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DPT 702: Biomechanics > Lecture 14: Wrist osteology and Arthrology Final > Flashcards

Lecture 14: Wrist osteology and Arthrology Final Flashcards

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1
Q

where is listers tubercle

A

dorsal radius

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2
Q

describe the distal articular surface of the radius

A

concave in both M-L and A-P with facets in the articular surface

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3
Q

what are the 2 important biomechanical configurations of the wrist

A

distal end of the radius is 25 deg toward ulna = “ulna tilt”; allows more ulnar dev than radial

palmar tilt = 10 deg allows more flexion than ext of wrist

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4
Q

describe the carpals

A

proximal row = scaphoid, lunate, triquetrum, and pisiform; loosely joined

distal row = trapezium, trapezoid, capitate, and hamate; tightly bound by ligaments

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5
Q

describe the scaphoid bone

A

looks like a boat

associated with both carpal rows

undersurface rides on radius

75% is lined with articular cartilahe

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6
Q

cargo area of the scaphoid holds what

A

head of capitate

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7
Q

scaphoid has synovial joints with how many other carpals

A

4

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8
Q

describe teh 2 poles of the scaphoid

A

2 convex poles

proximal articulates with radius; distal with trapezium and trapezoid

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9
Q

small concavity on scaphoid holds what

A

lunate

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10
Q

where can you palpate the scaphoid tubercle

A

thenar musculature

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11
Q

most frequent fractured carpal

A

scaphoid

midway between poles

proximal can develop AVN

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12
Q

what is kienbocks disease

A

softening of lunate AVN

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13
Q

describe the lunate

A

moon shaped

central bone in prox row

most unstable carpal due to lack of strong ligaments and no muscle attachments

fits into radius

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14
Q

describe triquetrum

A

triangular bone

most ulnar just distal to ulna

articular facet that accepts pisiform

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15
Q

describe pisiform

A

pea shaped

loose articulation with triquetrum

movable/palpable

embedded in FCU tendon

acts as sesamoid

attachment for abd digiti minimi and transverse carpal ligament

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16
Q

describe capitate

A

largets/central; means head

articulates with 7 bones

articulates with concavity of scaphoid and lunate

well stabilized by stong/short ligaments

joined to 2-4 metacarpal

provides longitudinal stability

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17
Q

describe trapezium

A

asymmetrical

concave at scaphoid

distal saddle like surface

tubercle = attachment for trans carpal lig

FCR groove

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18
Q

describe trapezoid

A

small

wedged between capitate and trapezium

firm attachment to 2nd metacarpal

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19
Q

describe hamate

A

large hooklike process

4th and 5th metacarpals

functional mobility “cupped hand”

attachment for trans carpal lig

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20
Q

what is carpal tunnel

A

thick fibrous band of connective tissue = trans carpal lig

connected on 4 raised points

attachment site for many intrinsic muscles in the hand and palmaris longus

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21
Q

what 4 raised points is the carpal tunnel attached to

A

pisiform

hook of hamate

tubercles of scaphoid and trapezium

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22
Q

what is the joint structure of the radiocarpal joint

A

concave radius and disc and convex scaphoid and lunate

triquetrum contacts with ulnar dev

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23
Q

when is there greatest contact at the radiocarpal joint

A

at slight ext and ulnar dev

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24
Q

how much force is present at the disc of the radiocarpal joint

A

20% compressive force

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25
joint structure of mid carpal joints
between proximal and distal rows continuous capsule lateral and medial compartmetns; more movement in medial
26
how many intercapral joints
13 small gliding and rotatory motions ligaments help disipate force
27
importance of ligaments of wrist
essential to maintain carpal alignment and transfer forces stretched ligaments hold muscle produced energy and help with arthrokinematics mechanoreceptors in ligaments; especially dorsal
28
describe the fibrous capsule of the hand/wrist
surrounds wrist and distal radioulnar joint ligaments embedded in capsule
29
describe what you might see where the TFCC is on a radiograph
looks like empty space
30
osteokinematics of the wrist
2 degrees of freedom flx/ext radial/ulnar dev
31
what is wrist circumduction
combo of movements; not a 3rd degree of freedom
32
where is the axis of the wrist
through head of capitate M-L axis for flexion and extension A-P for radial/ulnar dev axis migrates through ROM Rt of capitate directes osteokinematics of the whole hand
33
movement of wrist in sagittal plane
130-160 total flexion = 0-70/85 ext = 0-60/75 greater than normal palmar tilt of radius may limit ext
34
movements of wrist in frontal plane
50-60 total ulnar dev = 0-35/40 radial dev = 0-15/20
35
ROM required for ADLs
40 deg flexion and extension in each direction 10 deg radial dev 30 deg ulnar dev
36
position of function of wrist
10-15 degree of ext 10 deg ulnar dev
37
what movements naturally occur with radial and ulnar dev
extension naturally occurs with radial dev flexion naturally occurs with ulnar
38
arthrokinematics of wrist ext
convex lunate rolls dorsally (distal surface) and slides in a palmar direction head of capitate rolls dorsally on lunate and slides in palmar direction combination of both
39
closed packed position of wrist
full extension
40
arthrokinematics of wrist flexion
convex lunate rolls palmarly and slides dorsally head of capitate rolls palmarly on lunate and slides in dorsal direction
41
arthrokinematics of ulnar deviation
metacarpal more than radiocarpal RC: scaphoid, lunate, and triquetrum roll in ulnar direction and slide radially
42
radial deviation arthrokinematics
roll radially and slide ulnarly carpals run into radius 80% mvmt at MC joint
43
what is carpal instability
excessive mobility between carpals usually laxity/ruptured lig can be static or dynamic
44
describe rotational collapse of the wrist
mechanically proximal carpals are a row of mobile bone between 2 relatively rigid segments may collapse due to compression lunate is most frequently dislocated carpal bone
45
radial n supplies what
all muscles that cross dorsal side of wrist ECRB, ECRL, ECU
46
median and ulnar nn supply what
all muscles that cross the palmar side of the wrist median = FCR, PL ulnar = FCU
47
sensory innervations of wrist joint
RC and MC = C6 and C7 MC = C8
48
primary wrist extensors
act only on wrist extensor carpi radialis longus and brevis extensor carpi ulnaris
49
secondary wrist flexors
act on wrist and hand extensor digitorum extensor indicis extensor digiti minimi extensor pollicis longus
50
what structure secures extensor tendons into place
extensor retinaculum prevents bowstringing up
51
how many fibro-osseus compartments are in the wrist/hand
6 can develop tenosynovitis
52
what compartment does de quervains tenosynovitis occur
in compartment I pressing on power tools, gripping, or wringing out clothes
53
each muscles moment arm for a particular action is equal to what
perpendicular distance between the particular axis and the position of the muscles tendon
54
describe the muscle mechanics involved with producing a string grip
contraction of extrinsic finger flexors = flexion of fingers and creates wrist flexion torque activation of wrist extensors = block wrist flexion caused by activated flexors wrist extensors maintain optimal length of finger flexors to effectively flex fingers
55
when does maximal grip force occur
about 30 deg extension
56
sxs of lateral epicondylitis
painful/weak grip pain with passive wrist flexion and pronation tender over lateral epicondyle can see degeneration/inflammation
57
what happens with lateral epicondylistis
light grasp ECRB force increases with ECR and ECRL
58
primary wrist flexors
flexor carpi ulnaris and radialis palmaris longus (absent in 15%) palmar carpal ligament stabilizes/prevents bowstringing
59
secondary flexors of the wrist
flexor digitorum profundus and superficialis flexor pollicis longus abductor pollicis longus extensor pollicis longus
60
what muscle provides the greatest wrist flexion torque of all 3 flexors
FCU
61
what muscles work together as synergists opposing deviations
FCU and FCR
62
force comparison between wrist flexors and extensors
wrist flexors are able to produce at 70% greater isometric torque than extensors
63
peak wrist flexion torque is when
at 40 deg flex
64
peak wrist ext torque is when
30-70 deg of ext
65
muscles that radially deviate
Extensor carpi radialis loggus and brevis Extensor pollicis longus and brevis abductor pollicis longus flexor pollicis longus radial deviators are greater than ulnar by 15%
66
muscles that ulnarly deviate
extensor carpi ulnaris flexor carpi ulnaris flexor digitorum profundus and superficialis extensor digitorum

DPT 702: Biomechanics (13 decks)

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