Lecture 12: Wrist complex

Question 1

Flexion percentages at each joint

Answer 1

40% and radiocarpal joint

60% at midcarpal joint

Question 2

Radiocarpal arteries

Answer 2

Arise from dorsal and palmar carpal arches

Question 3

Pisiform

Answer 3

Sesamoid bone

Forms in tendon of the flexor carpi ulnaris

Question 4

Scaphoid

Answer 4

Forms floor of anatomical snuff box
Most commonly fractured, fractures may compromise radial artery in snuff box
Articulates with radius

Question 5

______ runs in the floor of the snuff box over the scaphoid

Answer 5

Radial artery

Question 6

Palmar structure sequence (radial to ulnar)

Answer 6

Radius
Radial artery
Flexor carpi radialis tendon
Median nerve (under palmaris longus tendon)
Flexor digitorum superficialis tendons
Ulnar artery
Ulnar nerve
Flexor carpi ulnaris tendon

Question 7

Branches of the __________ are in the roof of the snuff box

Answer 7

Superficial radial nerve

Question 8

Radiocarpal joint ligaments

Answer 8

Lateral collateral ligament
Medial collateral ligament
Dorsal radiocarpal ligament
Palmar radiocarpal ligament

Question 9

Metacarpal bones #

Answer 9

5 bones

Question 10

Proximal bones of wrist

Answer 10

Scaphoid
Lunate
Triquetral
Pisiform

Question 11

Radiocarpal movements

Answer 11

Some flexion/extension

Ulnar deviation

Question 12

Collateral ligaments of wrist/hand/digits

Answer 12

Radial
Ulnar
Phalangeal

Question 13

Extensor pollicis longus proximal attachment

Answer 13

Posterior surface of middle 1/3 of ulna and interosseous membrane

Question 14

Extensor pollicis longus distal attachment

Answer 14

Dorsal aspect of base of distal phalanx of thumb

Question 15

Lunate

Answer 15

Articulates with radius

Question 16

Radiocarpal joint articulates with

Answer 16

Scaphoid
Lunate
Distal radius
Triquetral (only during extreme ulnar deviation)

Question 17

Extensor pollicis brevis distal attachment

Answer 17

Dorsum of proximal phalanx of thumb

Question 18

Phalanges bone #

Answer 18

14 bones

Question 19

Extensor pollicis longus innervation

Answer 19

Posterior interosseous artery

Question 20

Extensor pollicis brevis proximal attachment

Answer 20

Posterior surface of distal 1/3 of radius and interosseous membrane

Question 21

Radiocarpal joint injuries

Answer 21

Colles fracture
Scaphoid fracture (compromises radial artery)

Question 22

Extension percentages at each joint

Answer 22

33% at midcarpal joint

67% and radiocarpal joint

Question 23

Abductor pollicis longus blood supply

Answer 23

Posterior interosseous artery

Question 24

Extensor pollicis brevis function and blood/nerve supply

Answer 24

Extends proximal phalanx of thumb at its metacarpophalangeal joint, also extends carpometacarpal joint
Posterior interosseous nerve/artery

Question 25

Radiocarpal joint

Answer 25

Condyloid synovial | 2 degrees of freedom

Question 26

Carpal bones #

Answer 26

8 bones

Question 27

Radiocarpal nerve supply

Answer 27

Anterior interosseous branch from median Posterior interosseous branch from radial Dorsal and deep branches of ulnar nerve

Question 28

Extensor pollicis longus blood supply

Answer 28

Posterior interosseous artery | Perforating branch of anterior interosseous arteries

Question 29

Abductor pollicis longus actions

Answer 29

Abducts thumb and extends it at the carpometacarpal joint

Question 30

Abductor pollicis longus distal attachment

Answer 30

Base of first metacarpal

Question 31

Midcarpal joint ligaments

Answer 31

Dorsal ligaments Palmar ligaments Interosseous ligaments

Question 32

Midcarpal joint arteries

Answer 32

Arise from dorsal and palmar carpal arches

Question 33

Extensor pollicis longus actions

Answer 33

Extends distal phalanx of thumb and extends metacarpophalangeal and carpometacarpal joints

Question 34

Tendons that define the anatomical snuff box

Answer 34

Extensor pollicis longus- dorsal and more medial Extensor pollicis brevis- palmar border Abductor pollicis longus- runs with extensor pollicis brevis

Question 35

Abductor pollicis longus nerve supply

Answer 35

Posterior interosseous nerve

Question 36

Movements of midcarpal joint

Answer 36

Some flexion/extension Radial deviation (abduction) -Especially due to movement of head of capitate in its socket

Question 37

Abductor pollicis longus proximal attachment

Answer 37

Posterior surface of proximal half of ulna, radius and interosseous membrane

Question 38

Other ligaments of wrist/hand/digits

Answer 38

``` Carpal ligaments Metacarpal ligaments Carpometacarpal ligaments Palmar ligaments Intermetacarpal ligaments ```

Question 39

Midcarpal joint nerves

Answer 39

Anterior interosseous branch from median Posterior interosseous branch from radial Dorsal and deep branches of ulnar nerve

Question 40

Triquetral

Answer 40

Articulates with ulna via ulnar disc during extreme ulnar deviation