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Wrist > Anatomy & Biomechanics > Flashcards

Anatomy & Biomechanics Flashcards

1
Q

Wrist Complex Anatomy - Type & DF

A

Type: compound & partly complex modified Ovoid
Motion: 2 DF (flex/ext & ulnar/radial deviation)

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2
Q

Wrist Capsular Pattern

A

Flexion = Extension = Radial deviation = Ulnar deviation

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3
Q

Wrist Closed Pack Position

A

Full Extension

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4
Q

Proximal Row (lateral –> medial)

A

Scaphoid (navicular)–>Lunate–>Triquetrum–>Pisiform (volar)

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5
Q

Distal Carpal Row (lateral –> medial)

A

Trapezium (1st) –> Trapezoid (2nd) –> Capitate (3rd) –> Hamate (4th/5th)

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6
Q

TFCC (Triangular Fibrocartilage Complex)

A

Triangular Fibrocartilage disc
Radio ulnar ligaments
Ulnocarpal ligaments
- powerful intra articular ligament that stabilizes joint & cushions forces transmitted through the LUNATE & TRIQUETRIUM

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7
Q

TFCC Injuries

A

Repetitive load & pronation/supination may generate tears or perforation

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8
Q

Volatr Ligaments - Palmar Intrinsic Ligaments

A

From 1 bone to next & Interosseous

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9
Q

Volar Ligaments - Extrinsic Ligaments

A 
RSC - radioscapholunate lig
LRL - long radiolunate
SRL - short radiolunate 
UL - ulnarlunate 
UT - ulnartriquetral
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10
Q

Dorsal Ligaments - Intrinsic Ligaments

A 
SL - scapho-lunate
LT - triqutrolunate
TT - trapezium- trapezoid
CT - capitate-trapezoid
CH - capitate-hamate
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11
Q

Dorsal Ligaments - Extrinsic Ligaments

A

DIC - dorsal intercarpal ligament

DRC - dorsal radiocarpal ligament

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12
Q

Surface Anatomy - Proximal Crease

A

Variable - proximal limit of synovial sheaths of flexor tendons

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13
Q

Surface Anatomy - Middle Crease

A

Joint line of radius & disc

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14
Q

Surface Anatomy - Distal Crease

A

Pisiform - flexor aspect on top of triquetrum

- formed within tendon of FCU

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15
Q

Surface Anatomy - Hook of Hamate

A

From pisiform, move distal and radial (tender)

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16
Q

Surface Anatomy - Tunnel of Guyon

A

Between pisiform & hook of hamate

- passageway of ulnar nerve & ulnar artery to hand

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17
Q

Surface Anatomy - Scaphoid

A

Neck in floor of anatomical snuff box

- prominent with wrist flexion/ulnar deviation

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18
Q

Surface Anatomy - Tubercle on Scaphoid

A

Rounded, near middle crease & FCR tendon

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19
Q

Surface Anatomy - Trapezium

A

Base of 1st metacarpal, just distal to scaphoid

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20
Q

Surface Anatomy - Tubercle of Trapezium

A

Ridge, at base of thenar eminence

- points to 2nd or 3rd

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21
Q

Surface Anatomy - Flexor Retinaculum

A

Roof of carpal tunnel

- attached to pisiform, hook of hamate, tubercles of trapezium/scaphoid, & proximal edge at distal crease of wrist

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22
Q

Anatomical Snuff Box

A

Just distal to radial styloid process

  • Medially = EPL
  • Laterally = EPB, APL
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23
Q

Thenar Eminence

A

APB (superficial)
Opponents (middle)
FPB (deep)

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24
Q

Hypothenar Eminence

A

AbdDM (superficial)
Opponens (middle)
FlexDM (deep)

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25
Q

Radial Artery

A

Just lateral to FCR

26
Q

Flexor Carpi Radialis (FCR)

A

Just lateral to Palmaris Longus (thick tendon that winds around tubercle of scaphoid on distal crease)

27
Q

Carpal Tunnel Structures

A 
Median Nerve
FDS
FDP
FPL
FCR
Scaphoid tubercle
28
Q

Tunnel of Guyon Structures

A

Ulnar nerve
Ulnar artery
-bwn pisiform & hook of hamate)
-palmar aspect

29
Q

AROM - Radial Deviation

A

15-20 deg

30
Q

AROM - Ulnar Deviation

A

30-40 deg

31
Q

AROM - Flexion

A

65-70 deg

32
Q

AROM - Extension

A

80-85 deg

33
Q

Lateral Column of Wrist

A

Trapezium, Trapezoid (distal)

Scaphoid (proximal)

34
Q

Central Column of Wrist

A

Capitate, Hamate (distal)

Lunate (proximal)

35
Q

Medial Column of Wrist

A

Triquetrum, Pisiform

36
Q

Biomechanics - Moving to CPP

A

Distal to proximal under influence of wrist extensor so

- Trapezium does NOT take part (thumb flexible in CPP)

37
Q

Biomechanics of Wrist Extension (to CPP)

A

Distal row locks on proximal row (lunate rolls dorsally on radius; slides palmarly)
- Convex carpals on Concave radius = roll posterior, glide volar
- Capitate locks on scaphoid at NEUTRAL
- Scaphoid unit extends on lunate/triquetrum
Moves as unit on proximal row & distal row CPP just into extension
All carpals extend on Radius & Ulnar disc
CPP = FULL extension

38
Q

Biomechanics of Wrist Flexion

A

Proximal row (lunate/triquetrum) rolls anterior/palmarly
Distal row glides posteriorly/dorsally
- Capitate locks on scaphoid
- Scaphoid locks on distal row

39
Q

Biomechanics Flexion - Scaphoid/Trapezii rotate ____________

A

Internally (IR)

40
Q

Biomechanics Flexion - Triquetrum & Hamate rotate ____________

A

Externally (ER)

41
Q

Biomechanics Extension - Triquetrum & Hamate rotate __________

A

Internally (IR)

42
Q

Biomechanics Extension - Scaphoid/Trapezii rotate ____________

A

Externally (ER)

43
Q

Biomechanics - Radial Deviation

A
  • Proximal carpals glide ulnarly (convex carpals on concave radius)
  • Scaphoid IR
  • Trapezii glide dorsally over scaphoid
  • Hamate glides palmarly over triquetrum
  • Result = supination of distal row on proximal row
44
Q

Biomechanics - Ulnar Deviation

A
  • Proximal carpals glide radially (convex carpals on concave radius)
  • Triquetrum ER
  • Trapezii glides palmarly
  • Hamate glides dorsally
  • Result = pronation of distal row on proximal row
45
Q

1st CMC Joint & DF

A
  • Simple Unmodified Sellar

- 2DF: flex/ext, abd/add

46
Q

1st CMC Capsular Pattern

A

Extension, Abduction

47
Q

1st CMC Joint Close Pack Position

A

Full Opposition

48
Q

Biomechanics - 1st CMC Joint Flexion

A
  • Frontal (coronal) plane movement
  • Concave 1st metacarpal on Convex trapezium
  • Rolls & glides ulnarly (medially)
  • ulnar adduction
49
Q

Biomechanics - 1st CMC Joint Extension

A
  • Frontal (coronal) Plane
  • Concave 1st metacarpal on Convex trapezium
  • Rolls & glides radially (laterally)
  • radial abduction
50
Q

Biomechanics - 1st CMC Joint Abduction

A
  • Sagittal plane
  • Convex metacarpal on Concave trapezium
  • Rolls anteriorly, glides DORSALLY
51
Q

Biomechanics - 1st CMC Joint Adduction

A
  • Sagittal plane
  • Convex metacarpal on Concave trapezium
  • Rolls dorsally, glides PALMARLY (anteriorly)
52
Q

1st CMC Least pack Position

A

Center of abd/add & flex/ext

53
Q

MCP Capsular Pattern

A

Ext > Flex

54
Q

MCP CPP

A

Full Ext

55
Q

MCP Least Pack Position

A

Semi-Flex

56
Q

MCP Mobility Tests

A

Palmar, Dorsal, Medial, Lateral

57
Q

MCP Stress Tests

A

Rotation with Flexion
Ulnar and Radial gapping
Traction in full Flexion

58
Q

IP Joint Capsular Pattern

A

Ext > Flex

59
Q

IP Joint CPP

A

Extension

60
Q

IP Least Pack Position

A

Semi-Flex

61
Q

IP Mobility Stress Tests

A 
Traction/compression
Dorsal/Palmer glide
Rotation (IR/ER)
Medial/lateral glide
Medial/lateral roll
62
Q

IP Stress Tests

A

Extension with radial/ulnar gapping

Traction in full ext

Wrist (2 decks)

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