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Wrist > Anatomy & Biomechanics > Flashcards

Anatomy & Biomechanics Flashcards

(62 cards)

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1
Q

Wrist Complex Anatomy - Type & DF

A

Type: compound & partly complex modified Ovoid
Motion: 2 DF (flex/ext & ulnar/radial deviation)

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2
Q

Wrist Capsular Pattern

A

Flexion = Extension = Radial deviation = Ulnar deviation

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3
Q

Wrist Closed Pack Position

A

Full Extension

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4
Q

Proximal Row (lateral –> medial)

A

Scaphoid (navicular)–>Lunate–>Triquetrum–>Pisiform (volar)

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5
Q

Distal Carpal Row (lateral –> medial)

A

Trapezium (1st) –> Trapezoid (2nd) –> Capitate (3rd) –> Hamate (4th/5th)

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6
Q

TFCC (Triangular Fibrocartilage Complex)

A

Triangular Fibrocartilage disc
Radio ulnar ligaments
Ulnocarpal ligaments
- powerful intra articular ligament that stabilizes joint & cushions forces transmitted through the LUNATE & TRIQUETRIUM

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7
Q

TFCC Injuries

A

Repetitive load & pronation/supination may generate tears or perforation

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8
Q

Volatr Ligaments - Palmar Intrinsic Ligaments

A

From 1 bone to next & Interosseous

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9
Q

Volar Ligaments - Extrinsic Ligaments

A 
RSC - radioscapholunate lig
LRL - long radiolunate
SRL - short radiolunate 
UL - ulnarlunate 
UT - ulnartriquetral
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10
Q

Dorsal Ligaments - Intrinsic Ligaments

A 
SL - scapho-lunate
LT - triqutrolunate
TT - trapezium- trapezoid
CT - capitate-trapezoid
CH - capitate-hamate
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11
Q

Dorsal Ligaments - Extrinsic Ligaments

A

DIC - dorsal intercarpal ligament

DRC - dorsal radiocarpal ligament

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12
Q

Surface Anatomy - Proximal Crease

A

Variable - proximal limit of synovial sheaths of flexor tendons

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13
Q

Surface Anatomy - Middle Crease

A

Joint line of radius & disc

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14
Q

Surface Anatomy - Distal Crease

A

Pisiform - flexor aspect on top of triquetrum

- formed within tendon of FCU

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15
Q

Surface Anatomy - Hook of Hamate

A

From pisiform, move distal and radial (tender)

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16
Q

Surface Anatomy - Tunnel of Guyon

A

Between pisiform & hook of hamate

- passageway of ulnar nerve & ulnar artery to hand

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17
Q

Surface Anatomy - Scaphoid

A

Neck in floor of anatomical snuff box

- prominent with wrist flexion/ulnar deviation

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18
Q

Surface Anatomy - Tubercle on Scaphoid

A

Rounded, near middle crease & FCR tendon

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19
Q

Surface Anatomy - Trapezium

A

Base of 1st metacarpal, just distal to scaphoid

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20
Q

Surface Anatomy - Tubercle of Trapezium

A

Ridge, at base of thenar eminence

- points to 2nd or 3rd

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21
Q

Surface Anatomy - Flexor Retinaculum

A

Roof of carpal tunnel

- attached to pisiform, hook of hamate, tubercles of trapezium/scaphoid, & proximal edge at distal crease of wrist

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22
Q

Anatomical Snuff Box

A

Just distal to radial styloid process

  • Medially = EPL
  • Laterally = EPB, APL
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23
Q

Thenar Eminence

A

APB (superficial)
Opponents (middle)
FPB (deep)

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24
Q

Hypothenar Eminence

A

AbdDM (superficial)
Opponens (middle)
FlexDM (deep)

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25
Radial Artery
Just lateral to FCR
26
Flexor Carpi Radialis (FCR)
Just lateral to Palmaris Longus (thick tendon that winds around tubercle of scaphoid on distal crease)
27
Carpal Tunnel Structures
``` Median Nerve FDS FDP FPL FCR Scaphoid tubercle ```
28
Tunnel of Guyon Structures
Ulnar nerve Ulnar artery -bwn pisiform & hook of hamate) -palmar aspect
29
AROM - Radial Deviation
15-20 deg
30
AROM - Ulnar Deviation
30-40 deg
31
AROM - Flexion
65-70 deg
32
AROM - Extension
80-85 deg
33
Lateral Column of Wrist
Trapezium, Trapezoid (distal) | Scaphoid (proximal)
34
Central Column of Wrist
Capitate, Hamate (distal) | Lunate (proximal)
35
Medial Column of Wrist
Triquetrum, Pisiform
36
Biomechanics - Moving to CPP
Distal to proximal under influence of wrist extensor so | - Trapezium does NOT take part (thumb flexible in CPP)
37
Biomechanics of Wrist Extension (to CPP)
Distal row locks on proximal row (lunate rolls dorsally on radius; slides palmarly) - Convex carpals on Concave radius = roll posterior, glide volar - Capitate locks on scaphoid at NEUTRAL - Scaphoid unit extends on lunate/triquetrum Moves as unit on proximal row & distal row CPP just into extension All carpals extend on Radius & Ulnar disc CPP = FULL extension
38
Biomechanics of Wrist Flexion
Proximal row (lunate/triquetrum) rolls anterior/palmarly Distal row glides posteriorly/dorsally - Capitate locks on scaphoid - Scaphoid locks on distal row
39
Biomechanics Flexion - Scaphoid/Trapezii rotate ____________
Internally (IR)
40
Biomechanics Flexion - Triquetrum & Hamate rotate ____________
Externally (ER)
41
Biomechanics Extension - Triquetrum & Hamate rotate __________
Internally (IR)
42
Biomechanics Extension - Scaphoid/Trapezii rotate ____________
Externally (ER)
43
Biomechanics - Radial Deviation
- Proximal carpals glide ulnarly (convex carpals on concave radius) - Scaphoid IR - Trapezii glide dorsally over scaphoid - Hamate glides palmarly over triquetrum - Result = supination of distal row on proximal row
44
Biomechanics - Ulnar Deviation
- Proximal carpals glide radially (convex carpals on concave radius) - Triquetrum ER - Trapezii glides palmarly - Hamate glides dorsally - Result = pronation of distal row on proximal row
45
1st CMC Joint & DF
- Simple Unmodified Sellar | - 2DF: flex/ext, abd/add
46
1st CMC Capsular Pattern
Extension, Abduction
47
1st CMC Joint Close Pack Position
Full Opposition
48
Biomechanics - 1st CMC Joint Flexion
- Frontal (coronal) plane movement - Concave 1st metacarpal on Convex trapezium - Rolls & glides ulnarly (medially) - **ulnar adduction**
49
Biomechanics - 1st CMC Joint Extension
- Frontal (coronal) Plane - Concave 1st metacarpal on Convex trapezium - Rolls & glides radially (laterally) - **radial abduction**
50
Biomechanics - 1st CMC Joint Abduction
- Sagittal plane - Convex metacarpal on Concave trapezium - Rolls anteriorly, glides DORSALLY
51
Biomechanics - 1st CMC Joint Adduction
- Sagittal plane - Convex metacarpal on Concave trapezium - Rolls dorsally, glides PALMARLY (anteriorly)
52
1st CMC Least pack Position
Center of abd/add & flex/ext
53
MCP Capsular Pattern
Ext > Flex
54
MCP CPP
Full Ext
55
MCP Least Pack Position
Semi-Flex
56
MCP Mobility Tests
Palmar, Dorsal, Medial, Lateral
57
MCP Stress Tests
Rotation with Flexion Ulnar and Radial gapping Traction in full Flexion
58
IP Joint Capsular Pattern
Ext > Flex
59
IP Joint CPP
Extension
60
IP Least Pack Position
Semi-Flex
61
IP Mobility Stress Tests
``` Traction/compression Dorsal/Palmer glide Rotation (IR/ER) Medial/lateral glide Medial/lateral roll ```
62
IP Stress Tests
Extension with radial/ulnar gapping | Traction in full ext

Wrist (2 decks)

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