Forearm, Wrist, & Hand Flashcards Preview

Orthopedic Diagnosis > Forearm, Wrist, & Hand > Flashcards

Flashcards in Forearm, Wrist, & Hand Deck (86):
1

The carpus is made up of how many bones?

8

2

What percentage of upper limb function does the hand account for?

90%

3

The thumb is involved in what percent of hand function?

40-50%

4

What type of joint is the distal radio-ulnar joint?

a double pivot joint that unites the distal radius with the ulna and an articular disc

5

Colles Fracture

aka dinner fork fracture
fracture of the radius within 20-35mm of the wrist with posterior angulation of the distal fragment

6

Smith's fracture

aka garden spade deformity
fracture of the radius within 20-35 mm of the wrist joint with anterior angulation of the distal fragment.

7

TFCC

triangular fibrocartilage complex
fibrocartilage disc between the medial, proximal row of carpals and the distal ulna

8

What is the primary function of the TFCC

to improve joint congruency and cushion against compressive forces
transmits about 20% of the axial load from the hand to the forearm

9

What is the most commonly fractured carpal?

Scaphoid (aka navicular)

10

Mid Carpal Joints

lie between the two rows of carpals
a compound articulation because each row has both a concave and convex segment

11

Where are the concave and convex segments located on the proximal row of carpals?

convex laterally
concave medially

12

Carpometacarpal joints

articulation between the distal borders of the distal carpal row bones and the bases of the metacarpals

13

What provides stability for the carpometacarpal joints

the palmar and dorsal carpometacarpal and intermetacarpal ligaments

14

Metacarpophalangeal joints

biaxial joints
allow for flexion-extension and medial-lateral deviation

15

First carpometacarpal joint

sellar (saddle shaped) joint
functionally the most important CMC joint

16

what is the attitude of the hand at rest?

MCP's and IP's are held in a position of slight flexion

17

Bennett's fracture

fracture through the base of the first metacarpal neck with dorsal and radial displacement of the shaft

18

Metacarpophalangeal joint of the thumb

hinge joint
consistes of a convex surface on the head of the metacarpal and a concave surface on the base of the phalanx

19

Bar room fracture

fracture of the fourth or fifth metacarpal neck with anterior displacement of the head

20

Boxer's fracture

fracture of the second or third metacarpal neck with anterior displacement of the head

21

Interphalangeal Joints

adjacent phalanges articulate in hinge joints that allow motion in one plane

22

Herberden's Nodes

distal joints are enlarged by hard nodules
painless, motion is unlimited

23

Where are herberden's nodes not found?

the thumb

24

Herberden's Nodes in women

localized process of OA
usually hereditary
commonly involves more than one joint

25

Herberden's nodes in men

generally as a result of trauma
usually involves just one joint

26

Bouchard's Nodes

abnormal fusiform enlargement at the pip joint which can indicate synovitis secondary to RA

27

Swan neck deformity

PIP joint deforms into hyperextension and the DIP is flexed

28

MOI of Swan Neck Deformity

Rheumatoid Arthritis

29

Boutonniere deformity

PIP is flexed, DIP is extended
central slip of the extensor digitorum communis tendon is avulsed from the insetion into the base of the middle phalanx

30

Which ligaments provide a majority of the wrist stability

extrinsic palmar ligaments

31

Which ligaments serve as rotational restraints in the wrist?

intrinsic ligaments
they bind the proximal row into a unit of rotational stability

32

carpal ligaments

the major ligaments of the wrist include the palmar intrisic ligaments, the volar extrinsic ligaments and the dorsal extrinsic and intrinsic ligaments

33

Radiocarpal joint

formed by the large articular concave surface of the distal end of the radius, the scaphoid, lunate, and the TFCC

34

Antebrachial fascia

a dense connective tissue bracelet that encases the forearm and maintains the relationships of the tendons that cross the wrist

35

Extensor retinaculum

serves to prevent the tendons from "bow-stringing" when they turn a corner at the wrist

36

what is the fibroosseous compartment

the tunnel like structure formed the the retinaculim and underlying bones

37

Flexor retinaculum

transforms the carpal arch into a tunnel

38

What is the proximal attachment of the flexor retinaculum

the tubercle of the scaphoid and pisiform

39

What is the distal attachment of the flexor retinaculum

to the hook of the hamate and the tubercle of the trapezium

40

Jersey Finger

avulsion of the flexor digitorum profundus tendon

41

What is the MOI of Jersey Finger

the finger gets caught in an object and actively flexed DIP joint is suddenly and forcibly extended resulting in a rupture

42

Carpal Tunnel

serves as a conduit for the median nerve and nine flexor tendons

43

What comprises the floor of the carpal tunnel

the palmar radiocarpal ligament and palmar ligament complex

44

What comprises the roof of the carpal tunnel

the flexor retinaculum aka the transverse carpal ligament

45

What makes up the ulnar border of the carpal tunnel?

the trapezium

46

what makes up the radial border of the carpal tunnel

the hook of hamate

47

Tunnel of Guyon

a depression superficial to the flexor retinaculum, located between the hook of hamate and pisiform

48

What makes up the roof of the tunnel of guyon?

the palmar (volar) carpal ligament, palmaris brecis muscle, and the palmar aponeurosis

49

What makes up the floor of the tunnel of guyon

the flexor retinaculum (aka transverse carpal ligament), pisohamate ligament, and pisometacarpal ligament

50

What runs through the tunnel of guyon?

the ulnar nerve and artery

51

Cyclist Hand

ulnar nerve and artery compression

52

palmar aponeurosis

a dense fibrous structure continuous with the palmaris longus tendon and fascia covering the thenar and hypothenar muscles

53

Dupuytren's contracture

a fibrotic condition of the palmar aponeurosis that results in nodule formation or scarring of the aponeurosis which may cause finger flexion contractures

54

extensor hood

a complex tendon which covers the dorsal aspect of the digits, formed from a combination of the tendons of insertion from extensor digitorum, extensor indicis, and extensor digiti minimi

55

mallet finger

terminal phalanx of the finger is permanently flexed at the distal joint, it cannot be voluntarily extended
rupture of the extensor tendon that inserts on the terminal phalanx with possible fracture of the distal phalanx

56

synovial sheaths

long narrow balloons filled with synovial fluid, which wrap around a tendon so that one wall is directly on the tendon (visceral layer) and the other wall is separate (parietal layer)

57

Where is surgical no man's land?

the distal palmar crease to the PIP joints

58

Trigger finger

usually involves the fourth or fifth finger
flexion of the finger feels normal, but re-extension is accompanied by a painful snap

59

Which muscles are superficial in the anterior compartment of the forearm

pronator teres, flexor capi radialis, palmaris longus, flexor carpi ulnaris

60

Which muscle is intermediate in the anterior compartment of the forearm

flexor digitorum superficialis

61

Which muscles are deep in the anterior compartment of the forearm

flexor pollicis longus, flexor digitorum profundus, pronator quadratus

62

Which muscles are superficial in the posterior compartment of the forearm

extensor carpi radialis longus and brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris

63

Which muscles are deep in the posterior compartment of the forearm

abductor pollicis longus, extensor pollicis longus and brevis, extensor indicis

64

What forms the floor of the anatomical snuff box?

the scaphoid

65

what forms the ulnar border of the anatomical snuff box

extensor pollicis longus tendon

66

what forms the radial border of the anatomical snuff box

abductor pollicis longus

67

De Quervains Disease

aka stenosing tenosynovitis
overuse and repetitious ulnar and radial deviation of the wrist

68

which are the short muscles of the thumb

abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, adductor pollicis

69

Skier's thumb

aka Gamekeeper's thumb
ulnar collateral ligament avulsion of the MCP joint

70

which are the short muscles of the fifth digit

abductor digiti minimi, flexor digiti minimi, opponens digiti minimi

71

What is the function of the three palmar interossei muscles

each functions to adduct the digit to which it is attached toward the middle digit

72

What is the function of the four dorsal interossei muscles

each functions to abduct the index, middle, and ring fingers from the mid-line of the hand

73

What is the function of the lumbricales?

to perform the motion of IP joint extension with the MCP joint held in extension

74

what are the functional arches of the hand?

the transverse, metacarpal, longitudinal, and oblique arches

75

The transverse arch

formed within the palmar concavity of the carpal bones, scaphoid and trapezium laterall yand pisiform and hamate medially

76

The metacarpal arch

formed by metacarpal heads

77

the longitudinal arch

formed by the third and fifth digit, spans lengthwise, keystone at the MCP joints

78

The oblique arches

formed by the thumb in opposition to the other fingers

79

Keinboch's Disease

aka avascular necrosis of lunate
usually unilateral after trauma or occupational excessive dominant hand use
presents with localized and radiating wrist pain, swelling & disability

80

What types of grips are known as power grips?

fist, cylindrical, ball, hook
digits work together to provide support and static control

81

Which grips are precision/prehension grips

chuck aka three finger pinch
lateral or key pinch grip
tip pinch grip
digits work provide control by working with the thumb to form a tripod for precision handling

82

Spoon nails

natural convexity is replaced by concave nails in a saucer form
nail plate is thinner and weaker
result of a severe fungus infection

83

Clubbed nails

pulmonary disease is the most common cause, followed by cardiovascular disease

84

Felon

inflammation of the terminal finger pad is confined by tough fascia attached to the periosteum
presence of pus is indicated by induration of the pulp and loss of resilience
pressure may cause the abscess to burst through the volar surface of the finger pad

85

Paronchia

aka hangnail
skin over the mantle of the nail and the lateral nail folds is swollen, reddened, painful and tender

86

thrower's wrist

over extension of the carpals, possibly straining or spraining structures