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1Principles of Biomedicine - MD1 > 134 - Joints of Upper Limb 3. Wrist Complex & Joints of Hand > Flashcards

134 - Joints of Upper Limb 3. Wrist Complex & Joints of Hand Flashcards

1
Q

Rows of phalanges in hand
1
2
3

A

Proximal, middle, distal

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2
Q

Orientation of metacarpal of the thumb

A

At right angle to other digits

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3
Q

Two nodular bones on thumb metacarpal

A

Sesamoid bones

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4
Q

Number of phalanges in thumb

A

Two

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5
Q

Bones forming the proximal row of carpal wrist

A

(Radius) Scaphoid, lunate, triquetrum, pisiform (last to ossify) (Ulna)

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6
Q

Bones forming the distal row of carpal wrist

A

Trapezium, trapezoid, capitate (largest & 1st to ossify), hamate (with hook)

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7
Q

Bone forming the floor of the anatomical snuffbox

A

Scaphoid bone

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8
Q

Example of a sesamoid bone of the wrist

A

Trapezoid bone

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9
Q

Proximal border of the flexor retinaculum

A

Corresponds to location of distal wrist crease

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10
Q

Which wrist bone does the ulna sit across from?

A

Triquetral bone

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11
Q

Largest bone in the wrist

A

Capitate

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12
Q

Bone likely to break when falling on an outstretched hand

A

Radius most likely.

Force passes through the capitate, as it is the largest, into radius.

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13
Q

When do carpal bones commence ossification?

A

After birth

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14
Q

First bone in wrist to ossify?

A

Capitate

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15
Q

Order of ossification of carpal bones

A

Starts at capitate, goes in a counterclockwise direction

capitate->hamate->etc

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16
Q

Age at which pisiform ossifies?

A

~10-13 years.

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17
Q

Last carpal bone to ossify

A

Pisiform

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18
Q

Orientation of base and head of metacarpals

A

Base is proximal, head is distal

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19
Q

When do ossification centres of metacarpals fuse?

A

Early teens

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20
Q

Bones areticular at the wrist

A

Scaphoid, lunate, radius.

Triquetral bone slides across, articulates with ulan when hand is bent laterally

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21
Q

Midcarpal joint

A

Where carpal bones articulate with one another.

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22
Q

Joints in the wrist complex
1
2

A

•2 joints:

  • Radiocarpal - ellipsoid
  • Intercarpal (midcarpal) - condylar
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23
Q 
Movements at the wrist complex
1
2
3
4
A 
•Biaxial movements
-flexion/extension
-radial/ulnar deviation
Circumduction 
-flexion > extension (F/E)
-ulnar deviation > radial (UD/ RD)
24
Q

Type of joint that radiocarpal joint is

A

Synovial ellipsoid joint

25
Q

Shape of radiocarpal joint

A

Articular surfaces concave in 2 directions

26
Q

Why is wrist flexion greater than extension?

A

Posterior radius projects more distally than anterior.

27
Q

Why is ulnar deviation greater than radial deviation?

A

Radial stiloid stops movement. Because of radial articulation with scaphoid, lunate

28
Q

Where are intercarpal joints?

A

Between proximal & distal carpal row (excluding pisiform)

29
Q 
Aspects of intercarpal joints 
1
2
3
4
A

•‘Functional’ rather than ‘anatomic’ joint
•No single joint capsule – each bone forms separate unit
•Concave-convex surfaces
•Movements generally opposite to wrist :
-extension > than flexion
-radial deviation > ulnar

30
Q

How do vessels go to carpal bones?

A

Travel with radiocarpal ligaments

31
Q

Two groups of radiocarpal ligaments

A

Palmar

Dorsal

32
Q

Palmar radiocarpal and ulnarcarpal ligament shape

A

Oblique bands from distal radius and distal ulnar

33
Q

Are palmar or dorsal ligaments stronger?

A

Palmar

34
Q

Are radiocarpal or ulnarcarpal ligaments stronger?

A

Radiocarpal

35
Q

Where do forearm flexor muscles attach distally?

A

Beyond carpal region, attach to proximal aspects of metacarpals

36
Q

Only forearm flexor that attaches to a carpal bone

A

Flexor carpi ulnaris

37
Q

Proportion of all fractures and dislocations that are of the wrist

A

6%

38
Q

Name for fracture of distal radius

A

Colles’ fracture

39
Q

Colles’ fracture

A

Fracture of distal radius.

Distal radius pulled downwards.

40
Q

Most commonly broken carpal bone

A

Scaphoid

41
Q

Most commonly subluxed carpal bone

A

Lunate.

42
Q

When is lunate commonly subluxed?

A

Secondary to ligament (radio-scaphoid-lunate) injury

43
Q

Bennett’s fracture

A

Fracture of base of the 1st metacarpal (thumb).

Fracture into the carpometacarpal joint..

44
Q

Type of joint between 1st metacarpal and trapezium bone

A

Saddle joint

45
Q

Dangerous blood supply to scaphoid bone

A

~30-35% have vascular foramina entering at distal pole of scaphoid. If scaphoid is fractured through the waist of the bone, you can have interrupted blood supply to proximal scaphoid. This leads to avascular necrosis.

46
Q

Carpal bone - other than the scaphoid - that suffers from avascular encrosis

A

Lunate. Not really known why

47
Q

What links metacarpals 2 - 4

A

Linked by deep transverse metacarpal ligament (all fingers linked, thumb is free)

48
Q

What does carpometacarpal joint allow?

A

It is the thumb ‘saddle joint’.

Enables opposition of thumb

49
Q

Type of joints of metacarpals 2 and 3

A

Immobile

50
Q

Type of joints of metacarpals 4 and 5

A

Hinge joints (flexion/extension)

51
Q

Why is it important to detect Bennett’s fractures early?

A

Abductor pollicis longus and adductor pollicis brevis attach to base of 1st metacarpal.
If there is a fracture, these muscles can pull bone apart.

52
Q

Street fighter’s fracture

A

Fracture of the 5th metacarpal

53
Q

Why is it hard to abduct fingers when wrist is flexed?

A

As you flex, collateral ligaments tighten, making abduction more difficult.

54
Q

How are wrists immobilised?

A

In slight flexion at wrist joint and metacarpophalyngeal joint

55
Q

Type of joints that metacarpophalyngeal joints are

A

Condyloid joints.
Convex head of metacarpal with concave base of phalanx. Note articular surface of head of metacarpal more extensive than phalanx

56
Q

Volar plate

A

Fibrocartilaginous plate expands surface area for articulation in metacarpophalangeal joints - also at interphalangeal joints

57
Q

Swan neck injury

A

Hyperextension of finger leads to compensatory flexion

1Principles of Biomedicine - MD1 (157 decks)

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