Kin wrist Flashcards

1
Q

functions of the wrist

A

Controls length-tension relationship of the multi-articular
hand muscles
́ Allows for fine adjustment of different grips
́ Contribute more to balance and control versus force
production (rock climbing vs throwing a baseball)
́ Wide range of “normal” presentation

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2
Q

Palmer/Volar
Ligaments

A

Palmer Radiocarpal
Ligament
́ Radial Collateral
Ligament
́ Palmer Intercarpal
Ligament
́ Transverse Carpal
Ligament

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3
Q

Dorsal Ligaments

A

́ Dorsal Radiocarpal Ligament
́ Dorsal Intercarpal Ligament
́ Ulnar Collateral Ligament

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4
Q

Two Compound Joints

A

Radiocarpal joint
Midcarpal

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5
Q

Midcarpal joint

A

consists of articulation between proximal row scaphoid/lunate and triquetrum and distal row

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6
Q

Radiocarpal joint

A

2 separate segments separated by the radioulnar articular disc, Proximal segment is the radius and the radial ulnar disc and the distal component is the disc with the scaphoid lunate and triquitrum

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7
Q

Distal Radioulnar Joint

A

́ Radius is biconcave,
both in frontal and
sagittal planes
́ Articulates with
proximal row of carpals
which is the convex
portion
́ Length of Ulna can
present with positive or
negative variance
which can affect
arthrokinematics

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8
Q

́ Importance of the scaphoid

A

́ Scaphoid has the greatest
mobility of the proximal
carpal bones
́ Acts as a link between the
proximal and distal carpal
rows
Distal Segment of the Radiocarpal Joint

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9
Q

́ Triangular Fibrocartilage
Complex (TFCC)

A

́ Articulates with triquetrum
and partially with the lunate
́ The Radioulnar disc is a
continuation or the articular
cartilage of the radius
́ “Meniscus of the wrist”
́ Important for transmission of
force from the hand
proximally

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10
Q

Wrist Flexion range

A

65 - 85

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11
Q

Wrist Extension

A

65 - 85

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12
Q

Radial Deviation

A

15-21

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13
Q

Ulnar Deviation

A

20-45

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14
Q

Open Packed wrist

A

neutral between flex/ext

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15
Q

Closed Packed

A

full extension and radial deviation

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16
Q

Six muscles cross volar surface of
wrist and contribute to wrist flexion

A

́ Palmaris Longus
́ Flexor Carpi Radialis
́ Flexor Carpi Ulnaris
́ Flexor Digitorum Superficialis
́ Flexor Digitorum Profundus
́ Flexor Pollicis Longus

17
Q

__________ provides six distinct
compartments for
these muscles

A

extensor retinaculum

18
Q

Carpal tunnel has what flexors under the transverse carpal ligament and also which nerve?

A

FDP, FDS, FPL, FCR, and median nerve

19
Q

compartment 1 of extensors

A

Abductor Pollicis Longus
́ Extensor Pollicis Brevis

20
Q

compartment 2 of extensors of wrist

A

Extensor Carpi Radialis Brevis
́ Extensor Carpi Radialis Longus

21
Q

compartment 3 of extensors of wrist

A

Extensor Pollicis Longus

22
Q

compartment 4 of extensors of wrist

A

Extensor Digitorum
Extensor Indicis

23
Q

compartment 5 of extensors of wrist

A

Extensor Digiti Minimi

24
Q

compartment 6 of extensors of wrist

A

Extensor Carpi Ulnaris

25
Q

Arthrokinematics Flexion/Extension

A

*Initiating movement starting in
full wrist FLEXION
́ Extension is initiated by distal
carpal row
́ Gliding of the distal row on a
fixed proximal row at initiation
́ Midcarpal motion then
occurs as a unit on radius and
TFCC (radiocarpal joint)
́ Carpals on radius = convex
on concave

26
Q

arthrokinematics of wrist flexion / extension in regards to scaphoid

A

́ *Scaphoid tends to move with the
distal carpal row with the proximal row
following
́ *At 45 degrees of extension the
scapholunate joint reaches close-
packed position, thus the carpals then
function as a full unit to finish full
extension

27
Q

arthrokin of radial / ulnar deviation

A

Ex: With Radial Deviation
́ Carpal complex slides ULNARLY
on the radius
́ Flexion of PROXIMAL carpal rows
́ Extension of DISTAL carpal rows
́ Full Radial Deviation puts the
radiocarpal and midcarpal joints
in close-packed

28
Q

FOOSH

A

́ Fall on an Outstretched Hand
(FOOSH)
́ Most common trauma to the
radiocarpal joint

29
Q

Wrist Instabilities

A

́ Keinbock’s Disease
́ Ulnar Positive/Negative Variance
́ Dorsal/Volar Intercalated Segmental Instability
́ Scapholunate Advanced Collapse

30
Q

Kienbock’s Disease

A

́ Avascular necrosis of the lunate
́ Usually seen in relation with ulnar
negative variance
́ Due to abnormal force
distribution across the
radiocarpal

31
Q

Ulnar Positive Variance

A

́ POSITIVE variance: Often seen
after a distal radius fracture
with healing in a shortened
position
́ Presents with pain at end
range ulnar deviation or
pronation

32
Q

Dorsal Intercalated
Segmental Instability
(DISI)

A

́ Injury to ligaments stabilizing lunate
and scaphoid
́ Scaphoid tends to flex, lunate tends
to extend
́ Often the subluxation of scaphoid
occurs with compressive loading of
the wrist
́ Volar Intercalated Segmental
Instability occurs when lunate and
triquetrum lose ligamentous stability

33
Q

Scapholunate
Advanced Collapse
Wrist (SLAC)

A

́ Scapholunate Advanced Collapse
́ Degenerative Changes at the
Radioscaphoid joint
́ Progression to intercarpal joints
́ Capitate can eventually su

34
Q

If dorsal intercalated segmental instability goes unchecked, this can lead to

A

Scapholunate advanced collapse or SLAC

35
Q

The lunate and scaphoid have synergistic stability and an injury to one or more of the scaphoid or lunate, True or false.

A

True

36
Q

No muscles act on the proximal carpals. True or false

A

True I believe. Pg 280 in levangie

37
Q
A