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move sci > Hand and Wrist Test 2 > Flashcards

Hand and Wrist Test 2 Flashcards

1
Q

The wrist complex has how many degrees of freedom?

A

2

biaxial

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2
Q

What carpal bones form the proximal radiocarpal joint?

A

Scaphoid, Lunate, Triquetrium

they attach to the radial head and tfcc

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3
Q

How is the end of the radius angled?

A

volarly (palmarly) and ulnarly/medially

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4
Q

What carpal articulates with the TFCC

A

Triquetrium

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5
Q

what carpals articulate with the end of the radius

A

medially-lunate
laterally-scaphoid

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6
Q

what is the function of the pisiform?

A

increases movement arm for flexor carpi ulnaris

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7
Q

what ligaments connect the proximal carpal row?

A

scapholunate interosseous and lunotriquetral interosseous ligaments

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8
Q

TFCC is Connected proximally via dorsal and volar radioulnar ligaments

A
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9
Q

the Distal radiocarpal segment is ___________ than proximal segment → incongruent joint!

A

sharper

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10
Q

The scaphoid and lunate receive ___ of axial load , the TFCC receives __

A

80%

20%

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11
Q

Keinböck’s disease = you have a ______ ulna + there is lack of blood supply to the _______

A

Short

Lunate

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12
Q

Most ligaments and muscles that cross radiocarpal joint also contribute to stability of midcarpal joint

FCU is the exception - because it attaches to _________, ________, and _________

A

5th metacarpal, hook of the hamate, and pisiform

so i guess it does not contribute to joint stability

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13
Q

What carpal bones are in the distal row?

A

Trapezium, trapezoid, capitate, and hamate

Note: the carpals move almost as a fixed unit, with equal distribution of loads across articulations with proximal row

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14
Q

Dorsal wrist ligaments can be described as….

Volar/palmar ligaments of the wrist can be described as…

A

Dorsal- thin

Volar- thicker stronger

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15
Q

Extrinsic carpal ligaments do what

A

connect the carpal bones to other bones

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16
Q

Scapholunate interosseous ligament does what?

Lunotriquetral interosseous ligament?

A

Maintains scapho-lunate stability

Maintains lunate-triquetral stability (star by this one on the slide for some reason i guess it’s important)

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17
Q

The Dorsal radiocarpal ligament
and Dorsal intercarpal ligament do what?

A

Together form “horizontal V” to stabilize scaphoid during wrist ROM

They both attach to triquetrium

They come tight in wrist flexion!

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18
Q

Dorsal radiocarpal ligament function

A

Possibly helps to offset sliding of proximal carpal condyle on inclined radius

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19
Q

What carpal bone is considered the keystone of the wrist?

A

capitate

it is thought to be center of wrist rotation

contacts 7 other bones.

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20
Q

What bones articulate with the capitate?

A

Scaphoid
Lunate
Hamate
Trapezoid
2nd metacarpal
3rd metacarpal
4th metacarpa

What bones do not? Pisiform, trapezium, triquetrium

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21
Q

1.From full flexion, wrist extension begins with the distal row ___________ on the proximal row

2.Then distal row and _________ move on lunate and triquetrium to 45 deg when scaphoid and lunate lock

3.finally proximal row extends on radius/disc to fully extend close-packed position

A

1.gliding posterior

This is the sequence to neutral

2.Scaphoid

Note: flexion is opposite sequence

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22
Q

In radial deviation: Carpals all slide _________ on radius with _____ of proximal row and _____ of distal row. Close-packed position.

A

Ulnarly

Flexion of proximal row

Extension of distal row

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23
Q

In ulnar deviation:
The carpals slide ______ and proximal row ______ and distal row _________

A

Ulnarly

Proximal - extends

distal row - flexion

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24
Q

When wrist is extended you have very little _____ (closed packed position)

_______ is the loosed packed position

A

deviation

Flexion

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25
Q

Dorsal intercalated segmental instability (DISI)

tear/instability of the _____

A

Ligamentous laxity/tear of the scapholunate

26
Q

Volar intercalated segmental instability (VISI)

tear or instability of ______

A

Ligamentous laxity/tear of the lunotriquetral

27
Q

What happens during a DISI?

A

scapholunate ligament causes lunate to extend or move dorsally separating it from scaphoid

28
Q

What happens during a VISI?

A

Volar intercalated segmental instability (VISI)

Ligamentous laxity/tear of the lunotriquetral ligament causes lunate to flex or move more volarly with scaphoid, separating lunate from triquetrum

29
Q

In a DISI, the lunate separates from the….

In a VISI the lunate seperates from the….

A

DISI- scaphoid

VISI- triquetrium

30
Q

What is the optimal wrist position for grip?

A

Optimal position = slight wrist EXT and ulnar deviation in order to maximize grip strength

31
Q

True or false: palmaris longus does no sort of deviation

A

true

32
Q

Extensor Pollicis Longus, Extensor Pollicis Brevis, and Abductor Pollicis Longus

all assist with what actions?

A

Wrist ext and radial dev

33
Q

The carpometacarpal joints have ______ mobility from radial to ulnar side of hand

A

Increasing

34
Q

The proximal arch is formed by what?

A

Concavity formed by carpal bones

35
Q

Which arch is fixed vs which is mobile?

A

fixed- proximal arch

mobile arch- distal arch, longitudinal arch

36
Q

What CMC joints are fixed?

What CMC joint is a saddle joint?

A

2nd and 3rd

5th

37
Q

which arch is proximal to distal and includes all the fingers?

A

Longitudinal arch

38
Q

In the metacarpophalangeal joint, the metacarpal is ______ and the proximal phalanx is _______

A

Metacarpal- convex

Proximal phalax- concave

39
Q

MCP joints are what kind of joint with how many degrees of freedom?

A

condyloid

2 degrees of freedom

40
Q

When the proximal phalanx moves on the metacarpal, the roll and slide happen in the…

A

same direction

41
Q

Function of the volar plates ( a lot)

A

Increases joint congruency
Adds stability
Limits hyperextension
Supports longitudinal arch
Resists tensile stress in EXT
Resists compressive forces from objects
Glides down during FLX
Prevents pinching of flexor tendons

42
Q

Radial and Ulnar Collaterals ligaments of fingers:
Two Parts
Collateral Ligament Proper (more taut in _____)
Accessory Collateral ligament (more taut in ______)

A

Proper- flexion

accessory- extension

43
Q

Finger joint ROM increases from ______ to _______

A

radially to ulnar

44
Q

FDS primarily flexes the….

A

PIP

also contributes to MP flexion

45
Q

What is more active, FDS or FDP

A

FDP

Note: FDP can also work alone for a pinch grasp, also it is the only one to flex the DIP

46
Q

What has a larger movement arm, FDS or FDP?

A

FDS

47
Q

Finger flexors are dependent on _______ to counterbalance for good length-tension

A

wrist extensors

48
Q

Smaller grip ulnarly allows for…

A

Greater ROM with grasping but less force

-Greater range on the ulnar side of the hand can be utilized with tools

49
Q

What is the function of Retinaculae

A

Retinaculae structures tether tendons to hand and prevent bowstringing while bursa and sheaths facilitate gliding

50
Q

How many annular pullies are there? How many Cruciate?

A

5-A

3-C

51
Q

EDC, EI & EDM all only extend up to which joint?

A

MCP only, not PIP or DIP

note:they are also synergists for wrist ext

52
Q

PIP and DIP extension requires EDC plus….

A

Lumbricals and palmar/dorsal interossei

53
Q

Simultaneous IP extension requires….

A

Lumbricals + Dorsal Interossei + Palmar Interossei

54
Q

Isolated EDC muscle contraction causes….

A

“claw fingers”/extrinsic minus position, ( active MCP extension with PIP and DIP flexion )

55
Q

If intrinsics are weak (ulnar nerve injury), splint MCP joint _________ allows EDC to ext IPs

A

in slight flexion

56
Q

How many dorsal interossei are there?

How many volar?

A

4 dorsal

3 volar/palmar

57
Q

Why is extension weaker at the 5th digit?

A

Only 1 interossei muscle

58
Q

What carpal does the thumb articulate with?

A

trapezium

59
Q

What axis does thumb flexion/ext take place in?

What axis does thumb abducton adduction take place in?

A

oblique A/P axis

Oblique coronal axis

60
Q
A

move sci (4 decks)

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