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Muscoskeletal System > Lecture 6.1: Wrist and Hand > Flashcards

Lecture 6.1: Wrist and Hand Flashcards

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1
Q

Bones of Hand (3)

A
  • Phalanges
  • Metacarpals
  • Carpals
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2
Q

Joints of the Hand (4)

A
  • Distal Interphalangeal (DIP) Joint of Phalanges
  • Proximal Interphalangeal (PIP) Joint Phalanges
  • Metacarpophalangeal (Knuckle) Joint Phalanges and Metacarpals
  • Carpometacarpal Joint Metacarpals and Carpals
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3
Q

Carpal Bones of the Hand

A

Scaphoid Lunate Triquetrum Pisiform - Hamate Capitate Trapezoid Trapezium
Straight line thumb to pinky, here comes the thumb

Starts at bottom carpals at thumb, travels to pinky, then upper carpals pinky to thumb

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4
Q

What type of Joint is the wrist?

A

Condyloid Synovial Joint

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5
Q

What bones make up the Wrist?

A

Articulation of the radius + Articular disc with the Scaphoid, Lunate & Triquetrum

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6
Q

Why is the Ulna not part of the Wrist Joint?

A

Separated from carpals by fibrocartilage disc

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7
Q

How many Extensor Compartments does the Wrist have?

A

6

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8
Q

What do the Extensor Compartments of the Wrist contain?

A

Specific posterior forearm tendons that are covered in common synovial sheaths

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9
Q

1st Extensor Compartments of the Wrist

A

EPB: Extensor pollicis brevis
ABL: Abductor pollicis longus

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10
Q

2nd Extensor Compartments of the Wrist

A

ECRB: Extensor carpi radialis brevis
ECRL: Extensor carpi radialis longus

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11
Q

3rd Extensor Compartments of the Wrist

A

EPL: Extensor pollicis longus

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12
Q

4th Extensor Compartments of the Wrist

A

ED: Extensor digitorum
EI: Extensor indicis

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13
Q

5th Extensor Compartments of the Wrist

A

EDM: Extensor digiti minimi

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14
Q

6th Extensor Compartments of the Wrist

A

ECU: Extensor carpi ulnaris

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15
Q

What problems are associated with the 1st Extensor Compartment of the Wrist?

A

EPB affected by painful De-Quervains tenosynovitis

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16
Q

What problems are associated with the 3rd Extensor Compartment of the Wrist?

A

EPL can wear on the dorsal radial tubercle and rupture

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17
Q

What problems are associated with the 6th Extensor Compartment of the Wrist?

A

ECU can wear on the ulnar styloid process and rupture

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18
Q

What is the Anatomical Snuffbox?

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A

A triangular depression found on the lateral aspect of the dorsum of the hand

19
Q

Scaphoid Fracture

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A

Results in anatomical snuffbox tenderness

Possible avascular necrosis (AVN)

20
Q

What anatomical structures can be found in the Anatomical Snuffbox?

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A
  • Radial artery (palpable pulse)
  • Radial styloid process
  • Scaphoid
  • Trapezium
  • Base of 1st metacarpal
  • Cephalic (houseman’s) vein passes over snuffbox.
21
Q

What is Carpal Tunnel Syndrome?

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A

Involves the compression of the median nerve in the carpal tunnel

22
Q

What forms the Carpal Tunnel? What passes through it?

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A

Carpal tunnel is formed by the carpal bones & the flexor retinaculum
Nine tendons and the median nerve pass through the carpal tunnel:
• Flexor digitorum superficialis (x4)
• Flexor digitorum profundus (x4)
• Flexor pollicis longus

23
Q

What is the Flexor Retinaculum?

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A

A strong, fibrous band that covers the carpal bones on the palmar side of the hand near the wrist

24
Q

How many Flexor Compartments does the Wrist have?

25
Where does the Ulnar Nerve run in the Wrist?
It runs above the carpal tunnel in Guyon’s canal
26
What is Tinel’s Test?
* Tap the median nerve near palmaris longus proximal to carpal tunnel * Elicits tingling in CTS
27
What is the Phalen Test?
* Test for Carpal Tunnel Syndrome * Put hands in prayer position, then flip them downwards * Elicits pain/ tingling in CTS
28
Risk Factors for Carpal Tunnel (8)
* Female * Increasing Age * Pregnancy * Obesity * Previous Wrist Injury * Diabetes Mellitus * Rheumatoid Arthritis * Hypothyroidism
29
Treatments for Carpal Tunnel: Conservative and Surgical
``` • Wrist Splint • Hand Physiotherapy • Corticosteroids Injections • Carpal tunnel release, cut through flexor retinaculum, decompresses carpal tunnel ```
30
What is the Palmar Aponeurosis?
It is a tough fibrous layer limiting movement of the palmar skin
31
Fibrous Digital Sheaths
• Tendons of Flexor Digitorum Superficialis (FDS) & Flexor Digitorum Profundus (FDP) are surrounded by a synovial sheath • They then cross palm and enter fibrous sheaths on the palmar aspect of the digits
32
What is the purpose of Fibrous Digital Sheaths?
• Hold the tendons in place and prevent bowing
33
What are the 2 Palmar Spaces?
``` Thenar Space (Thumb-side) Midpalmar Space ```
34
What is Dupuytren's Contracture?
Aponeurotic thickening leads to soft tissue contractures causing passive flexion of medial digits
35
What is Stenosing Tenosynovitis?
• Aka Trigger Finger • Occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger • Inflammations leads to trapping of the flexor tendon • If is severe, your finger may become locked in a bent position
36
What is Ulnar Claw Hand?
• Caused due to a lower ulnar nerve lesion (below elbow) • Clawing and Flexion of 4th and 5th Fingers • This is due to unopposed action of ulnar part of the flexor digitorum profundus muscle
37
Intrinsic Hand Muscles supplied by the Ulnar Nerve
* Palmaris brevis * Interossei muscles * Adductor pollicis * Hypothenar muscles * Lumbrical muscles: Medial 2
38
Intrinsic Hand Muscles supplied by the Median Nerve
* Lumbrical muscles: Lateral 2 | * Thenar muscles
39
What is a Fulcrum?
The point against which a lever is placed to get a purchase, or on which it turns or is supported
40
What are the Interossi?
They are hand muscles, situated between the metacarpal bones all innervated by ulnar nerve
41
What are the 2 types of Interosseous Muscles?
3 Palmar Interossi Muscles | 4 Dorsal Interossi Muscles
42
What are the Lumbricles? What do they do?
They are hand muscles | The lumbricals flex the MCP joints & extend PIP & DIP joints
43
Hand Muscles of the Palm (7)
* Adductor Pollicis (Ulnar n.) - Thumb Side * Flexor Pollicis Brevis - Thumb Side * Abductor Pollicis Brevis (Median n.) - Thumb Side * Opponens Pollicis - Thumb Side * Abductor Digiti Minimi Brevis- Pinky Side * Flexor Digiti Minimi Brevis - Pinky Side * Opponens Digiti Minimi - Pinky Side
44
What is Froment Sign?
* Excess thumb flexion whilst pinching | * Due to Adductor Pollicis loss (e.g. in Ulnar nerve lesion)

Muscoskeletal System (15 decks)

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