Final - Wrist And Hand

Question 1

What is the keystone of the wrist?

Answer 1

Capitate

Question 2

Which carpal row is unstable?

Answer 2

Proximal, most with the radius

Question 3

Which carpal is the main weight bearing the most fractured

Answer 3

Scaphoid

Question 4

Which carpal is most unstable and dislocates anteriorly?

Answer 4

Lunate

Question 5

Where is the longitudinal arch of the hand and what is the keystone?

Answer 5

• follow 2nd and 3rd rays

- keystone: 2nd and 3rd MCPs

Question 6

Where is the distal transverse arch of the hand and what is the keystone?

Answer 6

• passes through MCP joints

- keystone: 2nd and 3rd MCPs

Question 7

Where is the proximal transverse arch of the hand and what is the keystone?

Answer 7

• carpal tunnel

- keystone: capitate

Question 8

Which arch of the hand is static and rigid? Which is mobile?

Answer 8

Proximal transverse

Distal transverse

Question 9

What makes the bottom and top of the carpal tunnel?

Answer 9

Bottom: carpal gutter
Top: flexor retinaculum

Question 10

What are the contents of the carpal tunnel?

Answer 10

• flexor tendons
• median nerves
• no vessels

Question 11

When is the carpal tunnel compressed?

Answer 11

At high degrees of flexion and extension

Question 12

What are the borders of the tunnel of guy on (ulnar canal?)

Answer 12

• pisiform, hamate, pisohamate ligament, deep flexor retinaculum ad hypothenar muscles

Question 13

What is the contents of the tunnel of guy on (ulnar canal)?

Answer 13

• ulnar nerve and artery

Question 14

__% of axial loading is through scaphoid and lunate to the radius. __% of axial loading is through the articulation at the ulnocarpal space

Answer 14

80

20

Question 15

When the wrist is extended the compressive force on the thenars (FOOSH) increases __x through the scaphoid

Answer 15

4x

Question 16

What does the TFCC stand for, where is it and

Answer 16

Triangular fibrocartilage complex

Fibrocartilage disc at the distal end of the ulna that articulates with the lunate and triquetrum

Question 17

What is the primary function of the TFCC?

Answer 17

• bind the distal ends of the radius and ulna

Question 18

What is the primary stabilizer of the distal radioulnar joint?

Answer 18

TFCC

*helps transfer 20% of the compressive forces form the hand to the forearm

Question 19

The wrist joint is convex on concave meaning is has (same/opposite) roll and slide?

Answer 19

Opposite

Question 20

How much flexion occurs at the wrist? Which direction is the roll and slide?

Answer 20

70-85

Palmer roll, dorsal slide

Question 21

How much extension occurs at the wrist? Which direction is the roll and slide?

Answer 21

60-75

Dorsal roll, palmer slide

Question 22

Does the distal carpal row move more with flexion or extension? The proximal row?

Answer 22

Distal = flexion
Proximal = extension

Question 23

How much ulnar deviation is there? What is the roll and slide in the scaphoid, lunate and triquetrum?

Answer 23

35-40 degrees

- ulnar roll, radial slide

Question 24

How much radial deviation is there? What is the roll and slide in the scaphoid, lunate and triquetrum

Answer 24

15-20 degrees

- roll radially and slide ulnarly

Question 25

What is the min function of the extensors?

Answer 25

To position and stabilize wrist during finger flexion *max grip strength at 30-35 wrist extension

Question 26

Which is stronger, wrist extensors or flexors?

Answer 26

Flexors

Question 27

What is the functional position of the hand?

Answer 27

- wrist 20-30 degrees extension - fingers 45 degrees of MCP and 15 degree PIP/DIP flexion - thumb in 45 degrees abduction

Question 28

The MCP joints are __axial and concave on convex meaning they have (same/opposite) roll/slide

Answer 28

Biaxial | - same roll and slide

Question 29

What is the function of the valor plate (palmer plate). 2 things

Answer 29

- strengthens the structure of the MCP and IP joint | - limits extension

Question 30

Is there more passive or active motion available at the MCP joints?

Answer 30

Passive | *allows fingers to conform to shape of held objects

Question 31

The IP joint is __axial

Answer 31

Uniaxial

Question 32

What type of joint is the carpometacarpal joint of the thumb?

Answer 32

Saddle joint (allows full opposition)

Question 33

The CMC joint for adduction/ abduction is convex on concave meaning the roll and slide occur in (same/opposite) directions? what are they for thumb abduction and adduction?

Answer 33

Opposite Abduction: roll palmarly, slide dorsally Adduction: roll dorsally, slide palmarly

Question 34

The CMC joint for flexion extension is concave on convex meaning roll and slide occur in (same/opposite) direction

Answer 34

Same Flexion: roll and slide medially Extension: roll and slide laterally