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MS Therapeutics II: Exam II: Wrist Anatomy
Wrist
106
Science
Graduate
10/13/2011

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Cards

Term
What tubercle can you find on the distal radius? Dorsal or ventral? What muscles does it separate
Definition

Lister's Tubercle

Dorsal Radius

Separates ECRB (lateral) and EPL (medial)

Term
Is the articular surface of the radius convex or concave?
Definition
Concave in all directions (M/L and A/P)
Term
Discuss how the radius is angled.
Definition
25 degrees ulnarly

10 degrees palmarly
Term
What groove can you find on the distal, dorsal ulna?
Definition
groove for ECU
Term
The distal ulna articulates with what complex?
Definition
TFCC (Triangular Fibrocartilage Complex)
Term
Name the carpal bones in the proximal row.
Definition
1. Scaphoid
2. Lunate
3. Triquetrum
4. Pisiform
Term
Scaphoid contacts ___ carpals and ___ (radius or ulna)
Definition
Scaphoid contacts 4 carpals: lunate, Trapezium, trapezoid, capitate

Radius
Term
Where are the 2 convex surfaces on the scaphoid?
Definition
1. Proximal pole
2. Distal pole
Term
The proximal pole of the scaphoid articulates with the _____?
Definition
Radius (scaphoid facet)
Term
The distal pole of the scaphoid articulates with?
Definition
Trapezium and trapezoid
Term
Scaphoid tubercle projects _____. (palmarly or dorsally)
Definition
Palmarly
Term
What part of the scaphoid is concave?
Definition
medial facet
Term
What does the medial facet of the scaphoid articulate with?
Definition
Head of capitate
Term
Small facet at the proximal pole of the scaphoid articulates with?
Definition
lunate
Term
The scaphoid is the most commonly _____ carpal.
Definition
Fractured
Term
Does the scaphoid have good blood supply?
Definition
NO
Term
What is the central bone of the proximal row?
Definition
lunate
Term
The proximal surface of the lunate is ____ (convex or concave) and articulates with?
Definition
Convex
Articulates with the radius
Term
Distal surface of the lunate is ____ (convex or concave)
Definition
Concave
Term
What does the distal surface of the lunate articulate with?
Definition
Capitate and hamate
Term
Triquetrum is what shape of a bone?
Definition
Triangle
Term
What does the triquetrum articulate with?
Definition
lunate and hamate
Term
Pisiform is a ___shaped ___ bone.
Definition
Pea-shaped, sesamoid bone
Term
Where does the pisiform rest?
Definition
palmar side of the triquetrum
Term
Name the distal row carpals.
Definition
1. Trapezium
2. Trapezoid
3. Capitate
4. Hamate
Term
The proximal surface of the trapezium is ____ (convex/concave). It articulates with ____
Definition
concave trapezium articulates with scaphoid (distal pole)
Term
The distal surface of the trapezium is _____.
Definition
Saddle shaped
Term
What does the distal surface of the trapezium articulate with?
Definition
1st metacarpal
Term
Tubercle on the Trapezium projects ____.
Definition
Palmarly
Term
The tubercle of the trapezium is the attachment site for ______?
Definition
Transverse carpal ligament
Term
The tubercle of the trapezium is also a groove for what muscle?
Definition
Flexor carpi radialis
Term
Trapezoid proximal surface is ___ (convex/concave?
Definition
Concave
Term
The distal surface of the trapezoid articulates with?
Definition
Base of 2nd metacarpal
Term
What is the largest carpal bone?
Definition
Capitate
Term
What does the capitate articulate with proximally?
Definition
scaphoid and lunate
Term
The distal surface of the capitate is rigidily attached to the ?
Definition
3rd metacarpal
Term
Capitate and 3rd metacarpal form the stable pillar
Definition
Term
The distal surface of the hamate articulates with?
Definition
4th and 5th metacarpals
Term
The hook of the hamate is found palmarly. The hook of the hamate is the attachment site for the ?
Definition
transverse carpal ligament [medially]
Term
What forms the carpal tunnel?
Definition
palmar side carpal bones
Transverse carpal ligament
Term
What is contained within the carpal tunnel?
Definition
Median nerve
Tendons of the extrinsic digital flexors
Term
What are the attachment sites for the transverse carpal ligament
Definition
Medially: pisiform and hook of the hamate

Laterally: scaphoid tubercle and trapezium tubercle
Term
Name the joints of the wrist
Definition
1. Radiocarpal
2. Midcarpal
3. Intercarpal
Term
Load bearing through the radiocarpal joint?
Definition
20% of the load goes through TFCC
80% of the load goes through scaphoid and lunate directly to radius
Term
the joint contact of the radiocarpal joint is greatest in what wrist position?
Definition
extension and ulnar deviation

this is the position of max grip strength
Term
Medial compartment of the midcarpal joint is comprised of?
Definition
convex capitate and hamate
concave lunate and scaphoid
Term
Lateral compartment of the midcarpal joint?
Definition
convex scaphoid and concave trapezium and trapezoid
Term
Intercarpal joint
Definition
small joints between carpal bones

Allow small gliding motions between carpals
Term
Two groups of ligaments of the wrist?
Definition
Extrinsic= proximal attachment outside the carpal bones

Intrinsic= proximal and distal attachments are on carpal bones
Term
Name the Extrinsic Ligaments of the wrist
Definition
1. Dorsal radiocarpal
2. Radial Collateral
3. Palmar Radiocarpal
4. Ulnocarpal Complex (TFCC)
Term
Dorsal Radiocarpal Ligament is taut in?
Definition
Full flexion
Term
Radial Collateral ligament is taut in?
Definition
Ulnar deviation and Extension
Term
Palmar radiocarpal ligament is taut in?
Definition
Full extension
Term
Components of the palmar radiocarpal?
Definition
Radiocapitate
Radiolunate
Radioscapholunate
Term
Ulnocarpal Complex (TFCC): ulnar collateral ligament is taut in?
Definition
radial deviation
Term
TFCC: palmar ulnocarpal ligament is taut in?
Definition
Extension and ulnar deviation
Term
Name the intrinsic ligaments of the wrist
Definition
1. Short ligament of distal row
2. Intermediate Ligament
3. Long Ligaments
Term
Function of the short ligament of the distal row?
Definition
Allows the distal row to function as a unit
Term
Components of the intermediate ligaments
Definition
1. Lunotriquetral
2. Scapholunate
3. Scaphotrapezial
Term
Function of the intermediate ligaments
Definition
Link respective bones
Term
Name the long ligaments.
Definition
1. Palmar Intercarpal
2. Dorsal Intercarpal
Term
Where does the palmar intercarpal run?
Definition
Lateral leg: capitate to scaphoid
Medial leg: capitate to triquetrum
Term
Where does the dorsal intercarpal run?
Definition
Scaphoid to triquetrum
Term
List the primary wrist extensors.
Definition
1. Extensor Carpi Radialis Longus (ECRL)
2. Extensor Carpi Radialis Brevis (ECRB)
3. Extensor Carpi Ulnaris (ECU)
Term
List the secondary wrist extensors
Definition
1. Extensor Digitorum
2. Extensor Indicis
3. Extensor Digiti Minimi
4. Extensor Pollicis Longus
Term
Primary Wrist Flexors
Definition
1. Flexor carpi radialis
2. Flexor Carpi Ulnaris
3. Palmaris Longus
Term
List the secondary wrist flexors
Definition
1. Flexor digitorum profundus
2. Flexor digitorum superficialis
3. Flexor pollicis longus
Term
How many compartments are there in the dorsal wrist?
Definition
6
Term
List the 6 compartments of the dorsal wrist
Definition
1. EPB, ABPL
2. ECRL/ECRB
3. EPL
4. ED/EI
5. EDM
6. ECU
Term
List the Radial Deviators of the Wrist
Definition
ECRL
ECRB
EPL
EPB
FCR
ABPL
FPL
Term
List the ulnar deviators of the wrist
Definition
ECU
FCU
Term
What does the radial nerve innervate?
Definition

Muscles that cross the dorsum of the wrist

Extensors

Term
What does the median and ulnar nerve innervate?
Definition
Muscles that cross the palmar wrist surface
Term
How many degrees of freedom are there at the wrist?
Definition
2: Wrist Flexion/Wrist Extension, Radial Deviation/Ulnar Deviation
Term
Osteokinematics of Wrist Extension at the radiocarpal joint?
Definition
Convex lunate rolls dorsally and glides volarly on the radius
Term
Osteokinematics of wrist extension at the midcarpal joint?
Definition
Convex Head of capitate rolls dorsally and slides volarly on lunate
Term
Osteokinematics of wrist flexion at the radiocarpal joint?
Definition
Convex lunate rolls volarly and glides dorsally on radius
Term
Osteokinematics of wrist flexion at the midcarpal joint?
Definition
Convex head of capitate rolls volarly and glides dorsally on the lunate
Term
Osteokinematics of wrist ulnar deviation at the radiocarpal joint?
Definition
Scaphoid, lunate triquetrum roll ulnarly and slide radially
Term
Wrist osteokinematics of wrist ulnar deviation at the midcarpal joint?
Definition
Capitate rolls ulnarly and slides radially
Term
osteokinematics of wrist radial deviation at the radiocarpal joint?
Definition
scaphoid, lunate and triquetrum roll radially and glide ulnarly
Term
osteokinematics for wrist radial deviation at the midcarpal joint?
Definition
Capitate rolls radially and slides ulnarly
Term
All wrist motions are convex bones moving on concave bones meaning they will roll and slide in different directions
Definition
Term
3 components of stability of the wrist?
Definition

1. Muscular= compression

 2. Articular= intercalated segment; proximal row of carpals acts as an intercalated segment [no muscles attach directly to the proximal row]

3. Ligamentous

Term
Describe the shape of the ligamentous stability?
Definition
Double V system with and distal and proximal inverted V's
Term
Distal inverted v is comprised of?
Definition
Palmar intercarpal ligament
Term
Proximal inverted v is made up of?
Definition
Ulnocarpal and palmar radiocarpal ligaments
Term

Tension in double V system: Neutral?

UD?

RD?

Definition

Neutral: all under slight stretch

 

Ulnar Deviation: Lateral Palmar Intercarpal [Scaphoid to capitiate], Palmar Ulnocarpal

 

Radial Deviation: medial Palmar Intercarpal, Palmar Radiocarpal

 

Term
With a compression force from both ends the proximal carpal row is prone to?
Definition
Rotational collapse
(lunate is most common)
Term
Other names for this rotational collapse?
Definition
Zig Zag Deformity
Term
Dorsal Intercalated Segment Instability
Definition
Scapholunate ligament is disrupted and lunate dislocates. IF the distal articular surface of the lunate faces dorsally= dorsal intercalated segment instability
Term
Volar intercalated segment instability?
Definition
Disruption of the lunotriquetral ligament allowing the lunate to dislocate so the distal articular surface faces volarly
Term
Ulnar angulation of distal radius of 25 degrees creates a natural tendency for the carpus to translate?
Definition
ulnarly
Term
What is the loose packed position of the radiocarpal joint?
Definition
Neutral with slight ulnar deviation
Term
What is the closed pack position of the radiocarpal joint?
Definition
Extension with Ulnar Deviation
Term
Capsular pattern for radiocarpal joint?
Definition
Flexion and extension are equally limited
Term
What is the loose packed position of the midcarpal joint?
Definition
Neutral or slight flexion with UD
Term
What is the closed pack position of the midcarpal joint?
Definition
Extension with UD
Term
Capsular pattern for the midcarpal joint?
Definition
Flexion and extension are equally limited
Term
What is the loose packed position of the intercarpal joint?
Definition
Neutral or slight flexion
Term
What is the close packed position of the intercarpal joint?
Definition
Extension
Term
What is the loose packed position of the CMC joint (thumb and fingers)?
Definition

Thumb= midway between ABD/ADD and Flex/Ext

 

Fingers= midway between flexion and extension

Term
What is the closed packed position for the CMC (thumb and fingers)?
Definition

Thumb= full opposition

Fingers= full flexion

Term
What is the capsular pattern of the thumb? fingers?
Definition

Thumb: ABD most limited followed by extension

 

Fingers: equally limited in all directions

Term
What is the loose packed position of the distal radioulnar joint?
Definition
10 degrees of supination
Term
What is the closed pack position of the distal radioulnar joint?
Definition
5 degrees of supination
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