01 Pathology of the Hand Flashcards Preview

7202 Anatomy > 01 Pathology of the Hand > Flashcards

Flashcards in 01 Pathology of the Hand Deck (19):
1

most common level of quadriplegia

C5-6

2

tenodesis grip

when one extends the wrist and gets finger flexion

3

If you have a rupture of the pulleys and bowstringing, what occurs

person is grabbing something and fingers are forcibly extended; kind of stuck in this position
(picture on slide 29)

4

zig-zag deformities of the fingers

-Boutonniere
-Swan-Neck

5

Boutonniere Deformity

- flexion of the PIP
- hyperextension of the DIP

slipped lateral band (from central tendon rupture) causes flexion where there should be extension in the PIP

6

Swan-Neck Deformity

- hyperextension of the PIP
- flexion of the DIP

7

Rheumatoid Arthritis (RA) (Stages of Development)

1) Ulnar forces produce a natural bowstringing force on extensor digitorum » pannus formation occurs

2) Rupture of the dorsal hood transverse fibers allows the extensor tendon to increase ulnar deviation at MCP joint (greater moment arm)

3) Over time, RCL may rupture, resulting in ulnar drift deformity

8

What is pannus formation in RA development and where does it occur?

on the radial side at MCP joint= a calcium deposit that is growing out of the synovium)

9

Progressive dislocation

A) bend in tendons of flexor digitorum superficialis and flexor digitorum profundus across MCP joint produces palmar directed, bowstringing dorce against palmar plate, associated pulley and collateral ligaments.

B) with RA, bowstringing force can rupture weakened collateral ligaments and as a result, proximal phalanx may eventually dislocate.

10

Common deformities caused by severe RA

-Palmar dislocation of MCP joint
-Ulnar drift of fingers
-Swan-neck deformity
-Boutonniere deformity

11

Zig-Zag pathology of the thumb

-Due to RA:

Thumb dislocates laterally at the CMP joint, causing hyperextension at MCP joint

IP joint remains partially flexed

12

mallet finger

Distal phalanx is flexed due to direct blow to fingers, and at distal phalanx where extensors insert

It ruptures and is pulled away from bone

13

Where does the median nerve enter the hand

through the carpal tunnel

14

ulnar nerve pathway

- Passes lateral to the pisiform along with the ulnar artery in Guyon's tunnel.

-Branches into deep and superficial ulnar nerves

15

deep ulnar nerve

supplies all of the muscles of the hand, except the 3 thenar muscles and 2 lateral lumbricals

16

Superficial ulnar nerve

Cutaneous, supplying the medial 1.5 digits and the dorsal and palmar surfaces of the medial aspect of the hand

17

Ulnar nerve Lesion

-atrophy over the region of the 1st dorsal interosseus muscle
-paralysis of the adductor pollicis

18

What does the ulnar synovial sheath surround?

Tendons of the flexors digitorum superficialis and profundus

19

What does the radial synovial sheath surround

Tendon of the flexor pollicis longus