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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
Q

What are the flexors of the wrist ?

A

Main: Flexor carpi ulnaris, Flexor carpi radialis, Palmaris longus
Also: Flexor digitorum superficialis, Flexor digitorum profundus, Flexor pollicis longus:

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26
Q

What is the origin and insertion of the main flexors the wrist ?

A

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
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27
Q

What is the common flexor origin of the wrist flexors ?

A

Medial Epicondyle

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28
Q

What are other functions of flexor carpi ulnaris and radialis in addition to flexing the wrist ?

A

FLEXOR CARPI ULNARIS
-Adducting the hand

FLEXOR CARPI RADIALIS
-Abducting the hand

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29
Q

How are the flexors of the wrist innervated ?

A
  • Flexor carpi ulnaris: ulnar nerve
  • Flexor carpi radialis, palmaris longus, flexor digitorum superficialis, Flexor digitorum profundus, Flexor pollicis longus: median nerve
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30
Q

At the wrist, where are the ulnar vessels and the ulnar nerve located relative to the tendon of the flexor carpi ulnaris ?

A

At the wrist, ulnar vessels and the ulnar nerve is immediately lateral to the tendon of the flexor carpi ulnaris

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31
Q

Where does the ulnar nerve pass relative to the flexor carpi ulnaris ?

A

Ulnar nerve passes between the two heads of the flexor carpi ulnaris

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32
Q

What are the flexors of the ankle ?

A

Main: Triceps surae (Gastrocnemius, soleus and plantaris), and Tibialis posterior
Also: Flexor digitorum longus, Flexor hallucis longus

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33
Q

What is the origin and insertion of the main flexors of the ankle ?

A 
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
Q

How are the flexors of the ankle innervated ?

A

By the tibial nerve

35
Q

What two muscles participate in inversion of the foot ?

A

Tibialis posterior (its main function) and tibialis anterior

36
Q

What muscles supports the medial plantar longitudinal arch ?

A

Tibialis posterior and Tibialis anterior

37
Q

What actions of the body (more general than flexion of the ankle) does the triceps surae perform ?

A
  • propels the body forward off the planted foot during walking
  • elevates the body upward onto the toes when standing
38
Q

What are the extensors of the wrist ?

A

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
Q

What is the origin and insertion of the main extensors of the wrist ?

A

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
Q

How are the extensors of the wrist innervated ?

A

Radial nerve

41
Q

What is the common extensor origin of the wrist extensors ?

A

Lateral epicondyle of the humerus

42
Q

What action of the hand (other than extension of the wrist) do the extensors of the wrist perform ?

A

Flexion of the fingers (gripping)

43
Q

What are the extensors of the ankle ?

A

Main: Tibialis Anterior
Also: Extensor hallucis longus , Extensor digitorum longus, Fibularis tertius

44
Q

What is the origin and insertion of the main extensor of the ankle ?

A

TIBIALIS ANTERIOR
Origin: Lateral condyle and superior-lateral surface of tibia and interosseous membrane
Insertion: medial cuneiform and base of 1st metatarsal

45
Q

What is another name for extension of the ankle ?

A

Dorsiflexion

46
Q

How is the main extensor of the ankle innervated ?

A

Tibialis anterior, as with all muscles in the anterior compartment of the leg is supplied by the deep peroneal nerve

47
Q

Are the adductors of the wrist joint located on the ulnar or radial side ? The abductors of the wrist ?

A

Adductors of wrist joint:
• Positioned on ulnar side

Abductors of wrist joint:
• Positioned on more towards
radial side

48
Q

What are the adductors of the wrist ?

A

Extensor carpi ulnaris

Flexor carpi ulnaris

49
Q

What are the abductors of the wrist ?

A

Extensor carpi radialis longus, and brevis
Flexor carpi radialis
Abductor pollicis longus

50
Q

Classify the following joints:

  1. Radiocarpal
  2. Intercarpal
  3. Intermetarpal & Carpo-Metacarpal
  4. Metacarpo-phalangeal
  5. Interphalangeal
A
  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
Q

What movements are allowed at the following joints ?

  1. Radiocarpal
  2. Intercarpal
  3. Intermetarpal & Carpo-Metacarpal
  4. Metacarpo-phalangeal
  5. Interphalangeal
A

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
Q

Classify the following joints:

  1. Distal Tibiofibular
  2. Ankle
  3. Intertarsal
  4. Intermetatarsal and Tarso-Metatarsal
  5. Metatarsophalangeal
  6. Interphalangeal
A
  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
Q

What movements are allowed at the following joints ?

  1. Distal Tibiofibular
  2. Ankle
  3. Intertarsal
  4. Intermetatarsal and Tarso-Metatarsal
  5. Metatarsophalangeal
  6. Interphalangeal
A

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
Q

Name the different intertarsal joints.

A

Talo-calcaneo-navicular joint
+ Calcaneo-cuboid joint
=Transverse tarsal joint

Subtalar (Talocalcaneal) joint

55
Q

What is the difference between intercarpal, midcarpal and Pisotriquetral joints ?

A 
Intercarpal joints between carpals (within prox or dist rows)
Midcarpal joint (between rows)
Pisotriquetral joint between pisiform and triquetral bone
56
Q

At which joints does extension and abduction of the hand occur ?

A

At midcarpal joint

57
Q

Which of distal or proximal row is more mobile ?

A

Proximal row is most mobile

58
Q

Which articular feature of the hand favors the spread of infection ?

A

Intercarpal, midcarpal, and pisotriquetral joints share common articular cavity with CMC joint

59
Q

What two bones make up the subtalar joint ?

A

Talus and calcaneus

60
Q

Which structures reinforce the subtalar joint ?

A

Ligaments, including interosseal ligament of the subtalar joint

61
Q

What are the components of the Transvers tarsal joint ?

A

Talonavicular part of TCN + CC

62
Q

What movements does the Transvers tarsal joint participate in ?

A

Inversion and eversion

63
Q

What is the site for surgical amputation of foot ?

A

Transverse tarsal joint

64
Q

What important ligaments support the joints and plantar arches ?

A
  • Long plantar ligament

- Spring ligament: supports head of talus, and much of the body weight

65
Q

What are movements at CMC-1 joint ?

A

Flexion, Extension
Abduction, Adduction
Opposition of thumb

66
Q

What bones make up the CMC-1 joint ?

A

Trapezium and first metacarpal

67
Q

Which characteristic of the CMC-1 joint gives it increased mobility ?

A

Loose joint capsule

68
Q

True or false: CMC-1 has separate articular cavity.

A

True

69
Q

What are the extrinsic flexors of the fingers ?

A

Flexor digitorum superficialis, Flexor digitorum profundis, Flexor pollicis longus

70
Q

What is the origin and insertion of the extrinsic flexors of the fingers ?

A

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
Q

How are the extrinsic flexors of the fingers innervated ?

A

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
Q

What is meant by extensor expansion/dorsal digital expansions ?

A

Expansion of the tendons of the extensor digitorum and extensor pollicis longus muscles over the proximal phalanges

73
Q

What are the extrinsic extensors of the fingers ?

A

Extensor pollicis longus, Extensor pollicis brevis, Extensor indicis, Extensor digitorum, Extensor digiti minimi

74
Q

What is the origin and insertion of the extrinsic extensors of the fingers ?

A

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
Q

How are the extrinsic extensors of the fingers innervated ?

A

All extrinsic extensors of the fingers are supplied by the radial nerve

76
Q

Where and how are the extensor communis tendons of the fingers joined together ?

A

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
Q

What are the extrinsic extensors of the toes ?

A

Extensor hallucis longus
Extensor digitorum longus
Fibularis tertius

78
Q

What is the origin and insertion of the extrinsic extensors of the toes ?

A

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
Q

How are the extrinsic extensors of the toes innervated ?

A

All are supplied by the deep fibular [peroneal] nerve

80
Q

What are the extrinsic flexors of the toes ?

A

Flexor digitorum longus and Flexor hallucis longus

81
Q

What is the origin and insertion of the extrinsic flexors of the toes ?

A

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
Q

How are the extrinsic flexors of the toes innervated ?

A

All muscles in the posterior compartment of the leg are supplied by the tibial nerve

MD2002 Arvin (110 decks)

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