Hand packet 1 Flashcards by Stephanie Smith

Digital ray

1 metacarpal & 3 phalanges

only 2 phalanges in thumb

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joints of the fingers

1 cmc joint
1 mcp joint
2 ip joints

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joints of the thumb

1 cmc joint
1 mcp joint
1 ip joint

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total # of bones in the hand

19 bones

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digits 2-4 (@ CMC jt)

how many degrees of freedom?

1 DOF

flexion/extension

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articulations of the 2nd finger are with:

@ CMC jt

trapezoid
trapezium
capitate
3rd metacarpal

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articulations of the 3rd finger are with:

@ CMC jt

capitate
2nd metacarpal
4th metacarpal

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articulations of the 4th finger are with

@ CMC jt

hamate
capitate
3rd metacarpal
5th metacarpal

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articulations of the 5th metacarpal are with

@ CMC jt

hamate

5th metacarpal

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5th digit DOF

@ CMC jt

2 DOF

flexion/extention
abduct/adduct

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5th digit flexion ROM

@ CMC jt

10-15 deg

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5th digit abduction ROM

@ CMC jt

20-30 deg

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most mobile CMC joint is at which digit? (not incl thumb)

5th

but they are the least stabile

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least mobile CMC joint is at which digit? (not incl thumb)

2nd & 3rd digits

but they are the most stabile

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function of the CMC joints are to

form palmar arches

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function of palmar arches

to permit optimal function of the hand

- allows the hand and palm to conform to an object

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anatomy of the palmar arch

2 transverse connected by a longitudinal arch

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proximal transverse of the palmar arch

relatively fixed

- level of distal carpals

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keystone of the proximal transverse of the palmar arch

capitate

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distal transverse of the palmar arch

more mobile

- level of the metacarpal heads

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keystone of the distal transverse of the palmar arch

3rd metacarpal

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longitudinal palmar arch consists of

4 metacarpals and proximal carpals

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carpal tunnel consists of

carpals
flexor retinaculum
transverse carpal ligament
9 tendons
Median nerve

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9 tendons of the carpal tunnel

4 FDS
4 FDP
1 FPL

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purpose of the flexor retinaculum (that helps form the carpal tunnel)

supports the flexor tendons so they do not bow

arch integrity is maintained by

bones ligament intrinsic muscles of the hand

median nerve innervates the lumbricles at

2 lateral muscles

ulnar nerve innervates the lumbricles at

2 medial muscles

palmar and dorsal interossei are innervated by

ulnar nerve

MCP joints 2-4 have ____ bases of first phalanx on _____ metacarpal heads

concave on convex same direction

how many degrees of freedom in the MCP joints 2-5?

2 DOF flexion/ext abd/adduction

the fake 3rd degree of freedom in MCP joints 2-5??

rotation -- really a combination movement of: pronation/supination & abduction/adduction

volar/palmer plates

- fibrocartilage plates - multilayered thickening of the inside capsule - distal MET --> base of the proximal phalanx

volar/palmer plates proximally are:

membranous (blends with the capsule)

volar/palmer plates proximal motion is

gliding of the plate with finger flexion

volar/palmer plates blend with

transverse metacarpal ligaments

volar/palmer plates are stabilized by

collateral ligaments

volar/palmer plates resist

hyperextension

injury of the volar/palmer plate

- caused by hyperextension - subluxation and dislocation occurs - may even cause a velar plate tear (at the membraneous portion)

treatment for velar/palmer plate injury

immobilize MCP in relative flexion - retract the membranous tissue - flexion contracture

MCP flexion ______ as you move _____

increases; | ulnarly

MCP ROM

90 - 110 deg

MCP abduction/adduction is maximal in

extension

MCP abduction/adduction is minimal in | AND WHY??

flexion close-packed -because of: taut collateral ligaments & because of bony block secondary projections on MC head

Passive support for MCP

joint capsule volar plate collaterals

MCP joint capsule is: _____ in extension _____ in flexion

slack; | taut;

MCP collaterals are: _____ in extension _____ in flexion

slack; | taut;

No Man's Land

- an anatomical region (over the metacarpal heads) - In the past, the primary repair of flexor tendons was contraindicated -- no surgery here bc repair & rehab was too complex Now: surgery is performed but early mobilization = crucial

IP joints have a _____ head with a _____ base

convex; | concave

IP joints have:

volar fibrocarilagenous plate joint capsule collateral ligaments

how many DOF do IP joints have

1 DOF | flexion/extension

PIP joint ROM

100 - 110

DIP jt ROM

80 deg

_____ movement at PIP than DIP

IP ROM increases _____

ulnarly

5th PIP flexion ROM

135 deg

5th DIP flexion

90 deg

IP joints function

- enhances closure | - improves grip along with mobile 5th CMC

fingers are designed to function in

flexion | --therefore they're super stong

thick anterior capsule of the fingers is ???

palmer plate

dorsal capsule is ___ & ____

thin & lax

wrist extension function

maintain optimal length-tension relationships

weak wrist extension (ECRB or ED) causes

flexion of the wrist rather than finger flexion ----- LESS finger flexion than you would have when the wrist is flexed

finger flexor efficiency drops by _____ when the wrist is in extension (due to weakness)

75%