Lecture 14- Wrist and Hand Flashcards

0
Q

Scaphoid (“boat”) – ….. ….. ………
• Lunate (“moon”)
• Triquetrum (“3 cornered”)
• Pisiform (“pea”)

A

most commonly fractured

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1
Q
3 groups of bones: 
 • Carpals, n=....
 • Metacarpals, n=...
 • Phalanges, n=...
 • Cartilaginous at birth. 
• Ossified by .....-years-of-age
A

8
5
14
12

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2
Q

Trapezium (“Table”)
• Trapezoid (resembles trapezium)
• Capitate (“Head”)
• Hamate (“…. …..”)

A

Little hook

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3
Q

Condyloid radiocarpal joint
• Condyloid joint = oval articular surface of one
bone fits into complementary ……… in
another.

A

concavity

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4
Q

Wrist (Radiocarpal) joint
• Synovial (condyloid) joint between the distal end
of the radius and the articular disc overlying the
distal end of the ulna, and the …….,…….. And ……..

A

scaphoid, lunate

triquetrum.

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5
Q

Wrist (Radiocarpal) joint
Anterior & posterior ligaments strengthen the
……. ……

A

joint capsule

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6
Q

Wrist (Radiocarpal) joint

Movements?

A

Movements: flexion, extension, abduction,

adduction and circumduction.

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7
Q

Which has a greater range of motion?
Abduction ( radial deviation) or adduction (ulnar deviation)
WHY?

A

Abduction, ulnar styloid gets in the way

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8
Q

Palmar ………. and palmar …….. ligaments reinforce the wrist joint capsule.

A

radiocarpal

ulnocarpal

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9
Q

Dorsal ……… and radial and ulnar ……… ligaments

reinforce the wrist joint.

A

radiocarpal

collateral

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10
Q

What is the function of the deep transverse metacarpal ligament?

A

Bounds heads of metacarpals

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11
Q

Phalangeal ligaments

What is their function?

A

Strapping tendons to bone

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12
Q

What is the function of the extensor retinaculum?

A

Strapping down tendons

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13
Q

What is the function of the synovial sheaths?

A

Helps ligaments move independently

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14
Q

Flexor Retinaculum
Thickening of deep fascia that holds …… …… …… in
position at the wrist.

A

long flexor tendons

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15
Q

Flexor Retinaculum

Proximal border = ……. …….. …… crease on anterior wrist.

A

distal transverse skin

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16
Q

Flexor Retinaculum

Distal border = attached to ……… ………

A

palmar aponeurosis

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17
Q

Flexor Retinaculum

Medial attachment = ……. bone and ……. Of …….

A

pisiform

hook of hamate

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18
Q

Flexor retinaculum

Lateral attachment = tubercle of …….. and ………. bones.

A

scaphoid

trapezium

19
Q

Carpal Tunnel

Created by position of …….. bones and …….. ………

A

carpal

flexor retinaculum

20
Q

Carpal Tunnel
• 4 tendons of flexor ………. ………
• 4 tendons of flexor ………. ………
• Tendon of flexor ……… ……….
•……… nerve

A

digitorum profundus
digitorum superficialis
pollicis longus
Median

21
Q

Carpal Tunnel Syndrome
• Entrapment syndrome.
• Pressure on ……. nerve.

A

Median

22
Q

Carpal tunnel syndrome
Aetiology: overuse, swelling of tendons and tendon …….. (e.g.
rheumatoid arthritis) and cysts arising from …….. joints.

A

sheaths

carpal

23
Q

Carpal tunnel syndrome
Symptoms: pain and …… And …… in distribution of median nerve.
• Treatment: surgery, ……….. injections.

A

pins and needles

corticosteroid

24
Q

Palmar aponeurosis

Gives firm attachment to overlying …… to improve …… and protect underlying ……..

A

skin
grip
tendons

25
Q

Intrinsic hand muscles
• Entirely within hand (on ……. side)
• Execute ……… ……….

A

palmar

precision movements

26
Q
Intrinsic hand muscles
• Palmaris brevis 
• Interossei (dorsal or palmar) (n=7 or 8) 
• Lumbrical muscles (n=4) 
• Adductor pollicis 
• Thenar: ball of .......
• Hypothenar: ball of ......
A

Thumb

Pinky

27
Q

Phalangeal muscles
• Palmar ………
• Dorsal ……..
• Lumbricals

A

interossei

Interossei

28
Q

Interossei muscles
All innervated by deep branch of …… nerve
(…..,….)

A

ulnar C8, T1

29
Q

Palmar muscles:……. fingers toward middle finger PAD

A

adduct

30
Q

Dorsal: …… fingers from middle DAB

A

Abduct

31
Q

Adductor pollicis
Adducts …….;
Pollicis = Latin for ……

A

thumb

Thumb

32
Q

Thenar muscles
• …….. pollicis brevis
• ………. pollicis brevis
• ………. pollicis

A

Abductor
Flexor
Opponens

33
Q

Thenar muscles Chiefly responsible for

A

opposition of the thumb

34
Q

Abductor pollicis brevis (abducts thumb, moves anterior in AP
plane)
• Adductor pollicis (adducts thumb)
• Extensor pollicis longus
• Flexor pollicis brevis (flexes thumb at CM and MCP joints)
• Flexor pollicis longus
• Opponens pollicis (moves thumb to touch tip of little finger)

A

.

35
Q

Hypothenar muscles

What three muscles?

A
  • Abductor digiti minimi
  • Flexor digiti minimi brevis
  • Opponens digiti minimi
36
Q

Arteries of the palm
Ulnar artery => ……. ……. arch
Radial artery => ……. …… arch
Anastomoses between the two

A

superficial palmar

deep palmar

37
Q

Superficial palmar arch
Ulnar artery anterior to flexor retinaculum ->Superficial palmar
arch (deep to palmar aponeurosis)
Anastomoses with radial artery -> 4 digital arteries

A

.

38
Q

Deep palmar arch
Direct continuation of the ……. artery.
Joins with deep branch of …… artery.
Sends branches …….. to anastomosis around wrist joint and inferiorly to join digital branches of ……. ……. ……

A

radial
ulnar
superiorly
superficial palmar arch.

39
Q

Arteries of the palm
Thumb and lateral side of index finger mainly supplied by …… artery
Medial side of index finger, middle, ring and little finger mainly
supplied by …… artery

A

radial

ulnar

40
Q

Venous network

Dorsal venous network drain back into …… and …… veins

A

basilic

cephalic

41
Q

Dermatomes
C6 = ……
C7 = ……. … ……. ……
C8 = ….. ….. …… ……

A

Thumb
index & middle finger
ring & little finger

42
Q

Median nerve palsy
Median nerve lesion result in ?
Ring and little fingers still flexed because ?

A

inability to flex thumb, index and middle finger at MCP joint.
ulnar nerve is intact.

43
Q

Ulnar nerve palsy “Claw hand”
……. …… lesion results in inability to ……. ……. ……. of ring and little finger.
Patients can’t make a …….. …….

Also can’t extend
interphalangeal joints to
straighten fingers.

A

Ulnar nerve
flex the DIP joint
complete fist.

44
Q

Radial nerve palsy “Wrist drop”
Radial nerve lesion results in …….. ……… ….. in forearm. Because …….. …….. ……. no longer opposed, ……. ……..

A

denervation of extensor muscles
forearm flexor muscles
Wrist drops