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| Question | Answer |
| Which styloid process is more distal? | Radial. |
| What structures form the cubital tunnel? | 1. medial epicondyle of the humerus 2. arcuate ligament 3. Osborne's fascia |
| Which nerve gets entrapped easily in the cubital tunnel? | The ulnar nerve. |
| List the proximal row of carpal bones (lateral to medial) | 1. scaphoid 2. lunate 3. triquetrum 4. pisiform |
| List the distal row of carpal bones (lateral to medial) | 1. trapezium 2. trapezoid 3. capitate 4. hamate |
| To which carpal bones does the flexor retinaculum attach? | 1. scaphoid 2. trapezium |
| Most frequently fractured carpal bone? | Scaphoid. |
| Name the 3 arches of the hand. | 1. longitudinal arch 2. metacarpophalangeal transverse 3. carpal transvers |
| The radiocarpal joint is stabilized laterally by the _____ and medially by the _______. | lateral: radial collateral ligament medial: triangular fibrocartilage complex |
| Attachment of the TFCC | 1. ulna 2. lunate 3. triquetrum |
| Load bearing ratio at the distal radioulnar joint. | radius 60: ulnar 40 |
| T/F: there are 3 degrees of movement by the pisiform. | F. It rests on triquetrum and does not participate in intercarpal motion. |
| Which direction is common for lunate displacement? Which nerve might be impinged? | Anterior displacement. Median nerve. |
| Main joint for wrist extension. | Radiocarpal joint. |
| Main joint for wrist flexion. | Mid carpal joint. |
| Which muscle is the most active during gripping? | Extensor carpi radialis (holds wrist in slight extension) |
| The three 'stabilizers' of the wrist that are active during both flexion and extension. | 1. extensor carpi ulnaris 2. extensor pollicis brevis 3. abductor pollicis longus |
| Which two muscles are major wrist flexors? | Flexor carpi radialis Flexor carpi ulnaris |
| Three groups of anterior forearm muscles. | 1. pronators 2. Hand flexors 3. Digit flexors |
| Which muscles in the forearm pronate the wrist? | pronator teres, pronator quaratus |
| Which muscles in the forearm flex the hand? | 1. flexor carpi radialis 2. flexor carpi ulnaris 3. palmaris longus |
| Which muscles in the forearm flex the digits? | 1. flexor digitorum superficialis and profundus 2. flexor pollicis longus |
| Which muscles in the posterior forearm extend the hand and wrist? | 1. extensor carpi radialis longus/brevis 2. extensor carpi ulnaris |
| Which muscles in the posterior forearm extend the medial 4 digits? | 1. extensor digitorum 2. extensor indicis 3. extensor digiti minimi |
| Which muscles in the posterior forearm extend the thumb? | 1. abductor pollicis longus 2. extensor pollicis brevis and longus |
| The collateral ligaments of the metacarpophalangeal joints become tight during _______. | Flexion. |
| T/F: the IP collateral ligaments also become tight in flexion. | F. They do not. |
| Optimal use of hand requires ___ deg extension. | 20 - 30 |
| The ______ muscles extend IPs and MCP joints. The _____ muscle and ____ place tension on the extensor expansion to allow IP extension. | Extensor digitorum muscles. Interossei and lumbricals place tension. |
| Which muscle causes IP and MCP extension at CMC retroposition? | Extensor pollicis longus. |
| When the MCP joints are stable, the FDS flexes the _______. | PIP |
| When the PIPs are stable, the FDP flexes the _____s. | DIPs. |
| Which muscle can hollow the paln when holding a cup of water? | Oppones digiti minimi |
| The inability to maintain a functional wrist position and the inability to release object is most likely damage of the ______ nerve. | Radial. |
| The inability to flex 2nd and 3rd digits and unable to perform a precision grip is most likely caused by damage of the ______. | Median nerve. |
| The inability to flex the 4th and 5th digits and unable to perform the power grip is most likely due to damage of the ______. | Ulnar nerve. |
| Which actions does the dorsal radiocarpal ligament restrict? | flexion, pronation radial deviation |
| Which actions does the palma ulnocarpal ligament restrict? | extension, supination |
| During finger flexion, the digits rotate _____ to assist grasping. | Radially. |
| Thumb movement: (examprep page 12): (concave/convex) on (concave/convex) during flexion/extension. | concave on convex. |
| Thumb movement: (examprep page 12): (concave/convex) on (concave/convex) during abduction/adduction. | convex on concave. |
| Capsular pattern for wrist: | flexion = extension |
| Capsular pattern for midcarpal and carpometacarpal joints. | Equal in all directions |
| Capsular pattern for trapeziometacarpal joint | abduction more limited than extension |
| Which test is for the TFCC integrity? | ulnomeniscotriquetral dorsal glide test |
| What does the Watson test assess? | Carpal instabiity. |
| Which two tests are specifically for de Quervain's tenosynovitis? | 1. Eichhoff's test 2. Finkelstein's test |
| How long is the Phalen's test? | 1 min |
| What is normal for the two-point discrimination test? | successfully detect less than 6mm. |
| Describe the Allen test. | 1. open-close hand quickly then make a fist 2. compress both radial and ulnar arteries - open fist- let go of radial compression - observe refill 3. repeat on the ulnar side. |
| Describe the Bunnel-Littler test | 1. keep MCP extended, measure maximal PIP flexion 2. flex MCP then measure maximal PIP flexion If both tight: caspular tightness If only (1) is tight: tight intrinsic hand muscles |
| The 'Bunnel-Littler' test for DIP joint. | If both tight: capsule tightness If DIP tighter during PIP extension: retinaculum is tight. |
| For Carpal tunnel syndrome, (pg 64), What should you rule out first? | 1. c-spine 2. peripheral nerve entrapment elsewhere 3. TOS |
| Some common comorbidities of carpal tunnel syndrome? | 1. pregnancy 2. diabetes 3. RA |
| Weakness pattern of carpal tunnel syndrome? | 1. thenar muscles 2. lateral 2 lumbricals |
| De Quervain's tenosynovitis affects mainly ________ and _______ tendons. | 1. extensor pollicis brevis 2. abductor pollicis longus |
| Possible MOI for de Quervain's tenosynovitis? | 1. repetitive microtrauma 2. swelling during pregnancy |
| De Quervain's tenosynovitis involves pain at ______, decreased ____ strength, and a positive ______ test. | Pain at [anatomical snuffbox] , decreased [grip] strength, and a positive [Finkelstein's] test. |
| How long is the Colles' fracture site immobilized after the incident? | 5-8 weeks. |
| What is it called if the distal radius is volarly displaced during a wrist fracture? | Smith's fracture |
| Which carpal bone fractures the easiest? | Scaphoid |
| How long should the carpals be immobilized after a scaphoid fracture? | 4- 8 weeks. |
| Dupytren's contracture, if patient has DM, most likely _______ fingers. If no DM, most likely _____ fingers. | DM: 3rd and 4th fingers No DM: 4th and 5th fingers |
| Comparing Boutonniere deformity and swan neck deformity: Where is the tear? | Boutonniere: [central] tendinous slip of extensor hood. Swan neck: dorsal subluxation of [lateral] extensor tendons |
| Comparing Boutonniere deformity and swan neck deformity: MCP, PIP and DIP positions? | Boutonniere: PIP flexed, MCP and DIP extended. Swan neck: PIP extended, MCP and DIP flexed. |
| Ape hand deformity is an aspect of _____ nerve palsy. | Median. |
| Rupture of the extensor tendon at its insertion into distal phalanx of digits is called ________. | Mallet finger |
| Finger positioning for Mallet finger. | Flexed DIP. |
| Your patient is referred here for 'gamekeeper's thumb', which structure should you examine? | Ulnar colateral ligament of MCP joints of the 1st digit. |
| Boxer's fracture is at the neck of _____. usually casted for _____. | 5th metacarpal cast for 2-4 weeks. |
| What is the test for lunotriquetral ligament called? | Regan's test. |
| Which tendon is possibly ruptured if the patient presents with the jersey finger sign? | flexor tendon at the distal phalanx. |
| Which test, if positive, suggests ulnar nerve damage resulting in flexor pollicis brevis weakness? | Froment's sign |
| Which Arthritis: 1. painful at rest 2. swelling at DIPs 3. swelling at PIP, MCP, wrist in women 20 - 40. | 1. bacterial arthritis 2. OA 3. RA |
| T/F: carpal tunnel affects both radial and ulnar side equally. | F. mainly affects radial side. |
| Wrist pain and sensory changes with lunate tenderness might be due to | Kienbock's disease. (avascular necrosis of the Lunate) |
| Any ROM restriction in Kienbock's disease? | Yes. progressive limitation of wrist ROM. |
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