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Flashcards in Wrist and Hand Deck (92):
1

Name the soft tissue palpation for wrist and hand

Ulnar artery
Radial artery
Palmaris Longus Tendon
Carpal Tunnel Region
Thenar Eminence
Hypothenar eminence
Palmar Aponeurosis
Tissues Surrounding proximal interphalangeal joints
Tissues surrounding distal interphalangeal joints
Distal tufts of fingers

2

Wrist ROM

Flexion 80
Extension 70
Ulnar Deviation 30
Radial Deviation 20

3

ROM Hand

Finger abd
Finger add
Thumb flexion
Thumb Extension
Finger Flexion
Finger Extension
Finger Opposition

4

The thumb is involved with what percent of hand function?

40-50%

5

What is the strongest finger?

The middle

6

What type of joint is the Distal Radio-Ulnar joint?

A double pivot joint that unites the distal radius and ulan and articular disc TFCC

7

T or F

The radial styloid process is approx one-half inch shorter than the ulnar styloid process

False

8

This type of fracture results in posterior angulation of the distal radius fragment

Colle's Fracture

9

What is an aka for Colle's Fracture

Dinner Fork Fracture

10

This is an extension fracture of the radius...

Colle's Fracture

11

T or F

Smith's Fracture is an extension fracture of the radius

False

Flexion fracture of the radius

12

Smith's Fracture aka

Garden Spade Deformity

13

Is there posterior or anterior angulation with a Garden Spade Deformity

Anterior

14

What does TFCC stand for?

Triangular Fibrocartilage Complex

15

The TFCC lies in-between what structures of the wrist?

Between the medial proximal row and distal ulan within the medial aspect of the wrist.

16

All of the following are primary functions of the TFCC except:
1. Improve Joint Congruency
2. Increase ROM
3. Cushion against compressive forces
4. Transmit axial load from the hand to the forearm

2. Increase ROM was not mentioned as a primary function of this complex

17

There are ___ Carpal bones and ____ metacarpals

8
5

18

The proximal row of carpal bones from lateral to medial are...

Scaphoid (navicular)
Lunate
Triquetrum
Pisiform

19

Name the distal row of carpal bones

Trapezium
Trapezoid
Capitate
Hamate

20

What is the most common fractured bone of the wrist?

Navicular

21

T or F
Navicular is the largest bone carpal bone

True
aka for Navicular = Scaphoid

22

What feature of the wrist allows us to make a fist? Think structure and articulations

The triangular shaped gap between the distal radial head and Triquetrium

23

T or F

Hamate is the largest in the distal row of carpals

False

Capitate

24

Name the second most fractured and the most commonly sublimated carpal

Lunate

25

What tendon covers the lunate, capitate and base of the 3rd metacarpal?

Extensor Carpi radialis tendon which inserts into the base of the 3rd metacarpal.

26

In what direction does the arch of the hand fall?

Posterior -> Anterior

27

T or F

The proximal row of carpals is convex laterally and concave medially

True

28

What is meant by a compound articulation

Each row of carpal joints has both a concave and convex segment

29

Stability of the CMC joint is provided by what ligaments?

The palmar and dorsal Carpometacarpal and intermetacarpal ligaments

30

The metacarpals articulate with the respective proximal phalanges in what type of joint? Multi axial, uniaxial or biaxial?

Biaxial joints

31

The MCP joints allow for what type of movements?

Flexion-extension
Medial-Lateral Deviation with a slight degree of axial rotation

32

What joints in the body are consider to be "Sellar"

1st Carpometacarpal Joint
Calcaneal and Cuboid joint

33

Describe a Bennett's Fracture

Fracture through the base of the first metacarpal neck with dorsal and radial displacement of the shaft. Bone goes Posterior and Lateral

34

T or F

Bar room fracture consists of a posterior displacement of the head of the 4th or 5th metacarpal neck.

False

Anterior displacement

35

How does a Boxer's Fracture compare to a Bar Room

Boxer = 2nd or 3rd finger
Bar Room = 4th or 5th

36

What are Heberden's Nodes?

Fount on one or more fingers
Distal joints are enlarged by hard nodules on either side of the dorsal midline
Condition in women usually hereditary

37

T or F

Heberden's Nodes are painful and motion is unlimited

False

Painless

38

How does Bouchard's Nodes differ from Heberden's?

Involves the PIP

39

Does RA usually present unilaterally or bilaterally?

Bilaterally

40

When a patient comes in suffering from Bouchard's nodes as a good DC what should we check?

For an increase in ADI

41

MOI for Swan Neck Deformity

RA

42

Describe how someone's finger would look with a Swan Neck deformity

PIP joint deforms into hyperextension and the DIP joint is flexed

43

What is a Boutonniere Deformity?

The central slip of the Extensor Digitorum Communis tendon is avulsed from the insertion in to the base of the middle phalanx, the PIP is flexed and the DIP is extended.

44

T or F

The extrinsic palmar ligaments provide the majority of rotational restraints, binding the proximal row into a unit of rotational stability

False

This is describing the intrinsic ligaments
Extrinsic = wrist stability

45

What are the medial and lateral collateral ligaments of the fingers named?

LCL = Cleland's
MCL = Grayson's

46

This dense connective tissue bracelet encases the forearm and maintains the relationship of the tendons that cross the wrist.

Antebrachial Fascia

47

What prevents the tendons of the wrist area from "bow-stringing" when the tendons turn a corner at the wrist?

Extensor Retinaculum

48

The extensor retinaculum compartments contains the tendons of what muscles from medial to lateral?

Abductor pollicis longus and extensor pollicis brevis
Extensor Carpi Radialis Longus and Brevis
Extensor pollicis longus
Extensor digitorum indicis
Extensor digiti minimi
Extensor carpi ulnaris

49

Proximally where does the retinaculum attach?
Distally?

Prox = To the tubercle of the scaphoid and the pisiform
Dist = hook of the hamate and the tubercle of Trapezium

50

Avulsion of the Flexor Digitorum Profundus tendon is known as?

Jersey Finger

51

MOI for Jersey Finger

The finger gets caught in an object and actively flexed DIP joint is suddenly and forcibly extended resolution gin a rupture

52

What makes up the floor of the Carpal Tunnel

The palmar radiocarpal ligament + palmar ligament complex

53

T or F

The roof of the Carpal Tunnel is made of the Extensor Retinaculum (Transverse Carpal Ligament)

False

Flexor Retinaculum babyyyy

54

What is the name of the tunnel that serves as a passage way for the ulnar nerve and artery into the hand?

Tunnel of Guyon

55

Name the structures that form the Roof of the Tunnel of Guyon

The palmar (solar) carpal ligament, palmaris brevis muscle and the palmar aponeurosis

56

Tunnel of Guyon is located between what two carpal bones?

The hook of the hamate and the pisiform

57

T or F

Cyclist hand is irritation to the median nerve

false

Ulnar

58

Describe Dupuytren's Contracture

This is a fibrotic condition of the palmar aponeurosis that results in nodule formation or scarring of the aponeurosis, and which may ultimately cause finger flexion contractures

59

Are you able to palpate nodules with Dupuytren's Contracture?

There is evidence of a small painless nodule that can be palpated in the palmar aponeurosis near the base of the digit.

60

The extensor hood is formed from a combination of the tendons and insertion from what muscles?

Extensor Digitorum
Extensor Indicis
Extensor Digiti minimi

61

What is the name given when the terminal phalanx of the finger is permanently flexed at the distal joint and it cannot be voluntarily extended

Mallet Finger

62

T or F
Mallet Finger is caused by a rupture of the flexor tendon that inserts on the terminal phalanx

False
Extensor tendon

63

The hills/mounds/peaks on the palm of the hands are formed from what?

Neuromuscular bundles that supply the fingers and lumbricals.

64

The valleys on the palm are made from what?

The paths of the flexor tendons at the point where they cross the joints.

65

Surgical No Man's Land is located where on the hand?

The distal palmar crease approximately at the knuckles of the MCP's

66

When flexion of the finger feels normal; but re-extension is accompanied by a painful snap that the patient sometimes refers to the dorsum of the hand is known as?

Trigger Finger

67

Name the Anterior Compartment Superficial muslces

Pronator Teres
Flexor Carpi Radialis
Palmaris Longus
Flexor Carpi Ulnaris

68

Name the Intermediate Muscle of the Anterior Compartment

Flexor Digitorum Superficialis

69

How many deep muscles or the Anterior Compartment are there? Name them

3
Flexor pollicis longus
Flexor digitorum profundus
Pronator Quadratus

70

Name the Superficial muscles of the posterior compartment

Ext Carpi Radialis Longus
Ext Carpi Radialis Brevis
Ext Digitorum & Ext digiti minimi
Ext Carpi Ulnaris

71

Deep muscles of the Posterior Compartment

Abd Pollicis Longus
Abd Pollicis Brevis
Ext Pollicis Longus
Extensor Indicis

72

What soft tissue structures lie on the floor of the Anatomical Snuff Box

The deep branch of the radial artery and the tendinous insertion of the ECRL

73

What tendons form the Anatomical Snuff Box

APL
EPB and the ulnar border formed by the EPL

74

What bone forms the floor of the snuff box?

Scaphoid

75

Do males or females suffer from De Quervain's Disease?

8:1 Female

76

Ulnar Collateral Ligament Avulsion of the MCP joint is known as?

Skier's Thumb aka Gamekeeper's Thumb

77

Name the short muscles of the thumb (4)

Abd pollicis brevis
Flex pollicis brevis
Opponins pollicis
Add pollicis

78

Name the short muscles of the 5th digit

Abd digiti minimi
Flex digiti minimi
Opponens digiti minimi

79

Functions of the Lumbricales

Function to perform the motion of the IP joint extension with the MCP joint held in extension and can assist in MCP flexion.

80

Name the Functional Arches of the Hand

Transverse Arch
Metacarpal Arch
Longitudinal Arch
Oblique Arch

81

What arch of the hand is formed by the 3rd and 5th digit pans lengthwise

Longitudinal Arch

82

Avascular Necrosis of Lunate aka?

Keinboch's Disease

83

Is Keinboch's more common in men or women?

Males 20-40yrs

84

What structure limits supination?

the interosseous membrane, and the bony impaction between the ulnar notch of the radius and the ulnar styloid process.

85

T or F

During wrist flexion most of the motion occurs in the mid carpal joint

True

60% or 40 degrees versus 40% or 30 degrees at the radoiocarpal joint.

86

Where does the majority of wrist extension occur?

Radiocarpal joint 66.5%

87

T or F

Thumb flexion and extension occur in the sagittal plane that is perpendicular to the frontal plane of finger flexion and extension

False
Occurs in the frontal plane

88

Name the power grips

Fist Grip
Cylindrical Grip
Ball Grip
Hook Grip

89

What joints are mainly involved with precision or prehension grips

MCP

90

What is Felon?

- Inflammation of the terminal finger pad is confined by tough fascia attached to the periosteum
- tenderness is intense
- swelling of the fingertips

91

Paronychia aka?

Hangnail

92

What is a functional range of motion for the hand?

Is the range in which the hand can perform most of its grip and other functional activities