The wrist joint
also known as the _____ joint
is a ____ joint in the upper limb, marking the area of transition between the _____ and the ____
radiocarpal
synovial
forearm and the hand.
Articulating Surfaces of wrist joint
The wrist joint is formed by:
Distally – The (proximal or distal ?) row of the carpal bones (except the ____).
Proximally – The distal end of the ____, and the _______
Proximal
pisiform
radius
articular disk
The ulna is part of the wrist joint
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Ulna articulates with the ___, just proximal to the wrist joint, at the______ joint.
radius
distal radioulnar
Ulna is prevented from articulating with the carpal bones by a ________, called the _______, which lies over the (superior or Inferior?) surface of the ulna.
fibrocartilaginous ligament
articular disk
Superior
the carpal bones form a (concave or convex?) surface, which articulates with the (concave or convex?) surface of the _____ and _____
Convex
Concave
radius and articular disk.
Joint Capsule of the wrist
Like any synovial joint, the capsule is ____ layered.
dual
Joint Capsule of the wrist
The (fibrous or serous?) outer layer attaches to the __,____ and the ___ row of the carpal bones.
The internal layer is comprised of a ____, secreting ____ which lubricates the joint.
fibrous
radius, ulna
proximal
synovial membrane
synovial fluid
Ligaments
Palmar radiocarpal –
radius
both rows of carpal bone
increasing stability
hand follows the forearm during supination.
Dorsal radiocarpal ligament-
radius
both rows of carpal bones
stability
pronation
Ulnar collateral ligament
–Runs from the ______ to the ____ and ___
-It acts to _______ of the hand.
ulnar styloid process
triquetrum and pisiform.
prevent excessive radial (lateral) deviation
Radial collateral
radial styloid process
scaphoid and trapezium
prevent excessive ulnar (medial) deviation
Neurovascular Supply
The wrist joint receives blood from branches of the _____ and ______ arches, which are derived from the ____ and ____arteries
dorsal and palmar carpal
ulnar and radial
Innervation to the wrist is delivered by branches of three nerves:
____ nerve – _____ interosseous branch.
_____ nerve – ____ interosseous branch.
___nerve –____ and ___ branches.
Median; Anterior
Radial; Posterior
Ulnar; deep and dorsal
The wrist is an _____ (____) type synovial joint, allowing for movement along ___ axes.
This means that ___,___,___,____ can all occur at the wrist joint.
ellipsoidal; condyloid
two
flexion, extension, adduction and abduction
Movements of the wrist
Flexion – Produced mainly by the ___,_____, with assistance from the ________
flexor carpi ulnaris, flexor carpi radialis
flexor digitorum superficialis.
Movements of the wrist
Extension – Produced mainly by the _____ and _____, and _________, with assistance from the _________.
extensor carpi radialis longus and brevis
extensor carpi ulnaris
extensor digitorum
Movements of the wrist
Adduction – Produced by the _______ and _____
Abduction – Produced by the ________,_______, _________ and _____
extensor carpi ulnaris and flexor carpi ulnaris
abductor pollicis longus, flexor carpi radialis, extensor carpi radialis longus and brevis.
The _____ bone of the hand is the most commonly fractured carpal bone – typically by ______
scaphoid
falling on an oustretched hand
In a fracture of the scaphoid, the characteristic clinical feature is pain and tenderness in the _______
anatomical snuffbox.
The scaphoid is at particular risk of avascular necrosis after fracture because of its so-called ‘__________’ which enters at its (proximal or distal?) end.
This means that a fracture to the middle (or ‘waist’) of the scaphoid may ____ the blood supply to the (proximal or distal?) part of the scaphoid bone rendering it ______.
retrograde blood supply
Distal
interrupt
Proximal
avascular
Patients with a missed scaphoid fracture are likely to develop _______ of the wrist in later life
osteoarthritis
Anterior Dislocation of the Lunate
This can occur by ______________.
-The lunate is forced (anteriorly or Posteriorly?) and compresses the ______, causing the symptoms of ______
This manifests clinically as _____ in the sensory distribution of the ____ nerve and weakness of ____ muscles.
falling on a dorsiflexed wrist
Anteriorly
carpal tunnel
carpal tunnel syndrome.
paraesthesia; median
thenar
In Anterior Dislocation of the Lunate
The lunate can also undergo avascular necrosis
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