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Kines Exam 3 > Hand packet 2 > Flashcards

Hand packet 2 Flashcards

1
Q

flexor surface of the hand consists of a ____ mechanism & a _____ system

A

gliding;

pulley;

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2
Q

flexor surface contains (anatomy)

A

flexor retinaculum
bursae
flexor tendon sheath
ligaments

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3
Q

flexor retinaculum prevents

A

bowstringing of flexor tendons of the wrist

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4
Q

flexor retinaculum is a ________ _______ ligament

A

transverse carpal

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5
Q

bursae decreases _____ between ____ & ______

A

friction;

flexor tendons; & retinaculum

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6
Q

bursae has a _____-like sheath and serves as a _____

A

synovial;

lubricant;

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7
Q

bursae of the hand begins at the distal

A

radius/ulna

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8
Q

ulna bursae location

A
  • ends just distal to proximal crease

- continues up 5th digit

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9
Q

radial bursa consists of

A

Flexor pollicis longus

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10
Q

ulna bursa consists of

A

FDS & FDP

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11
Q

digital flexor tendon sheath function

A
  • envelope tendons

- synovial-like

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12
Q

digital flexor tendon sheath begins

A

just proximal to the 1st annular pulley and ends at FDS split

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13
Q

purpose of the anatomical pulleys of the fingers

A
  • hold the tendons & sheath to phalanges
  • prevents bowstringing of tendons
  • minimizes stress/pressure between tendon & sheath
  • promotes gliding
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14
Q

how many annular pulleys?

A

5

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15
Q

how many cruciform pulleys?

A

3

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16
Q

A1 is located at the

A

MC Head

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17
Q

A2 location

A

base of proximal phalanx

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18
Q

A3 location

A

Head of the proximal phalanx

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19
Q

A4 location

A

Middle of the middle phalanx

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20
Q

A5 location

A

over DIP

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21
Q

C1 location

A

middle of proximal phalanx

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22
Q

C2 location

A

base of middle phalanx

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23
Q

C3 location

A

head of middle phalanx

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24
Q

extensor mechanisms of the fingers

A
  • Extensor Digitorum
  • Extensor expansion/extensor hood/dorsal aponeurosis
  • dorsal & volar interossei
  • lumbricals
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25
Q

As the extensor digitorum progression:

5 STEPS

A

1) under extensor retinaculum (synovial sheath)
2) loses sheath distal to the retinaculum
3) then, distal to MCP the ED tendons flatten leading to a dorsal aponeurosis (DA)
4) DA is joined by interossei tendons (prox wing tendon)
5) DA trifurcates just proximal to the PIP

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26
Q

central tendon of the distal aponeurosis goes to

A

base of the middle phalanx

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27
Q

two lateral bands of the distal aponeurosis go to

A

form a single terminal tendon, which goes to the base of the distal phalanx

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28
Q

Two lateral bands of the distal aponeurosis receive contributions from:

A
  • interossei
  • lumbricals
  • lateral brachi (send slip to terminal tendon)
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29
Q

lumbricals fall on the _____ side of the joint

A

radial

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30
Q

lateral brachi receives

A

ORL (oblique retinacular ligament)

extension mechanism

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31
Q

ORL arises from the sides of _____ & ______

A

1st phalanx;
digital tendon sheaths

(extension mechanism)

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32
Q

triangular ligament/transverse retinaculum consist of

A

lateral bands interconnected dorsally

help with extension

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33
Q

dorsal hood attached to the _____ metacarpal ligament prevents

A

transverse;
bowstringing

(help with extension)

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34
Q

transverse metacarpal ligament connects

A

heads of all of the ligaments

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35
Q

MCP joints extend because ______ tendon is dorsal to _______

this causes the pull of the ______ proximally

A

extensor digitorum;
joint AOR;
hood

36
Q

MCP will extend regardless if lumbricals and/or interossei fire…. why????

A

because extensor digitorum is stronger than those intrinsic muscles

37
Q

extensor digitorum (central tendon) can extend ____ but not ____

A

PIP;

alone

38
Q

if there is an isolated extensor digitorum then the outcome of this is _____

A

clawing

39
Q

lumbricles and interossei produce ____ to the central tendon/lateral bands through the _____. This causes _____ extension.

A

tension;
ORL;
PIP

40
Q

lumbrical grip

A

ex: reading a newspaper
- flex MCPs
- extend IPs

41
Q

DIP & PIP are _____.

Ex: With active DIP _____ you get active PIP _____

A 
interdependent;
extension;
extension;
OR
flexion;
flexion;
42
Q

Active intrinsics on the lateral bands/terminal tendons causes:

A

passive stretching of ORL and DIP extension

43
Q

Intrinsic hand (-)

A

MCP hyperextension with IP flexion

claw hand

44
Q

active or passive PIP full flexion prevents:

A

active DIP extension

45
Q

Dorsal interossei do what movement

A

abduct

46
Q

dorsal interossei _____ MCP when MCP is _____

2 ANSWERS!!!

A

abduct; extended;
OR
flex; flexed

47
Q

Dorsal Interossei allow for the IP extension of what digits

A

2nd, 3rd & 4th

48
Q

how does the 5th digit get abducted? (what muscle)

A

abductor digiti minimi

49
Q

Palmar interossei are responsible for what movement

A

adduction

50
Q

palmar interossei _______ MCP when MPC is _____

2 ANSWERS!!!

A

adduct; extended;
OR
flex; flexed

51
Q

Palmer interossei allow for the IP extension of what digits?

A

2nd, 4th, 5th

not the middle finger

52
Q

why do the palmer interossei have no effected on the middle finger (digit 3)???

A

b/c adduction isn’t needed

all of the fingers go to the middle finger during adduction

53
Q

Lumbricals origin

A

tendon of FDP

54
Q

lumbricals insertion

A

radial side of the distal lateral bands of EM

55
Q

lumbricals attachment to the _______ allow for effective ________

A

distal lateral bands; IP extension

56
Q

lumbricals can _____ MCP but weaker than ______

A

flex;

interossei

57
Q

function of lumbricales is dependent on function of the FDP & ED because:

A

lumbricales attach to FDP & ED tendons – therefore if those muscles are lax than the lumbricles will be wayyy less efficient

58
Q

The FDP can close hand without other musculature, however without _____, there will be uncoordinated finger _____, causing a _________

A

intrinsics;
flexion;
ineffective grasp;

AKA INTRINSIC NEGATIVE (-) HAND

59
Q

Thumb DOF

A

2-3 DOF –
flexion/extension
abduction/adduction
axial rotation???

60
Q

type of joint of the thumb CMC

A

saddle joint

61
Q

articulations of the thumb CMC

A

trapezium & base of 1st metacarpal

62
Q

thumb opposition is the coupled motion

A

abduction –> flexion –> adduction & rotation

63
Q

1st CMC joint structure

A

lax joint capsule with radial, ulnar, velar, & dorsal ligaments

64
Q

1st CMC joint has slips of ______ ligaments to support it volarly & dorsally

A

intercarpal

65
Q

IP joint of the thumb is what kind of joint

A

hinge

66
Q

thumb is controlled by more muscles than digits _____

A

2-4

67
Q

how many muscles control the thumb?

A

8

68
Q

____#____ extrinsic muscles in the thumb & the names

A

4

  • FPL (volar)
  • EPL, APL, & EPB (dorsolaterally – snuff box)
69
Q

___#_____ intrinsic muscles in the thumb & names

A

4

  • OP
  • FPB - 2 heads
  • ADP
  • APB
70
Q

power grasp 3 types

A

cylindrical
spherical/ball
hook

71
Q

power grasp occurs when:

A
  • fingers clamp object into palm
  • fingers in sustained flexion
  • palm conforms to object
  • thumb may or may not contribute to this
72
Q

cylindrical power grasp

A
  • fingers surrounds object with counterforce from thenar eminence &/or thumb
73
Q

spherical/ball power grasp

A
  • fingers surrounds object with counterforce from thenar eminence &/or thumb (SAME AS CYLINDRICAL)
  • however, there is a GREATER spread of fingers evoking more interossei activity
74
Q

hook power grasp

A

no opposition of thumb,

ex: carrying a brief case

75
Q

precision handling types

A

1) tip to tip pinch
2) pad to pad/palmer pinch
3) pad to side/lateral/key
4) 3-jaw chunk/tripod

76
Q

precision handling definition

A

objects pinched or manipulated between fingers & thumb

77
Q

functional ROM for slight wrist extension

A

20-30 degrees

78
Q

functional ROM for slight ulnar deviation

A

10 deg

79
Q

functional ROM for MCP flexion

A

45 deg

80
Q

functional ROM for PIP flexion

A

30 deg

81
Q

functional ROM for DIP flexion

A

just a slight flexion is k

82
Q

mallet finger

A

distal terminal tendon rupture of extensor digitorum

it causes flexion of the DIP

83
Q

boutonniere (button hole) finger

A

disease of the tendon in which the central slip is thinning

this causes the lateral bands to dislocate,

causing flexion of PIP & hyperextension of DIP

84
Q

swan neck finger

A

spasm & contracture of intrinsics which attaches to lateral bands

  • causes a laxity or rupture of the palmer plate (this normally prevents hyperextension)
  • lateral bands then dislocate dorsally
  • this causes hyperextension of PIP and flexion of PIP
85
Q

swan neck finger occurs in ___% of __________ patients

A

28%

rheumetoid arthritis

Kines Exam 3 (5 decks)

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