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Move Sci > Hand and Wrist Test 2 > Flashcards

Hand and Wrist Test 2 Flashcards

1
Q

The wrist complex has how many degrees of freedom?

A

2

biaxial

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2
Q

What carpal bones form the proximal radiocarpal joint?

A

Scaphoid, Lunate, Triquetrium

they attach to the radial head and tfcc

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3
Q

How is the end of the radius angled?

A

volarly (palmarly) and ulnarly/medially

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4
Q

What carpal articulates with the TFCC

A

Triquetrium

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5
Q

what carpals articulate with the end of the radius

A

medially-lunate
laterally-scaphoid

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6
Q

what is the function of the pisiform?

A

increases movement arm for flexor carpi ulnaris

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7
Q

what ligaments connect the proximal carpal row?

A

scapholunate interosseous and lunotriquetral interosseous ligaments

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8
Q

TFCC is Connected proximally via dorsal and volar radioulnar ligaments

A
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9
Q

the Distal radiocarpal segment is ___________ than proximal segment → incongruent joint!

A

sharper

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10
Q

The scaphoid and lunate receive ___ of axial load , the TFCC receives __

A

80%

20%

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11
Q

Keinböck’s disease = you have a ______ ulna + there is lack of blood supply to the _______

A

Short

Lunate

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12
Q

Most ligaments and muscles that cross radiocarpal joint also contribute to stability of midcarpal joint

FCU is the exception - because it attaches to _________, ________, and _________

A

5th metacarpal, hook of the hamate, and pisiform

so i guess it does not contribute to joint stability

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13
Q

What carpal bones are in the distal row?

A

Trapezium, trapezoid, capitate, and hamate

Note: the carpals move almost as a fixed unit, with equal distribution of loads across articulations with proximal row

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14
Q

Dorsal wrist ligaments can be described as….

Volar/palmar ligaments of the wrist can be described as…

A

Dorsal- thin

Volar- thicker stronger

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15
Q

Extrinsic carpal ligaments do what

A

connect the carpal bones to other bones

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16
Q

Scapholunate interosseous ligament does what?

Lunotriquetral interosseous ligament?

A

Maintains scapho-lunate stability

Maintains lunate-triquetral stability (star by this one on the slide for some reason i guess it’s important)

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17
Q

The Dorsal radiocarpal ligament
and Dorsal intercarpal ligament do what?

A

Together form “horizontal V” to stabilize scaphoid during wrist ROM

They both attach to triquetrium

They come tight in wrist flexion!

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18
Q

Dorsal radiocarpal ligament function

A

Possibly helps to offset sliding of proximal carpal condyle on inclined radius

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19
Q

What carpal bone is considered the keystone of the wrist?

A

capitate

it is thought to be center of wrist rotation

contacts 7 other bones.

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20
Q

What bones articulate with the capitate?

A

Scaphoid
Lunate
Hamate
Trapezoid
2nd metacarpal
3rd metacarpal
4th metacarpa

What bones do not? Pisiform, trapezium, triquetrium

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21
Q

1.From full flexion, wrist extension begins with the distal row ___________ on the proximal row

2.Then distal row and _________ move on lunate and triquetrium to 45 deg when scaphoid and lunate lock

3.finally proximal row extends on radius/disc to fully extend close-packed position

A

1.gliding posterior

This is the sequence to neutral

2.Scaphoid

Note: flexion is opposite sequence

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22
Q

In radial deviation: Carpals all slide _________ on radius with _____ of proximal row and _____ of distal row. Close-packed position.

A

Ulnarly

Flexion of proximal row

Extension of distal row

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23
Q

In ulnar deviation:
The carpals slide ______ and proximal row ______ and distal row _________

A

Ulnarly

Proximal - extends

distal row - flexion

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24
Q

When wrist is extended you have very little _____ (closed packed position)

_______ is the loosed packed position

A

deviation

Flexion

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25
Dorsal intercalated segmental instability (DISI) tear/instability of the _____
Ligamentous laxity/tear of the scapholunate
26
Volar intercalated segmental instability (VISI) tear or instability of ______
Ligamentous laxity/tear of the lunotriquetral
27
What happens during a DISI?
scapholunate ligament causes lunate to **extend** or move dorsally separating it from scaphoid
28
What happens during a VISI?
Volar intercalated segmental instability (VISI) Ligamentous laxity/tear of the lunotriquetral ligament causes lunate to **flex** or move more volarly with scaphoid, separating lunate from triquetrum
29
In a DISI, the lunate separates from the.... In a VISI the lunate seperates from the....
DISI- scaphoid VISI- triquetrium
30
What is the optimal wrist position for grip?
Optimal position = slight wrist EXT and ulnar deviation in order to maximize grip strength
31
True or false: palmaris longus does no sort of deviation
true
32
Extensor Pollicis Longus, Extensor Pollicis Brevis, and Abductor Pollicis Longus all assist with what actions?
Wrist ext and radial dev
33
The carpometacarpal joints have ______ mobility from radial to ulnar side of hand
Increasing
34
The proximal arch is formed by what?
Concavity formed by carpal bones
35
Which arch is fixed vs which is mobile?
fixed- proximal arch mobile arch- distal arch, longitudinal arch
36
What CMC joints are fixed? What CMC joint is a saddle joint?
2nd and 3rd 5th
37
which arch is proximal to distal and includes all the fingers?
Longitudinal arch
38
In the metacarpophalangeal joint, the metacarpal is ______ and the proximal phalanx is _______
Metacarpal- convex Proximal phalax- concave
39
MCP joints are what kind of joint with how many degrees of freedom?
condyloid 2 degrees of freedom
40
When the proximal phalanx moves on the metacarpal, the roll and slide happen in the...
same direction
41
Function of the volar plates ( a lot)
Increases joint congruency Adds stability Limits hyperextension Supports longitudinal arch Resists tensile stress in EXT Resists compressive forces from objects Glides down during FLX Prevents pinching of flexor tendons
42
Radial and Ulnar Collaterals ligaments of fingers: Two Parts Collateral Ligament Proper (more taut in _____) Accessory Collateral ligament (more taut in ______)
Proper- flexion accessory- extension
43
Finger joint ROM increases from ______ to _______
radially to ulnar
44
FDS primarily flexes the....
PIP also contributes to MP flexion
45
What is more active, FDS or FDP
FDP Note: FDP can also work alone for a pinch grasp, also it is the only one to flex the DIP
46
What has a larger movement arm, FDS or FDP?
FDS
47
Finger flexors are dependent on _______ to counterbalance for good length-tension
wrist extensors
48
Smaller grip ulnarly allows for...
Greater ROM with grasping but less force -Greater range on the ulnar side of the hand can be utilized with tools
49
What is the function of Retinaculae
Retinaculae structures tether tendons to hand and prevent bowstringing while bursa and sheaths facilitate gliding
50
How many annular pullies are there? How many Cruciate?
5-A 3-C
51
EDC, EI & EDM all only extend up to which joint?
MCP only, not PIP or DIP note:they are also synergists for wrist ext
52
PIP and DIP extension requires EDC plus....
Lumbricals and palmar/dorsal interossei
53
Simultaneous IP extension requires....
Lumbricals + Dorsal Interossei + Palmar Interossei
54
Isolated EDC muscle contraction causes....
"claw fingers"/extrinsic minus position, ( active MCP extension with PIP and DIP flexion )
55
If intrinsics are weak (ulnar nerve injury), splint MCP joint _________ allows EDC to ext IPs
in slight flexion
56
How many dorsal interossei are there? How many volar?
4 dorsal 3 volar/palmar
57
Why is extension weaker at the 5th digit?
Only 1 interossei muscle
58
What carpal does the thumb articulate with?
trapezium
59
What axis does thumb flexion/ext take place in? What axis does thumb abducton adduction take place in?
oblique A/P axis Oblique coronal axis
60

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