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Metabolism > Session 9 > Flashcards

Session 9 Flashcards

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1
Q

What are the components of the osteology of the hand?

A

Carpal bones, Metacarpal bones, Phalanges

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2
Q

What joint is this?

A

Distal Interphalangeal (DIP)

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3
Q

What joint is this?

A

Proximal Interphalangeal (PIP)

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4
Q

What joint is this?

A

Metacarpophalangeal (Knuckle)

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5
Q

What joint is this?

A

Carpometacarpal

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6
Q

How can you remember the carpal bones?

A

Straight Line To Pinky, Here Comes The Thumb

Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium

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7
Q

What carpal bone is this?

A

Scaphoid

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8
Q

What carpal bone is this?

A

Lunate

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9
Q

What carpal bone is this?

A

Triquetrum

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10
Q

What carpal bone is this?

A

Pisiform

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11
Q

What carpal bone is this?

A

Hamate

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12
Q

What carpal bone is this?

A

Capitate

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13
Q

What carpal bone is this?

A

Trapezoid

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14
Q

What carpal bone is this?

A

Trapezium

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15
Q

What type of joint is the wrist?

A

Condyloid synovial joint

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16
Q

What is the articulation of the wrist?

A

The wrist is the articulation of the radius & articular disc with the scaphoid, lunate & triquetrum.

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17
Q

What planes of movement occur with the wrist joint?

A

2 planes of movement: Flex/extend, Adduct/abduct, Circumduction (combination of above)

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18
Q

The ulna is separated from the carpal bones by ___ disc.

A

Fibrocartilage

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19
Q

What ligament is found between the ulnar styloid and triquetrum?

A

Medial collateral ligament

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20
Q

What ligament is found between the radial styloid and scaphoid?

A

Lateral collateral ligament

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21
Q

What is found in Extensor compartment 1?

A

Extensor Pollicis Brevis (EPB) and Abductor Pollicis Longus (ABL)

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22
Q

What is found in Extensor compartment 2?

A

Extensor Carpi Radialis Brevis (ECRB) and Extensor Carpi Radialis Longus (ECRL)

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23
Q

What is found in Extensor compartment 3?

A

Extensor Pollicis Longus (EPL)

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24
Q

What is found in Extensor compartment 4?

A

Extensor Digitorum (ED) and Extensor Indicis (EI)

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25
What is found in Extensor compartment 5?
Extensor Digiti Minimi (EDM)
26
What is found in Extensor compartment 6?
Extensor Carpi Ulnaris (ECU)
27
Which compartment of the hand is prone to painful De-Quervains tenosynovitis?
Extensor Pollicis Brevis (EPB) in COMPARTMENT 1 can be affected by painful De-Quervains tenosynovitis.
28
Which compartment of the hand is prone to wear on the dorsal radial tubercle and rupture?
Extensor Pollicis Longus (EPL) in COMPARTMENT 3 can wear on the dorsal radial tubercle and rupture.
29
Which compartment of the hand is prone to wear on the ulnar styloid process and rupture?
Extensor Carpi Ulnaris (ECU) in COMPARTMENT 6 can wear on the ulnar styloid process and rupture.
30
What are the borders of the anatomical snuffbox?
Extensor Pollicis Longus (EPL), Extensor Pollicis Brevis (EPB), Abductor Pollicis Longus (APL)
31
What are the contents of the anatomical snuffbox?
Radial artery (pulse), Radial styloid process, Scaphoid, Trapezium, Base of the 1st metacarpal
32
What structure runs OVER the anatomical snuffbox?
Cephalic (houseman's) vein passes over the snuffbox. It is commonly cannulated.
33
What can tenderness in the anatomical snuffbox indicate?
Scaphoid carpal bone fracture
34
What forms the carpal tunnel?
Flexor retinaculum and carpal bones
35
What are the contents of the carpal tunnel?
Nine tendons and median nerve pass through the carpal tunnel: 4 tendons of Flexor Digitorum Superficialis, 4 tendons of Flexor Digitorum Profundus, 1 tendon of Flexor Pollicis Longus, Median nerve
36
What is carpal tunnel syndrome (CTS)?
Compression of the median nerve through the carpal tunnel. Symptoms: Sensory loss, Paresthesia, Nocturnal pain, Thenar muscle wasting.
37
What tests are used for carpal tunnel syndrome (CTS)?
Tinel test, Phalen test
38
What type of injury commonly leads to scaphoid fracture?
Fall on the outstretched hand (FOOSH). Symptoms: Scaphoid fracture, Anatomical snuffbox tenderness, Possible avascular necrosis (AVN).
39
What structure found on the palmar surface of the hand limits movement of the palmar skin?
The palmar aponeurosis is a tough fibrous layer limiting movement of the palmar skin.
40
What do the tendons of the Flexor Digitorum Superficialis (FDS) and Flexor Digitorum Profundus (FDP) enter on the palmar aspect of the digits?
Fibrous digital sheaths on the palmar aspect of the digits. These hold the tendons in place and prevent bowing.
41
What is a common synovial sheath in the hand?
Common sheath extends distally along the 5th digit and through the carpal tunnel into proximal forearm.
42
What are palmar spaces?
Located deep to the flexor tendons in the palm of the hand.
43
What is Dupuytren's contracture?
Aponeurotic thickening causing passive flexion of the medial digits.
44
What is stenosing tenosynovitis (trigger finger)?
A problem with the sliding mechanism of a tendon in its sheath.
45
What is ulnar claw hand?
Distal ulnar nerve lesion, ulnar deviation of wrist upon wrist flexion; loss of MEDIAL lumbrical function; 4th and 5th digits are clawed.
46
What is the Benediction sign (trying to make a fist)?
Caused by a high injury of the median nerve. The patient is unable to flex the second and third digits at the MCP joint while attempting to make a fist.
47
What nerve supplies everything in the hand, except the thenar muscles and lumbricals to digits 2 & 3?
Everything in the hand is supplied by the ULNAR nerve, EXCEPT the thenar muscles and lumbricals to digits 2 & 3 (which are supplied by the median nerve).
48
What does thenar wasting indicate?
Median nerve damage.
49
What do the lumbricals flex and extend?
The lumbricals flex the metacarpophalangeal joints and extend the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints.
50
What are interosseous muscles?
Muscles located between the metacarpal bones, all innervated by the ulnar nerve.
51
What is the Froment sign?
Pronounced flexion of the thumb during lateral pinch. Weak adductor pollicis (ulnar nerve).
52
Where does the ulnar nerve pass in relation to the carpal tunnel?
The ulnar nerve passes superficial to the carpal tunnel in Guyon's canal, lateral to the pisiform.
53
What is the sensory nerve distribution of the hand in the yellow shaded area?
Ulnar
54
What is the sensory nerve distribution of the hand in the purple shaded area?
Median
55
What is the sensory nerve distribution of the hand in the red shaded area?
Radial
56
What is the blood supply to the upper limb?
Subclavian → Axillary artery → Brachial artery → Radial artery → Ulnar artery
57
What is the blood supply to the hand?
Brachial artery → RADIAL AND ULNAR ARTERIES → 2 anastomotic palmar arches.
58
When might the radial artery need to be accessed clinically?
Radial pulse, Arterial Blood Gases (ABG)
59
What is Bennett's fracture?
Fracture of the base of the metacarpal of the thumb (proximal metacarpal 1).
60
What is Smith's fracture?
Fracture of the distal radius at the wrist with ventral displacement (inward).
61
What is Colle's fracture?
Fracture of the distal radius at the wrist with dorsal displacement (outward).
62
What arterial pulse can you palpate in the anatomical snuffbox?
Radial pulse
63
What wrist bone articulates with the 1st metacarpal?
Trapezium
64
What dermatome and cutaneous nerve area includes the ventral side of your thumb?
B) C6 and Median nerve
65
Briefly describe the unique blood supply of the scaphoid bone in the wrist.
Blood supply from the radial artery is from a distal point of the bone to a proximal point of the bone, with blood flowing towards a proximal position.
66
What forms the borders of the anatomical snuffbox?
Tendons of extensor pollicis longus and extensor pollicis brevis.
67
What arterial pulse can you palpate in the anatomical snuffbox?
Radial artery
68
Explain why it is easier for a right handed person to open a difficult jam jar.
Because it is an action of supination for a right handed person and pronation for a leftie. Supination is more powerful because of the strength of biceps brachii than the pronators.
69
Identify the joint encircled and the structure indicated by the red arrow.
Yellow circle: Acromioclavicular joint, Red Arrow: Coracoacromial arch
70
Identify the bony structure marked by the 'x'. Name TWO of the three muscles that attach to this bony projection.
Coracoid process. Muscles: Short head of the biceps/coracobrachialis/pec minor.

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