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kines exam 2 > Finger Joints and Ligaments > Flashcards

Finger Joints and Ligaments Flashcards

1
Q

how is the hand a multi-purpose organ

A

manipulate things in our environment

use it to interact with our environment

sensory organ

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2
Q

what is the primary goal of treating the hand

A

restoration of function

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3
Q

can the hand function w/o the brain

A

no

but the brain needs the hand as a primary tool of expression

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4
Q

carpometacarpal joints of the fingers (CMC joints)

A

digits 2-5

articulation b/w the distal carpal row and bases of 2nd-5th metacarpals

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5
Q

2nd metacarpal articulates with

A

primarily the trapezoid

secondarily with the trapezium, capitate and 3rd metacarpal

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6
Q

3rd metacarpal articulates with

A

primarily with capitate

secondarily w/ second and fourth metacarpals

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7
Q

4th metacarpal articulates with

A

primarily w/ capitate and hamate

also with 3rd and 5th metacarpals

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8
Q

5th metacarpal articulates w/

A

primarily w/ the hamate

also w/ ulnar side of the 4th metacarpal

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9
Q

what kind of joints are the 2-4th CMC joints

A

plane synovial joints

have slightly curved articular surfaces

1 degree of freedom

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10
Q

what motion do the CMC joints allow

A

potentially allow flexion/extension in sagittal plane around a frontal axis

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11
Q

normal ROM flexion/extension CMC joint

A

ranges up to 10-20 degrees

increases as you go from radial to ulnar side

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12
Q

what kind of joint is the 5th CMC joint

A

saddle joint with 2 degrees of freedom

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13
Q

what movements does the 5th CMC joint allow

A

flexion/extension
ABD/ADD
some rotation

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14
Q

flexion/extension 5th CMC joint

A

10-20 degrees

motion increases as you go from radial to ulnar side

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15
Q

are you ever going to measure CMC motion

A

no

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16
Q

what ligaments support all CMC joints

A

supported by strong transverse and weaker longitudinal ligaments volary and dorsally

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17
Q

transverse metacarpal ligament (CMC)

A

tethers together the heads of the four metacarpals of the fingers

prevents CMC ABD

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18
Q

what predominately controls ROM at CMC joints

A

ligamentous structure

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19
Q

what happens from radial to ulnar side

A

ROM increases

2nd and 3rd joints are essentially immobile

4th is more mobile

5th is most mobile

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20
Q

stability of the 2nd and 3rd CMC joints

A

functional adaptation

enhances the function of the radial wrist flexors and extensors

MORE EFFICIENT

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21
Q

what happens since there are muscles that insert on the bases of the 2nd and 3rd metacarpals

A

when they contract

they would act initially on the CMC joints before flexing or extending the midcarpal or radiocarpal joints

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22
Q

since the CMC joints are immobile

A

it allows the muscles to have a more distal attachment, functionally

leads to an increased lever arm

leads to greater efficiency for wrist extensors and flexors

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23
Q

joint capsule for CMC joint

A

continuous w/ that of the intermetacarpal joints

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24
Q

primary function of CMC joint

A

contribute to hollowing of the palm

form arches of the hand

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25
Q

which joints creates the palm/hollows the hand

A

4/5th CMC joints

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26
Q

how many arches in the palm

A

4

3 structural and 1 functional

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27
Q

structural arches

A

transverse carpal arch

transverse metacarpal arch

longitudinal arch

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28
Q

transverse carpal arch

A

most proximal arch

is a consistent concavity

created by the curved shapes of the carpals and by the ligaments that maintain concavity

this arch forms the carpal tunnel

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29
Q

ligaments that maintain concavity

A

intercarpal ligaments

transverse carpal ligament

flexor retinaculum

30
Q

transverse metacarpal arch

A

formed by heads of the metacarpals

4th and 5th metacarpal heads move towards the 2nd and 3rd via the CMC joint

31
Q

longitudinal arch

A

formed by each finger with respective carpal, metacarpal and phalanges

32
Q

functional arch

A

oblique arch

33
Q

oblique arch

A

formed by the thumb with each finger in opposition

4 of them

34
Q

what do the arches of the hand allow

A

palm and fingers to conform to objects being held

bones form the arches of the hand

intrinsic muscles maintain the integrity of the arches

35
Q

what happens if the hand looks flat

A

muscle issue

wasting of intrinsic muscles

36
Q

metacarpophalangeal joints (MCP, MP)

A

each MCP joint is composed of a convex metacarpal head articulating with the concave base of the proximal phalanx

Concave moving on convex

everything in the same direction

37
Q

what kind of joints are the MCP joints

A

condyloid joints with 2 degrees of freedom

38
Q

what motions do MCP joints allow

A

flexion/extension

ABD/ADD

39
Q

flexion/extension MCP

A

sagittal plane around a frontal axis

motion will vary from radial side to ulnar side (more ROM on ulnar side)

40
Q

MCP flexion

A

90 degrees (radial side)

135 degrees (ulnar side)

41
Q

MCP extension

A

45 degrees beyond neutral

42
Q

ABD/ADD MCP

A

frontal plane around a sagittal axis

most motion is at the index finger

43
Q

ABD/ADD ROM MCP

A

45 degrees both ways

44
Q

middle finger MCP ABD/ADD

A

radial ABD and ulnar ABD

45
Q

what is ABD/ADD MCP ROM referred to as

A

normal arc of motion

total ABD + total ADD

for each finger

46
Q

ligaments of MCP joint

A

transverse metacarpal ligament

radial and ulnar collateral ligaments

accessory collateral ligaments

47
Q

transverse metacarpal ligament

A

runs on volar aspect and attaches one metacarpal tot he next via the volar plates

48
Q

radial and ulnar collateral ligaments

A

run obliquely from the dorsal aspect of the metacarpal to ventral aspect of the base of the proximal phalanx

are taut in MP flexion and slack in extension

49
Q

accessory collateral ligaments

A

run from dorsal aspect of metacarpal to the volar plate

slack in flexion

50
Q

joint capsule (MCP)

A

surrounds the joint

relatively loose and is reinforced dorsally by the extensor expansion

lines by synovial membrane

slack in extension which allows for some axial rotation

51
Q

volar plate

A

MCP articulation w/in the sagittal plane d/t incongruency

volar plate reduces the incongruency and make MCP joint more congruent in the sagittal plane

52
Q

what is the volar plate

A

fibrocartilage that is firmly attached to the base of the proximal phalanx

blends with the more superficial transverse metacarpal ligament

53
Q

volar plate function

A

increases the articular surfaces in the sagittal plane

prevent pinching of the flexor tendons

restrict hypertension

54
Q

how is the volar plate stabilized

A

by attachments of the accessory collateral ligaments

55
Q

accessory movements of MCP joint

A

great deal of joint play at MCP joint

A-P glides

M-L glides

large amount of distraction available

56
Q

interphalangeal joints of the fingers and thumb

A

a convex head articulating with the concave base

concave moving on convex

bone motion, roll and glide in the same direction

57
Q

how many types of IP joints are there

A

3

DIP, PIP, IP

58
Q

what kind of joints are the IP joints

A

synovial hinge joint

one degree of freedom

59
Q

what motion does the IP joint allow

A

flexion/extension

sagittal plane around a frontal axis

60
Q

pip joint flexion ROM

A

90-135 degrees

increasing as you go towards the ulnar side

61
Q

why is full PIP joint flexion important

A

hand function

62
Q

extension of PIP joint

A

0 degrees

beyond 0 is hyperextension

63
Q

DIP joint flexion ROM

A

0-70 or 90 degrees

64
Q

DIP joint extension ROM

A

active –> 0 degrees

passive –> up to 30 degrees

65
Q

ligaments of IP joints

A

collateral ligaments

66
Q

collateral ligaments IP joint

A

insert on the proximal phalanges

remain taut in all positions

67
Q

joint capsule IP joint

A

relatively loose

helps maintain integrity of the joint

reinforced by the presence of the volar plate

68
Q

volar plate of IP joint

A

reinforced each of the capsules

structurally and functionally identical to the ones at the MCP joints

NOT CONNECTED BY A TRANSVERSE LIG

69
Q

accessory movements of IP joint

A

rotation

distraction

70
Q

rotation @ IP joints

A

positions pads of fingers in an optimal position to oppose the thumb

71
Q

distraction at IP joints

A

M-L and A-P glides from external forces

72
Q

what accessory movement is mostly @DIP joints

A

oppose the pads of your thumb

more efficient grip

kines exam 2 (17 decks)

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