Wrist Flashcards
Describe the DRUJ capsule
Encloses the dist radius and ulna, TFCC and carpals. Thick anteriorly/posteriorly, lax proximally
What is the TFCC?
Group of integral structures in lateral wrist. Lies btw ulnar, triquetrum and lunate. Includes: articular disc, meniscus homologue, UCL, vestigial remains of D&P radioulnar ligs
Describe the ligaments involved in the DRUJ
Palmar and dorsal radioulna ligaments which blend into the TFCC to form dorsal and palmar thickenings. Also include the interosseous ligaments
Describe the median nerve supply
Palmar aspect of forearm going down to the digits 1-3.5.
Describe the ulnar nerve supply
Ulnar aspect of palmar skin
Describe the articular surface of the radiocarpal and ulnarmeniscocarpal jts
Radius and TFCC = concave, prox carpal row = convex. The radius articulates with scaphoid and lunate whilst the TFCC articulates with the lunate and triquetrum
Describe the ligamants of the wrist (radiocarpal + ulna menisco carpal)
UCL RCL Palmar radiocarpal ligamants Palmar ulnocarpal ligamants Dorsal radiocarpal ligament
Describe the capsule of the wrist (radiocarpal + ulnarmeniscocarpal
Lined with synovial membrane. RC capsule is isolated from the DRUJ by the TFCC, and from midcarpal jt by the interosseus ligament
Classify the DRUJ type and complexity
Synovial
Complex (articular disc)
Describe the radial nerve supply
Dorsal aspect of forearm and hand (digits 1-3.5)
Calassify the DRUJ shape and degrees of motion
Modified ovoid but acts as modified sellar functionally due to the interosseous membrane. 1 degree of motion
Describe the osteokinematics of the DRUJ (mechanical axis)
Mechanical axis = oblique longitudinal (vertical) axis from the end of the ulna to centre of capitulum
Describe the osteokinematics of DRUJ actions and planes/axis
Pronation/Supination - impure swing around vertical axis in transverse plane
Describe the DRUJ arthrokinematics
Pronation - anterior (palmar) glide of radius on ulnar
Supination - posterior (dorsal) glide of radius on ulna
Classify radiocarpal & ulnarmeniscocarpal jts (type and complexity)
Synovial, compound, complex
Classify the radiocarpal & ulnarmeniscocarpal (shape and degrees of motion)
Modified ovoid, 2 degrees of motion
Describe the osteokinematics of radiocarpal & ulnarmeniscocarpal (mechanical axis)
Mechanical axis - obligue transverse axis btw lunate and capitate
Describe the osteokinematics of radiocarpal & ulnarmeniscocarpal actions, planes/axis
Flexion/Extension - impure swing, oblique transverse axis in sagittal plane. Conjunct adduction (ulnar deviation) with flexion. Conjunct abduction (radial deviation) with extension
Radial/Ulnar deviation - impure swing about sagittal axis in frontal plane
Describe the Arthrokinematics of radioulnar & ulnarmeniscocarpal jts
Flexion - dorsal glide of proximal carpal row on TFCC & radius. Extension - palmar glide of proximal carpal row on TFCC & radius. Radial deviation - ulnar glide. Ulnar deviation - radial glide
What is the capsular pattern + end feel of radioulnar & ulnarmeniscocarpal jts
Equal restrictions of all movements. End feel: flexion, extension, ulnar deviation is capsular (firm); radial deviation is bony
What is the capsular pattern of DRUJ + end feel
Equal limitations of pronation and supination
End feel pronation - capsular of bony
supination - capsular
Classify the Midcarpal and intercarpal jts (type and complexity)
Synovial, compound
Classify the midcarpal and intercarpal jts (shape and degrees of motion)
Modified ovoid, 2 degrees of motion
Describe the midcarpal and intercarpal osteokinematics (actions, axis/planes)
Flexion/Extension - impure swing, oblique transverse axis in sagittal plane. Conjunct adduction (ulnar deviation) with flexion. Conjunct abduction (radial deviation) with extension. Radial/Ulnar deviation - swing about sagittal axis in frontal plane
