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becky: MSK UQ > LECTURE 14: Wrist and hand > Flashcards

LECTURE 14: Wrist and hand Flashcards

(48 cards)

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1
Q

how many bones in wrist and hand?

A

29 (half of all bones are in hands, wrist, ankle and feet)

  • 2 forearm bones
  • 8 carpal bones
  • 5 metacarpal bones
  • 14 finger bones
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2
Q

3 main functions of hand/wrist:

A
  1. expression/communication
  2. motor/manipulative
  3. sensory input: (temp, texture, shape, etc)
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3
Q

DRUJ:
what is normal ulnar variance
what is +
what is -

A

normal: neutral (less than 1 mm is ideal)
positive: ulna >2 mm longer than radius
negative: ulna >2 shorter than radius

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4
Q

which ulnar variance is associated with scapholunate instability/TFCC tear

A

positive ulnar variance

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5
Q

CPP of radial carpal joint

A

full extension, radial deviation

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6
Q

OPP of radial carpal joint

A

neutral with slight ulnar deviation

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7
Q

capsular pattern of radial carpal joint

A

flexion loss = extension loss

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8
Q

main stabilizer of the DRUJ

A

TFCC

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9
Q

DRUJ closed packed position

A

5 degrees supination

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10
Q

DRUJ open packed position

A

10 degrees supination

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11
Q

DRUJ is a _ _ joint
capsular pattern:

A

uniaxial, pivot joint 1 DOF

capsular: pain at extreme pronation/supination

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12
Q

What is ulnar variance at the DRUJ? What population gets this often?

A
  1. determined by age, genes, load, prime for medial and lateral elbow pathologies
  2. gymnasts (+ variance)
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13
Q

capsular pattern for radio-carpal joint

A

Capsular pattern: flex motion loss = ext motion loss

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14
Q

proximal row carpal bones

A

scaphoid
lunate
triquetrum
pisiform

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15
Q

carpal bones
distal row

A

trapezium
trapezoid
capitate
hamate

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16
Q

intercarpal joints
CPP
OPP
capsular pattern?

A

CPP: full extension
OPP: neutral to slight flexion
Capsular pattern: none

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17
Q

intercarpal joints
passive vs active structures

A

passive: bony congruency and ligaments

NO ACTIVE STRUCTURES
*look for passive stability

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18
Q

midcarpal joints
CPP
OPP
capsular

A

CPP: full extension w/ ulnar deviation
OPP: neutral to slight flexion w/ ulnar deviation
Capsular pattern: flex motion loss = ext motion loss

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19
Q

midcarpal joints
passive vs active structures?

A

Passive structures: Bones (congruency)
+ Dorsal and palmar interosseous ligaments

NO ACTIVE

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20
Q

1st CMC joint is a _ joint with _ DOF

Study These Flashcards
A

sellar joint: 3 DOF

21
Q

1st CMC joint
CPP
OPP
capsular

Study These Flashcards
A

CPP: full opposition
OPP: midway between abduction and adduction and between flex/ext
capsular: ABD > extension loss

22
Q

passive structures involved in 1st CMC joint

Study These Flashcards
A

capsule large, LOOSE
at least 5 ligaments

23
Q

active structures involved in 1st CMC joint

Study These Flashcards
A

AbdPL, AbdPB, EPL, EPB, FPL, FPB, AddP, OP mm.

24
Q

other CMC joints are _ joints with _ DOF

25
2nd and 3rd CMC JOINTS are relatively _ 4th and 5th CMC joints are relatively _
2/3: immobile 4/5: mobile (grasp)
26
MCP joints CPP OPP Capsular
CPP: full opposition (1st), full flexion (2nd-5th) OPP: slight flexion Capsular pattern: flex loss > ext loss
27
MCP joints are _ with _ DOF
condyloid 2 DOF
28
PIP joints are _ with _ DOF
uniaxial hinge joints 1 DOF
29
PIP joints passive structures
1. bony congruency 2. collateral ligaments 3. dorsal hood, volar plate
30
PIP joints active structures
FDS tendons ED tendons
31
PIP joints: CPP OPP capsular pattern
CPP: full extension OPP: slight flexion Capsular pattern: flex loss > ext loss
32
DIP joints are _ joints with _ DOF
uniaxial hinge joints 1 DOF
33
DIP joints CPP OPP capsular
CPP: full extension OPP: slight flexion Capsular pattern: flex loss > ext loss
34
DRUJ ligaments
1. Dorsal radio-ulnar ligament 2. palmar
35
Which tendons have pulleys? Which are flat, which are round?
flexors: pulleys, round extensors: no pulleys, flat
36
what lives in snuffbox, why do we care?
scaphoid at the subfloor fractures
37
median nerve passes through _ except _
carpal tunnel except palmar branch passes over carpal tunnel
38
carpal tunnel borders
hook of hamate, trapezium floor: plamar RC ligament and ligament complex roof: transverse ligament/flexor retinaculum
39
carpal tunnel involves the recurrent branch of the median nerve (not palmar). What muscles will be impacted?
1. lateral 2 lumbricals 2. FPB 3. APB (abd pollicus brevis) 4. OP | may see thenar atrophy
40
what sensory impairment will you have with carpal tunnel
first 3 fingers on the palm side + inside of 4th finger dorsally: just the tips of your fingers
41
What muscles of the hand might be impacted with ulnar nerve (guyon's canal)
1. medial 2 lumbricals 2. adductor pollicis 3. interossei 4. palmaris brevis
42
someone is having problems with fine movements of the hand. What nerve might be involved?
ulnar nerve
43
someone has hypothenar and interossei atrophy. What nerve is involved
ulnar nerve
44
What is sensory involvement in the hand of ulnar nerve?
dorsal and palmar aspect of 5th and medial side of 4th fingers
45
radial nerve: motor involvement sensory involvement
motor: wrist and finger extensors sensory: radial side, dorsum of 1st-3rd hand and fingers EXCEPT DIPS also lateral side of thumb
46
What is the blood supply of the hand?
brachial artery bifurcates at elbow --> radial and ulnar branches 2 arches of the hand, dorsal and palmar arches, superficial and deep
47
what does the DRUJ do? what does the RC joint do?
DRUJ: pronation/sup RC: flex/ext, radial/ulnar dev
48
what is the key joint of the hand
wrist

becky: MSK UQ (19 decks)

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