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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
Q

Prime movers of MCP extension

A
  • extensor digitorum
  • extensor indicis
  • extensor digiti minimi
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26
Q

Compensatory movement of MCP extension

A
  • wrist extension
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27
Q

ROM of MCP abduction/adduction

A
  • 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
Q

Typical ROM of MCP abduction/adduction

A

20 degrees

29
Q

Prime movers of MCP abduction/adduction

A
  • dorsal interossei (abduction)
  • palmar interossei (adduction)
30
Q

Compensatory movement of MCP abduction/adduction

A
  • radial or ulnar deviation
31
Q

ROM of PIP flexion

A
  • 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
Q

Typical ROM of PIP flexion

A

0-100 degrees

33
Q

Prime movers of PIP flexion

A
  • FDS
  • FDP
34
Q

Compensatory movement of PIP flexion

A
  • MCP flexion
  • DIP flexion
  • wrist flexion
35
Q

ROM of PIP extension

A
  • 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
Q

Typical ROM of PIP extension

A

0-100 degrees

37
Q

Prime movers of PIP extension

A
  • interossei
  • lumbricals
  • extensor digitorum (central slip)
38
Q

Compensatory movement of PIP extension

A
  • MCP extension
  • DIP extension
  • wrist extension
39
Q

ROM of DIP flexion

A
  • 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
Q

Typical ROM of DIP flexion

A

0-90 degrees

41
Q

Prime movers of DIP flexion

A
  • FDP
42
Q

Compensatory movement of DIP flexion

A
  • MCP flexion
  • PIP flexion
  • wrist flexion
43
Q

ROM of DIP extension

A
  • 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
Q

Typical ROM of DIP extension

A

0-90 degrees

45
Q

Prime movers of DIP extension

A
  • interossei
  • lumbricals
  • extensor digitorum (terminal tendon)
46
Q

Compensatory movement of DIP extension

A
  • MCP extension
  • PIP extension
  • wrist extension
47
Q

MMT of MCP flexion

A
  • 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
Q

MMT of MCP extension

A
  • 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
Q

MMT of MCP abduction/adduction

A
  • 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
Q

MMT of PIP flexion

A
  • patient position = forearm and wrist in neutral
  • stabilizing hand = proximal phalanx
  • resistive hand = volar aspect of middle phalanx
  • force application = against flexion
51
Q

MMT of PIP extension

A
  • 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
Q

MMT of DIP flexion

A
  • patient position = forearm and wrist in neutral
  • stabilizing hand = pinching middle phalanx
  • resistive hand = distal phalanx
  • force application = against flexion
53
Q

MMT of DIP extension

A
  • patient position = forearm and wrist in neutral
  • stabilizing hand = pinching middle phalanx
  • resistive hand - dorsal aspect of distal phalanx
  • force application = against extension
54
Q

Clinical implications

A
  • trigger finger
  • Boutonniere deformity
  • Swan Neck deformity
  • Dupuytren’s contracture
  • DeQuervain’s tenosynovitis
  • osteoarthritis
  • tenodesis
55
Q

Trigger finger

A
  • 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
Q

Interventions of trigger finger

A
  • surgical release
  • activity modification
  • preventing prolonged flexion
57
Q

Boutonniere deformity

A
  • PIP flexion with DIP hyperextension
  • damage of the central slip
  • interventions = orthoses, splints
58
Q

Interventions of Boutonniere deformity

A
  • orthoses
  • splints
59
Q

Swan neck deformity

A
  • PIP hyperextension and DIP flexion
  • occurs from laceration volar plate or damage to terminal tendon
  • interventions = orthoses, splints
60
Q

Interventions of Swan Neck deformity

A
  • orthoses
  • splints
61
Q

Dupuytren’s contracture

A
  • 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
Q

Interventions of Dupuytren’s contracture

A
  • surgical release
  • steroid injection
  • postoperative rehabilitation
  • scar management
  • splinting
63
Q

DeQuervain’s Tenosynovitis

A
  • 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
Q

Osteoarthritis

A
  • common in fingers and thumb
  • interventions = conservative management, modalities, splints, activity modifications, adaptive equipment
65
Q

Interventions of osteoarthritis

A
  • conservative management
  • modalities
  • splints
  • activity modifications
  • adaptive equipment
66
Q

Tenodesis

A
  • 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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