Test 2 Wrist and Hand Flashcards by B Burr

The hand accounts for about __% of upper limb function. The thumb is involved in __-__% of hand function. The index finger is involved in about __% of hand function.

90%
40-50%
20%

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The middle finger is the strongest and accounts for about __% of all hand function. It is important for both __ and __ functions

20
precision
power

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DIstal radio-ulnar joint is a __ joint that unites the distal radius and ulna and an ___ ___. The rounded head of the ulnar head contacts both the ___ of the radius laterally and the ____ distally.

double pivot
articular disc
ulnar notch
TFCC

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The ulnar styloid process is about __ inch(es) shorter than the radial styloid process, resulting in more __ deviation. (30 vs. 20)

1/2

ulnar

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Colles’ fx aka ___ ___ fracture is a fx of the radius within __-__mm of the wrist joint with ___ angulation of the distal fragment.

Dinner Fork
20-35
posterior

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Reversed Colles fx. (2 AKAs __ and __) is a fx of the radius within __-__mm of the wrist joint with __ angulation of the distal fragment.

Smith’s fx
Garden Spade deformity
20-35
anterior

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Triangular fibrocartilage complex is in between the __ __ row and the distal ___ within the __ aspect of the wrist. Primary function is to improve joint congruency and to cushion against __ forces.

Medial Proximal
Ulna
medial
compressive

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The TFCC transmits about __% of the axial load from the hand to the forearm.

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__ is the most commony fractured bone of the wrist. __ __ helps to slide it out from under the radial styloid process for palpation.

Scaphoid (Navicular)

ulnar deviation

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__ is the largest and most prominent of the MCP bases as well as largest of all carpal bones.

Capitate

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__ is the 2nd most often fractured and most commonly subluxated wrist bone.

Lunate

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What 3 things are covered by the extensor carpi radialis brevis tendon? Where does the tendon insert?

Lunate, Capitate, base of 3rd metacarpal

Inserts into base of 3rd metacarpal

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The ___ joint lies between the two rows of carpals. The proximal row of carpals is __ laterally and __ medially.

Midcarpal
convex
concave

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The proximal row of carpals presents with a __ surface to the distal row. The distal row of carpals presents with a __ surface to the proximal row.

Concave

Convex

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What provides stability to the carpometacarpal joints?

Palmar and Dorsal carpometacarpal and intermetacarpal ligaments

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The 2nd-5th metacarpals articulate with the

respective proximal phalanges in __ joints

Biaxial

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The MCP joints allow __/__ and __/__deviation associated with a slight degree of __ rotation

flexion/extension
medial/lateral
axial

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Functionally, the ___-shaped ___ joint is the most important joint of the thumb

sellar (saddle)

carpometacarpal

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ROMs at the thumb

Flex/Ext
Abd/Add
Opposition

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Bennett’s Fx is through the base of the __ metacarpal neck with __ and __ displacement of the shaft

first
dorsal
radial

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Bar Room Fx is in the __ or __ metacarpal neck with __ displacement of the head

fourth
fifth
anterior

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Boxer’s fx is the __ or __ metacarpal neck with __ displacement of the head

second
third
anterior

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The PIP joint is a hinged joint capable of __ and __. The DIP is similar but is less stable and allows some ___.

flexion
extension
hyperextension

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Heberden’s nodes are found on one or more fingers, except the ___. Distal joints are enlarged by 2 nodules, __ to __ mm in diameter, one on either side of the __ midline.

thumb
2-3
dorsal

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Hebdeden's nodes are painless, process is a localized __. Involvement of several joints is more common in __ in whom they appear at the __ age.

OA women menopausal

Herberden's nodes in women is usually ___ and a single joint is usually involved in __. Condition on men is usually the result of __

hereditary men trauma

What is swan neck deformity?

PIP jt deforms into hyperextension and the DIP jt is flexed

In Boutonniere deformity,The central slip of the ___ tendon is avulsed from the___ to the base of the __ phalanx, the PIP is __ and the DIP is __.

``` Extensor Digitorum Communis insertion middle flexed extended ```

The extrinsic palmar ligaments provide the majority of the __ __.

wrist stability

The intrinsic ligaments serve as __ __, binding the proximal row into a unit of rotational stability

rotational restraints

Medial and Lateral collateral ligaments of the fingers are named __ and __ ligaments

Cleland's | Grayson's

Radiocarpal is formed by the large articular __ surface of the distal end of the radius , the __ and __ of the proximal carpal row, and the __

concave scaphoid lunate TFCC

Antebrachial fascia is a __ ct bracelet that encases the forearm and maintains the relationships of the __ that cross the wrist

dense | tendons

Extensor Retinaculum serves to prevent the tendons from "__ __" when the tendons turn the corner at the wrist. The tunnel-like structures formed by the retinaculum and the underlying bones are called __-__ compartments

bow-stringing | fibro-osseous

Extensor retinaculum from lateral to medial, contains tendons of...

- Abductor pollicis longus and extensor pollicis brevis - Ext. Carpi radialis longus and brevis - Extensor Pollicis longus - Extensor Digitorum and indicis - Extensor DIgiti Minimi - Extensor Carpi Ulnaris

Flexor retinaculum transforms carpal arch to tunnel, through which pass the __ nerve and some tendons. Proximally, the retinaculum attaches to the tubercle of __ and __. Distally, it attaches to ___ and tubercle of __

``` median scaphoid pisiform hook of hamate trapezium ```

Jersey finger is an avulsion of the ___ tendon. MOI- finger gets caught in an object and actively flexed __ joint is suddenly and forcibly __ resulting in a __

flexor digitorum profundus DIP extended rupture

What makes the floor of the carpal tunnel?

Palmar radiocarpal ligament and palmar ligament complex

What makes up the roof of the carpal tunnel?

Flexor retinaculum (transverse carpal ligament)

What are the ulnar and radial borders of carpal tunnel?

Trapezium and hook of hamate

Tunnel of Guyon is a depression __ to the flexor retinaculum, located between the __ and the __ bones

superficial hook of hamate pisiform

Whats forms the roof of the Tunnel of guyon?

Palmar (volar) carpal ligament, palmaris brevis muscle, palmar apopneurosis

What forms the floor of the tunnel of guyon?

Flexor retinaculum, pisohamate ligament, pisometacarpal ligament

Tunnel of guyon serves as a passageway for the __ nerve and artery into the hand

ulnar

Cyclist hand is __ nerve and artery compression injuries between __ and __. What other activities could elicit similar problems?

ulnar hook of hamate pisiform -Crutch use and weight lifting

Palmar apopneurosis is a dense fibrous structure continuous with ___ tendon and fascia covering the __ and __ muscles.

palmaris longus thenar hypothenar

Dupuytern's contracture is a fibrotic condition of the ___ that results in __ formation or __ of the apopneurosis, and which may ultimately cause finger __ contractures

palmar apaopneurosis nodule scarring flexion

In Dupuytren's contracture, palpation of the palm reveals a __ __ over the __ tendon. Passive __ of the finger raises the cord taut where is can be readily seen

hard cord flexor extension

Extensor hood is a complex tendon, which covers the __ aspect of the digits and is formed by a combination of the tendons of insertion from __(3)__

dorsal Extensor difitorum Extensor Indicis Extensor Digiti Minimi

Extensor hood creates a "__" system that provides a mechanism for extending the ___ and __ joints, and allows the __ and possibly __ muscles to assist is __ of the MCP joints.

``` cable MCP IP Lumbrical Interosseous flexion ```

Mallet finger is when __ phalanx of finger is permanently flexed at the __ joint. Cannot be voluntarily extended.

terminal | distal

Mallet finger is caused by rupture of the __ tendon that inserts on the __ phalanx. Possibly a fx of the __ phalanx

extensor terminal distal

Synovial sheaths are long narrow balloons filled with synovial fluid, which wrap around a __ so that one part of the balloon wall (__ layer) is directly on the tendon, while the other part of the balloon wall (__layer) is separatet

tendon visceral parietal

Annular and Cruciate pulleys restrain the __ tendons to the ___ and __ and contribute to fibro-osseous tunnels through which the tendons travel

flexor MCP's Plalanges

Where is surgical no man's land?

Distal palmar crease to the pip joints

The surgical no man's land is where 2 __ tendons run into 1 __

flexor | sheath

Trigger finger usually occurs in __ or __ finger. __ feels normal but __ is accompanied by a painful snap that may refer to the __ of the hand

``` 4th 5th Flexion Extension Dorsum ```

There are __ muscles that arise and insert into the hand

There are __ extrinsic muscles that originate in the forearm and insert within the hand

What makes up the floor of the anatomic snuff box?

Deep branch of radial artery and tendinous insertion of extensor carpi radialis longus Scaphoid and trapezium are under these

What is ulnar border of anatomic snuff box?

Extensor pollicis longus tendon

What is radial border of anatomic snuff box?

Abductor pollicis longus

Test 2 Wrist and Hand Flashcards

(62 cards)