OCS Study Wrist/Hand

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chrisgarcia34
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6423
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OCS Study Wrist/Hand
Updated:
2010-02-09 00:24:06
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OCS
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Wrist/Hand Study Guide
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  1. What is the tie rod of the proximal and distal row?
    The scaphoid
  2. What is Kienbock disease?
    AVN of the lunate.
  3. This arch contributes to powerful grasp.
    Longitudinal
  4. This arch allows the hand to adapt to objects held in the palm.
    Distal transverse arch
  5. This arch is defined by the volar concavity of the distal row of carpal bones and serves as a stable base for the hand.
    Proximal transverse arch
  6. Name the structures of the TFCC
    • Articular disk
    • Lunar collateal lig
    • ECU tendon sheath
    • Meniscus homologue
    • Dorsal and volar radioulnar ligs
  7. This portion of the disk of the TFCC is vascularized.
    • The apex
    • If injury is at the radial attachment then open reduction is required for healing.
  8. What is normal ROM for the wirst?
    • Flexion = 85
    • Extension = 80
    • Radial deviation = 20
    • Ulnar deviation = 35
  9. What is the closed pack position of the wrist?
    Wrist extension
  10. What angle should MP joints be splinted in post injury or surgery and why?
    70 to 90 deg of flexion to prevent lig contracture.
  11. What position should IP joints be splinted in and why?
    In full extension to prevent contracture of the collateral ligs.
  12. What runs through extensor compartment 1?
    Abductor pollicis longus and extensor pollicis brevis.
  13. What runs through extensor compartment 2?
    Extensor carpi radialis longus and extensor carpi radialis brevis.
  14. What runs through extensor compartment 3?
    Extensor pollicis longus
  15. What runs through extensor compartment 4?
    Extensor digitorum and Extensor indicis
  16. What runs through extensor compartment 5?
    Extensor digiti minimi
  17. What runs through extensor compartment 6?
    Extensor carpi ulnaris
  18. What action do the lumbricals help with?
    IP jt extension and MP jt flexion.
  19. Name the thenar intrinsics.
    • Adductor pollicis
    • Abductor pollicis brevis
    • Opponens pollicis
    • Flexor pollicis brevis
  20. Name the hypothenar intrinsics.
    • Abductor digiti minimi
    • Flexor digiti minimi
    • Opponens digiti minimi
  21. Name the muscles innervated by the median nerve.
    • Pronator teres
    • Flexor carpi radialis
    • Palmaris longus
    • Flexor digitorm superficialis
  22. Name the muscles innervated by the anterior interosseous branch of the median nerve.
    • Flexor digitorum profundus to the index and long finger
    • Flexor pollicis longus
    • Pronator quadratus
  23. Name the muscles innervated by the median nerve past the carpal tunnel.
    • Abductor pollicis brevis
    • Opponens pollicis
    • Flexor pollicis brevis
    • Lumbricals I and II
  24. What is the innervation of the palmar cutaneous branch of the median nerve?
    Skin over the central part of the volar wrist (unaffected by CTS).
  25. What muscles does the ulnar nerve innervate in the forearm?
    • Flexor carpi ulnaris
    • Flexor digitorum profundus to IV & V
  26. What muscles does the ulnar nerve innervate in the hand?
    • Palmaris brevis
    • Abductor digiti minimi
    • Opponens digiti minimi
    • Flexor digiti minimi
    • Lumbricals III & IV
    • Dorsal & volar interossei
    • Flexor pollicis brevis (deep head)
    • Adductor pollicis
  27. Describe the distribution of the palmar cutaneous branch of the ulnar nerve.
    The skin over the medial wrist and hypothenar eminence.
  28. Describe the distribution of the dorsal branch of the ulnar nerve.
    Skin over the dorsal aspect of the medial part of the hand and dorsal medial 1 1/2 digits.
  29. What muscles are innervated by the radial nerve?
    • Triceps
    • Brachioradialis
    • Extensor carpi radialis longus
  30. List the muscles innervated by the posterior interosseous branch of the radial nerve.
    • Extensor carpi radialis brevis
    • Supinator
    • ED
    • Extensor carpi ulnaris
    • EDM
    • Abductor pollicis longus
    • Extensor pollicis brevis
    • Extensor pollicus longus
    • EI
  31. Describe the cutaneous distribution of the radial nerve.
    • Skin over the dorsal aspect of both the lateral part of the hand and lateral 3 1/2 digits distal to the DIP joints.
    • It emerges superficailly at the wrist between the brachioradialis and ECRL tendons
  32. This artery bifurcates at the elbow, turning into the radial and ulnar branches.
    • Brachial artery
    • The radial and ulnar artery divide into the superficial and deep branches.
    • The radial artery supplies the scaphoid.
  33. What artery supplies the schaphoid?
    Radial artery
  34. What extensor compartments are most commonly involved in tendinitis?
    1st, 2nd, and 6th
  35. What is DeQuervain syndrome?
    • Inflammation of the synovial sheaths of the abductor pollicis longus and EPB tendons in the 1st compartment.
    • Clinical features are pain and swelling around the radial styloid with a positive Finkelstein test.
  36. What does Finkelstein test indicate.
    DeQuervain syndrom, tendinitis of AbPL and EPB
  37. What is trigger finger?
    Stenosing tenosynovitis of the digital flexor tendon sheath in the area of the A1 pulley.
  38. List the common areas of a ganglion cyst.
    • Dorsal scapholunate lig (60%)
    • Volar radiocarpal lig
    • Flexor carpi radialis sheath
    • Extrinsic flexor tendons
    • 50% of episodes disappear spontaneously
  39. What is Dupuytren disease?
    A progressive fibrosis of the palmar aponeurosis, natatory ligs and digital fascia.
  40. List those likely to get Dupuytren disease.
    • Norther European descendant
    • Persons with epilepsy
    • Diabetes
    • Alcoholism
    • Men 8:1
  41. What is the effective treatment of Dupuytren disease?
    Sugery
  42. What are the most crucial pulleys?
    A2 & A4
  43. Where is the A1 pulley?
    MP joint
  44. Where is the A2 pulley?
    Proximal portion of the proximal phalanx
  45. Where is the C1 pulley?
    Middle portion of the proximal phalanx
  46. Where is the A3 pulley?
    PIP joint
  47. Where is the C2 pulley?
    Proximal portion of the middle phalanx
  48. Where is the A4 pulley?
    Middle portion of the middle phalanx
  49. Where is the C3 pulley?
    Distal portion of the middle phalanx
  50. Where is the A5 pulley?
    DIP joint
  51. What is neurapraxia?
    • A transient compression that leaves the axon intact but blocks segmental conduction through ischemic changes.
    • May take a few days to 3 mo to resolve.
  52. What is axonotmesis?
    Crush or traction injury where the axon is damaged but the endoneurial tube is intact. Wallerian degeneration will occcur.
  53. What is neurotmesis?
    • Severance or laceration and surgial repair is necessary for recovery, although recovery is generally incomplete.
    • Ideal reinnervation occurs in 1-3 mo but may take up to a year or more.
  54. Describe the order of sensory return.
    • 1. Pain and temp
    • 2. 30 cps
    • 3. Moving touch and moving 2 point discrimination
    • 4. Constant touch and static 2 point discrimination
    • 5. 256 cps
  55. What fiber type trasmits pain and is the first to heal?
    C-fibers
  56. What fiber types are medium sized and are for pain, temp, and proprioception?
    B-fibers
  57. What fiber types are for touch, pressure, and movement sensation?
    • A beta/A gamma
    • Largest and slowest to heal

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