Wrist, Hands and Fingers Flashcards
What is the TFCC?
Triangular Fibrocartilage Complex
How many phalanges are in the hand?
14 phalanges
How many degrees of freedom does the distal radioulnar joint have?
One degree of freedom for pronation and supination
How many degrees of freedom does the radiocarpal joint have?
Two degrees of freedom for flexion and extension, abduction and adduction
What makes up the TFCC?
Extensor Carpi Ulnaris Sheath Meniscus Homologue Ulnotriquetral Ligament Ulnolunate ligament Volar radioulnar ligament Dorsal Radioulnar ligament Articular Disk
What are the borders of the anatomical snuff box?
Abductor pollicis longus tendon Extensor pollicis brevis tendon Extensor pollicis longus tendon
What are the ten structures that run through the carpal tunnel?
Four tendons of the flexor digitorum profundus Four stacked tendons of the flexor digitorum superficialis Median Nerve Flexor Pollicis Longus Tendon
Name this pathology:
Colles’ fracture
(Dorsal Displacement of the Distal Segment)
What is Preiser’s Disease?
Osteoporosis of the Scaphoid bone
What is De Quervain’s Syndrome?
Tenosynovitis of the Extensor Pollicis Brevis and Abuctor Pollicis Longus Tendons
Name this deformity:
Boutonniere Deformity
(Rupture of the central extensor tendon… extension of the MCP and DIP joints and flexion of the PIP joint)
What characterizes Bishop’s Deformity?
Weakness and atrophy of the hypothenar interossei, and medial two lumbricals. Limited extension at the PIP and DIP joints. This deformity is due to the inhibition of the ulnar nerve
Why is Volkmann’s Ischemic Contracture a life-threatening situation?
It is life-threatening because this contracture leads to a decrease in blood supply and possible a forearm compartment syndrome
Name this posture:
Dupuytren’s contracture
(caused by a shortening of adhesion of the palmar fascia. It is usually a hereditary condition)
What are the carpal bones of the distal row?
Hamate, Capitate, Trapezoid, Trapezium
Name this fracture:
Barton’s Fracture (Rim of the articular surface of distal radius)
What is a common MOI of a scaphoid fracture?
FOOSH (Fall on outstretched hand)
What is the MOI of the fracture of the body of the hamate?
Direct blow or axial load to the 4th and 5th metacarpals
What is Guyon Canal Syndrome?
Compression of ulnar nerve at the hypothenar eminence due to repetitive wrist extension and radial deviation
What is a sign for Handlebar Neuropathy?
Medial digit numbness due to direct compression from gripping
What must be ruled out first before ruling in a wrist sprain?
TFCC tears and carpal fractures
What can predispose an athlete to a TFCC injury?
A long ulna bone may predispose an athlete to a TFCC injury
Name this fracture:
Bennett’s Fracture (Fracture of the base of the 1st metacarpal bone)
Name this pathology:
Lunate Dislocation
What are signs and symptoms of a lunate dislocation?
3rd knuckle may become level with the other knuckles
Pain at wrist and along radius
May suffer from paresthesia in middle finger
What is the name for osteochondritis dissecans of the lunate bone?
Kienbock’s Disease
What is the Ape Hand deformity?
Weakness and atrophy of the muscles of the thenar eminence due to median neuropathy
What bone articulates with the trochlea of the humerus, the head of the radius and the distal end of the radius?
The Ulna
What are the extrinsic ligaments of the wrist?
Dorsal radiocarpal ligament, ulnar collateral ligament, radial collateral ligament, TFCC, palmar volar radiocarpal ligament
What are the intrinsic wrist and hand ligaments?
Radio/ulnar collateral ligaments, intercarpal ligaments, carpometacarpal ligaments, intermetacarpal ligaments, metacarpophalangeal ligaments, interphalangeal ligaments
True or False, there are muscles that originate on the phalanges.
False
Name the extrinsic thumb movers
Flexor pollicis Longus- flexion at CM, MCP and IP, Wrist flexion; Abductor Pollicis Longus- thumb ABD, thumb ext at CM, Wrist Radial Dev; Extensor Pollicis Longus- Thumb ext at CM, MCP, and IP joints, Wrist Radial Dev; Extensor Pollicis Brevis- thumb extension at MCP joint, wrist radial deviation
Which muscles radially deviate the hand?
Extensor pollicis brevis, Extensor Pollicis longus, Extensor Carpi Radialis longus, Extensor Carpi Radialis brevis, Abductor pollicis longus
Where do the lumbricals originate?
Tendons of the flexor digitorum profundus tendons
What is comprised of Guyon’s Canal?
Guyon’s Canal is between the pisiform and the hook of hamate and involves the ulnar artery and nerve passing through. The roof is made of the flexor retinaculum band. The floor is made of the pisohamate ligament.
What is a true Colles’ Fracture?
Dorsal displacement of distal fragment of the radius; 1.5 inches proximal to the radiocarpal joint
What is a Barton’s Fracture?
Rim of the articular surface of distal radius is fractured. Often involves carpal bone dislocation
Which carpal bone is the most commonly fractured?
Scaphoid bone (approx. 70%)
What is a common, absolute symptom with a hamate fracture?
Pain with 5th finger movement
True or false? A Jersey Finger deformity is an avulsion at the insertion of the extensor digitorum tendon
False. The Mallet finger is an avulsion at insertion of the extensor digitorum tendon
What is a Pseudo Boutonniere deformity?
It is a deformity that involves the injury to the volar plate, but there is no active or passive extension at the PIP joint
Which two structures are involved in De Quervain’s Syndrome?
Extensor Pollicis Brevis and Abductor Pollicis Longus
