Forearm, Wrist, and Hand Flashcards
The hand accounts for about __% of UE function
90%
What is the capsular pattern of the distal radioulnar joint?
pain at extremes of pronation/supination
What is the resting position of the distal radioulnar joint?
10 degrees of supination
What is the closed packed position of the distal radioulnar joint?
5 degrees of supination
Where is the Triangular Fibrocartilage Complex (TFCC) found?
between medial proximal row of carpal bones and distal ulna
What are the functions of the TFCC?
- Enhance joint congruity between the ulna and carpal bones
- Cushion against compressive forces
What are the 4 ligaments that originate from the TFCC?
- Ulnolunate ligament
- Ulnotriquetral ligament
- Ulnar collateral ligament
- Radioulnar ligament
What are the 2 structures that support the TFCC?
- Ulnocarpal ligaments
- Sheath of the extensor carpi ulnaris tendon
Which carpals articulate with the TFCC?
lunate and triquetrum
What is the capsular pattern of the radiocarpal joint?
Flexion and Extension equally limited
What is the resting position of the radiocarpal joint?
Neutral with slight ulnar deviation
What is the closed packed position of the radiocarpal joint?
Extension with radial deviation
Which carpal bone is most susceptible to injury during a fall onto an outstretched hand?
scaphoid
What is the capsular pattern of the intercarpal joints?
No recognized capsular pattern for the intercarpal joints
What is the resting position of the intercarpal joints?
Neutral or slight flexion
What is the closed packed position of the intercarpal joints?
Extension
Approximately 50% of the total arc of wrist flexion and extension occur at what level?
the Midcarpal level
What is the capsular pattern of the midcarpal joints?
Equal limitation of Flexion/Extension
What is the resting position of the midcarpal joints?
Neutral or slight flexion with ulnar deviation
What is the closed packed position of the midcarpal joints?
Extension with ulnar deviation
What is the capsular pattern of the first CMC joint?
Thumb abduction > thumb extension
What is the resting position of the first CMC joint?
Midway between abduction and adduction, and flexion and extension
What is the closed packed position of the first CMC joint?
Full opposition
What is the capsular pattern of CMC joints 2-5?
Equal limitation in all directions
What is the resting position of CMC joints 2-5?
Midway between flexion and extension
What is the closed packed position of CMC joints 2-5?
Full flexion
What is the capsular pattern of the interphalangeal joints?
Flexion, then extension
What is the resting position of the interphalangeal joints?
Slight flexion
What is the closed packed position of the interphalangeal joints?
Full extension
What is the capsular pattern of the MCP joints?
Flexion, then extension
What is the resting position of the MCP joints?
Slight flexion
What is the closed packed position of the MCP joints?
Full opposition
What is the function of the extrinsic (radiocarpal/ulnocarpal) carpal ligaments?
provide the majority of wrist stability
What is the function of the intrinsic (midcarpal) carpal ligaments?
serve as rotational restraints, binding the proximal row into a unit of rotational stability
What is the antebrachial fascia?
A dense connective tissue that encases the forearm and maintains the relationship of the tendons that cross the wrist
What does the extensor retinaculum do?
Serves to prevent the tendons from bowstringing when the tendons turn a corner at the wrist
What is the flexor retinaculum aka?
transverse carpal ligament
The flexor retinaculum transforms the carpal arch into what?
the carpal tunnel
What are the functions of the flexor retinaculum?
- Serves as an attachment site for the thenar and hypothenar muscles
- Helps maintain the transverse carpal arch
- Acts as a restraint against bowstringing of the extrinsic flexor tendons
- Protects the median nerve
What 2 structures restrain the flexor tendons to the metacarpals and phalanges ?
Annular and cruciate pulleys
What are the 3 arches of the hand?
- transverse
- longitudinal
- oblique
Dorsal interossei muscles ____duct the fingers.
Palmar interossei muscles ____duct the fingers.
abduct
adduct
What motion do the lumbricals perform?
“Lumberjacks eat Big Macs”
What are 6 types of functional hand tests?
- Hand Disability Index
- Minnesota Rate of Manipulation Test
- Jebsen-Taylor Hand-Function Test
- Nine-Hole Peg Test
- Purdue Pegboard Test
- Crawford Small Parts Dexterity Test
Ape hand deformity is indicative of what type of nerve palsy?
median nerve
Bishop’s hand deformity is indicative of what type of nerve palsy?
Ulnar Nerve
Drop-wrist deformity is indicative of what type of nerve palsy?
radial nerve
claw finger deformity is indicative of what type of nerve palsy?
Median Nerve and Ulnar Nerve palsy
What is Dupuytren’s Contracture?
A fixed flexion contracture of the hand due to a palmar fibromatosis
