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Orthopedic Diagnosis > Forearm, Wrist, & Hand > Flashcards

Forearm, Wrist, & Hand Flashcards

(86 cards)

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1
Q

The carpus is made up of how many bones?

A

8

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2
Q

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

A

90%

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3
Q

The thumb is involved in what percent of hand function?

A

40-50%

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4
Q

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

A

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

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5
Q

Colles Fracture

A

aka dinner fork fracture

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

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6
Q

Smith’s fracture

A

aka garden spade deformity

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

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7
Q

TFCC

A

triangular fibrocartilage complex

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

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8
Q

What is the primary function of the TFCC

A

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

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9
Q

What is the most commonly fractured carpal?

A

Scaphoid (aka navicular)

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10
Q

Mid Carpal Joints

A

lie between the two rows of carpals

a compound articulation because each row has both a concave and convex segment

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11
Q

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

A

convex laterally

concave medially

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12
Q

Carpometacarpal joints

A

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

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13
Q

What provides stability for the carpometacarpal joints

A

the palmar and dorsal carpometacarpal and intermetacarpal ligaments

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14
Q

Metacarpophalangeal joints

A

biaxial joints

allow for flexion-extension and medial-lateral deviation

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15
Q

First carpometacarpal joint

A

sellar (saddle shaped) joint

functionally the most important CMC joint

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16
Q

what is the attitude of the hand at rest?

A

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

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17
Q

Bennett’s fracture

A

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

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18
Q

Metacarpophalangeal joint of the thumb

A

hinge joint

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

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19
Q

Bar room fracture

A

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

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20
Q

Boxer’s fracture

A

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

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21
Q

Interphalangeal Joints

A

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

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22
Q

Herberden’s Nodes

A

distal joints are enlarged by hard nodules

painless, motion is unlimited

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23
Q

Where are herberden’s nodes not found?

A

the thumb

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24
Q

Herberden’s Nodes in women

A

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

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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

Orthopedic Diagnosis (10 decks)

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