02 Wrist Flashcards Preview

7232 Ortho > 02 Wrist > Flashcards

Flashcards in 02 Wrist Deck (42):
1

Atrophy of the thenar eminence would indicate involvement of which nerve?

median

2

no man's land
- borders
- significance

- proximal palmar crease
- proximal interphalangeal crease
- flexor tendon is hard to operate on (results in stiffness, hard to get tendon gliding back to normal)

3

Where is the distal palmar crease

roughly at the line of the MCP joint

4

digital palmar crease

palmar side, base of fingers

5

observation/palpation
what to look for

- not difference between injured and non-injured hand
- if they have a lot of swelling on the dorsal side of the hand, could still be an injury on the palmar side

6

Why do you get swelling on the dorsal side of the hand with a palmar injury?

- edema migrates to dorsum because there's more room
- palmar aponeurosis gets in the way

7

Lister's tubercle

bony nodule ⅓ of the way across the radius

8

palpations
scaphoid

- base of anatomical snuff box
- most commonly fractured bone in the hand

9

palpations
trapezium

- base of 1st metacarpal
- have patient flex and extend to make it pop out

10

palpations
trapezoid

not distinctly palpable, just know it's next to trapezium

11

palpations
capitate

- distal to Lister's tubercle
- feel the cavity - this is where the capitate sits

12

palpations
lunate

- proximal to capitate, sits just behind it
- must have pt flex the wrist to pop it out
- second most commonly fractured bone in the hand
- most commonly dislocated bone in the hand

13

palpations
ulnar styloid process

- may have a nodule or pain with RA or Colle's fx
- articulates with TFCC

14

palpations
triquetrum

- distal to ulnar styloid process
- have pt radially deviate to pop out
- 3rd most commonly fractured bone in the hand

15

palpations
pisiform

sesamoid bone palmar aspect of hand

16

palpations
hook of hamate

- turn tip of thumb toward fingers from the pisiform

17

What forms the tunnel of Guyon?

- borders of hook of hamate and pisiform

18

What runs through the tunnel of Guyon?

- ulnar nerve
- ulnar artery

19

Tunnel locations in the hand are determined based on

where they come out of the wrist, not their hand attachment

20

Tunnel 1
- location/how to see it
- what's in it?

in snuffbox
- abductor pollicis longus
- extensor pollicis brevis

21

Tunnel 2
- location/how to see it
- what's in it?

have pt make a fist and extend » between 2nd and 3rd metacarpal
- ECRL
- ECRB

22

Tunnel 3
- what's in it?

EPL

23

Tunnel 4
- how to see it
- what's in it?

extend the wrist and hand
- extensor digitorum
- extensor indicis

24

Tunnel 5
- what's in it?

extensor digiti minimi

25

Tunnel 6
- how to see it
- what's in it?

- flex and ulnarly deviate, palpable
- extensor carpi ulnaris

26

flexor carpi ulnaris - palpate

flex and ulnarly deviate

27

palmaris longus - palpate

- pinky/thumb opposition
- FDS lies beneath

28

What's in the carpal tunnel?

- 4 tendons of FDS
- 4 tendons of FDP
- FPL

29

flexor carpi radialis - palpate

- radial to palmaris longus
- flex and radially deviate

30

goniometric measurements of the wrist

- flexion
- extension
- radial deviation
- ulnar deviation

31

gonio norms
wrist extension

70˚

32

gonio norms
wrist flexion

80˚

33

gonio norms
radial deviation

20˚

34

gonio norms
ulnar deviation

30˚

35

gonio
axis of motion for flexion/extension

triquetrum

36

gonio
flexion/extension - position

- hand off table
- axis of motion is triquetrum
- stationary arm midline of forearm
- moveable arm follows 5th metacarpal

37

gonio
radial and ulnar deviation - axis of rotation

capitate

38

gonio
radial and ulnar deviation - position

- axis is capitate
- stationary arm midline of forearm
- moveable arm follows 3rd metacarpal

39

MMT
extension

- stabilize under the wrist
- apply pressure to dorsum

40

MMT
flexion

- stabilize under wrist so you're not on top of muscles contracting

41

MMT
ulnar deviation

- extend and ulnarly deviate
- apply pressure toward radius

42

MMT
radial deviation

- flex and radially deviate
- apply pressure toward ulna