Flashcards

The Wrist Joint

anam.ijaaz English 78 cards

What is the radiocarpal joint made up of?

Cards in this deck (78)

1What is another word for the wrist joint?Radiocarpal joint
2What type of joint is the radiocarpal joint? Saddle, ellipsoid or hinge?Ellipsoid joint
3What is the radiocarpal joint made up of?Formed on one side by the radius and the articular disc, and on the other by the proximal row of carpal bones.
4What is the name of the joint between the articular disc (TFCC) and the ulnar?Ulnocarpal joint
5The triquetrum is always touching the triangle articular disc. True or false?False; it only comes in close contact with it during ulnar abduction but loses contact on radial abduction.
6The capsule of the radiocarpal joint is very strong. True or false?False it is lax and thin, supported by numerous ligaments.
7Which nerve innervates the wrist joint?Anterior and posterior interosseous nerves
8Name the joint highlighted in yellowDistal radioulnar joint
9Name the joint highlighted in yellowCarpometacarpal joint
10Name the joints highlighted in yellowMidcarpal and intercarpal joint
11The wrist joint shares a common capsule with the inferior radioulnar joint. True or false?True
12The proximal row of carpal bones are just as mobile as the distal row. True or false?False; the distal row of carpal bones is more mobile since they are joined to the metacarpal bones by strong ligaments by carpometacarpal joints.
13Which carpal bones project significantly toward the palmar side?Hamate and pisiform
14Why is the hand tilted to one side? Which side is it and by how many degrees is it tilted?It is tilted because the radial styloid process is distal to that of the ulnar styloid, and hence there is an ulnar tilt of between 21-25 degrees.
15How many degrees is the palmar tilt of the hand?12
16What defines a sesamoid bone?One which is embedded within tendons and may be partly or completely ossified.
17Where is the styloid process and tubercle on the distal part of the radius? (in terms of posterior, anterior, lateral, distal)Styloid process: lateral
Tubercle: posterior
18Which styloid process extends more distally, the radial or ulnar styloid process?Radial
19In what circumstance would the ulnar styloid process extend more distally than usual?When there has been a fracture - therefore used as a clinical sign of fracture in a patient examination
20What type of joint is the distal radioulnar joint?Pivot
21What lies between the radius and styloid process of the ulna?Articular fibrocartilaginous disc (TFCC)
22With which bones does the radius articulate with in the hand?Lunate and scaphoid
23What is the function of the interosseous membrane?Prevents parallel displacement of the radius and ulna but also allows pulling and pressure stresses to be transmitted from one bone to the other. Bones fracture before interosseous membrane is torn.
24Which carpal bone is not a 'true' carpal bone and why?Pisiform; it is a sesamoid bone
25Within which tendon lies the pisiform bone?Flexor carpi ulnaris
26Name the carpal bones on this image
27Name the carpal bones in the proximal rowSLTP:
scaphoid
lunate
triqetrum
pisiform
28Name the carpal bones in the distal rowHCTT
hamate
capitate
trapezoid
trapezium
29Through which bones does the central axis of the hand run through?Capitate, lunate and radius
30Which carpal bone is most commonly fractured?Scaphoid (60-70% of cases)
31What are Gilula's arcs and how are they clinically significant?Arcs used to demarcate normal position of carpal bones and disruption of these arcs is an indication of ligament tear or fracture of the carpal bones.
32Which carpal bone is boat shaped and has a tubercle on its lateral side?Scaphoid
33Which carpal bone is half-moon shaped?Lunate bone
34Which bone is pyramidal in shape, and has an isolated oval facet on the distal part of the palmar surface.Triquetrum
35Which carpal bone is pea-shaped, and has only one oval facet on the proximal part of its dorsal surface?Pisiform
36Which carpal bone is quadrangular in shape, and has a crest and a groove anteriorly. It has a concavoconvex articular surface distally.Trapezium
37Which carpal bone resembles a small baby shoe?Trapezoid
38Which carpal bone is the largest carpal bone, with a rounded head.Capitate
39Which carpal bone is wedge-shaped, with a hook near its base.Hamate
40What is the meaning of the term 'position of function' in terms of the wrist? How is the position helpful in clinically?Neutral position: When the flexor and extensor tendons have equilibrium - also referred to as 'splinting' position as it prevents excessive contracture of either sets of muscles in cases of neurological disease or inflammation.
41What is the tenodesis effect?When the wrist is extended, the fingers flex and when the wrist is flexed, the fingers extend.
42In order to exert power for grip, does the wrist have to be extended or flexed? Why?Extended as this stretches the flexor tendons and causes a reflex increase in the contractions of flexor muscles.
43Abduction can also be referred to as what? (in terms of the forearm bones)Radial deviation
44Adduction can also be referred to as what? (in terms of the forearm bones)Ulnar deviation
45Adduction of the wrist is capable of a greater range of movement that abduction. True or false?True but only in anatomical position. This is because normally, the wrist is held in partial adduction so from this starting position, adduction and abduction would be equal.
4660% of wrist flexion occurs where?At the midcarpal joint
4733.3% of wrist extension occurs where?At the midcarpal joint
48The wrist is a bi-axial joint. True or false?True
49Through which bone articulations do the axes of the wrist bisect each other?Radial-lunate articulation
50Which muscles are used to produce wrist abduction?Radial carpals muscles (extensor and flexors, each cancelling out their flexor/extensor action)
51Which muscles are used to produce wrist adduction?Ulnar carpal muscles
52Which carpal bone becomes palpable through the skin during pure radial abduction?Scaphoid
53Radial abduction and ulnar adduction occurs through which axis, and which carpal bone does the axis run through?Dorsopalmar axis which runs through the head of the capitate bone
54In pure ulnar adduction, the proximal carpal bones are tilted about which axis?Radioulnar axis
55What is the normal scapholunate angle?30-60 degrees
56Which side (radial or ulnar) do the proximal and distal rows of the carpal bones rotate to during radial deviation?Proximal - ulnar
Distal - radial
57During radial deviation, the scaphoid and lunate bones rotate to which side? (dorsal or palmar)Palmar
58Which side (radial or ulnar) do the proximal and distal rows of the carpal bones rotate to during ulnar deviation?Distal - ulnar
Proximal - radial
59During ulnar deviation, the scaphoid and lunate bones rotate to which side? (dorsal or palmar)Dorsal
60State the boundaries (roof, wall and floor) of the carpal tunnel.Roof - Flexor retinaculum
Floor - hamate, capitate, trapezoid, trapezium
61What passes through the carpal tunnel?Nine flexor tendons (not the muscles themselves) pass through the carpal tunnel:
flexor digitorum profundus (four tendons)
flexor digitorum superficialis (four tendons)
flexor pollicis longus (one tendon)
*flexor carpi radialis (one tendon), travels in the flexor retinaculum which covers the carpal tunnel, rather than running in the tunnel itself.
AND median nerve between tendons of flexor digitorum profundus and flexor digitorum superficialis
62What is in place to prevent friction between flexor tendons?Tendons are surrounded by synovial sheaths
63List the attachments of the flexor retinaculumAttaches to pisiform bone and hook of hamate medially, and tubercle of scaphoid and trapezium bone laterally.
64What is carpal tunnel syndrome?When structures in the carpal tunnel are compressed, inc. the median nerve which produces pain, paraesthesia and muscle weakness.
65What can cause carpal tunnel syndrome?Inflammation/swelling in the hand from oedema (e.g. in pregnancy), arthritis etc.
66Name the STRONG ligaments that support the radiocarpal joint.Ulnar and radial carpal COLLATERAL ligaments
67Name the weak ligaments that support the radiocarpal joint.Anterior and posterior ligaments:
palamar and dorsal radiocarpal ligaments
palmar ulnocarpal ligament
68Which ligament is most commonly ruptured? (not examined material)Scaphoulnate ligamnets
69Colle's Fracture is a very uncommon wrist fracture. True or false?False, it's the most common
70What is Colle's Fracture?Fracture on the lower end of the radius due to a fall on the palm of the hand with the arm extended.
71What happens to the distal end of the radius and the fibres of the interosseous membrane in Colle's Fracture?The distal fragment is displaced radially and dorsally and the fibres of the interosseous membrane fix the shaft of the radius to the ulna (bayonet position).
72What is bayonet position?When two bone fragments are aligned side-by-side rather than in end-to-end contact - see picture.
73What is dinner fork deformity?A bayonet deformity which is usually as a result of Colle's fracture.
74In a patient with Colle's fracture, how will the x-ray of their hand differ from that of a normal person? (other than the obvious image of the fracture)The ulnar will be in a more distal position.
75How is Colle's fracture treated?Requires surgical intervention to fix the bones back in proper alignment.
76Which carpal bone is most commonly fractured?Scaphoid bone
77Patients with wrist pain and tenderness in the anatomical snuffbox after a wrist hypertension injury should be assumed to have what?A scaphoid fracture - even if initial radiographs are normal because they are hard to spot on X-rays.
78What can occur as a result of a scaphoid fracture not being detected and thus not being treated?Avascular necrosis of the scaphoid = change in alignment of the other carpal bones and over years resulting in degenerative arthritis of the radioscaphoid joint, the midcarpal joint and ultimately the remaining wrist joints.