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ortho 3 > Wrist And Hand Preclass > Flashcards

Wrist And Hand Preclass Flashcards

1
Q

Thumb contributes what percent of hand function

A

40

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2
Q

3 main arches of hand

A

Longitudinal
Metacarpal phalangeal transverse
Carpal tunnel

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3
Q

Distal radioulnar joint

A

Uniaxial pivit joint

Pronation supination occur here-ulna not fixed

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4
Q

Ulna moves ___ for pronation

A

Back and lateral

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5
Q

Ulna moves ___ for supination

A

Forward and medial

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6
Q

Distal RU resting

A

10 deg supination

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7
Q

distal RU closed pack

A

5 deg supination

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8
Q

Distal RU capsular pattern

A

Pain at extreme of rotation

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9
Q

DRUJ trauma

A

Fall on pronated and ulnarly deviated hand

Injury here accompanies forearm fx

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10
Q

DRUJ trauma symptoms

A

Ulnar sided wrist pain associated w/ pronation and supination
Tenderness and swelling over joint
Clunks during rotation (possible TFCC tear)

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11
Q

Forces when you fall

A

80% up radius
20% up ulna
Load differential based on radial angulation of 10-15 deg volar LT and 20-25 deg toward ulna

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12
Q

During immobilization for collies Fox

A

Edema control and retrograde massage of hand
-HEP for mainting ROM of shoulder, elbow, digits (full MP flex)
-full composite digitize flexion and extension
Tendon gliding

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13
Q

Radiocarpal joint

A

2 deg freedom
Radius post portion extends distally
Articulate w/ scaphoid and lunate
CONVEX rule

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14
Q

TFC disc

A 
Attaches at ulnar side of radius
Attaches to ulnar styloid process
Articulates w/ lunate and triquetrum
Acts as stabilizer and shock absorber
Commonly injured w/ FOOSH
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15
Q

Load bearing ration for TFC disc

A

Intact 60:40 radius to ulna

Removed is 95:5

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16
Q

TFCC acute trauma

A

Peripheral tears

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17
Q

TFCC degeneration

A

Central tears

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18
Q

TFCC injury

A

Ulnar impaction or positive ulnar variance may contribute to lesion
Local tenderness, pain w/ pronation/sup and forceful gripping
May also hear clicking w/ motion

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19
Q

Ulnar impaction and positive ulnar variance - radiograph

A

May show flattening, subchrondral sclerosis or cysts, lyric changes in lunate/triquetrum w/ similar changes seen over distal ulna

  • pt may have positive ulnar variance
  • in subtle cases, a pronation grip gradiophragph may demonstrate ulnar variance
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20
Q

Carpal stability

A

Ligaments
Scapholunate ligament is commonly injured
Palmar ligaments stronger than dorsal

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21
Q

Scaphoid Fx

A

Falling onto radial side of hand w/ supination and ext

Young active people

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22
Q

Most frequently fractured bone in the wrist

A

Scaphoid

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23
Q

Fractures and the waist

A

70% occur through the waist

Proximal Fx above the waist lead to a vascular necrosis

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24
Q

Scaphoid Fx symptoms

A

Snuff box effusion and tenderness
Local tenderness to palpation over scaphoid tubercle w/ wrist extended
Snuff box pain w/ resisted pronation

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25
Q

Wrist dislocation

A

Most commonly involve Lunate and scaphoid
May or may not spontaneously reduce
Can compress median n

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26
Q

Wrist hyperextension dislocation

A

Volar subluxation of lunate

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27
Q

Dorsal wrist syndrome

A

Scapholunate snovitis w/ or w/out measurable ligamentous disruption

  • pain w/ activity
  • post activity aching
  • dorsal tenderness over scapholunate joint
  • provocation w/ resisted finger ext in wrist flexion
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28
Q

Tears of IO ligament

A

Volar lunate—> dorsal scaphoid

Volar rotary subluxation occurs w/ complete disruption of scapholunate lig

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29
Q

Radiocarpal resting

A

Neutral w/ slight ulnar deviation

30
Q

Radiocarpal closed pack

A

Extension

31
Q

Radiocarpal capsular pattern

A

Flexion and extension equally limited

32
Q

Most common site for restricted motion after immobilization

A

Intercarpal joints

Minimal amounts of gliding occur here

33
Q

Intercarpal resting

A

Neutral or slight flexion

34
Q

Intercarpal closed pack

A

Extension

35
Q

Intercarpal capsular pattern

A

None

36
Q

Medial midcarpal joints

A

Scaphoid, lunate, triquetrum
Articulate w/
Capitate and hamate

37
Q

Lateral medial carpal joints

A

Scaphoid articulates w/ trapezium and trapezoid

38
Q

Midcarpal joints bound by

A

Palmar and dorsal lig

No IO

39
Q

Midcarpal center of rotation

A

Base of capitate for wrist flexion/ext, radial/ulnar deviation

40
Q

Wrist extension and flexion occurs primarily at

A

Radiocarpal joint

So target here before midcarpal if they’re lacking movement

41
Q

Midcarpal resting position

A

Neutral or slight flexion w/ ulnar deviation

42
Q

Midcarpal closed pack

A

Extension w/ ulnar deviation

43
Q

Midcarpal capsular pattern

A

Equal limitation of flexion and extension

44
Q

Carpal tunnel roof

A

Volar

Transverse carpal lig

45
Q

Carpal tunnel floor

A

Dorsal

Volar radiocarpal lig, volar intercarpal lig, carpals form concave arch

46
Q

Carpal tunnel medial wall

A

Pisiform and hook of hamate

47
Q

Carpal tunnel lateral wall

A

Tuberosity of scaphoid and tubercle of trapezium

48
Q

Carpometacarpal joint

A

2-4 plane synovial - gliding
5 resembles stellar
Thumb is true stellar

49
Q

First CMC joint arthro

A

Radial ab/ad concave

Palmar ab/ad convex

50
Q

MCP movements

A

2-5 flex/ex, and ab/ad
1 only flex/ext and some rotation
Collateral light right in flexion

51
Q

Wrist power

A

Extrinsic muscles

52
Q

Wrist fine control

A

Interinsic muscles

53
Q

20-30 deg wrist ext allows

A

Maintenance and development of required tension

54
Q

Functional position of the hand

A

20-25 deg wrist ext

10-15 deg ulnar devation

55
Q

Position of hand immobilization

A

Similar to functional position but MP flexed, IP extended

Decreased potential for contracture

56
Q

Power grip

A

Finger flexion, ulnar devation and wrist ext

57
Q

Median nerve entrapment - wrist

A

Pronator teres or FDS
Carpal tunnel
The air eminence

58
Q

Radial nerve entrapment - wrist

A

Arcade of froshe
B/n tendon os ECRL and brachioradialis
Along the radius

59
Q

Ulnar nerve course

A

Courses through 2 heads of FCU •  Enters Guyon’s tunnel formed by the pisiform,
hook of the hamate and pisohamate ligament

60
Q

Wrist hyperextension injuries may result in

A

Capsuloligamentous injury

Lightamentous sprain and/or fx

61
Q

Long standing wrist/hand problems may have

A

RSD or CRPS

62
Q

Wrist drop

A

Radial nerve palsy

63
Q

Claw hand

A

Intrinsic minus hand
Combined median and ulnar nerve palsy
MP ext
PIP and DIP flexion

64
Q

Ape hand

A

Median nerve palsy
Put unable to oppose or flex thumb
Thenar eminence wasting

65
Q

Bishop’s hand

A

Ulnar nerve palsy
Waisting of hypothenar eminence
Loss of interossei and two medial lumbricals

66
Q

OA hand deformities

A

Heberden’s nodes

Bouchard’s nodes

67
Q

RA hand deformities

A

Ulnar drift

“Z” deformity (flexed MP, ext IP)

68
Q

Swan neck

A

Extension at PIP (rupture of ext hood)

Flex at DIP, MCP

69
Q

Boutonnière

A

Flexion at PIP (rupture of ext hood)

Ext at DIP, MCP

70
Q

Hand tendon deformities

A

Mallet finger
Dupuytren’s contracture
Trigger finger

ortho 3 (12 decks)

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