hand Flashcards
1
Q
___ musc, ___ bones, ___ articulations of the hand
A
29
19
19
2
Q
wrist/carpus = ___ carpal bones
A
8
3
Q
T/F: metacarpal = metacarpus
A
F: all 5 metacarpals together
4
Q
CMC joint consists of
A
Prox end of metacarpals and distal row of carpal bones
5
Q
MCP joint consists of
A
Metacarpals and prox phalanges
6
Q
T/F: MCP = convex in frontal plane only
A
F: frontal and sagittal
7
Q
What do the palmar plates prevent?
A
Hyperext
8
Q
What are the 2 interphalangeal joints?
A
PIP and DIP
9
Q
T/F: thumb= 3 phalanges and 1 intercarpal joint
A
F: 2 phalanges
10
Q
Palmar side of wrist contains ___ & ___ wrist creases
A
Prox and distal
11
Q
T/F: the distal wrist crease marks loc of the prox margin of the transverse carpal lig
A
T
12
Q
T/F: digit #4= shortest and stoutest
A
F: #1
13
Q
T/F: digit #2= longest and each= shorter than previous
A
T
14
Q
Palmar surface of shaft of metacarpal = convex/concave longitudinally
A
Concave
15
Q
Distal end of each metacarpal = ___ head
A
Convex
16
Q
T/F: metacarpal neck = common site of fracture (esp #5)
A
T
17
Q
T/F: the thumb metacarpal= similar plane as digits #2-5
A
F: thumb= different plane
18
Q
The thumb= rotated 90 deg __
A
Medially
19
Q
T/F: thumb dorsal surface face of bones= laterally, palmar= medially, radial= ant, ulnar= post
A
T
20
Q
Prox and middle phalanges = ___ base and ___head
A
Concave
Convex
21
Q
Distal phalanx = ___ base
A
Concave
22
Q
What static, rigid arch forms the carpal tunnel?
A
Prox transverse arch
(formed by distal row carpal)
23
Q
T/F: lunate = keystone of prox transverse arch
A
F: capitate
24
Q
What mobile arch passes through the MCP joints?
A
Distal transverse arch
25
T/F: metacarpals #1,4,5 fold around more stable #2,3
T
26
What is the keystone of the distal transverse arch?
MCP joints of central metacarpals
27
What arch follows the general shape of digits #2&3 (/rays)
Longitudinal arch
28
Prox end of longitudinal arch= attached to ___, distal end?
CMC
Mobile
29
What is the keystone of longitudinal arch?
2&3 MCP joints
30
T/F: digits 2&3 = keystone for proximal and longitudinal arches
F: longitudinal and distal
31
T/F: planes of motion of thumb = oppo fingers
T
32
CMC joint = ___ region of hand
Prox
33
T/F: 4&5 CMC joints = rigid --> fixed central pilar
F: 2&3
(4&5 = mobile, fold around pilar)
34
CMC joint shape = __ metacarpal on ___ hamate
Convex
Concave
35
Radial central metacarpals provide form attachment points for which musc?
Extensor carpi radialis longus
Extensor carpi radialis brevis
Flexor carpi radialis
ADD pollicis
36
What joint improves effectiveness of grasp
CMC
37
T/F: CMC of thumb = saddle
T
38
Radial collateral and post oblique lig= enhances ___
Proprioception, joint protection, NM control of opposition
39
T/F: post oblique lig = most ruptured
F: ant
40
Most lig of CMC = taut w/ thumb in _______
Ext
ABD
Opposition
41
T/F: common dislocation thumb = radially
T
42
Saddle joint trapezium POV
Concave P-D
Convex M-L
43
T/F: AoR for CMC joint in all planes of motion = concave part of articulation
F: convex
44
Max ABD thumb = __ deg ant to plane of palm
45
45
ABD thumb = ___thumb moving on___ trapezium
Convex
Concave
46
Full ABD of CMC joint elongates most lig of joint and what musc
ADD pollicis
47
ABD CMC thumb stretches what lig and activates what musc?
Post oblique lig
Opponens pollicis
48
T/F: forces fr both activated musc and stretched lig= imp in promoting maximal congruity and stability of CMC joint once in full opposition
T
49
During CMC thumb flex, rotates ___, ext?
Medially
Laterally
50
Flex thumb = __ metacarpal surface on ___ trapezium
Concave
Convex
51
What are the 2 phases of opposition?
1: thumb metacarpal ABD
2: ABD metacarpal flexes and medially rotates across palm --> fingers
52
Full opposition includes __ deg of medial rotation @ thumb
45-60
53
T/F: MCP formed between concave metacarpal heads and convex prox surface of prox phalanges
F: convex met heads, concave prox phalanges
54
Collateral lig of MCP attaches on/near post tubercle of met head. What are the 2 distinct parts?
Dorsal cord
Accessory
55
T/F: dorsal cord= thinner, accessory= thicker
F: dorsal= thick
Accessory= thin
56
Dorsal cord attaches distally to ___ region of prox end of phalanges
Palmar
57
Accessory part attaches distally along edge of ___ plate
Palmar
58
What is 1' func of palmar/volar plates?
Strengthen structures of MCP joints and limit extremes of ext
59
Concave components of MCP include:
Arctic surface prox phalanx
Collateral lig MCP
Dorsal surface of palmar plate
60
Overall ranges of flex/ext MCP gradually inc from __ to __ digit?
Digit #2 --> #5
61
Digit #2 flex ___, #5?
90 deg
110-115 deg
62
MCP ext passively beyond neutral for a range of = ___
30-45 deg
63
T/F: ABD and ADD @ MCP occur @ about 20 deg on both sides
T
64
Arthrokin MCP = ___ arctic surface of phalanx on ___ met head
Concave
Convex
65
What part of collateral lig = isometric in length throughout flexion and extension
Accessory
66
T/F: most of cord of collateral lig= slacken in 0 deg ext
T
67
ABD and ADD of MCP fingers= sig less when motions performed in full ___ than full ___
Flexion
Extension
68
MCP fingers: most of cord of collateral lig= taut in near full ___
Flexion
69
MCP joint of thumb concave vs convex:
Convex met head
Concave prox surface of prox phalanx
70
T/F: active and passive motion @ MCP thumb= sig less than fingers
T
71
Fr full ext, (thumb MCP) prox phalanx thumb can actively flex ___ deg across palm toward middle finger
60
72
T/F: thumb MCP can do flex/ext and ABD/ADD
F: flex/ext ONLY
ABD/ADD = limited (accessory mvt)
73
T/F: skier's injury (leg external ABD torque @ MCP) injures radial collateral lig
F: ulnar
74
What is the rupture point for ulnar collateral lig?
45 deg ABD
(most vulnerable to rupture when ABD torque = applied 1/ MCP flexed @ 30 deg)
75
Head of prox phalanx= ___ rounded condyles separated by shallow central groove
2 (convex)
76
T/F: DIP= surrounded by radial and ulnar collateral lig
F: PIP
77
PIP, cord of collateral lig limits ___, accessory?
ABD and ADD
Blends w/ and reinforces palmar/volar plate
78
What is the primary structure that limits hyperextension of PIP joint?
Palmar plate
79
T/F: palmar surface of plates= attachment for base of fibrous digital sheath (houses tendon extrinsic finger flex)
T
80
What is the check-rein lig?
Prox-lat region of each palmar plate @PIP thicken longitudinally form fibrous tissue which reinforce prox attachment of plate and assist in limiting hypertext joint
81
T/F: PIP and DIP both have check-rein lig
F: only PIP
82
T/F: flexion @PIP and DIP= greater in radial digits
F: ulnar
83
When immobilized, PIP and DIP= positioned in near ext why?
Pos= stretch palmar plates, reducing likelihood of flexion contracture
84
Thumb allows active flexion of ___ deg, IP joint thumb= passively ext beyond neutral to about ___ deg
70
20
85
What is tabes dorsalis?
Condition affects sensory/afferent tracts w/in spinal cord
86
What nerve innervates extreinsic musc of hands?
Radial
87
Extrinsic musc of hand have prox attachment ___
Forearm (or as far as epicondyles of humerus)
88
T/F: intrinsic musc of hand= attach prox and distally w/in hand
T
89
T/F: radial n innervates all extrinsic extensors on palmar side of hand
F: dorsal
90
Median n innervates most of the ___ (lat portion palm)
Extrinsic flexors
91
T/F: ulnar n innervates most medial musc (medial palm)
T
92
C6 =___, C7=___, C8=___ digits
1,2
3
4,5
93
T/F: FDP splits to allow FDS to attach to distal phalanx
F: FDS splits
94
What musc is the primary PIP flexor? DIP flexor?
FDS
FDP
95
T/F: FDP digit #2 can be controlled indep of oth digits
T
96
What does FPL do?
Flex thumb IP joint
97
T/F: FPL exerts substantial flex torque @ MCP and CMC joints thumb
T
98
What synovial sheath is distal to carpal tunnel?
Ulnar synovial sheath (surrounds FDS and FDP tendons)
99
Where does radial synovial sheath attach?
Tendon FPL
100
T/F: fibrous digital sheath are anchored to phalanges and palmar plates
T
101
What synovial sheath surrounds extrinsic flexor from distal wrist crease to DIP and serves as lubrication to tendons?
Digital
102
What are the 5 pulleys?
3 cross joints, 2 attach to shaft phalanges
103
What is the role of pulleys?
Hold tendon @ constant distance fr MA during flexion
104
What is tenosynovitis?
Inflamm flexor tendons and surrounding synovial membranes
105
T/F: flexion and extension will --> more pressure for carpal tunnel
T
106
What is the best position to help relieve pressure of carpal tunnel?
Neutral
107
What is tenodesis?
Stretch musc passively across 1 joint --> creates passive mvt @ oth joints the musc crosses
(ext wrist, fingers flex naturally)
108
What are the extrinsic finger extensors?
EDC
EI
ED Min
109
T/F: extensor indicis= predominant finger ext bc cross sectional area
F: EDC
110
T/F: extensor tendons lack pulley and defined digital sheath
T
111
T/F: central band of extensor mech = extension of EDC
T
112
T/F: lateral band = backbone of extensor mech
F: central band
113
T/F: lateral band of extensor mech= wraps around joint @ prox phalanx
F: distal
114
Central band attaches to ___ phalanx, lateral band?
Middle
Distal
115
T/F: dorsal hood connects tendon to palmar plate and provide attachment to lumbricals and interossei
T
116
Dorsal hood stabilizes extensor tendons relative to __
MCP joint
117
T/F: oblique retinacular lig insert distally in lateral band and coord mvt beta PIP and DIP fingers
T
118
Isolated cxn EDC prod __ @ MCP joint
Hyperext
119
T/F: EDC can fully ext PIP and DIP alone
F: need activated intrinsic musc fingers
120
What musc make up anatomic snuff bos? (extrinsic extensors thumb)
EPL
EPB
AbPL
121
Which tendons pass through the 1st dorsal compartment w/in extensor retinaculum of wrist
AbPL
EPB
122
Where does tendon EPL cross?
3rd compartment (groove med to dorsal tubercle of radius)
123
Which joints does EPL ext?
CMC, MCP, IP thumb
124
T/F: EPL only ext CMC joint
F: also ADD
125
What joints does EPB ext?
CMC and MCP
126
T/F: AbPL ext only CMC
T
127
T/F: EPL and ECB= radial dev
F: EPL and AbPL
128
3 thenar musc prox attachment
Transverse carpal lig and adjacent carpal bones
129
T/F: FPB and OP attach distally to radial side of base of prox phalanx
F: AbPL and FPB
(OP= radial border of thumb metacarpal)
130
T/F: AbPL attaches to extensor mech/expansion
T
131
Median n injury results in ___ opposition and flattens the thenar area of hand
Disabled
132
Med rot of opposition occurs w/ which musc? Flexion and ABD?
OP
All 3 thenar
133
T/F: ADD policies > ABD pollicis
T
134
Median n injury --> ___ contracture of CMC thumb
ADD
135
Where is the ABD DM insertion?
Pisiform (stable insertion for FCU tendon)
136
What is the func of hypothenar?
Cup ulnar border of hand
137
Ulnar lesion results in
Flat hypothenar eminence
138
Ulnar n injury --> clawing, what's position?
Hyperext MCP
Flex IP
139
Ulnar lesion paralyzes what musc?
ADD policies
All interosseous musc
140
2 heads ADD policies attach __ side of prox phalanx
Ulnar
141
T/F: greatest flexor and ADD torque @CMC = ADD pollicis
T
142
What 2 n innervate lumbricals?
Median n (lateral)
Ulnar n (medial)
143
Actions of lumbricals?
Flex MCP, ext DIP and PIP
144
Interossei = __&__
PAD
DAB
145
PAD
ADD digits #2,4,5
146
DAB
ABD digits 2,3,4
147
T/F: ABD digit #5= dorsal interossei
F: ABD digiti minimi
148
T/F: interossei and ABD digiti minimi= dynamic stabilizers MCP joints
T
149
Cxn interossei = __ MCP, __ IP
Flex
Ext
150
T/F: lumbricals stronger than interossei
F: interossei bc prod lrg force over shorter cxn distance
151
Intrinsic + pos? Extrinsic +?
Flex MCP, IP ext
Ext MCP, IP flex
152
Forces fr FDP and FDS flex __ joints of fingers
All 3
153
What is prehension?
Ability fingers and thumb to grasp/seize, holding, securing, picking up obj
154
If unable to pinch, what musc do you compensate w/ for ulnar n lesion?
FPL (median n) (partially flex IP)
155
What is froment's sign an indication of?
Ulnar n lesion
156
What is zig-zag deformity? Eg?
Collapse of multiple interconnected joints in alternating directions
Advanced RA
157
Common deformity pos?
CMC flex and ADD
MCP hypertext
IP flex
158
T/F: finger flexors generate bowstring force in palmar direc when gripping
T
159
Weakened lig (w/ RA) -->
Bowstringing force dislocating MCP completely
160
Ulnar drift = deformity @MCP of ____
Excessive ulnar dev and ulnar translation (slide) prox phalanx
161
T/F: healthy hand, transverse fibers dorsal hood and radial collateral lig maintain extensor tendon over AoR
T
162
W/ RA, transverse fibers dorsal hood ruptures allowing EDC tendon to slide ___ side of AoR
Ulnar
163
Ulnar drift may be assoc w/
Wrist instability
