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2 Biomechanics > Hand > Flashcards

Hand Flashcards

1
Q

Arches of hand

A

proximal transverse
distal transverse
longitudinal

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2
Q

Proximal transverse arch

A

distal row of carpal bones
capitate is keystone

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3
Q

Distal transverse arch

A

metacarpophalangeal joints
keystone was MC 2 and 3

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4
Q

Longitudinal Arch

A

curve of 2nd, 3rd rays
keystone: MC2 and 3

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5
Q

Carpal Tunnel

A

Transverse carpal ligament
passageway for median nerve and tendons of extrinsic digit muscles
prevents bowstringing of tendons out of carpal tunnel

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6
Q

Transverse carpal ligament

A

connected to 4 points, pisiform, hook of hamate, scaphoid, trapezium
converts palmar concavity into carpal tunnel

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7
Q

Radiocarpal joint makeup

A

lunate, scaphoid, triquetrum (sometimes), radius
80% compression forces pass through scaphoid/luante

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8
Q

Midcarpal joint makeup

A

articulation between proximal and distal row of carpal bones
medial and lateral compartments

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9
Q

Intercarpal joints makeups

A

13 articulations

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10
Q

Medial Midcarpal joint convex/concave heads

A

convex head of capitate and hamate –> fit into concave triquetrum, lunate, medial scaphoid

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11
Q

Lateral Midcarpal joint convex/concave heads

A

convex scaphoid fitting into concave trapezoid and trapezium
less motion then medial compartment

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12
Q

Wrist ligaments

A

maintain natural intercarpal alignment and transferring forces across carpals

help to contribute to proprioception
signal travel to wrist muscles to reflexively protect the wrist

intrinsic and extrinsic

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13
Q

Extrinsic ligaments

A

dorsal radiocarpal
radial collateral
palmar radiocarpal
TFCC

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14
Q

Dorsal radiocarpal ligament

A

distal radius to lunate and triquetrum
major contributor to arthrokinematics
rich innervation

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15
Q

Radial collateral ligament

A

radial styloid to scaphoid

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16
Q

Palmar radiocarpal ligament

A

several ligaments known as 1
greater stability than dorsal
radial-scaphate, radial-lunate
taut at extension, guides arthrokinematics

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17
Q

Triangular Fibrocartilage Complex

A

5 structures occupy space
bind radius & ulna, permits pronation and supination
contains an articular disc
reinforced by surrounding ligaments

made up of UCL, palmar radioulnar, triangular fibrocartilage, dorsal radioulnar, ECU tendon

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18
Q

Intrinsic ligaments of wrist

A

short, intermediate, long

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19
Q

Wrist Joint Type

A

Condyloid
2 degrees of freedom
axis of rotation through capitate

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20
Q

Combined motions of wrist

A

Natural path combines both planes of motion
extension & radial deviation, flexion & ulnar deviation

ADLs use these motions

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21
Q

Joints of the wrist

A

called the central column, which is made up of three separate joints
radiocarpal –> L/R
midcarpal –> C/L
Carpometacarpal

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22
Q

Flexion/Extension of Wrist

A

Vex on Cave
radiocarpal on midcarpal

roll = palmar
slide = dorsal
opposite roll/slide for extension

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23
Q

Closed pack position of wrist

A

full extension

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24
Q

Ulnar/Radial deviation

A

Vex on Cave

Ulnar deviation is l/s/t on radius, capitate on l/s
Roll –> ulnar
Slide –> Radial
opposite for radial deviation

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25
Q

Radial deviation is limited by….

A

ulnar tilt

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26
Q

85% of midcarpal of movement during radial deviation is due to…

A

styloid/ulnar tilt of radius

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27
Q

Proximal carpals ____ during ulnar deviation

A

extends

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28
Q

Proximal carpals ____ during radial deviation

A

flexes

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29
Q

Double V Ulnar deviation

A

palmar ulnocarpal and lateral palmar intercarpal ligaments tense

causes more slide than roll

30
Q

Double V Radial Deviation

A

Palmar radiocarpal and medial palmar intercarpal ligaments tense

causes more slide than roll

31
Q

CMC Joints 2-5, capsules

A

strengthened by dorsal and palmar carpometacarpal and intermetacarpal ligaments

32
Q

Thumb joint

A

saddle joint of the body
shape allows full opposition
complex set of ligaments

33
Q

CMC Joints 2-5 characteristics

A

Type of joint varies
degrees of freedom: 0-2
Flex/Ext is main movement

irregular and varied shapes

34
Q

CMC joint 1 characteristics

A

saddle
2 degrees of freedom
allows for abd/add and flex/ext

35
Q

Abduction/Adduction in Thumb

A

Vex on Cave, MC on trapezium

roll: palmar
slide: dorsal

opposite for adduction

36
Q

Flexion/extension in thumb

A

Cave on vex
MC on trapezium

Roll/Slide: ulnar, involves IR

opposite for extension, involves ER

37
Q

Opposition of CMC

A

composite of primary motions
phase 1 = abduction
phase 2 = flexion (w/medial rotation)

38
Q

Closed pack position of thumb

A

full opposition

39
Q

MCP capsules (2-5)

A

Fibrous capsule
have RCL and UCL, plus deep transverse metacarpal ligaments, palmar plates

40
Q

MCP Joints 2-5 Characteristics

A

Condyloid
Degrees of Freedom = 2
Flex/Ext, Abd/Add

41
Q

Flexion/Extension MCP 2-5

A

Cave on Vex, proximal phalanx on MC

Flexion –> Roll/Slide = palmar
Extension –> Roll/slide = dorsal

42
Q

Abduction/Adduction 2-5 MCP

A

cave on vex, proximal phalanx on MC

Abduction –> Roll/slide = radial
Adduction –> Roll/slide = ulnar

43
Q

Characteristics of MCP 1

A

less ROM than other fingers
abd/add limited, considered accessory motions
have same arthrology as 2-5

44
Q

IP Joints Ligaments

A

fibrous capsule, RCL, UCL, palmar plates

45
Q

Characteristics of IP joints

A

hinge
1 degree
Flexion/Extension

46
Q

Flexion/Extension of IP joints

A

cave on vex, phalanx on phalanx
Flexion –> roll/slide = palmar
Extension –> roll/slide = dorsal

47
Q

Primary Wrist Extensors

A

ECRL
ECRB
ECU

48
Q

Secondary Wrist Extensors

A

ED
EI
EDM
EPL

secondary does not always indicate lower torque potential, just a secondary action

49
Q

Muscles that have good MA for deviation and flex/ext

A

ECRL
ECU
EPB
APL

50
Q

Best positions for wrist extensors

A

when making a fist, wrist is generally held in 30-35° extension and 5-15° ulnar deviation

optimizes length-tension relationship for extrinsic finger flexors

51
Q

What position is grip strength maximized?

A

around 30 degrees of extension

52
Q

Why is grip reduced in flexion?

A

finger flexors are at shortened position
passive extensor torque of finger extensors

53
Q

Weakness of Wrist Extensors

A

also can be a radial nerve injury

difficulty producing max grip force
wrist extensors cannot counteract wrist flexion

54
Q

Wrist Flexor muscles, primary

A

FCR
FCU
Palmaris longus

55
Q

Secondary wrist flexor muscles

A

FDP
FDS
FPL

56
Q

Wrist flexors vs wrist extensors

A

wrist flexors can produce 70% greater torque than wrist extensors

peak torque will occur 40° of flexion, wrist flexor MA rise sharply with increased flexion

57
Q

Radial Deviators

A

ECRL
APL

many other secondary muscles

58
Q

Ulnar Deviators

A

ECU
FCU

few other secondary muscles

59
Q

Radial vs Ulnar Deviators

A

Radial deviators produce 15% greater torque compared to ulnar deviators

muscles on both sides of M/L axis combine to produce radial and ulnar deviation torque despite wrist position

60
Q

Extrinsic Digital Flexors

A

FDS
FDP
FPL

larger MA at more proximal joints

61
Q

Flexor digitorum superficialis

A

flexion of PIP joint, but can flex any joint it crosses

62
Q

Flexor Digitorum profundus

A

flexion of DIP joint, flex any joint it crosses
index DIP can flex independently

63
Q

Fibrous Digital Sheath

A

5 annular pulleys and 3 cruciate pulleys
common torn in rock climbers
function is to hold tendons at close distance to joints

64
Q

Tenodesis

A

active wrist extension = passive finger flexion
active wrist flexion = passive finger extension

there’s a passive tension in muscles that causes this

65
Q

Extrinsic Digital Extensors

A

Extensor Digitorum
Extensor Indicis
Extensor digiti minimi

66
Q

Extensor mechanisms

A

central band
lateral bands
dorsal hood
oblique retinacular ligament

67
Q

Dorsal Hood

A

forms sling around base of proximal phalanx

68
Q

Extrinsic Thumb Extensors

A

EPL
EPB
APL

69
Q

Intrinsic Thenar Muscles of the Hand

A

APB
FPB
OP

70
Q

Intrinsic hypothenar muscles

A

FDM
ADM
ODM
palmaris brevis

71
Q

FOOSH Injury

A

scaphoid fracture and scapholunate ligament tear

72
Q

What angle are the extensors at the best length-tension?

A

30°
puts them at midrange

2 Biomechanics (9 decks)

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