Intro UE Wrist and Hand Flashcards
3 wrist joints
Radiocarpal
Midcarpal
Intercarpal
Radiocarpal joint consists of what bones
Scaphoid, lunate, Triquetrum, radius
Intercarpal row bones
All joints between proximal row and distal row, articulation between pisiform and triquetrum
Scaphoid is what shape AP and med/lat
Convex AP
Concave med/lat
Trapezi are what shape AP and med lat
Concave AP
Convex med/lat
Proximal surface of mid carpal joint is bi what
Concave
Distal surface of mid carpal joint is what
Bi convex
Radio carpal and mid carpal proximal and distal row arthros for extension
Posterior (dorsal) roll, anterior (volar) glide
Radio carpal and mid carpal flexion arthros for proximal and distal row
Anterior (volar) roll, post (dorsal) glide
Radial deviation arthros
Proximal row glides
Scaphoid glides
Gapping occurs where
Distal row rotates
Trapezi glides
Ulnar direction
Anterior
Ulnar side as triqeitrum moves away from disc
Distal row rotates radially
Posterior
Ulnar deviation arthros
Proximal row glides
Distal row
Hamate glides
Radially
Rotates ulnarly
Anteriorly
1st CMC arthros
Abd
Add
Abd: volar (ant roll), dorsal (post glide)
Add: dorsal roll, volar glide
1 CMC is what kind of joint
Sellar
Opposition consists of what 2 motions
Flx and abd
2-5 CMC joints
Consists of what bones
What type of joint
2-5 metacarpals, trapezoid, capitate, hamate
Modified sellar
2-5 intermetacarpal joints
Bones
Type of joint
Based of metacarpals
Amphiarthroses
MCP joints
Type of joint
What helps ext distal phalanx
Relaxed in
Max tight in
How much ab/add in extension and flexion
Amount of possible rotation
Bi axial ellipsoid
Fibrocartilage plate
Extension
Flexion
20-30 in extension
0 in flexion
60
IP joints
Type
Max tight in
Flexion increases from to a max of PIPs and DIps
Uniaxial hinge
Flexion
2nd to 5th to max 135
2nd to 5th to max 90
Wrist resting, closed packed, capsular
Slight ext and UD
Full extension and RD
Equal flx/ext, little in UD/RD
Wrist AROM
Flx/ 85
Ext: 85
UD: 45
RD/ 20
How much flexion in wrist total and how much comes from Radiocarpal vs modcarpal
85
Radio: 50
Mid: 35
(Opp in extension)
IP and 2-5 MCP jt resting, closed and capsular
IP rest: slight flexed
Ip closed: full ext
Ip capsular: flx, ext
2-5 MCP rest: slight flexed
Closed: full flexion
Capsular, flx,ext
1 MCP rest, closed
Rest: slight fix
Closed: full ext
1 CMC rest, closed, capsular
Rest: 1/2 bw max flx/ext and ad/add
Closed: full OPP
Capsular: abduction/ext
Thumb AROM MCP
Flx MCP: 50
Ext MCP: 0
Thumb AROM
CMC flx: 15
CMC ext: 20
CMC abd: 70
Thumb AROM
IP flx: 80
Ip ext: 20
MCP 2-5 AROM
Flx: 90
Ext: 30
Abd: 80
Circumduction greatest in MCP II
IP 2-5
Flx: pip 120 dip 90
Ext: pip 0-5 dip 10-30
Lunate dislocation
Moi
Complications
Foosh
Avadcuksr necrosis, med n, fracture
Colles fracture
What is it
Moi
Most common in age
Gender
Aka
Fracture of distal end of radius
Foosh
Over 40
Women
Dinner fork
Scaphoid fracture
Common in
Moi
Pain levels
Tenderness where
Young adults
Foosh
Low pain and able to use hand
Anatomical snuff box
CPR for scaphoid fracture
Male
Sport activity
Snuffbox pain on ulnar deviation within 72 hours of injury
Scaphoid tubercle tenderness at 2 weeks
A vascular necrosis of scaphoid can occur where
Prox pole
Scaphoid fracture test
Axial loading of thumb
Passively abduct and extend thumb at MCP and apply compression
+ is pain with pressure
TFCC pathology
Pain worse with
Sx
Testing
UD, pronation, gripping
Clicking
Shear test
TFCC functions
Stabilize distal radioulnar and ulnar wrist joints
Reinforce ulnar side wrist
Forms concavity of Radiocarpal joint
Compression transfers forces
TFCC absorbs how much loading forces
20%
Functional load test
Holds 3-5 pound dumbbell at end range UD and pronation
+ = pain
