Wrist, Hands and Fingers

Question 1

What is the TFCC?

Answer 1

Triangular Fibrocartilage Complex

Question 2

How many phalanges are in the hand?

Answer 2

14 phalanges

Question 3

How many degrees of freedom does the distal radioulnar joint have?

Answer 3

One degree of freedom for pronation and supination

Question 4

How many degrees of freedom does the radiocarpal joint have?

Answer 4

Two degrees of freedom for flexion and extension, abduction and adduction

Question 5

What makes up the TFCC?

Answer 5

Extensor Carpi Ulnaris Sheath Meniscus Homologue Ulnotriquetral Ligament Ulnolunate ligament Volar radioulnar ligament Dorsal Radioulnar ligament Articular Disk

Question 6

What are the borders of the anatomical snuff box?

Answer 6

Abductor pollicis longus tendon Extensor pollicis brevis tendon Extensor pollicis longus tendon

Question 7

What are the ten structures that run through the carpal tunnel?

Answer 7

Four tendons of the flexor digitorum profundus Four stacked tendons of the flexor digitorum superficialis Median Nerve Flexor Pollicis Longus Tendon

Question 8

Name this pathology:

Answer 8

Colles’ fracture

(Dorsal Displacement of the Distal Segment)

Question 9

What is Preiser’s Disease?

Answer 9

Osteoporosis of the Scaphoid bone

Question 10

What is De Quervain’s Syndrome?

Answer 10

Tenosynovitis of the Extensor Pollicis Brevis and Abuctor Pollicis Longus Tendons

Question 11

Name this deformity:

Answer 11

Boutonniere Deformity

(Rupture of the central extensor tendon… extension of the MCP and DIP joints and flexion of the PIP joint)

Question 12

What characterizes Bishop’s Deformity?

Answer 12

Weakness and atrophy of the hypothenar interossei, and medial two lumbricals. Limited extension at the PIP and DIP joints. This deformity is due to the inhibition of the ulnar nerve

Question 13

Why is Volkmann’s Ischemic Contracture a life-threatening situation?

Answer 13

It is life-threatening because this contracture leads to a decrease in blood supply and possible a forearm compartment syndrome

Question 14

Name this posture:

Answer 14

Dupuytren’s contracture

(caused by a shortening of adhesion of the palmar fascia. It is usually a hereditary condition)

Question 15

What are the carpal bones of the distal row?

Answer 15

Hamate, Capitate, Trapezoid, Trapezium

Question 16

Name this fracture:

Answer 16

Barton’s Fracture (Rim of the articular surface of distal radius)

Question 17

What is a common MOI of a scaphoid fracture?

Answer 17

FOOSH (Fall on outstretched hand)

Question 18

What is the MOI of the fracture of the body of the hamate?

Answer 18

Direct blow or axial load to the 4th and 5th metacarpals

Question 19

What is Guyon Canal Syndrome?

Answer 19

Compression of ulnar nerve at the hypothenar eminence due to repetitive wrist extension and radial deviation

Question 20

What is a sign for Handlebar Neuropathy?

Answer 20

Medial digit numbness due to direct compression from gripping

Question 21

What must be ruled out first before ruling in a wrist sprain?

Answer 21

TFCC tears and carpal fractures

Question 22

What can predispose an athlete to a TFCC injury?

Answer 22

A long ulna bone may predispose an athlete to a TFCC injury

Question 23

Name this fracture:

Answer 23

Bennett’s Fracture (Fracture of the base of the 1st metacarpal bone)

Question 24

Name this pathology:

Answer 24

Lunate Dislocation

Question 25

What are signs and symptoms of a lunate dislocation?

Answer 25

3rd knuckle may become level with the other knuckles Pain at wrist and along radius May suffer from paresthesia in middle finger

Question 26

What is the name for osteochondritis dissecans of the lunate bone?

Answer 26

Kienbock's Disease

Question 27

What is the Ape Hand deformity?

Answer 27

Weakness and atrophy of the muscles of the thenar eminence due to median neuropathy

Question 28

What bone articulates with the trochlea of the humerus, the head of the radius and the distal end of the radius?

Answer 28

The Ulna

Question 29

What are the extrinsic ligaments of the wrist?

Answer 29

Dorsal radiocarpal ligament, ulnar collateral ligament, radial collateral ligament, TFCC, palmar volar radiocarpal ligament

Question 30

What are the intrinsic wrist and hand ligaments?

Answer 30

Radio/ulnar collateral ligaments, intercarpal ligaments, carpometacarpal ligaments, intermetacarpal ligaments, metacarpophalangeal ligaments, interphalangeal ligaments

Question 31

True or False, there are muscles that originate on the phalanges.

Answer 31

False

Question 32

Name the extrinsic thumb movers

Answer 32

Flexor pollicis Longus- flexion at CM, MCP and IP, Wrist flexion; Abductor Pollicis Longus- thumb ABD, thumb ext at CM, Wrist Radial Dev; Extensor Pollicis Longus- Thumb ext at CM, MCP, and IP joints, Wrist Radial Dev; Extensor Pollicis Brevis- thumb extension at MCP joint, wrist radial deviation

Question 33

Which muscles radially deviate the hand?

Answer 33

Extensor pollicis brevis, Extensor Pollicis longus, Extensor Carpi Radialis longus, Extensor Carpi Radialis brevis, Abductor pollicis longus

Question 34

Where do the lumbricals originate?

Answer 34

Tendons of the flexor digitorum profundus tendons

Question 35

What is comprised of Guyon's Canal?

Answer 35

Guyon's Canal is between the pisiform and the hook of hamate and involves the ulnar artery and nerve passing through. The roof is made of the flexor retinaculum band. The floor is made of the pisohamate ligament.

Question 36

What is a true Colles' Fracture?

Answer 36

Dorsal displacement of distal fragment of the radius; 1.5 inches proximal to the radiocarpal joint

Question 37

What is a Barton's Fracture?

Answer 37

Rim of the articular surface of distal radius is fractured. Often involves carpal bone dislocation

Question 38

Which carpal bone is the most commonly fractured?

Answer 38

Scaphoid bone (approx. 70%)

Question 39

What is a common, absolute symptom with a hamate fracture?

Answer 39

Pain with 5th finger movement

Question 40

True or false? A Jersey Finger deformity is an avulsion at the insertion of the extensor digitorum tendon

Answer 40

False. The Mallet finger is an avulsion at insertion of the extensor digitorum tendon

Question 41

What is a Pseudo Boutonniere deformity?

Answer 41

It is a deformity that involves the injury to the volar plate, but there is no active or passive extension at the PIP joint

Question 42

Which two structures are involved in De Quervain's Syndrome?

Answer 42

Extensor Pollicis Brevis and Abductor Pollicis Longus