Kin wrist

Question 1

functions of the wrist

Answer 1

Controls length-tension relationship of the multi-articular
hand muscles
́ Allows for fine adjustment of different grips
́ Contribute more to balance and control versus force
production (rock climbing vs throwing a baseball)
́ Wide range of “normal” presentation

Question 2

Palmer/Volar
Ligaments

Answer 2

Palmer Radiocarpal
Ligament
́ Radial Collateral
Ligament
́ Palmer Intercarpal
Ligament
́ Transverse Carpal
Ligament

Question 3

Dorsal Ligaments

Answer 3

́ Dorsal Radiocarpal Ligament
́ Dorsal Intercarpal Ligament
́ Ulnar Collateral Ligament

Question 4

Two Compound Joints

Answer 4

Radiocarpal joint
Midcarpal

Question 5

Midcarpal joint

Answer 5

consists of articulation between proximal row scaphoid/lunate and triquetrum and distal row

Question 6

Radiocarpal joint

Answer 6

2 separate segments separated by the radioulnar articular disc, Proximal segment is the radius and the radial ulnar disc and the distal component is the disc with the scaphoid lunate and triquitrum

Question 7

Distal Radioulnar Joint

Answer 7

́ Radius is biconcave,
both in frontal and
sagittal planes
́ Articulates with
proximal row of carpals
which is the convex
portion
́ Length of Ulna can
present with positive or
negative variance
which can affect
arthrokinematics

Question 8

́ Importance of the scaphoid

Answer 8

́ Scaphoid has the greatest
mobility of the proximal
carpal bones
́ Acts as a link between the
proximal and distal carpal
rows
Distal Segment of the Radiocarpal Joint

Question 9

́ Triangular Fibrocartilage
Complex (TFCC)

Answer 9

́ Articulates with triquetrum
and partially with the lunate
́ The Radioulnar disc is a
continuation or the articular
cartilage of the radius
́ “Meniscus of the wrist”
́ Important for transmission of
force from the hand
proximally

Question 10

Wrist Flexion range

Answer 10

65 - 85

Question 11

Wrist Extension

Answer 11

65 - 85

Question 12

Radial Deviation

Answer 12

15-21

Question 13

Ulnar Deviation

Answer 13

20-45

Question 14

Open Packed wrist

Answer 14

neutral between flex/ext

Question 15

Closed Packed

Answer 15

full extension and radial deviation

Question 16

Six muscles cross volar surface of
wrist and contribute to wrist flexion

Answer 16

́ Palmaris Longus
́ Flexor Carpi Radialis
́ Flexor Carpi Ulnaris
́ Flexor Digitorum Superficialis
́ Flexor Digitorum Profundus
́ Flexor Pollicis Longus

Question 17

__________ provides six distinct
compartments for
these muscles

Answer 17

extensor retinaculum

Question 18

Carpal tunnel has what flexors under the transverse carpal ligament and also which nerve?

Answer 18

FDP, FDS, FPL, FCR, and median nerve

Question 19

compartment 1 of extensors

Answer 19

Abductor Pollicis Longus
́ Extensor Pollicis Brevis

Question 20

compartment 2 of extensors of wrist

Answer 20

Extensor Carpi Radialis Brevis
́ Extensor Carpi Radialis Longus

Question 21

compartment 3 of extensors of wrist

Answer 21

Extensor Pollicis Longus

Question 22

compartment 4 of extensors of wrist

Answer 22

Extensor Digitorum
Extensor Indicis

Question 23

compartment 5 of extensors of wrist

Answer 23

Extensor Digiti Minimi

Question 24

compartment 6 of extensors of wrist

Answer 24

Extensor Carpi Ulnaris

Question 25

Arthrokinematics Flexion/Extension

Answer 25

*Initiating movement starting in full wrist FLEXION ́ Extension is initiated by distal carpal row ́ Gliding of the distal row on a fixed proximal row at initiation ́ Midcarpal motion then occurs as a unit on radius and TFCC (radiocarpal joint) ́ Carpals on radius = convex on concave

Question 26

arthrokinematics of wrist flexion / extension in regards to scaphoid

Answer 26

́ *Scaphoid tends to move with the distal carpal row with the proximal row following ́ *At 45 degrees of extension the scapholunate joint reaches close- packed position, thus the carpals then function as a full unit to finish full extension

Question 27

arthrokin of radial / ulnar deviation

Answer 27

Ex: With Radial Deviation ́ Carpal complex slides ULNARLY on the radius ́ Flexion of PROXIMAL carpal rows ́ Extension of DISTAL carpal rows ́ Full Radial Deviation puts the radiocarpal and midcarpal joints in close-packed

Question 28

FOOSH

Answer 28

́ Fall on an Outstretched Hand (FOOSH) ́ Most common trauma to the radiocarpal joint

Question 29

Wrist Instabilities

Answer 29

́ Keinbock’s Disease ́ Ulnar Positive/Negative Variance ́ Dorsal/Volar Intercalated Segmental Instability ́ Scapholunate Advanced Collapse

Question 30

Kienbock’s Disease

Answer 30

́ Avascular necrosis of the lunate ́ Usually seen in relation with ulnar negative variance ́ Due to abnormal force distribution across the radiocarpal

Question 31

Ulnar Positive Variance

Answer 31

́ POSITIVE variance: Often seen after a distal radius fracture with healing in a shortened position ́ Presents with pain at end range ulnar deviation or pronation

Question 32

Dorsal Intercalated Segmental Instability (DISI)

Answer 32

́ Injury to ligaments stabilizing lunate and scaphoid ́ Scaphoid tends to flex, lunate tends to extend ́ Often the subluxation of scaphoid occurs with compressive loading of the wrist ́ Volar Intercalated Segmental Instability occurs when lunate and triquetrum lose ligamentous stability

Question 33

Scapholunate Advanced Collapse Wrist (SLAC)

Answer 33

́ Scapholunate Advanced Collapse ́ Degenerative Changes at the Radioscaphoid joint ́ Progression to intercarpal joints ́ Capitate can eventually su

Question 34

If dorsal intercalated segmental instability goes unchecked, this can lead to

Answer 34

Scapholunate advanced collapse or SLAC

Question 35

The lunate and scaphoid have synergistic stability and an injury to one or more of the scaphoid or lunate, True or false.

Answer 35

True

Question 36

No muscles act on the proximal carpals. True or false

Answer 36

True I believe. Pg 280 in levangie