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COMP ORTHO > Wrist > Flashcards

Wrist Flashcards

(70 cards)

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1
Q

Proximal joint surface

A

Biconcave

Radius and radioulnar disc

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2
Q

Distal joint surface

A

Convex

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3
Q

Open chain

A

Convex carpals on concave radius

VEX on CAVE = OPP

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4
Q

Closed chain

A

Concave on convex

SAME

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5
Q

Ligaments - Volar (palmar) radiocarpal

A

From radius to carpal bones
Limit extension
Prevents carpal separation

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6
Q

Ligaments - Volar (palmar) radiocarpal - radiocapitate

A

Stabilizes lunate when tight
Pulls capitate towards radius
Traps scaphoid

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7
Q

Ligaments - Volar (palmar) radiocarpal - radiotriquetral

A

Stabilizes lunate by pulling obliquely

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8
Q

Ligaments - Volar (palmar) ulnocarpal

A

Stabilize midcarpal joint
Limit ext
Prevent carpal separation

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9
Q

Ligaments - Dorsal radiocarpal

A

From radial styloid to lunate and triquetrum

Limits flex and prevents carpal separation

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10
Q

Ligaments - Ulnar collateral

A

From ulna to pisiform and triquetrum

Limits radial deviation

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11
Q

Ligaments - Radial collateral

A

From radius to scaphoid, trapezium, and 1st MC

Limits ulnar deviation

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12
Q

Close packed (radiocarpal and midcarpal)

A

Radiocarpal in full ext and RD

Midcarpal in full ext

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13
Q

Open packed (radiocarpal and midcarpal)

A

Radiocarpal in neutral with slight UD

Midcarpal in slight flex with UD

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14
Q

Flex to ext Sequence

A

distal row initiates - distal glides on proximal row
volar radioscaphoid and radiocapitate lig tighten and pull distal row into close packed
at 45 ext, volar radioscaphoid and lunat tighten and pull lunate into close packed on scaphoid

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15
Q

Radial deviation sequence

A

Distal carpal row initiates mvmnt and moves toward radius
Ulnar lig tighten, prox row moves in ulnar direction
Scaphoid and trapezium approach radial styloid
Scaphoid forced into flex - ligament btw scaph and lunate pulls lunate into flex
Radial dev continues with prox row ulnar glide

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16
Q

Carpal tunnel

A

upside down arch/bridge
proximal part is more narrow than distal part
If you extend the wrist, the area gets tighter

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17
Q

Carpal tunnel is maintained by

A

the flexor retinaculum and transverse intercarpal ligaments

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18
Q

Carpal tunnel contains

A

Flexor digitorum superficialis/profundus
Flexor pollicis longus
flexor carpi radialis
median nerve

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19
Q

Longitudinal arch

A

From carpal bones to tip of phalanges
centered around 3rd digit
relatively stable

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20
Q

Transverse arch

A

Proximal through distal row of carpals
Distal through heads of MCs
Mobility of wrist/fingers

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21
Q

Oblique arch

A

digits move obliquely to thumb/carpals

thumb opposition to fingers

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22
Q

Carpometacarpal joints (CMC) motion increases from

A

radial to ulnar

2nd and 3rd are immobile

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23
Q

CMC Thumb opposition includes

A

flex
abd
IR

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24
Q

Metacarpophalangeal joints (MCP) (2nd to 5th) close packed

A

full flexion

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25
Interphalangeal joints (IP) close packed
full ext
26
Thenar mm
Abductor pollicis brevis Opponens pollicis Flexor pollicis brevis Adductor pollicis
27
Hypothenar mm
Abductor digiti minimi Flexor digiti minimi Opponens digiti minimi
28
Prehension
act of gripping something with the hand
29
Prehension - Precision grip
For fine movements great strength not available mainly index and thumb
30
Prehension - preciision grip - which has the most strength
Pad to side
31
Prehension - power grip
Used when strength is needed fine movement not available mainly flexion of all fingers
32
Prehension power grip - palmar grip
gives more dexterity, can have full fist without ulnar deviation
33
Prehension power grip - hook grip
gives more strength | thumb does not carry weight but locking mechanism stabilizes
34
Collies fracture
Fracture of the distal radius in an extended position | Most common
35
Smith fracture
Fracture of the radius in a wrist flexion position
36
Scaphoid fracture
worry about necrosis
37
Bennetts fracture
metacarpal fracture
38
Gamekeepers thumb
Ulnar collateral ligament sprain | Forceful radial deviation of thumb
39
Dequervains tenosynovitis
Irritation of the tendons and tendon sheath | Abd pollicis longus and ext pollicis brevis
40
Trigger finger
pulleys not working stretched out and ruptured finger stuck in flexion might have to pull it back with other hand
41
Dupuytrens contracture
proliferation of palmar fascia adheres to itself as it grows usually affects 4th and 5th digits get finger flex contracture
42
Volkmanns ischemic contracture
Obstruction of blood supply to forearm mm typically due to cast being too tight mm necrose and fibrose in as little as 6 hours flexor mm contracture results
43
Mallet fingers
Disruption to profundus tendon from OA Avulsion of extensor tendon at DIP hangs down in flexion and they will have trouble extending fingers
44
Heberdens nodes
At DIP joints typically on dorsal aspect have ext limitations might also present with stiffness in hands - OA might be starting
45
RA - ulnar drift often seen at
MCPs
46
RA - Swan neck deformity
PIP hyperextension DIP flex Rupture of volar plate
47
RA - Boutonniere deformity
PIP flex DIP ext rupture of extensor mechanism
48
RA - Bouchards nodes
at PIP joints
49
Wrist drop
radial nerve compromise | can;t actively extend wrist but they can passively
50
Claw hand
intrinsic minus hand interossei and lumbricals occurs due to median and ulnar compromise
51
Ape hand
medain nerve compromise involvement of 1st and 2nd and 3rd digits get recessed thumb and MCP extension indicative of progressive, long term carpal tunnel syndrome
52
Bishops deformity
Ulnar compromise, flexed fingers
53
Complex regional pain syndrome
sympathetic dysfunction of unknown origin | hypovascularity to a portion of body due to abnormal sympathetic activity
54
Raynauds syndrome
Vasospasm of small cutaneous and subcutaneous arteries and arterioles idiopathic usually B
55
Manual dexterity - Jebsen taylor
``` writing card turning picking up small objects stacking picking up large light and heavy objects ```
56
Manual dexterity - Minnesota rate of manupulation tets
wood cutouts, blocks with diff colors | placing, turning, displacing, one hand turning and placing, two hands
57
Manual dexterity - Purdue pegboard
``` fine motor assembly place in in holes washer on top of pin then another washer timed test ```
58
Manual dexterity - Nine hole peg
time it
59
Murphys sign
for dislocated lunate have pt make fist pos if 3rd MC level with 2nd and 4th
60
Ulnar snuff box test
for triquetrum integirty | palpate snuff box - pos if pain (compressing triqutrum into disc)
61
Watsons sign
Scaphoid shift Scapholunate ligament stability palpate scaphoid passively move pt wrist from ulnar dev and ext to rad dev and flex
62
Finkelstein
for dequervains
63
trigger finger test
palpate volar surface of PIP pt flex and extend PIP pos if snapping
64
Phalen
Median nerve B flex elbows at 90 fully flex wrists for 60 sec
65
Pinch test
median nerve | pt tries tip to tip pinch btw thumb and 2nd
66
Fromets
Ulnar | Pt hold piece of paper try to pull away
67
Wartenbergs sign
Ulnar | therapist passively spreads fingers apart and if pt can't adduct 5th digit is pos
68
Allens
Radial and ulna rarterial supply pt amke fist and relax repetitively squeeze hand tightly and then PT compress both radial and ulnar for 10-20 sec pt open hand and PT release pressure over one artery - watch for refill should have rapid refill within 3 sec
69
Digital blood flow
Compress nailbed and note time to return | avg is 3 sec
70
Contraindications for neural provocation tests
``` Irritable and inflammatory conditions Spinal cord lesions Nerve root compression Malignancy Complex regional pain syndrome Suspicion that distal sympts are result of spinal segment issues ```

COMP ORTHO (11 decks)

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