Hand and Wrist Flashcards
(54 cards)
1
Q
T or F: The Hand fine-tunes the Wrist position
A
False.
The wrist fine-tunes the hand position
2
Q
What is the function of Listers’ Tubercle and what muscle(s) pass through there
A
Function: It acts as a pulley and redirects pull
Muscles: Extensor Digitorum Longus and Brevis, Extensor Indices on Radial side, Extensor Pollicis Longus on Ulnar side
3
Q
What are the proximal and distal rows of the carpal bones
A
Proximal: scaphoid, lunate, triquetrum, pisiform
Distal: trapezium, trapezoid, capitate, hamate
4
Q
Pisiform serves as an attachment site for which muscle
A
Flexor Carpi Ulnaris
5
Q
Which bone is the reference point of the hand
A
Capitate
6
Q
T or F: The shaft of the metacarpals are curved with a palmar convexity
A
False: they are curved with a palmar concavity
7
Q
The base of the metacarpals articulate with which strucutre(s)
A
- Carpal bones
2. Adjacent metacarpals
8
Q
The head of the metacarpal bones articulate with which structure(s) and forms which joint
A
The base of the proximal phalange, forms the Metacarpophalangeal joint
9
Q
List all the wrist joints
A
Distal Radioulnar
Radiocarpal
Midcarpal
Intercarpal
10
Q
Distal Radioulnar joint
- joint type
- action
- comprised of
A
- Uniaxial synovial pivot joint
- Pronation and supination
- Comprised of TFCC, oblique fibres of distal interosseous membrane, and radioulnar ligaments
11
Q
Radiocarpal Joint
- joint type
- actions/ DOF
- articulations
A
- ellipsoidal (condylar) synovial joint
- 2 DOF, contributes to general flexion/extension and radial/ulnar deviation
- biconcave distal radius articulates with convex proximal row of carpal bones, scaphoid and lunate
12
Q
Midcarpal joint
- joint type/ formed by
- action
- articulation
A
- Synovial plane joint formed by proximal and distal carpal rows
- Contributes to general flexion/extension, radial/ulnar deviation
- Compound articulation:
- Planar laterally
- Condylar medially
13
Q
Intercarpal joints
- joint type
- articulations
A
- plane, synovial joints
- joints between proximal and distal rows
14
Q
List the joints of the hand
A
- Carpometacarpal 2-5
- Carpometacarpal 1st
- Metocarpal Phalangeal
- Interphalangeal
15
Q
Carpometacarpal joint 2-5
- joint type
- articulation
- ROM
A
- plane, synovial
- MC bases articulate with distal row of carpals & with one another
- third has minimal motion, fourth and fifth have much more
16
Q
Carpometacarpal joint 1st
- joint type
- articulations
- ROM
A
- synovial saddle joint
- between base of first MC and trapezium
- “pringle” both concave and convex
- 6 motions available
17
Q
ROM of First Carpometacarpal joint
A
- Flexion/Extension
- Abduction/Adduction
- Opposition/Repositioning
18
Q
Metacarpophalangeal joint
- joint type
- DOF/action
- articulations
A
- synovial condyloid
- 2 DOF, flex/ex, ab/ad
- convex MC heads articulate with bases of phalanges (extended by volar plate)
19
Q
Interphalangeal joint
- joint type
- action/DOF
- DIP/PIP/IP
A
- synovial hinge joint
- 1 DOF, flex/ex
- 2-5 have DIP and PIP
- 1 has only IP
20
Q
Ligaments of the Wrist and Hand
A
- Volar Plate
- Wrist
- Extrinsic (radius, ulna, metacarpal to carpal)- Collaterals, retinacula, radial and ulnocarpal ligaments
- Intrinsic (between carpal bones only)- Short, intermediate, and interossei
- TFCC - Hand and Fingers
- Medial and lateral collateral
- Deep transverse metacarpal ligament
- Thumb ligaments
21
Q
T o F: There is no ligament between capitate and lunate
A
True.
22
Q
Volar Plate
- found in which joint(s)
- attaches to
- action/purpose
- function
A
- found in IP and MCP joints
- attaches to distal phalanx and collateral ligaments
- as joint flexes, volar plate slides proximally UNDER metacarpal (folds membranous part), this = large ROM for small surface area
- functions to prevent hyperextension and dorsal subluxation
23
Q
T or F: Dorsal ligaments are always thicker than palmar
A
False: palmar ligaments are always thicker than dorsal
24
Q
Distal radioulnar ligament (palmar and dorsal)
-action
A
Stabilizes distal radioulnar joint
25
```
Collateral ligament (radial and ulnar)
-actions
```
Radial: restricts ulnar deviation, lateral stabilization of radial wrist
Ulnar: restricts radial deviation, lateral stabilization of ulnar wrist
26
```
Radiocarpal ligament (palmar and dorsal)
-actions
```
Palmar: Volarly stabilizes radius to carpals; limits extensive wrist extension
Dorsal: Dorsally stabilizes radius to carpals; limits extensive wrist flexion
27
Triangular Fibrocartilage Complex
| -function
- load absorption and transmission
| - stabilizes distal radioulnar joint
28
Palmar ulnocarpal ligaments
| - name all 4
- Ulnotriquetrial ligament
- Ulnolunate ligament
- Ulnocapitate ligament
- Palmar radioulnar ligament
29
Flexor retinaculum
| -function
- creates passage for tendons of flexor pollicus longus, flexor digitorum superficialis, profundus, and median nerve
- point of origin for muscles of thenar eminence
30
Extensor Retinaculum
| -function
- restricts tendon bow stringing during wrist hyperextension
- reduces friction on tendons
31
Medial and lateral collateral ligaments
| -actions
- taut in flexion, assist with ability to grip
- loose in extension, allow abduction/adduction at MCP
- accessory collaterals control volar plate
32
Deep transverse ligament
| -actions
- allows for flexible metacarpal arch
- limits spread
- has volar plate attachment
33
Thumb ligaments
- two sesamoids attached to volar plate in muscular tendons
| - facilitates pinch precision
34
Muscles- Wrist (Extensors and Flexors)
```
Wrist Extensors
-Extensor Carpi Radialis Longus and Brevis
-Extensor Carpi Ulnaris
-Extensor Carpi Digitorum Secondary Extensor
Wrist Flexors
-Flexor Carpi Radialis
-Flexor Carpi Ulnaris
-Flexor Digitorum Superficialis
-Flexor Digitorum Profundus
-Palmaris Longus
-Flexor Pollicus Longus
-Abductor Pollicus Longus
```
35
T or F: All wrist extensors have a common origin (lateral epicondyle) except extensor carpi radialis longus and extensor carpi digitorum
True
36
T or F: All wrist flexors have a common origin (medial epicondyle)
True
37
Radial/Ulnar Deviation at the Wrist
- plane
- axis
- frontal plane
| - ap axis
38
Muscles- Fingers (extrinsic)
- extensor digitorum
- extensor carpi radialis longus
- extensor carpi radialis brevis
- extensor carpi ulnaris
- extensor pollicus longus
- extensor pollicus brevis
- abductor pollicus
- extensor indicies
- extensor digitorum minimi
- flexor digitorum superficialis
- flexor digitorum profundus
- flexor pollicus longus
39
Muscles- Fingers (Intrinsic)
- abductor pollicis brevis
- flexor pollicis brevis
- opponens
- flexor digitorum minimi
- abductor digitorum minimi
- opponens digiti minimi
- interossei (palmar adductor, dorsal abductor)
- lumbricals
- adductor pollicus
40
Extensor Mechanism
Intricate structures in fingers in thumb designed to:
- hold flexor and extensor tendons in place
- allow them to move and glide
- guide the direction of pull
- extension of digits in multiple positions of finger flexion & to permit full flexion
- as finger flexes, the hood is pulled distally due in part to the palmar attachments
41
Motions at the wrist- Osteokinematics
Radial deviation
Ulnar deviation
Flexion
Extension
42
Wrist Radial Deviation
- end feel
- axis
- bony end feel
| - ap axis through capitate
43
Wrist Ulnar Deviation
| - end feel
firm end feel
44
Wrist Flexion/Extension
| - axis
Through capitate
45
Wrist close packed position
Full wrist extension
46
Motions at the Metacarpophalangeal joints 2-5
Flexion
Extension
Abduction
Adduction
47
MCP 2-5 Flexion and Extension
| -end feels
both firm
48
MCP joint Close pack position
Finger Flexion to 90 degrees
49
Metacarpophalangeal joint- thumb
- osteokinematics
- DOF
- type of joint
- flexion/extension
- 1 DOF
- hinge joint
50
Interphalangeal joint
- osteokinematics
- DOF
- type of joint
- flexion/extension
- 1 DOF
- hinge joint
51
Metacarpal and Interphalangeal close pack position
Thumb: MCP and IP = full extension
| Digits 2-5: MCP and IP = full flexion
52
Types of grasp - Power Grip
- incorporates entire hand
| - gross grasping activities
53
Types of grasp - Precision Grip
-accuracy, refinement, object manipulation
54
Grasping
- finger flexion occurs when wrist is in extension
| - grip is significantly weakened if wrist flexion occurs
