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Functional Anatomy > Hand and Wrist > Flashcards

Hand and Wrist Flashcards

1
Q

T or F: The Hand fine-tunes the Wrist position

A

False.

The wrist fine-tunes the hand position

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2
Q

What is the function of Listers’ Tubercle and what muscle(s) pass through there

A

Function: It acts as a pulley and redirects pull
Muscles: Extensor Digitorum Longus and Brevis, Extensor Indices on Radial side, Extensor Pollicis Longus on Ulnar side

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3
Q

What are the proximal and distal rows of the carpal bones

A

Proximal: scaphoid, lunate, triquetrum, pisiform
Distal: trapezium, trapezoid, capitate, hamate

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4
Q

Pisiform serves as an attachment site for which muscle

A

Flexor Carpi Ulnaris

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5
Q

Which bone is the reference point of the hand

A

Capitate

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6
Q

T or F: The shaft of the metacarpals are curved with a palmar convexity

A

False: they are curved with a palmar concavity

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7
Q

The base of the metacarpals articulate with which strucutre(s)

A
  1. Carpal bones

2. Adjacent metacarpals

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8
Q

The head of the metacarpal bones articulate with which structure(s) and forms which joint

A

The base of the proximal phalange, forms the Metacarpophalangeal joint

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9
Q

List all the wrist joints

A

Distal Radioulnar
Radiocarpal
Midcarpal
Intercarpal

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10
Q

Distal Radioulnar joint

  • joint type
  • action
  • comprised of
A
  • Uniaxial synovial pivot joint
  • Pronation and supination
  • Comprised of TFCC, oblique fibres of distal interosseous membrane, and radioulnar ligaments
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11
Q

Radiocarpal Joint

  • joint type
  • actions/ DOF
  • articulations
A
  • ellipsoidal (condylar) synovial joint
  • 2 DOF, contributes to general flexion/extension and radial/ulnar deviation
  • biconcave distal radius articulates with convex proximal row of carpal bones, scaphoid and lunate
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12
Q

Midcarpal joint

  • joint type/ formed by
  • action
  • articulation
A
  • Synovial plane joint formed by proximal and distal carpal rows
  • Contributes to general flexion/extension, radial/ulnar deviation
  • Compound articulation:
    • Planar laterally
    • Condylar medially
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13
Q

Intercarpal joints

  • joint type
  • articulations
A
  • plane, synovial joints

- joints between proximal and distal rows

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14
Q

List the joints of the hand

A
  1. Carpometacarpal 2-5
  2. Carpometacarpal 1st
  3. Metocarpal Phalangeal
  4. Interphalangeal
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15
Q

Carpometacarpal joint 2-5

  • joint type
  • articulation
  • ROM
A
  • plane, synovial
  • MC bases articulate with distal row of carpals & with one another
  • third has minimal motion, fourth and fifth have much more
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16
Q

Carpometacarpal joint 1st

  • joint type
  • articulations
  • ROM
A
  • synovial saddle joint
  • between base of first MC and trapezium
  • “pringle” both concave and convex
  • 6 motions available
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17
Q

ROM of First Carpometacarpal joint

A
  • Flexion/Extension
  • Abduction/Adduction
  • Opposition/Repositioning
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18
Q

Metacarpophalangeal joint

  • joint type
  • DOF/action
  • articulations
A
  • synovial condyloid
  • 2 DOF, flex/ex, ab/ad
  • convex MC heads articulate with bases of phalanges (extended by volar plate)
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19
Q

Interphalangeal joint

  • joint type
  • action/DOF
  • DIP/PIP/IP
A
  • synovial hinge joint
  • 1 DOF, flex/ex
  • 2-5 have DIP and PIP
  • 1 has only IP
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20
Q

Ligaments of the Wrist and Hand

A
  1. Volar Plate
  2. Wrist
    - Extrinsic (radius, ulna, metacarpal to carpal)- Collaterals, retinacula, radial and ulnocarpal ligaments
    - Intrinsic (between carpal bones only)- Short, intermediate, and interossei
    - TFCC
  3. Hand and Fingers
    - Medial and lateral collateral
    - Deep transverse metacarpal ligament
    - Thumb ligaments
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21
Q

T o F: There is no ligament between capitate and lunate

A

True.

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22
Q

Volar Plate

  • found in which joint(s)
  • attaches to
  • action/purpose
  • function
A
  • found in IP and MCP joints
  • attaches to distal phalanx and collateral ligaments
  • as joint flexes, volar plate slides proximally UNDER metacarpal (folds membranous part), this = large ROM for small surface area
  • functions to prevent hyperextension and dorsal subluxation
23
Q

T or F: Dorsal ligaments are always thicker than palmar

A

False: palmar ligaments are always thicker than dorsal

24
Q

Distal radioulnar ligament (palmar and dorsal)

-action

A

Stabilizes distal radioulnar joint

25
Q 
Collateral ligament (radial and ulnar)
-actions
A

Radial: restricts ulnar deviation, lateral stabilization of radial wrist
Ulnar: restricts radial deviation, lateral stabilization of ulnar wrist

26
Q 
Radiocarpal ligament (palmar and dorsal)
-actions
A

Palmar: Volarly stabilizes radius to carpals; limits extensive wrist extension
Dorsal: Dorsally stabilizes radius to carpals; limits extensive wrist flexion

27
Q

Triangular Fibrocartilage Complex

-function

A
  • load absorption and transmission

- stabilizes distal radioulnar joint

28
Q

Palmar ulnocarpal ligaments

- name all 4

A
  • Ulnotriquetrial ligament
  • Ulnolunate ligament
  • Ulnocapitate ligament
  • Palmar radioulnar ligament
29
Q

Flexor retinaculum

-function

A
  • creates passage for tendons of flexor pollicus longus, flexor digitorum superficialis, profundus, and median nerve
  • point of origin for muscles of thenar eminence
30
Q

Extensor Retinaculum

-function

A
  • restricts tendon bow stringing during wrist hyperextension
  • reduces friction on tendons
31
Q

Medial and lateral collateral ligaments

-actions

A
  • taut in flexion, assist with ability to grip
  • loose in extension, allow abduction/adduction at MCP
  • accessory collaterals control volar plate
32
Q

Deep transverse ligament

-actions

A
  • allows for flexible metacarpal arch
  • limits spread
  • has volar plate attachment
33
Q

Thumb ligaments

A
  • two sesamoids attached to volar plate in muscular tendons

- facilitates pinch precision

34
Q

Muscles- Wrist (Extensors and Flexors)

A 
Wrist Extensors
-Extensor Carpi Radialis Longus and Brevis
-Extensor Carpi Ulnaris
-Extensor Carpi Digitorum Secondary Extensor
Wrist Flexors
-Flexor Carpi Radialis
-Flexor Carpi Ulnaris
-Flexor Digitorum Superficialis
-Flexor Digitorum Profundus
-Palmaris Longus
-Flexor Pollicus Longus
-Abductor Pollicus Longus
35
Q

T or F: All wrist extensors have a common origin (lateral epicondyle) except extensor carpi radialis longus and extensor carpi digitorum

A

True

36
Q

T or F: All wrist flexors have a common origin (medial epicondyle)

A

True

37
Q

Radial/Ulnar Deviation at the Wrist

  • plane
  • axis
A
  • frontal plane

- ap axis

38
Q

Muscles- Fingers (extrinsic)

A
  • extensor digitorum
  • extensor carpi radialis longus
  • extensor carpi radialis brevis
  • extensor carpi ulnaris
  • extensor pollicus longus
  • extensor pollicus brevis
  • abductor pollicus
  • extensor indicies
  • extensor digitorum minimi
  • flexor digitorum superficialis
  • flexor digitorum profundus
  • flexor pollicus longus
39
Q

Muscles- Fingers (Intrinsic)

A
  • abductor pollicis brevis
  • flexor pollicis brevis
  • opponens
  • flexor digitorum minimi
  • abductor digitorum minimi
  • opponens digiti minimi
  • interossei (palmar adductor, dorsal abductor)
  • lumbricals
  • adductor pollicus
40
Q

Extensor Mechanism

A

Intricate structures in fingers in thumb designed to:

  • hold flexor and extensor tendons in place
  • allow them to move and glide
  • guide the direction of pull
  • extension of digits in multiple positions of finger flexion & to permit full flexion
  • as finger flexes, the hood is pulled distally due in part to the palmar attachments
41
Q

Motions at the wrist- Osteokinematics

A

Radial deviation
Ulnar deviation
Flexion
Extension

42
Q

Wrist Radial Deviation

  • end feel
  • axis
A
  • bony end feel

- ap axis through capitate

43
Q

Wrist Ulnar Deviation

- end feel

A

firm end feel

44
Q

Wrist Flexion/Extension

- axis

A

Through capitate

45
Q

Wrist close packed position

A

Full wrist extension

46
Q

Motions at the Metacarpophalangeal joints 2-5

A

Flexion
Extension
Abduction
Adduction

47
Q

MCP 2-5 Flexion and Extension

-end feels

A

both firm

48
Q

MCP joint Close pack position

A

Finger Flexion to 90 degrees

49
Q

Metacarpophalangeal joint- thumb

  • osteokinematics
  • DOF
  • type of joint
A
  • flexion/extension
  • 1 DOF
  • hinge joint
50
Q

Interphalangeal joint

  • osteokinematics
  • DOF
  • type of joint
A
  • flexion/extension
  • 1 DOF
  • hinge joint
51
Q

Metacarpal and Interphalangeal close pack position

A

Thumb: MCP and IP = full extension

Digits 2-5: MCP and IP = full flexion

52
Q

Types of grasp - Power Grip

A
  • incorporates entire hand

- gross grasping activities

53
Q

Types of grasp - Precision Grip

A

-accuracy, refinement, object manipulation

54
Q

Grasping

A
  • finger flexion occurs when wrist is in extension

- grip is significantly weakened if wrist flexion occurs

Functional Anatomy (5 decks)

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