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Kinesiology > Hand > Flashcards

Hand Flashcards

1
Q

Bony landmarks of the hand

A
  • metacarpals
  • phalanges
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2
Q

Metacarpals

A
  • first segment of each finger
  • form the bone section of the palm
  • form the transverse arches that enhance grasp and in hand manipulation
  • longitudinal arch allows for radial and ulnar aspects of palm to come together (thumb and pinky come together)
  • metacarpal heads = knuckles
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3
Q

Phalanges

A
  • 3 distinct sections = proximal, middle, distal
  • thumb only has proximal and distal phalanges
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4
Q

Joints of the hand

A
  • metacarpophalangeal (MCP) joint
  • interphalangeal (IP) joints
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5
Q

Metacarpophalangeal (MCP) joint

A
  • ellipsoid joints
  • movements = flexion/extension and adduction/abduction
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6
Q

Interphalangeal (IP) joints

A
  • hinge joints
  • flexion and extension
  • proximal IP (PIP)
    • important for power grips
  • distal IP (DIP)
    • smaller with less movements
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7
Q

Grasp

A

The entire use of the hand to hold an object

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8
Q

Types of grasp

A
  • cylindrical grasp
  • spherical grasp
  • hook grasp
  • composite grasp
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9
Q

Cylindrical grasp

A
  • flexion around a tube shaped object
  • ex: golf club, steering wheel
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10
Q

Spherical grasp

A
  • flexion around a round object
  • ex: holding a ball, apple, doorknob
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11
Q

Hook grasp

A
  • simultaneous flexion of PIPs and DIPs with extension of MCPs
  • ex: carrying a briefcase or basket
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12
Q

Composite grasp

A
  • maximal flexion of all digits
  • ring and pinky finger generate more force than radial digits
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13
Q

Pinch

A

Involved the varying use of thumb, index, and middle fingers for precise object manipulation

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14
Q

Types of pinch

A
  • tip pinch
  • three jaw chuck
  • lateral (key) pinch
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15
Q

Tip pinch

A
  • distal tips of thumb and index finger
  • precise fine motor
  • ex: threading needle
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16
Q

Three jaw chuck

A
  • also known as tripod pinch
  • tip of thumb against index and middle fingers
  • ex: writing with pen/pencil
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17
Q

Lateral (key) pinch

A
  • pad of thumb pressed against radial side of index finger
  • ex: turning pages of book, presenting credit card, turning key
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18
Q

Range of motion for the hand

A
  • allows for purposeful movement of fingers and thumb
  • supply precise and coordinated movement that contribute to fine motor coordination (FMC), grasp, and pinch
  • due to small size and minimal weight of fingers and thumb = the effect of gravity is negligible
    • MMT and ROM can be performed in against gravity or gravity eliminated positions
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19
Q

ROM of MCP flexion

A
  • prime movers = interossei, lumbricals, FDS, FDP
  • patient position = forearm and wrist neutral
  • goniometer axis = dorsal MCP joint
  • stationary arm = midline of dorsal metacarpal
  • moving arm = midline of dorsal proximal phalanx
  • compensatory movement = wrist flexion, tenodesis
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20
Q

Typical ROM of MCP flexion

A

90 degrees

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21
Q

Prime movers of MCP flexion

A
  • interossei
  • lumbricals
  • FDS
  • FDP
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22
Q

Compensatory movement of MCP flexion

A
  • wrist flexion
  • tenodesis
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23
Q

ROM of MCP extension

A
  • prime movers = extensor digitorum, extensor indicis, extensor digiti minimi
  • patient position = forearm and wrist in neutral
  • goniometer axis = volar MCP joint
  • stationary arm = midline of volar metacarpal
  • moving arm = midline of volar proximal phalanx
  • compensatory movement = wrist extension
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24
Q

Typical ROM of MCP extension

A

45 degrees

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25
Prime movers of MCP extension
- extensor digitorum - extensor indicis - extensor digiti minimi
26
Compensatory movement of MCP extension
- wrist extension
27
ROM of MCP abduction/adduction
- prime movers = dorsal interossei (abduction), palmar interossei (adduction) - patient position = forearm in pronation, hand flat on table - goniometer axis = dorsal metacarpal head - stationary arm = midline of dorsal metacarpal - moving arm = midline of dorsal proximal phalanx - compensatory movement = radial or ulnar deviation
28
Typical ROM of MCP abduction/adduction
20 degrees
29
Prime movers of MCP abduction/adduction
- dorsal interossei (abduction) - palmar interossei (adduction)
30
Compensatory movement of MCP abduction/adduction
- radial or ulnar deviation
31
ROM of PIP flexion
- prime movers = FDS, FDP - patient position = forearm and wrist neutral - goniometer axis = dorsal PIP joint - stationary arm = midline of dorsal proximal phalanx - moving arm = midline of dorsal middle phalanx - compensatory movement = MCP flexion, DIP flexion, wrist flexion
32
Typical ROM of PIP flexion
0-100 degrees
33
Prime movers of PIP flexion
- FDS - FDP
34
Compensatory movement of PIP flexion
- MCP flexion - DIP flexion - wrist flexion
35
ROM of PIP extension
- prime movers = interossei, lumbricals, extensor digitorum (central slip) - patient position = forearm and wrist neutral - goniometer axis = dorsal PIP joint - stationary arm = midline of dorsal proximal phalanx - moving arm = midline of dorsal middle phalanx - compensatory movement = MCP extension, DIP extension, wrist extension
36
Typical ROM of PIP extension
0-100 degrees
37
Prime movers of PIP extension
- interossei - lumbricals - extensor digitorum (central slip)
38
Compensatory movement of PIP extension
- MCP extension - DIP extension - wrist extension
39
ROM of DIP flexion
- prime movers = FDP - patient position = forearm and wrist neutral - goniometer axis = dorsal DIP joint - stationary arm = midline of dorsal middle phalanx - moving arm = midline of dorsal distal phalanx - compensatory movement = MCP flexion, PIP flexion, wrist flexion
40
Typical ROM of DIP flexion
0-90 degrees
41
Prime movers of DIP flexion
- FDP
42
Compensatory movement of DIP flexion
- MCP flexion - PIP flexion - wrist flexion
43
ROM of DIP extension
- prime movers = interossei, lumbricals, extensor digitorum (terminal tendon) - patient position = forearm and wrist neutral - goniometer axis = dorsal DIP joint - stationary arm = midline of dorsal middle phalanx - moving arm = midline of dorsal distal phalanx - compensatory movement = MCP extension, PIP extension, wrist extension
44
Typical ROM of DIP extension
0-90 degrees
45
Prime movers of DIP extension
- interossei - lumbricals - extensor digitorum (terminal tendon)
46
Compensatory movement of DIP extension
- MCP extension - PIP extension - wrist extension
47
MMT of MCP flexion
- position = forearm and wrist in neutral - stabilizing hand = distal metacarpals - resistive hand = volar aspect of proximal phalanges - force application = against flexion of the MCP joints
48
MMT of MCP extension
- position = forearm and wrist in neutral - MCPs in midrange flexion with PIPs and DIPs in extension - stabilizing hand = distal metacarpal(s) - resistive hand = dorsal aspect of proximal phalanges - force application = against extension
49
MMT of MCP abduction/adduction
- position = forearm pronated, wrist in neutral - stabilizing hand = distal metacarpal - resistive hand = lateral or medial aspect of proximal phalanx - force application = lateral or medial aspect of proximal phalanx
50
MMT of PIP flexion
- patient position = forearm and wrist in neutral - stabilizing hand = proximal phalanx - resistive hand = volar aspect of middle phalanx - force application = against flexion
51
MMT of PIP extension
- patient position = forearm and wrist in neutral - stabilizing hand = dorsal aspect of proximal phalanx - resistive hand = dorsal aspect of middle phalanx - force application = against extension
52
MMT of DIP flexion
- patient position = forearm and wrist in neutral - stabilizing hand = pinching middle phalanx - resistive hand = distal phalanx - force application = against flexion
53
MMT of DIP extension
- patient position = forearm and wrist in neutral - stabilizing hand = pinching middle phalanx - resistive hand - dorsal aspect of distal phalanx - force application = against extension
54
Clinical implications
- trigger finger - Boutonniere deformity - Swan Neck deformity - Dupuytren’s contracture - DeQuervain’s tenosynovitis - osteoarthritis - tenodesis
55
Trigger finger
- also known as stenosing tenosynovitis - finger becomes lodged in a flexed position - high repetition activities put client at higher risk - interventions = surgical release, activity modification, preventing prolonged flexion
56
Interventions of trigger finger
- surgical release - activity modification - preventing prolonged flexion
57
Boutonniere deformity
- PIP flexion with DIP hyperextension - damage of the central slip - interventions = orthoses, splints
58
Interventions of Boutonniere deformity
- orthoses - splints
59
Swan neck deformity
- PIP hyperextension and DIP flexion - occurs from laceration volar plate or damage to terminal tendon - interventions = orthoses, splints
60
Interventions of Swan Neck deformity
- orthoses - splints
61
Dupuytren’s contracture
- abnormal thickening of palmar aponeurosis leading to contracture of ring and small finger - interventions = surgical release, steroid injection, postoperative rehabilitation, scar management, and splinting
62
Interventions of Dupuytren’s contracture
- surgical release - steroid injection - postoperative rehabilitation - scar management - splinting
63
DeQuervain’s Tenosynovitis
- AKA texting thumb - cumulative trauma disorder (CTD) of the tendons of the first dorsal compartment - occurs from extended ulnar deviation and rapid thumb movement - occupations that can cause it examples: rock climbing, knitting, gaming
64
Osteoarthritis
- common in fingers and thumb - interventions = conservative management, modalities, splints, activity modifications, adaptive equipment
65
Interventions of osteoarthritis
- conservative management - modalities - splints - activity modifications - adaptive equipment
66
Tenodesis
- fingers relaxed and wrist extended = causes fingers to flex - fist is created by passive tension (passive insufficiency) on finger flexor muscles - provides functional grasp for persons with spinal cord injuries (SCIs) at C6 Tendo = tendon Desks = binding or fixation

Kinesiology (11 decks)

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