WHF - structure, function, anatomy Flashcards
(93 cards)
1
Q
Mechanical purpose of shoulder, elbow, WFH
A
shoulder - mobility and gross placement of handelbow - stabilityWHF - strength and precision
2
Q
How may carpals, metacarpals, and phlanges
A
8 carpals, 5 metacarpals, 14 phalanges
3
Q
name the carpals
A
scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
4
Q
1st Metacarpal lines up with
A
Trapezium
5
Q
2nd metacarpal lines up with
A
trapezoid
6
Q
3rd MC lines up with
A
Capitate
7
Q
4 and 5 MC lines up with
A
Hamate
8
Q
Pisiform floats on
A
triquetrum
9
Q
commonly fractured
A
scaphoid
10
Q
commonly dislocated
A
lunate
11
Q
proximal articulating surfaces of long bones
A
concave
12
Q
distal articulating surfaces of long bones
A
convex
13
Q
purpose of sesamoid bones on first MC
A
improve mechanical line of pull of the flexor pollicis brevis, abductor pollicis brevis, adductor pollicis muscles
14
Q
Distal radioulnar joint - degrees of freedom - movements
A
ulnar head/ulnar notch
1 degree of freedom
pronation and supination
15
Q
Radiocarpal joint
A
ellipsoid joint
2 degrees of freedom
flexion and extension
radial and ulnar deviation
fibrous capsule formed by distal radius and the scaphoid and lunate
16
Q
RCL
A
radial collateral ligamentlimits ulnar deviation becomes taut when the wrist is at the extreme ranges of flexion and extension
17
Q
Palmar radiocarpal ligament
A
controls motion and wrist stability
18
Q
Dorsal radiocarpal ligament
A
limits flexion
19
Q
TFCC
A
triangular fibrocartilanginous complex-articular disc-dissipates stress imposed on forearm during loading-stabilizes distal radioulnar joint
20
Q
Intercarpal joints
A
allow for gliding movements
21
Q
First CMC joint
A
2 degrees of freedom synovial saddle joint flexion and extension, abduction and adduction accessory motion: opposition and reposition
22
Q
CMC joints 2-4
A
plane synovial joint
1 degree of freedom
flexion and extension
23
Q
CMC joint 5
A
2 degrees of freedom
flexion and extension
abduction and adduction
24
Q
MCP joints
A
condyloid joints
2 degrees of freedom
flexion and extension
abduction and adduction
25
collateral ligaments at fingers
protect against valgus and varus forces make gripping less dependent on dynamic stability
26
IP joints
1 degree of freedom
| flexion and extension
27
natural position of hand
slight flexion
28
Extensor muscles
Extensor muscles
location: posterolateral forearm
6 compartments
radial nerve innervation
```
extensor carpi radialis longus/brevis
extensor carpi ulnaris
extensor digitorum communis
extensor pollicis longus
extensor pollicis brevis
abductor pollicis longus
extensor indicus
```
all secured by extensor retinaculum
increase efficiency of the muscles’ pull and prevents “bow stringing” when the wrist is extended
29
Flexor muscles
```
Flexor Muscles
Location: anteromedial forearm
2 compartments
flexor carpi radialis,
palmaris longus (absent in 12-15% of population)
flexor carpi ulnaris
flexor digitorum superficialis
flexor digitorum profundus
flexor pollicis longus
```
median nerve innervation
(fourth and fifth - ulnar nerve)
30
Palmar muscles groups
thenar central, hypothenar, adductor interosseous compartments
31
muscles of thenar eminence
abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
32
muscles of hypothenar eminence
abudctor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi muscles
33
To prevent bowstringing
series of pulleys restrain and guide the tendonsduring flexion and extension of the fingers
34
flexor tendons require how much more excursion than extensor tendons
4x
35
annular pulleys
tunnels for tendons
36
cruciate pulleys
pliable, allow annular pulleys to move towards each other in flexion
37
4 Lumbrical muscles
flex MCP, extend PIP and DIP
38
Palmar aponeurosis equals
volar plate
39
Ulnar
passes through tunnel of guyon.palmar/dorsum - 1/2 ring finger, pinky finger.
40
median
runs through carpal tunnellateral palm, 1/2 ring finger, fingers 3-1.dorsum - fingers 1,2 and half of ring finger
41
Radian nerve
base of thumb, back of hand near thumb below 1st and 2nd fingers
42
Carpal tunnel
fibro-osseus structurefloor formed by proximal carpal bonesroof - transverse carpal ligaments
43
PVD
peripheral vascular disease (Raynaud's)
44
Russell's signs
abrasions, small cuts, callosities over dorsal surface of MCP or IP joints-outward signs of bullimia
45
Drop wrist associated with
radial nerve
46
Trigger finger
stenosing tenosynovitisnodule in flexor tendonaffects MCP flexion and extension
47
Ape Hand
median nerve pathologyweakness in thenar eminencepulls thumb medially
48
Bishop's Deformity
ulnar nerve, hypothenar muscles, flexion in PIP and DIP joints, extension limited
49
Claw Hand
ulnar and median nerveextension of MCP, flexion of PIP and DIP
50
Dupuytren's Contracture
excessive flexed resting positioncan't extend MCP and PIP jointsshortening or adhesion of palmar fascia
51
Swan Neck Deformity
flexion of MCP and DIPhyperextension of PIPvolar plate injuries,malunion, trauma, arthritis
52
Volkmann's Ischemic Contracture
flexion contraction of wrist and fingers,limited extensiondecreased blood supply
53
Jersey Finger
avulsion of extensor digitorum longus tendon-can't actively extend distal phalanx
54
Mallet Finger
avulsion of extensor digitorum longus tendoncan't actively extend distal phalanx
55
Boutonniere Deformity
rupture of central extensor tendonrupture of volar plate-extension of MCP and DIP joints-flexion of PIP joint
56
Hard end feels
radial deviation, MCP flexion, PIP flexion
57
Soft end feels
thumb flexion, thumb adduction
58
numbness on dorsal hand correlates with what nerve pathology
ulnar nerve in elbow
59
numbness on palmar side of hand correlates with
ulnar nerve near tunnel of guyon
60
distal forearm fractures common in
children
61
Colles fracture
any fracture of distal radius
62
scaphoid fracture common in
15-30 year olds and younger males
63
concerns with scaphoid fracture
blood supply from radial artery compromised - necrosisPreiser's disease - osteoporosis of scaphoidnonunion
64
MOI of schaphoid fracture
foosh, land on palm, hyperextension of wrist
65
Hamate fractures, MOI
hook of hamateMOI - foosh or trauma from golf club or bat,axial loadcould compress ulnar nerve - symptoms in fingers 4 and 5.
66
concerns with hamate fractures
nonunion, vascular supplycan be removed
67
Lunate dislocation
lunate is disassociated from other carpals
68
perilunate dislocation
proximal carpal row being stripped from around the lunate
69
Lunate MOI
high energy forced hyper extension of wrist
70
Murphy's sign
depressed third knuckle - lunate dislocation
71
Wrist sprains
scapholunate ligaments - most commonly sprained
72
Watson test
positive for tear - clunk with pain
73
TFCC injury
traumu, or repeated injury
74
MOI of TFCC
forced hyperextension w/ pronating force; rotary force, repeated weight bearing
75
Carpal tunnel syndrom
compression of median nerve-fibrosis of the synovium of flexor tendons secondary to tenosynovitis-repeptive microtraumau-caused by poor biomechanics, poor posture, obesity, pregnancy, typing, work related activities, diabetes,
76
CTS signs and symptoms
numbness or pain and thumb, index, middle, lateral half of ring finger (median nerve)
77
Boxer's fracture
common in young men, punching somethingfracture of 5th MC
78
Collateral ligament injuries
unilateral stress applied to extended finger
79
Dequeravain's syndrome
finkelstein's test-tenosynovitis of the extensor pollicis brevis, abductor pollicis longus tendonswomen 20-40repetitive radial deviation
80
UCL sprain
limits opposition and decreases grip strengthhyperabduction or hyper extenstion"gamekeeper's thumb"pain on ulnar side, can't pinch or grasp
81
Bennett's fracture
base of first MC
82
Splinting jersey finger
DIP joint in flexion
83
Splinting mallet finger
dIP joint in extension
84
Splinting boutonniere finger
PIP and DIP joints in extension
85
radial collateral and ulnar collateral ligament stress tests
UCL - test with valgus stressRCL - test with varus stress
86
Valgus and Varus IP tests
tests for collateral ligament sprainavulsion fracture
87
Laxity of thumb MCP collateral ligaments
valgus stress to thumb UCLsprain or avulsion fracture
88
Watson's test
arm in arm wrestling position-apply dorsal pressure with thumb at scapholunate area-move hand from ulnar deviation to radial deviationtests for: scapholunate dissociation
89
Phalen's Test
test for carpal tunnel-tingling from irritation of median nerve-patient is standing-overpressure applied though wrist flexion for 1 minute
90
Finkelstein's
dequervain's syndrome
91
the pisiform improves what?
mechanical efficiency of the flexor carpi ulnaris
92
history
where is the painMOIprevious historygeneral medical healthSounds or sensationshow long?type of pain, pain scalechanges in activity
93
keystone of carpal group
lunate
