05a: Hand

Question 1

How many hinge joints in hand?

Answer 1

10

Question 2

“Boxer fracture” is:

Answer 2

fracture of fifth metacarpal

Question 3

CMC joint in digits 2-5 is what type of joint?

Answer 3

Plane (gliding)

Question 4

CMC joint in thumb is what type of joint?

Answer 4

Saddle

Question 5

MCP joint in digits 2-5 is what type of joint?

Answer 5

Condyloid

Question 6

MCP joint in thumb is what type of joint?

Answer 6

Hinge

Question 7

PIP joint in digits 2-5 is what type of joint?

Answer 7

Hinge

Question 8

IP joint in thumb is what type of joint?

Answer 8

Hinge

Question 9

DIP joint in digits 2-5 is what type of joint?

Answer 9

Hinge

Question 10

Making a tight fist involves which motion(s) at which joint(s) for digits 2-5?

Answer 10

Flexion;

MCP, PIP, DIP

Question 11

Abduction and adduction of digits 2-5 occurs at which joint(s)?

Answer 11

MCP

Question 12

Abd/add of thumb occurs (parallel/perpendicular) to plane of palm.

Answer 12

Perpendicular

Question 13

Abd/add of thumb occurs at which joint(s)?

Answer 13

CMC

Question 14

F/E of thumb occurs (parallel/perpendicular) to plane of palm.

Answer 14

Parallel

Question 15

F/E of thumb occurs at which joint(s)?

Answer 15

CMC, MCP, IP

Question 16

Opposition of thumb occurs at which joint(s)?

Answer 16

CMC

Question 17

Collateral ligaments are found on which surface(s) of (MCP/IP) joints? They protect against which motion(s)?

Answer 17

Both MCP and IP joints;
Medial and lateral;
Protect against excessive lateral deviation

Question 18

The (dorsal/palmar) thickening of the joint capsule on MCP/IP joints serves which function(s)?

Answer 18

Palmar;

1. Centers flexor tendons
2. Guards against hyperextention

Question 19

What are the components of the flexor sheath?

Answer 19

1. Membranous portion

2. Retinacular portion

Question 20

(X) portion of the flexor sheath is between the tendon and (Y). It serves to:

Answer 20

X = membranous
Y = Retinacular portion

Promotes tendon gliding

Question 21

(X) portion of the flexor sheath is continuous with (Y) and serves to:

Answer 21

X = retinacular
Y = periosteum

Forms pulley, stabilizing the tendon

Question 22

Bowstringing of tendon occurs when:

Answer 22

Retinacular portion of flexor sheath (“pulley”) ruptures

Question 23

Juncturae Tendinum are (X) located on (dorsal/palmar) surface, proximal to (Y) joints. What’s the function?

Answer 23

X = intertendinous connections
Dorsal; Y = MCP

Link EDC tendons, restricting independent extension of fingers (couple action of digits 2-5)

Question 24

The extensor expansion (hood) is an elaboration of (X) structure.

Answer 24

X = ED tendon

Question 25

Patient can't make a round OK sign (collapsed circle). Which muscle(s)/nerve(s) are dysfunctional?

Answer 25

Anterior Interosseous nerve; FPL and FDP muscles

Question 26

Anatomical snuffbox includes (X) tendons and contains (Y) vessel(s). What's the floor?

Answer 26

``` X = EPL, EPB, Abd pollicis longus Y = radial artery ``` Scaphoid bone

Question 27

Finklestein's Test is used to assess presence of (X). What are the steps of the test?

Answer 27

X = De Quervain's Tenosynovitis 1. Make tight fist 2. Ulnar deviate 3. Sharp pain over radial styloid means positive test

Question 28

What is De Quervain's Tenosynovitis?

Answer 28

Inflammation of EPB and Abd pollicis longus tendons as they glide over radial styloid process

Question 29

Which tendon(s) pass through carpal tunnel?

Answer 29

FDS, FDP and FPL

Question 30

T/F: Ulnar artery doesn't pass through carpal tunnel.

Answer 30

True (same with ulnar nerve)

Question 31

T/F: All branches of median nerve pass through carpal tunnel.

Answer 31

False - cutaneous branch does not.

Question 32

T/F: Palmaris brevis is in the hypothenar compartment.

Answer 32

False (superficial to it)

Question 33

What are some functions of palmaris brevis?

Answer 33

1. Deepens hollow of palm (aids palmar grip) | 2. Covers/protects ulnar nerve and artery

Question 34

List the compartments of the intrinsic hand.

Answer 34

1. Thenar 2. Hypothenar 3. Adductor 4. Central

Question 35

Simian (ape) hand is a symptom that is due to (X), which results from damage to (Y).

Answer 35

``` X = thenar wasting Y = median nerve (carpal tunnel syndrome) ```

Question 36

There are (X) number of lumbricals, and they pass on the (anterior/posterior) side of the (Y) joints, just before attachment on (Z).

Answer 36

X = 4 Anterior Y = MCP Z = Extensor hood

Question 37

If IP flexion is okay with MCP extension, but tight in MCP flexion, there is tightness in (intrinsic muscles/extrinsic muscles/joint capsule).

Answer 37

Extrinsic muscles

Question 38

If IP flexion is tight with MCP extension and tight in MCP flexion, there is tightness in (intrinsic muscles/extrinsic muscles/joint capsule).

Answer 38

IP joint capsule

Question 39

If IP flexion is tight with MCP extension, but okay in MCP flexion, there is tightness in (intrinsic muscles/extrinsic muscles/joint capsule).

Answer 39

Intrinsic muscles

Question 40

There are (X) number of dorsal interossei and (Y) number of palmar interossei.

Answer 40

``` X = 4 Y = 3 ```

Question 41

(X) deformity: Laxity of the volar plate causes slippage of (Y). This causes which action(s) at which joint(s)?

Answer 41

``` X = swan neck Y = collateral ligaments ``` Hyperextention at PIP; flexion at DIP

Question 42

(X) deformity: rupture of central tendon, through which (Y) protrudes. This causes which action(s) at which joint(s)?

Answer 42

``` X = boutonniere Y = PIP joint ``` PIP flexion; DIP extension

Question 43

(X) deformity: extensor tendon laxity, resulting in decreased efficiency of (Y). This causes which action(s) at which joint(s)?

Answer 43

``` X = mallet Y = extensor hood ``` Inability to extend DIP

Question 44

Tenodesis refers to:

Answer 44

Increase in grasp strength when wrist is extended, due to increase in distance over which flexors act

Question 45

Patients with (X) injury rely on tenodesis grasp for functional activity.

Answer 45

X = C6 SC