneiform
34
How are the flexors of the ankle innervated ?
By the tibial nerve
35
What two muscles participate in inversion of the foot ?
Tibialis posterior (its main function) and tibialis anterior
36
What muscles supports the medial plantar longitudinal arch ?
Tibialis posterior and Tibialis anterior
37
What actions of the body (more general than flexion of the ankle) does the triceps surae perform ?
- propels the body forward off the planted foot during walking - elevates the body upward onto the toes when standing
38
What are the extensors of the wrist ?
Main: Extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris Also: Extensor digitorum, Extensor indicis, Extensor digiti minimi, Extensor pollicis longus and Extensor pollicis brevis
39
What is the origin and insertion of the main extensors of the wrist ?
EXTENSOR CARPI RADIALIS LONGUS - Origin: Lateral epicondyle of humerus - Insertion: dorsal base of 2nd metacarpal EXTENSOR CARPI RADIALIS BREVIS - Origin: Lateral epicondyle of humerus - Insertion: dorsal base of 3rd metacarpal EXTENSOR CARPI ULNARIS - Origin: Lateral epicondyle of humerus - Insertion: dorsal base of 5th metacarpal
40
How are the extensors of the wrist innervated ?
Radial nerve
41
What is the common extensor origin of the wrist extensors ?
Lateral epicondyle of the humerus
42
What action of the hand (other than extension of the wrist) do the extensors of the wrist perform ?
Flexion of the fingers (gripping)
43
What are the extensors of the ankle ?
Main: Tibialis Anterior Also: Extensor hallucis longus , Extensor digitorum longus, Fibularis tertius
44
What is the origin and insertion of the main extensor of the ankle ?
TIBIALIS ANTERIOR Origin: Lateral condyle and superior-lateral surface of tibia and interosseous membrane Insertion: medial cuneiform and base of 1st metatarsal
45
What is another name for extension of the ankle ?
Dorsiflexion
46
How is the main extensor of the ankle innervated ?
Tibialis anterior, as with all muscles in the anterior compartment of the leg is supplied by the deep peroneal nerve
47
Are the adductors of the wrist joint located on the ulnar or radial side ? The abductors of the wrist ?
Adductors of wrist joint: • Positioned on ulnar side Abductors of wrist joint: • Positioned on more towards radial side
48
What are the adductors of the wrist ?
Extensor carpi ulnaris | Flexor carpi ulnaris
49
What are the abductors of the wrist ?
Extensor carpi radialis longus, and brevis Flexor carpi radialis Abductor pollicis longus
50
Classify the following joints: 1. Radiocarpal 2. Intercarpal 3. Intermetarpal & Carpo-Metacarpal 4. Metacarpo-phalangeal 5. Interphalangeal
1. Radiocarpal = Condyloid joint 2. Intercarpal = Plane joint 3. Intermetarpal & Carpo-Metacarpal = Plane joint (CMC-1 (Thumb) joint is a saddle joint) 4. Metacarpo-phalangeal = Condyloid joint 5. Interphalangeal = Hinge joint
51
What movements are allowed at the following joints ? 1. Radiocarpal 2. Intercarpal 3. Intermetarpal & Carpo-Metacarpal 4. Metacarpo-phalangeal 5. Interphalangeal
RADIOCARPAL: Flex / extension, Abduction and adduction INTERCARPAL: Sliding movements Increase range of flex / extension of wrist INTERMETACARPAL and CARPOMETACARPAL: Flex / extension, Abduction and adduction METACARPO-PHALANGEAL: Flex and extension, Abduction and adduction INTERPHALANGEAL: Flex / extension
52
Classify the following joints: 1. Distal Tibiofibular 2. Ankle 3. Intertarsal 4. Intermetatarsal and Tarso-Metatarsal 5. Metatarsophalangeal 6. Interphalangeal
1. Distal Tibiofibular = Syndesmose 2. Ankle = Hinge joint 3. Intertarsal = Plane joints 4. Intermetatarsal and Tarso-Metatarsal = Plane joints 5. Metatarsophalangeal = Condyloid joints 6. Interphalangeal = Hinge joints
53
What movements are allowed at the following joints ? 1. Distal Tibiofibular 2. Ankle 3. Intertarsal 4. Intermetatarsal and Tarso-Metatarsal 5. Metatarsophalangeal 6. Interphalangeal
DISTAL TIBIOFIBULAR No movement, helps to stabilise ankle and foot ANKLE Plantar flexion and dorsiflexion INTERTARSALS Inversion and eversion INTERMETATARSAL and TARSO-METATARSAL Gliding movements METATARSOPHALANGEAL Flexion, extension, Abduction, adduction INTERPHALANGEAL Flexion and extension
54
Name the different intertarsal joints.
Talo-calcaneo-navicular joint + Calcaneo-cuboid joint =Transverse tarsal joint Subtalar (Talocalcaneal) joint
55
What is the difference between intercarpal, midcarpal and Pisotriquetral joints ?
``` Intercarpal joints between carpals (within prox or dist rows) Midcarpal joint (between rows) Pisotriquetral joint between pisiform and triquetral bone ```
56
At which joints does extension and abduction of the hand occur ?
At midcarpal joint
57
Which of distal or proximal row is more mobile ?
Proximal row is most mobile
58
Which articular feature of the hand favors the spread of infection ?
Intercarpal, midcarpal, and pisotriquetral joints share common articular cavity with CMC joint
59
What two bones make up the subtalar joint ?
Talus and calcaneus
60
Which structures reinforce the subtalar joint ?
Ligaments, including interosseal ligament of the subtalar joint
61
What are the components of the Transvers tarsal joint ?
Talonavicular part of TCN + CC
62
What movements does the Transvers tarsal joint participate in ?
Inversion and eversion
63
What is the site for surgical amputation of foot ?
Transverse tarsal joint
64
What important ligaments support the joints and plantar arches ?
- Long plantar ligament | - Spring ligament: supports head of talus, and much of the body weight
65
What are movements at CMC-1 joint ?
Flexion, Extension Abduction, Adduction Opposition of thumb
66
What bones make up the CMC-1 joint ?
Trapezium and first metacarpal
67
Which characteristic of the CMC-1 joint gives it increased mobility ?
Loose joint capsule
68
True or false: CMC-1 has separate articular cavity.
True
69
What are the extrinsic flexors of the fingers ?
Flexor digitorum superficialis, Flexor digitorum profundis, Flexor pollicis longus
70
What is the origin and insertion of the extrinsic flexors of the fingers ?
FLEXOR DIGITORUM SUPERFICIALIS -Origin: Humero-ulnar head: medial epicondyle of humerus and coronoid process of ulna Radial head: oblique line of radius -Insertion: Middle phalanges of medial four digits FLEXOR DIGITORUM PROFUNDIS - Origin: Proximal three quarters of medial and anterior surfaces of ulna and interosseous membrane - Insertion: Distal phalanges of medial four digits FLEXOR POLLICIS LONGUS - Origin: Anterior surface of radius and adjacent interosseous membrane - Insertion: Distal phalanx of thumb
71
How are the extrinsic flexors of the fingers innervated ?
All flexor muscles in the forearm are supplied by the median nerve except Flexor digitorum profundus (by both ulnar and median nerves) and flexor carpi ulnaris (by the ulnar nerve)
72
What is meant by extensor expansion/dorsal digital expansions ?
Expansion of the tendons of the extensor digitorum and extensor pollicis longus muscles over the proximal phalanges
73
What are the extrinsic extensors of the fingers ?
Extensor pollicis longus, Extensor pollicis brevis, Extensor indicis, Extensor digitorum, Extensor digiti minimi
74
What is the origin and insertion of the extrinsic extensors of the fingers ?
EXTENSOR POLLICIS LONGUS - Origin: Posterior middle ulna and interosseous membrane - Insertion: Distal phalanx of 1st finger EXTENSOR POLLICIS BREVIS - Origin: Posterior distal radius and interosseous membrane - Insertion: Proximal phalanx of 1st finger EXTENSOR INDICIS - Origin: Posterior distal ulna and interosseous membrane - Insertion: Extensor expansion of 2nd finger EXTENSOR DIGITORUM - Origin: Lateral epicondyle of humerus - Insertion: Extensor expansions of medial four fingers EXTENSOR DIGITI MINIMI - Origin: Lateral epicondyle of humerus - Insertion: Extensor expansions of 5th finger
75
How are the extrinsic extensors of the fingers innervated ?
All extrinsic extensors of the fingers are supplied by the radial nerve
76
Where and how are the extensor communis tendons of the fingers joined together ?
The extensor communis tendons of the fingers are joined together at the distal part of the back of the hand by the connexus intertendineus
77
What are the extrinsic extensors of the toes ?
Extensor hallucis longus Extensor digitorum longus Fibularis tertius
78
What is the origin and insertion of the extrinsic extensors of the toes ?
EXTENSOR HALLUCIS LONGUS - Origin: Middle part of anterior surface of fibula and interosseous membrane - Insertion: Dorsal aspect of base of distal phalanx of great toe (hallux) EXTENSOR DIGITORUM LONGUS - Origin: Lateral condyle of tibia and superior 2/3 of anterior surface of fibula and interosseous membrane - Insertion: Middle and distal phalanges of lateral four digits FIBULARIS TARTIUS - Origin: Inferior third of anterior surface of fibula and interosseous membrane - Insertion: Dorsum of base of 5th metatarsal
79
How are the extrinsic extensors of the toes innervated ?
All are supplied by the deep fibular [peroneal] nerve
80
What are the extrinsic flexors of the toes ?
Flexor digitorum longus and Flexor hallucis longus
81
What is the origin and insertion of the extrinsic flexors of the toes ?
FLEXOR DIGITORUM LONGUS - Origin: Medial part of posterior surface of tibia inferior to soleal line and by a broad tendon to fibula - Insertion: Bases of distal phalanges of lateral four toes FLEXOR HALLUCIS LONGUS - Origin: Inferior two thirds of posterior surface of fibula and inferior part of interosseous membrane - Insertion: Base of distal phalanx of hallux
82
How are the extrinsic flexors of the toes innervated ?
All muscles in the posterior compartment of the leg are supplied by the tibial nerve

MD2002 Arvin (110 decks)

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