KNPE 325: WRIST / HAND

Name the borders of the anatomical snuffbox, and the structure located within.

Abductor pollicis longus/Extensor pollicis brevis and the Extensor pollicis longus; Scaphoid

What special test indicates a scapholunate ligament injury? a. Allen test b. Watson test c. Phalen's test d. Finkelstein's test

B

Which carpal bone is most commonly dislocated? a. Scaphoid b. Lunate c. Pisiform d. Trapezium

B

Which carpal bone is palpable as the floor of the anatomical snuffbox? a. Pisiform b. Scaphoid c. Trapezoid d. Capitate

B

Which is false regarding a scaphoid fracture? a. It is most common in people ages 15 to 30. b. It is common because of its role as a bony block-limiting flexion. c. It has a high incidence in nonunion fractures. d. Of carpal fractures, 70% involve the scaphoid.

B

Which ligament forms the roof of the carpal tunnel? a. Ulnar carpal b. Transverse carpal c. Radiocarpal d. Palmar

B

Which of the following is classified as a saddle joint and is capable of 2 degrees of freedom? a. Fifth carpometacarpal joint b. First carpometacarpal joint c. First metacarpophalangeal joint d. Fifth metacarpophalangeal joint e. Fourth carpometacarpal joint

B

Name the 8 carpal bones of the wrist.

Scaphoid, Lunate, Triquetrium, Pisiform, Trapezium, Trapezoid, Capitate, Hamate

An isometric test in midrange is the recommended method to determine muscle pain or weakness. True False

T

Patients with carpal tunnel syndrome typically describe increased pain when sleeping. True False

T

The probability of fracturing the hook of the hamate is increased when someone is gripping an object such as a bat or racquet. True False

T

Which incident can easily cause a fracture within the carpal bone structure? a. Throwing a baseball repeatedly, even after arm is fatigued b. Pushing a heavy object above one's head with misaligned arms c. Bracing one's fall with an extended wrist when falling to the ground d. Performing an excessive amount of bicep curl exercises

C

Which ligament is most important in controlling motion and wrist stability? a. Ulnar collateral b. Radial collateraL c. Palmar radiocarpal d. Dorsal radiocarpal

C

Which nerve supplies the primary innervation for wrist flexion and radial deviation? a. Radial b. Musculocutaneous c. Median d. Ulnar

C

Which of the carpal bones "floats" on the triquetrum? a. Capitate b. Lunate c. Pisiform d. Scaphoid

C

Which of the following is responsible for checking radial deviation and becomes taut at the end-ranges of flexion and extension? a. Dorsal radiocarpal ligament b. Radial collateral ligament (RCL) c. Ulnar collateral ligament (UCL) d. Palmar radiocarpal ligament

C

A basketball player is undercut while dunking and uses his outstretched hand to break his fall. He reports immediate pain in his wrist and fracture is suspected. Which carpal bone is most commonly fractured? a. Scaphoid b. Pisiform c. Hamate d. Capitate e. Lunate

A

Trauma or pathology to which nerve results in a drop-wrist deformity? a. Radial b. Ulnar c. Musculocutaneous d. Median

A

Upon suffering a perilunate or lunate dislocation, active ROM is typically noted as painful for which of the following? a. Extension b. Flexion and extension c. Extension and ulnar deviation d. Flexion and ulnar deviation

A

What are small cuts or abrasions over the dorsal surface of the MCP or IP joints known as? a. Russell's sign b. Raynaud's phenomenon c. Preiser's sign d. Keinböck's sign

A

What is a fracture of the base of the first metacarpal that extends into the articular surface called? a. Bennett's fracture b. Boxer's fracture c. Scaphoid fracture d. Volar plate fracture

A

Which ligament is not stressed during passive flexion of the wrist? a. Palmar ulnocarpal b. Radial collateral c. Ulnar collateral d. Dorsal radiocarpal

A

Which of the following is a standard radiograph taken for suspected scaphoid fracture? a. 45° pronation b. Anteroposterior with wrist in neutral c. Medial view d. Anteroposterior with wrist ulnarly deviated

A

Which pulleys are located on the distal aspect of the metacarpal and the most proximal member of the pulley system? a. Palmar aponeurosis b. Cruciate c. Lumbrical d. Annular

A

Which wrist pathology is commonly associated with clicking on the ulnar side of the wrist? a. Triangular fibrocartilage tear b. Tenosynovities c. De Quervain syndrome d. Trigger finger

A

You evaluate a basketball player who has sustained a finger injury while attempting to catch a ball. During your examination, you observe that the athlete is unable to extend the distal phalanx and the tip of his finger is positioned in approximately 30 degrees of flexion. You determine the athlete has mallet finger. This injury is caused by which of the following? a. An avulsion of the extensor tendon from its insertion b. A subungual hematoma c. Dupuytren's contracture d. A sprain of the extensor pollicis brevis e. Tenosynovitis of the abductor pollicis longus

A

Which of the following statements is correct? a. An avulsion of the flexor digitorum profundus is known as mallet finger. b. Pseudoboutonnière deformities show with limited active and passive extension. c. A mallet finger presents with an inability to actively flex the distal interphalangeal joint (DIP). d. A rupture of the volar plate is known as a boutonnière deformity.

B

Which of the following statements is not correct? a. The pisiform is in the proximal row of carpal bones. b. The trapezoid aligns with the first metacarpal. c. The lunate is the third bone in the proximal row when starting on the ulnar side. d. The capitate aligns with the third metacarpal.

B

Allen's test is used to test what? a. For tarsal tunnel syndrome b. Integrity of the ulnar nerve c. The integrity of the radial and ulnar arteries of the hand d. For carpal tunnel syndrome e. The integrity of the vertebral arteries

C

Extending the proximal and distal interphalangeal joints (PIP & DIP) will - a. Curl fingers b. Spread fingers c. Straighten fingers d. Bring fingers together

C

Jamming my thumb will cause the metacarpal thumb bone to compress into the - a. Hamate b. Pisiform c. Trapezium d. Captitate

C

The deep branch of what nerve innervates the hypothenar eminence? a. Median b. Interosseous c. Ulnar d. Radial

C

What is the muscle responsible for flexing the four proximal interphalangeal (PIP) joints? a. Palmaris longus b. Flexor carpi radialis c. Flexor digitorum superficialis d. Flexor carpi ulnaris

C

What is the primary extensor of the lateral four fingers' interphalangeal (IP) joints and assists in wrist extension? a. Extensor carpi ulnaris b. Extensor carpi radialis longus c. Extensor digitorum communis d. Extensor carpi radialis brevis

C

A positive Phalen's sign is suspect of what problem? a. Thoracic outlet syndrome b. Suprascapular entrapment syndrome c. Long thoracic nerve injury d. Carpal tunnel syndrome e. Tarsal tunnel syndrome

D

A reverse Phalen's test is used to assess which nerve? a. Radial b. Ulnar c. Musculocutaneous d. Median

D

During a wrist evaluation, an athletic trainer completes Tinel's sign test. The athlete complains of tingling and paresthesia in the area of the nerve distribution. What should the athletic trainer do? a. Inspect the area for neurovascular deficits to rule out other pathologies. b. Assess the strength of the wrist flexor and extensor muscles. c. Assess the integrity of the ulnar nerve at the elbow to rule out other pathologies. d. Assess the integrity of the median nerve at the elbow, shoulder, and neck to rule out other pathologies.

D

Upon suffering a scapholunate dislocation, range of motion (ROM) is typically noted as painful for which of the following? a. Flexion and ulnar deviation b. Extension c. Extension and ulnar deviation d. Flexion and extension

D

What is an infection around the periphery of the fingernail that results in redness and swelling? a. Pilonidal cyst b. Felon c. Hang nail d. Paronychia

D

What is the anatomical name of the finger bones? a. hamates b. metacarpals c. carpals d. phalanges

D

Which bone in the hand is involved in a boxer's fracture? a. Third metacarpal b. Radial styloid process c. Scaphoid d. Fifth metacarpal

D

Which finger's MCP is not commonly injured? a. Second digit b. First digit c. Fifth digit d. Third digit

D

Which nerve travels through the carpal tunnel in the wrist? a. Radial b. Ulnar c. Musculocutaneous d. Median

D

Which nerve travels through the tunnel of Guyon? a. Median b. Radial c. Musculocutaneous d. Ulnar

D

Which of the carpal bones is most commonly dislocated? a. Scaphoid b. Cuboid c. Hamate d. Lunate e. Triquetral

D

Which of the following is a nonarticular fracture of the radius occurring approximately 1.5 inches proximal to the radiocarpal joint, causing the distal radius to be displaced dorsally? a. Smith's fracture b. Reverse Colles' fracture c. Tom's fracture d. Colles' fracture

D

Which of the following is a rupture of the central extensor tendon that causes the lateral bands to slip palmarly on each side of the PIP, changing its line of pull on this joint from an extensor to a flexor? a. Mallet finger b. Pseudoboutonnière deformity c. Jerry finger d. Boutonnière deformity

D

Which of the following is an extrinsic muscle of the wrist? a. Flexor pollicis brevis b. Abductor pollicis brevis c. Flexor digiti minimi d. Extensor pollicis brevis

D

Which of the following is not a function of the triangular fibrocartilage complex (TFCC)? a. It provides stability during pronation and supination. b. It decreases loading stresses. c. It stabilizes the distal radioulnar joint. d. It provides stability during flexion and extension.

D

Which of the following muscles does not influence wrist movement? a. Flexor digitorum superficialis b. Flexor carpi ulnaris c. Extensor carpi radialis longus d. Brachioradialis

D

An athlete complains of a collection of a thick fluid within a tendinous sheath of her wrist extensor tendons. What is the most appropriate advice to give the athlete to manage this condition? a. Initiate comprehensive rehabilitation program focusing on wrist flexion range-of-motion strength of wrist extensors. b. Seek evaluation from a wrist/hand surgeon regarding excision. c. Utilize a paraffin bath and cross-friction massage daily to break up the fluid. d. Tape to limit wrist flexion, and avoid repetitive wrist flexion exercises. e. Treat the condition symptomatically, and play as tolerated.

E

Which of the following is a simple movement to check the integrity of the radial nerve? a. Shoulder flexion b. Elbow flexion c. Forearm supination d. Thumb-to-little finger opposition e. Wrist extension

E

An individual suffering from de Quervain's syndrome will typically undergo a series of magnetic resonance imaging. True False

F

Ape hand is a pathological hand posture resulting from weakness and atrophy of the hypothenar eminence. True False

F