Hand packet 1 Flashcards

1
Q

Digital ray

A

1 metacarpal & 3 phalanges

only 2 phalanges in thumb

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2
Q

joints of the fingers

A

1 cmc joint
1 mcp joint
2 ip joints

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3
Q

joints of the thumb

A

1 cmc joint
1 mcp joint
1 ip joint

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4
Q

total # of bones in the hand

A

19 bones

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5
Q

digits 2-4 (@ CMC jt)

how many degrees of freedom?

A

1 DOF

flexion/extension

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6
Q

articulations of the 2nd finger are with:

@ CMC jt

A

trapezoid
trapezium
capitate
3rd metacarpal

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7
Q

articulations of the 3rd finger are with:

@ CMC jt

A

capitate
2nd metacarpal
4th metacarpal

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8
Q

articulations of the 4th finger are with

@ CMC jt

A

hamate
capitate
3rd metacarpal
5th metacarpal

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9
Q

articulations of the 5th metacarpal are with

@ CMC jt

A

hamate

5th metacarpal

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10
Q

5th digit DOF

@ CMC jt

A

2 DOF

  • flexion/extention
  • abduct/adduct
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11
Q

5th digit flexion ROM

@ CMC jt

A

10-15 deg

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12
Q

5th digit abduction ROM

@ CMC jt

A

20-30 deg

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13
Q

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

A

5th

but they are the least stabile

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14
Q

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

A

2nd & 3rd digits

but they are the most stabile

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15
Q

function of the CMC joints are to

A

form palmar arches

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16
Q

function of palmar arches

A
  • to permit optimal function of the hand

- allows the hand and palm to conform to an object

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17
Q

anatomy of the palmar arch

A

2 transverse connected by a longitudinal arch

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18
Q

proximal transverse of the palmar arch

A
  • relatively fixed

- level of distal carpals

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19
Q

keystone of the proximal transverse of the palmar arch

A

capitate

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20
Q

distal transverse of the palmar arch

A
  • more mobile

- level of the metacarpal heads

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21
Q

keystone of the distal transverse of the palmar arch

A

3rd metacarpal

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22
Q

longitudinal palmar arch consists of

A

4 metacarpals and proximal carpals

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23
Q

carpal tunnel consists of

A
carpals
flexor retinaculum
transverse carpal ligament
9 tendons
Median nerve
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24
Q

9 tendons of the carpal tunnel

A

4 FDS
4 FDP
1 FPL

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25
Q

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

A

supports the flexor tendons so they do not bow

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26
Q

arch integrity is maintained by

A

bones
ligament
intrinsic muscles of the hand

27
Q

median nerve innervates the lumbricles at

A

2 lateral muscles

28
Q

ulnar nerve innervates the lumbricles at

A

2 medial muscles

29
Q

palmar and dorsal interossei are innervated by

A

ulnar nerve

30
Q

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

A

concave on convex

same direction

31
Q

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

A

2 DOF

flexion/ext
abd/adduction

32
Q

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

A

rotation –
really a combination movement of:

pronation/supination
&
abduction/adduction

33
Q

volar/palmer plates

A
  • fibrocartilage plates
  • multilayered thickening of the inside capsule
  • distal MET –> base of the proximal phalanx
34
Q

volar/palmer plates proximally are:

A

membranous (blends with the capsule)

35
Q

volar/palmer plates proximal motion is

A

gliding of the plate with finger flexion

36
Q

volar/palmer plates blend with

A

transverse metacarpal ligaments

37
Q

volar/palmer plates are stabilized by

A

collateral ligaments

38
Q

volar/palmer plates resist

A

hyperextension

39
Q

injury of the volar/palmer plate

A
  • caused by hyperextension
  • subluxation and dislocation occurs
  • may even cause a velar plate tear (at the membraneous portion)
40
Q

treatment for velar/palmer plate injury

A

immobilize MCP in relative flexion

  • retract the membranous tissue
  • flexion contracture
41
Q

MCP flexion ______ as you move _____

A

increases;

ulnarly

42
Q

MCP ROM

A

90 - 110 deg

43
Q

MCP abduction/adduction is maximal in

A

extension

44
Q

MCP abduction/adduction is minimal in

AND WHY??

A

flexion
close-packed

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

45
Q

Passive support for MCP

A

joint capsule
volar plate
collaterals

46
Q

MCP joint capsule is:
_____ in extension
_____ in flexion

A

slack;

taut;

47
Q

MCP collaterals are:
_____ in extension
_____ in flexion

A

slack;

taut;

48
Q

No Man’s Land

A
  • 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

49
Q

IP joints have a _____ head with a _____ base

A

convex;

concave

50
Q

IP joints have:

A

volar fibrocarilagenous plate
joint capsule
collateral ligaments

51
Q

how many DOF do IP joints have

A

1 DOF

flexion/extension

52
Q

PIP joint ROM

A

100 - 110

53
Q

DIP jt ROM

A

80 deg

54
Q

_____ movement at PIP than DIP

A

more

55
Q

IP ROM increases _____

A

ulnarly

56
Q

5th PIP flexion ROM

A

135 deg

57
Q

5th DIP flexion

A

90 deg

58
Q

IP joints function

A
  • enhances closure

- improves grip along with mobile 5th CMC

59
Q

fingers are designed to function in

A

flexion

–therefore they’re super stong

60
Q

thick anterior capsule of the fingers is ???

A

palmer plate

61
Q

dorsal capsule is ___ & ____

A

thin & lax

62
Q

wrist extension function

A

maintain optimal length-tension relationships

63
Q

weak wrist extension (ECRB or ED) causes

A

flexion of the wrist rather than finger flexion

—– LESS finger flexion than you would have when the wrist is flexed

64
Q

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

A

75%