Wrist and Hand

Question 1

4 characteristics of hand function

Answer 1

assume variety of postures

change positions (able to accommodate different sizes of same shape)

Versatility: power and fine motor

Accommodate unique shapes

Question 2

How many bones in the hand

Answer 2

27

Question 3

what wrist bone is most commonly broken with a FOOSH

Answer 3

scaphoid

Question 4

What carpal bones attach to the transverse carpal ligament

Answer 4

scaphoid tubercle

Trapezium tubercle

Pisiform

Hook of Hamate

Question 5

What is the keystone of the proximal row

what is the keystone of the distal row

Answer 5

lunate (proximal)

Capitate (distal)

Question 6

What is the normal degree of radial inclination

how much shorter/longer can the ulna be compared to the radius while still being functional

Answer 6

22-23 degrees

2mm

Question 7

The MCP collateral ligaments are elongated during ______

The IP collateral ligaments are elongated during _______

Answer 7

flexion

ext

(this is why a resting hand splint has MCP flexion and IP ext, same position as lumbricals!)

Question 8

What is the proper resting hand splint position?

Answer 8

MCP flexion

IP ext

Question 9

What are the most important pulleys in the hand?

Answer 9

A2 and A4

Question 10

What are the structures that go through the carpal tunnel

Answer 10

4 tendons of FDS

4 tendons of FDP

Median nerve

FPL tendon

(10 structures total)

Question 11

What are the 2 structures that go through guyon’s canal?

Answer 11

Ulnar Nerve

Ulnar artery

Question 12

What muscles are in compartment 1 of the extensor tendons?

Answer 12

Abductor Pollicis Longus (APL)

Extensor Pollicis Brevis (EPB)

Question 13

What is in the second extensor compartment

Answer 13

Extensor Carpi Radialis Brevis and Longus

Question 14

What is in compartment 6 of the extensors

Answer 14

Extensor carpi ulnaris

Question 15

The radiocarpal joint contributes more to ___________, the midcarpal joint contributes more to ____________

Answer 15

Radio-carpal: wrist flexion

Midcarpal: wrist extension

Question 16

How many muscles attach to the proximal row of the carpal bones?

Answer 16

none!!

Question 17

When you have wrist flexion, the distal row moves as a unit and the proximal row _________________

Answer 17

rotates in same direction as the distal row and slides in opposite direction

Question 18

If you lose A2 flexor pulley, how much of your ROM will be lost?

Answer 18

10% or 26 degrees

Question 19

For what precautions would we want to discontinue edema treatment

Answer 19

DVT/Thrombosis

Discoloration

Change in sensation

Question 20

At what 2 levels of the hand grip dynomometer will a pt be the strongest

What shape should the strength curve be in?

Answer 20

At level 2 and 3 (best at 2)

Bell curve

Question 21

Wrist drop sign is a problem of what nerve

Answer 21

Radial

Question 22

Pt with a radial nerve injury will have problems with what task

Answer 22

power grip

limited ability to receive objects

inability to perform prehensile grip patterns

Question 23

Hand of benediction is a sign of what nerve problem

Answer 23

median

Question 24

Claw hand is a problem of what nerve?
d/t what 2 muscles?

Answer 24

ulnar nerve

loss of 3rd and 4th lumbricals

Question 25

Whats the difference between claw hand and hand of benediction?

Answer 25

Claw hand= 4th and 5th MCP is in hyperextension

Question 26

What hand sign will people with median nerve injuries be unable to do?

Answer 26

OK sign

Question 27

To treat carpal tunnel we want to __________

Answer 27

stretch the muscles of the carpal tunnel

Question 28

T or F: immobilization is recommended for trigger finger

Answer 28

T, it stops the pt from continually making it more inflamed through use

Question 29

Which way do you glide the proximal carpal row for increasing wrist EXT?

Answer 29

Towards flexion (toward the palm)

Question 30

What are 2 methods to measure swelling in the hand

Answer 30

Figure 8 measurement Volumentric (water displaced)

Question 31

Flexor carpi ulnaris attaches to what carpal bone

Answer 31

Pisiform

Question 32

Which CMC joints are stable? Which CMC joints are mobile?

Answer 32

1st- saddle joint 2nd and 3rd- stable, immobile 4th and 5th- mobile

Question 33

What muscles originate from the hamate and the transverse carpal ligament What muscles originate from the trapezium and the transverse carpal ligament?

Answer 33

Hamate: * ODM (to the HoH) * flexor digiti minimi brevis Trapezium * Abductor pollicis brevis * Flexor pollicis brevis * Opponens pollicis

Question 34

What is campers chiasm

Answer 34

Where the tendon of FDS splits to allow FDP to go in the middle, then it reunites as one attaching to the PIP

Question 36

What is in compartment 3

Answer 36

Extensor pollicis longus

Question 37

What is in compartment 4

Answer 37

Extensor digitorum Extensor indicis

Question 38

What is in compartment 5

Answer 38

EDM

Question 39

Every extensor compartment:

Answer 39

1 APL EPB 2 ECRB ECRL 3 EPL 4 EI ED 5 EDM 6 ECU

Question 40

Where does the scaphoid have the most blood supply?

Answer 40

At the distal end

Question 41

During pronation the radius migrates… During supination the radius migrates..

Answer 41

Proximally 2mm, and the ulna translates into the dorsal sigmoid notch Distally 2mm, and the ulna translates into the sigmoid notch volarly