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Flashcards in Hand & Wrist Deck (133)
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1

`Describe the blood supply to the scaphoid? What is the main supply?

Dorsal carpal branch of the radial artery is the main - supplies 80% Also: Superficial palmar branch of the radial artery

2

Which ligament is violated and must be repaired in the volar approach to the scaphoid?

Radioscaphocapitate ligament

3

Which ligament is the strongest ligament that resists perilunate dislocations in the wrist?

Long radiolunate ligament

4

What is the weakest point in the volar wrist?

Space of Poirier

5

What is the significance of the Space of Poirier?

It is the weakest point in the volar wrist and is where volar lunate dislocations occur most often.

6

Where is the Space of Poirier located?

Volar wrist at the junction of the Lunate and Trapezium/Trapezoid

Bordered by the Radiocapitate & Radiolunotriquetral ligaments (aka long radiolunate)

7

What "ligament" in the wrist is actually a neurovascular bundle?

Radioscapholunate ligament

8

What are the components of the radioscapholunate ligament?

Vascular branches of the anterior interosseous and radial arteries Nerve branches of the anterior interosseous nerve

9

Where is the radioscapholunate ligament found?

Between the long and short radiolunate ligaments, piercing the joint capsule

10

What are the components of the TFCC?

Triangular fibrocartilage disc (articular disc)

Meniscus homolog (disc-carpal ligaments)

Volar Ulnocarpal ligaments (ulnolunate & ulnotriquetral)

Dorsal and volar Radioulnar ligaments (palmar & dorsal, each with a superficial & deep component)

ECU subsheath

11

What is the ligament of Testut?

Radioscapholunate ligament. Actually a neurovascular bundle with no contribution to carpal stability

12

What are the contents of the anatomical snuffbox?

Radial artery Sensory branch of the radial nerve Wrist joint capsule Fat

13

What are the borders of the anatomical snuffbox?

Trianglr: Anterior: EPB, ABL Posterior: EPL (extensor compartments 1&3) Base: radial stylus process Floor: scaphoid & trapezium

14

What are the stabilizers of the DRUJ?

Extrinsic:

ECU tendon & Subsheath

Pronator quadratus

Interosseous membrane

Joint capsule

TFCC

Intrinsic:

Bony contact

Superficial radioulnar ligaments - origina at ulnar styloid

Deep radioulnar ligaments (ligamentum subcruentum) origin at fovea

 

15

What are the components of the scapholunate ligament?

Dorsal (strongest) Palmar Proximal (thin, membranous)

16

What is a lesser arc injury?

Purely ligamentous perilunate injury

17

What is a greater arc injury?

Fracture around the lunate - scaphoid, capitate, hamate, triquetrum

18

What are the extrinsic ligaments of the dorsal wrist?

Dorsal radiocarpal ligaments Dorsal intercarpal ligaments

19

What is Kienbock's disease?

Avascular necrosis of the lunate.

20

Why do perilunate dislocations usually NOT end up in AVN?

Because it has a rich blood supply including: Dorsal and volar radial branches Branches of the dorsal and volar intercarpal arch Anterior interosseous artery

21

How many articulations does the scaphoid have?

5 Radius, capitate, lunate, trapezoid, trapezium

22

What is intersection syndrome?

Overuse condition affecting the second dorsal compartment - ECRL and ECRB

23

What is DeQuervain's tenosynovitis?

Inflammation of the tenosynovium of the abductor pollicis longus and extensor pollicis brevis tendons

Affects 1st dorsal compartment

Diagnosed with Finklestein's test - Increase in pain when the thumb is held in palm and wrist is ulnarly deviated - Pain is over the radial side of the wrist (1st dorsal compartment)

24

What is Wartenberg's Syndrome

Radial neuritis - Neuritis of the superficial branch of the radial nerve - Inflammation due to stretch, compression or direct blow - Compression occurs between the brachioradialis and ECRL

25

Describe Eaton's classification of the radiographic stages of thumb CMC OA

1: Normal

2: Joint spacer narrowing, osteophytes 2mm

3: Joint space narrowing, osteophytes >2mm

4: pantrapezial arthritis

26

What is the bony articulation of the distal radioulnar joint?

Sigmoid notch of the radius articulation with the ulna

i.e. "lesser" sigmoid notch

27

What are the stabilizers of the distal radio-ulnar joint (DRUJ)?

- Bony integrity between sigmoid notch of the radius and ulna - Interosseous membrane - TFCC - Joint capsule - Pronator quadratus - Extensor carpi ulnaris

28

What are the muscular attachments of the proximal row of the carpal bones?

None

29

What carpal bones do not contribute to carpal motion?

Pisiform: it's a sesamoid bone of the flexor carpi ulnaris

30

The Pisiform is a sesamoid bone for what tendon?

Flexor carpi ulnaris (FCU)