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DPT 702/3: AFAB > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

what is the primary goal of elbow and FA

A

placement of hand

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2
Q

what connects on the med epicondyle

A

common flexors/pronators

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3
Q

what connects on the lat epicondyle

A

common extensor/supinators

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4
Q

describe the proximal ulna

A

thick
olecranon process
trochlear notch
radial notch

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5
Q

describe the distal ulna

A

articular cartilage
styloid process

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6
Q

what attaches to the supinator crest

A

LCL and sup mm

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7
Q

what attaches to the tuberosity of the ulna

A

brachialis

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8
Q

how is the radius positioned in supination

A

parallel and lateral

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9
Q

describe the distal end of radius

A

large
styloid process

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10
Q

describe the proximal end of radius

A

small
radial head
fovea

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11
Q

describe radial head

A

disc like articular cartilage
280 deg of rim
radial notch on ulna

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12
Q

what is the fovea on the radial head

A

shallow up connected to capitulum

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13
Q

describe the humeral-ulnar jt

A

FLX/EXT
stability

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14
Q

describe the humeroradial jt

A

FLX/EXT
ligaments attach to radial head and capitulum

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15
Q

what is the normal cubitus valgus

A

carrying angle
13 deg

excessive = 20-25 deg

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16
Q

describe the capsule/ligaments of the elbow

A

encompass 3 jts
multiplanar stability

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17
Q

describe the ant fibers of MCL

A

strongest
resist valgus
med epicondyle to coronoid process
stability in sagittal

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17
Q

describe the post fibers of MCL

A

posterior/med capsule
med epicondyle to olecranon
resist valgus
tight in flexion

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18
Q

describe the transverse fibers of the MCL

A

olecranon to coronoid process
articular stability

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19
Q

what is a WB injury to MCL

A

extended/valgus force
compression fx
ant capsule
med muscles at epicondyle

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20
Q

what is a NWB injury to MCL

A

repetitive valgus force (overhead athletes)
ant fibers damaged - tommy john surgery

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21
Q

what is the RCL

A

annular lig
supinator
extensor carpi radialis brevis

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22
Q

what is the LCL

A

thicker
taut at full flexion
sling for radial head
frontal/horizontal plane stability

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23
Q

what is a triad injury in the elbow

A

full outstretch supinated
elbow jt dislocation
fx radial head
fx coronoid process

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24
Q

what are complications of the triad injury

A

persistent instability
n damage
stiffness

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25
Q

what level of spinal injury can cause paralysis in elbow

A

above C5 spinal injury

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26
Q

what is a flexion contracture

A

after immobilization
ossification
inflammation
m spasticity
tricep paralysis
scarring

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27
Q

what is the functional arc of elbow

A

145-150

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28
Q

what are the humero-ulnar jt arthro

A

concave trochlear notch on convex trochlea

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29
Q

what fibers are taut in full elbow extension

A

anterior m and tissues
ant capsule
ant MCL fibers

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30
Q

what fibers are taut in FLX

A

elongation of ulanr n
post capsule and m
post MCL fibers

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31
Q

what are the humeroradial arthro

A

radius rolls and slides
cuplike fovea and capitulum

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32
Q

what is the fovea doing in active FLX

A

firmly against capitulum

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33
Q

how is the central band of interosseus membrane positioned

A

directed distally medially at 20 deg from radius

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34
Q

what are complications of interosseus membrane tears

A

proximal migration of radius

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35
Q

Describe the proximal radio-ulnar jt

A

Radial notch + annular ligament
Lined with cartilage
Attachment for radial collateral and supination m

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36
Q

Describe the distal radio-ulnar jt

A

Convex head of ulna
Shallow concavity on radius
TFC, disc, m

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37
Q

What is the TFC

A

Triangular fibrocartilage
Holds the ulna head to the notch during supination and pronation

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38
Q

What are the stabilizers of the distal radio-ulnar jt

A

TFCC, pronator quadratus, ECU, interosseus membrane

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39
Q

What limits supination

A

Pronator teres
Pronator quadratus
Flexor carpi radialis
TFCC
quadrate lig
Interosseus membrane

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40
Q

what limits pronation

A

biceps
supinator
radial wrist extensors
extensor pollicis longus
TFCC

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41
Q

how do the bones move during supination at the proximal and distal seg

A

radius and carpal bones rotate around fixed humerus and ulna
prox- radial head RT
distal- radius rolls and slides same direction

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42
Q

where is the axis of RT in the radio-ulnar jt

A

nearly parallel to the interosseus membrane
limits tension
stabilizer

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43
Q

what is happening in pronation in open chain activities

A

pronator rotates the radius around fixed ulna

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44
Q

what is happening in pronation in closed chain activities

A

the infraspinatus rotates the humerus relative to fixed scapula
ER of ulna around fixed radius

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45
Q

what are the elbow flexors

A

brachialis (MSC n)
bicep brachii (MSC n)
brachioradialis (radial n)
pronator teres (median n)

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46
Q

what are the elbow extensors

A

tricep brachii (radial n)
anconeus (radial n)

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47
Q

what are the FA pronators

A

pronator quadratus (median n)
pronator teres (median n)

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48
Q

what are the FA supinators

A

bicep brachii (MSC n)
supinator (radial n)

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49
Q

what is the job of the 3 heads of tricep

A

medial - workhorse
lateral - mod to high levels of demand
long - reserve for high performance

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50
Q

when does the tricep have max torque

A

80-90 elbow flexion

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51
Q

what does the tricep do in WB

A

stability as isometric or low velocity eccentric

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52
Q

when does the tricep do high velocity concentric

A

sports
pushing up from a chair
pushing up from door

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53
Q

what are the secondary supinator m

A

radial wrist extensors
extensor pollicis longus
extensor indicis
brachioradialis

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54
Q

when is the bicep recruited for supination

A

90 deg elbow flexion

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55
Q

where does the median n pass through

A

2 heads of pronator teres

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56
Q

what is an effect of median n injury

A

pronators are paralyzed

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57
Q

what are secondary pronators

A

flexor carpi radialis
palmaris longus
brachioradialis

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58
Q

what is different from carpul tunnel syndrome and pronator teres syndrome

A

pronator teres has pain in medial FA plus the paresthesia on palmar 3.5 digits

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59
Q

what is the ulna tilt

A

distal end of radius tilts towards ulna 25 deg

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60
Q

what is the palmar tilt

A

ulna is 10 deg more in flexion than wrist ext

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61
Q

what makes up the prox carpal row

A

scaphoid, lunate, triquetrum, and pisiform
loosely joined

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62
Q

what makes up the distal carpal row

A

trapezium, trapezoid, capitate, and hamate
bound tightly by ligaments

63
Q

describe the scaphoid

A

undersurface of radius
holds head of capitate
lined with articular cartilage
synovial jt with 4 other carpals

64
Q

what is the mostly fx carpal

65
Q

what is kienbocks disease

A

softening of lunate- AVN

66
Q

describe the lunate

A

moon shaped
central bone of prox row
most unstable

67
Q

describe the triquetrum

A

triangular bone
most ulnar
articular facet that accepts pisiform

68
Q

describe the pisiform

A

shaped like a pea
articulates with triquetrum
embedded in FCU
acts like sesamoid bone
attachment for ABD DM, transverse carpal lig

69
Q

describe the capitate

A

largest, central
articulates with 7 bones
stable
axis through captitate

70
Q

describe the trapezium

A

asymmetrical
concave at scaphoid
distal saddle
tubercle is attachment for transverse carpal lig
FCR groove

71
Q

describe the trapezoid

A

small
between capitate and trapezium
firm attachment to 2nd metacarpal

72
Q

describe the hamate

A

large hook
at 4/5th metacarpal
functional mobility- cupped hand
attachment of transverse lig

73
Q

what makes the carpal tunnel

A

transverse carpal lig

74
Q

what are the attachments for transverse carpal lig

A

pisiform, hook of hamate, tubercle of trapezium and scaphoid

75
Q

describe the radiocarpal jt

A

concave radius and convex scaphoid and lunate
greatest contact at slight ext and ulnar dev (triquetrum is apart of it)

76
Q

describe the midcarpal jt

A

between prox and distal rows
lat and med compartment

77
Q

how many joints are in the intercarpal jt

78
Q

how many DOF are within the wrist

A

2
sagittal and frontal plane

79
Q

what is the degrees of sagittal plane

A

FLX- 0-70/85
EXT- 0-60/75

80
Q

what is the degrees of frontal plane

A

R dev- 0-50/60
U dev- 0-35/40

81
Q

what are functional ranges for ADLS

A

40 deg FLX/EXT
10 deg R dev
30 deg U dev

82
Q

what is the position of function for wrist

A

10-15 deg EXT
10 deg U dev

83
Q

what are the motion combos of the wrist

A

EXT occurs with R dev
FLX occurs with U dev

84
Q

what is the central column

A

formed by linkages between radius and lunate, med compartment of midcarpal jt

85
Q

describe the arthro of wrist EXT

A

concave on convex
lunate rolls dorsally and slides palmarly
capitate rolls dorsally and slides palmarly on lunate
closed packed position in wrist EXT

86
Q

describe the arthro of wrist FLX

A

lunate rolls palmar and slides dorsal
capitate rolls palmar and slides dorsal on lunate

87
Q

describe the arthro of R dev

A

prox row rolls radially and slides ulnar
capitate rolls radially and slides ulnar
carpals run into radius

88
Q

describe the arthro of U dev

A

prox row rolls ulnarly and slides radially
capitate rolls ulnarly and slides radially
MC jt has most motion

89
Q

what do the prox row of carpals do with R dev

A

scaphoid and lunate rock into FLX

90
Q

what carpal is most likely dislocated

91
Q

what m are innervated by the radial n

A

ECRB
ECRL
ECU

92
Q

what m is innervated by the ulnar n

93
Q

what m are innervated by the median n

A

FCR
Palmaris longus

94
Q

what is the sensory innervation of RC

95
Q

what is the sensory innervation of MC

96
Q

what are the primary wrist EXT that act only on the wrist

A

ECRL
ECRB
ECU

97
Q

what are the secondary wrist EXT that act on wrist and hand

A

ED
EXT indicis
EDM
EPL

98
Q

what is in compartment 1

A

extensor pollicis brevis
abd pollicis longus

99
Q

what is in compartment 2

100
Q

what is in compartment 3

A

extensor pollicis longus

101
Q

what is in compartment 4

A

ED
extensor indicis

102
Q

what is in compartment 5

103
Q

what is in compartment 6

104
Q

what are the primary wrist fLX

A

FCR
FCU
PL
palmar carpal lig

105
Q

what are the secondary wrist FLX

A

FDP
FDS
FPL
ABD PL

106
Q

what m has the greatest torque for wrist FLX

107
Q

what mm work together as synergists for wrist deviations

A

FCR and FCU

108
Q

what motion is able to produce more isometric torque, wrist FLX or EXT

109
Q

what is peak wrist fLX torque

110
Q

what is peak wrist EXT torque

111
Q

what mm produce R dev

A

ECRB
ECRL
ABD PL
EPL
EPB
FCR
FPL

112
Q

what mm produce U dev

A

ECU
FCU
FDP
FDS
ED

113
Q

describe the arches of the hans

A

natural concavity allows for control

114
Q

What are the arches of the hand

A

proximal transverse
distal transverse
longitudinal

115
Q

what is the proximal transverse arch

A

formed by distal row of carpals
forms carpal tunnel
capitate is the key

116
Q

what is the distal transverse arch

A

MCP joints
sides of arch are mobile
MCP of 2nd/3rd is key

117
Q

what is the longitudinal arch

A

follows shape of 2nd/3rd rays
proximal end is rigid
distal end is mobile
MCP at 2nd/3rd is key

118
Q

where is the central pillar

A

2nd/3rd CMC rigidly joined

119
Q

what is the CMC joints

A

distal row carpals and bases of MC bones

120
Q

match the carpal with the MC

A

2- trapezoid/capitate/trapezium
3-capitate
4-hamate/capitate
5-hamate

121
Q

describe the kinematics of the 2nd/3rd

A

very little motion
central pillar
firm attachments

122
Q

describe the kinematics of 4th

A

FLX/EXT at 20 deg
IR- 27 deg

123
Q

describe the kinematics of 5th

A

FLX/EXT- 28 deg
IR- 22 deg

124
Q

describe the kinematics of 4/5th

A

convex base to concave hamate
mobility for cupping- FLX and IR
they are linked- 44 deg FLX/EXT

125
Q

what is the kinematics of the thumb

A

saddle joint
2 DOF- FLX/EXT(frontal) and ABD/ADD(sagittal)

126
Q

what is the arthro of the thumb in ABD/ADD

A

ABD- palmar roll dorsal slide
ADD- dorsal roll palmar slide

127
Q

what is the arthro of the thumb in FLX/EXT

A

FLX- medial roll/slide
EXT- lateral roll/slide

128
Q

describe the thumb kinematics of ABD/ADD

A

convex MC on concave trapezium
elongates ADD pollicis and most ligs

129
Q

describe the thumb kinematics of FLX/EXT

A

concave MC on convex trapezium

130
Q

what is the combo of thumb opposition

A

thumb MC ABD
FLX and medial RT toward pinky

closed pack position

131
Q

what is the key for mechanical stability critical for stability of the hand

132
Q

what is collateral lig of the fingers

A

attach at tubercle
cord is thick and strong

133
Q

what is volar plate

A

dense, thick fibrocartilage
base of prox phalanx thinner elastic portion

134
Q

what is fibrous digital sheath

A

form tunnels or pulleys for extrinsic finger flexors anchored to plates

135
Q

what is the osteo of MCP joints

A

FLX/EXT- sagittal 90-115, ext past neutral 20-45
ABD/ADD- frontal 20 deg from midline

136
Q

what is the arthro of MCP

A

concave phalanx on convex MC head
roll and slide same way

137
Q

what is the arthro/osteo of the MCP thumb

A

convex head and concave prox phalanx
1 DOF- FLX/EXT
ABD/ADD is accessory motion

138
Q

what limits hyperextension in IP joints

A

volar plates

139
Q

what are check rein lig

A

reinforce palamar plates and assist in limiting hyperextension

140
Q

what are the kinematics of of the IP joints

A

concave base rolls and slides palmar direction

141
Q

which IP joint has hyperextension

A

DIP- 30 deg

142
Q

what helps provide tension and helps stabilize in IP joints

A

dorsal capsule

143
Q

what m group does the radial n innervate in the hand

A

extensive extensor
ED, EDM, EI, EPL, EPB, ABD PL

144
Q

what m group does the median n innervate in the hand

A

extrinsic flexors
FDS, FDP, FPL, ABD PB, OP, FPB, thenar eminience, lat 2 lumbricals

145
Q

what m group does the ulnar n innervate in the hand

A

hypothenar m
medial half of FDP, FDM, ABD DM, PB, ADD P, all interossei, and 2 medial lumbricals

146
Q

what does the digital synovial sheath serve as

A

nutritional and lubrication

147
Q

what has a greater force at PIP as a proximal stabilizer

A

greater force stabilizer at ED

148
Q

where do the extrinsic extensors of fingers cross

A

at the wrist under retinaculum

149
Q

what attaches to the hood and assists ED with EXT at IP joints

A

lumbricals and interossei

150
Q

where does the extrinsic m of the thumb comprise at

151
Q

what are the intrinsic m of the hand

A

thenar
hypothenar
ADD pollicis
lumbricals/interossei

152
Q

describe the thenar eminence

A

ABD PB, FPB, OP
attach to transverse carpal lig
grasp and opposition, CMC ABD, FLX, IR

153
Q

describe the hypothenar eminence

A

FDM, ABD DM, ODM, PB
ABD DM FCU contracts to stabilize
cupping- transverse arch

154
Q

what m in the hand has high level m spindles

A

lumbricals and interossei

155
Q

what force couple happens when trying to extend the thumb

A

FCU activates with thumb EXT (EPL and ABD PL)

156
Q

what force couple happens when flexing your IP joints

A

ED activates to resist wrist flexion when flexing IP jts (FDS/FDP)

DPT 702/3: AFAB (7 decks)

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