Kines Wrist Flashcards by Shyanne Howard

what is normal values of wrist flexion & extension?

80-90 flexion & 70-80 extension

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what is the normal value of radial & ulnar deviation?

20-25 radial, 30-35 ulnar deviation

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what Is the proximal portion of the radiocarpal joint?

articulation of radius & radioulnar disk/ TFC

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what is the distal portion of the radiocarpal joint?

the scaphoid, lunate & triquetrum

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what does the lateral radial facet articulate with?

scaphoid (46%)

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what does the medal radial facet articulate with?

lunate

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what does the inferior radioulnar disk articulate with?

triquetrum

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true/ false is there a formal carpal articulation with ulna

false

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what is the pisiform carpal bone?

sesamoid bone
function to increase MA of FCU

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true or false: no muscles act directly on the RC joint

true

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how does the motion at the radiocarpal joint happen?

Motion is a result of ligamentous forces distributed & muscles that insert at distal carpals & metacarpal

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does more extension or flexion come from the radiocarpal joint?

flexion

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does more ulnar devotion or radial deviation come from radiocarpal joint?

ulnar deviation

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describe the functional unit of the mid carpal joint?

No isolated capsule
Interrupted multiarticular surface
Scaphoid contributes to motion both at midcarpal & radiocarpal joints in certain portions of wrist motion

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how many DF does the midcarpal joint have?

2 DF, Condyloid Joint = Extension > Flexion, Radial Deviation > Ulnar Deviation

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what is the intercarpal joints an articulation between?

all the carpal bones

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what does the inter carpal joints allow?

Allow minimal movement to accommodate hand & wrist positioning

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how is the intercarpal joints bound together and which side is more mobile?

many ligaments, ulnar side is more mobile

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which ligament is stronger palmar or dorsal?

palmar ligament `

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what is the clinical implication of ligament integrity of the intercarpal joints?

-Weakened area palmarly near lunate, relatively unstable (causes dislocation palmarly → most commonly dislocated carpal)
-Proximal pole of scaphoid has no ligament attached dorsally = ganglion cyst formation

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describe the dorsal radiocarpal ligament?

Thickening of capsule
Lunate & radius contract
Check rein to end range wrist flexion

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what is the radial & ulnar collateral ligament a check rein for?

check rein for frontal plane motions

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describe the volar (palmar) radiocarpal ligament?

Most important of all ligaments for stability & passive mobility contribution
3 distinct bands all intracapsular (so thick)

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how much do the RC & MC joint contribute to extension?

50 (MC) & 35 (RC)

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what motion is coupled with flexion?

ulnar deviation

what motion is coupled with extension?

radial deviation

what are the arthrokinematics of the radiocarpal joint for flexion?

anterior roll & posterior slide

what are the arthrokinematics of the radiocarpal joint for extension?

posterior roll, anterior glide

what are the arthrokinemtics of the radiocarpal joint for radial deviation?

lateral roll, medial glide

what are the arthrokinematic of the radiocarpal joint for ulnar deviation?

medial roll, ulnar glide

what is check rein to radial deviation?

radial styloid impacting into carpals

what is the closed pack position for radiocarpal joint?

palmar & intercarpal II become taut in full extension

why does counter rotation which increase ligaments tension occur?

With flexion the scaphoid anterior flexes (glides anterior), Lunate & Triquetrum posterior extends (glides posteriorly)

what occurs at the intercalated segments during extension?

the scaphoid glides posterior & lunate and triquetrum glides anterior

what are the arthrokinematic of mid carpal joint ulnar side of hand?

-Convex (HA&CA) on concave (LU&TQ) in frontal & sagittal

what are the arthrokinematic of mid carpal joint, radial side of hand?

-Concave (TP&TZ) moving on convex (SC) in frontal & sagittal plane

what are the arthrokinematic of mid carpal joints during flexion? (ulnar & radial side)

-(Ulnar): palmar roll & dorsal glide -(Radial): palmar roll & glide

what are the arthrokinematic of mid carpal joint during extension? (ulnar & radial side)

-(Ulnar): dorsal roll & palmar glide -(Radial): dorsal roll & glide

what are the arthrokinematics of the mid carpal joint during radial deviation?

-Distal row of carpal roll towards RD w/ proximal row until legs & bones create limitation -THEN SC & LU move palmately & TP & TZ move dorsally

when is the radiocarpal joint & the mid carpal joint in closed pack position?

radial deviation

what are the arthrokinematics of the midcarpal joint during ulnar deviation?

-Distal row of carpal roll towards UD w/proximal row until legs & bones create limitation -THEN TP & TZ move palmately & SC & LU more dorsally

what is the closed pack position of the wrist (radiocarpal)?

- 45 degrees wrist extension & slight radial deviation

what is the open pack position of the wrist (radiocarpal)?

-Slight flexion w/slight ulnar deviation

what are the primary wrist flexors?

Palmris longus, FCR, & FCU

Between FCU & FCR which better as an effective secondary deviator and why?

-FCU b/c more proximal insertion making it a spurt muscle

what are the digit flexors with secondary wrist action?

-FDS, FDP, & FPL

which is better able to function as a wrist flexor FDS or FDP and why?

-FDS b/c spurt muscle

what are the primary wrist extensors?

-ECRL, ECRB & ECU

which is more effective as a wrist extensor, ECRB or ECRL?

ECRB, b/c of central insertion at MCP 3

what are the digit extensors with secondary wrist action?

ED, EI, EDM, EPL, EPB, & APL

describe ECR (L or B) & ED muscle synergies?

-Weak ECR leads to wrist extension combined w/ finger extension combined w/ finger extension due to ED compensation

describe FCU & ADM muscle synergies?

- ADM originated on pisiform -FCU contraction stabilizes pisiform to allow abduction of 5th digit -Proximal stability for mobility

describe ECU & EP (L & B) muscle synergies?

-During thumb extension ECU maintains hand in neutral position

describe wrist & finger flexion muscle synergies?

-Extend wrist, fingers flex -Flex wrist, fingers extend -Minimizes active & passive insufficiency

what is tenodesis?

-Minimal active wrist extension = adaptive shortening of finger flexors -Increased passive tension = increased ADL function -Series & parallel elastic components advantage to produce "tension" or force

when does FCU & ECU allow pure ulnar deviation?

if same torque output

when FCU > ECU what occurs?

flexion & ulnar deviation

when ECU > FCU what occurs?

extension & ulnar deviation

what type of joints are carpometacarpal joints (CMC) 2-4?

-Plane synovial 1 DF (flx/ext) concave on convex

what type of joint is CMC 5?

-Condyloid/saddle - 2 DF (flx/ext & abduction/adduction) Concave on convex

what type of joint is CMC 1?

-Saddle biaxial jt b/w trapezium & 1st metacarpal

in CMC 1, what are the arthrokinematic in the sagittal plane?

-Trapezium concave - (Abd/ADD) -Convex on concave -AB (anterior roll, posterior glide -ADD (posterior roll, anterior glide)

in CMC 1, what are the arthrokinematics in the frontal plane?

-Trapezium convex -Flx/Ext -Concave on convex -Flex : medial roll & glide -Ext : lateral roll & glide

what are the ranges for flexion, extension & abduction of the 1 CMC jt?

Flex: 15-20 Ext: 20-30 Abd: 70

what are the arthrokinematic for CMC 2-5?

-Concave on convex -Flex: anterior roll & slide -Ext: posterior roll & slide

what type of joints are the MCP 2-5?

-Condyloid jt - 2 DF (flx/ext & AD/ADD)

what is the closed pack position for the MCP joints and why?

-flexion collateral lig & capsule are taut in flexion

what is the open pack position for MCP joints?

neutral to slight flexion

how much does flexion of MCP ROM increase from radially to ulnarly?

90 degrees radialy to 110 degrees ulnarly

what is the range of extension of the MCP joint?

30-40

what is the range of ab/add rom of the MCP joint?

30-40

what type of joint is MCP 1?

-Condyloid -2 DF

what type of joints are the interphalangeal joints (PIP & DIP)?

-Synovial, hinge jt 1 DF Concave on convex

what is PIP 2 rom?

100-110

what is DIP 2 ROM?

what is PIP 5?

135

what is DIP 5?

what is power grip?

-Stability Large forces w/o need for precision object spherical or cylindrical

what is precision grip>

-Delicate -Contour of object neede -use all finger

what is power grip?

-B/W thumb & lateral border of index -large forces

what is precision pinch?

-Fine control b/w index & thumb w/o power -Pad to Pad or Tip to Tip

what is hook grip?

-Partial flexion PIP & DIP -Static nature -Doesn't use thumb Flexion of digitorm profundus

what is swan neck deformity?

-RA implicated -Synovitis -increase flexor pull on MCP jt -Decrease ligament integrity -Results in MCP flexion, PIP extension, DIP flexion

what is boutonniere deformity?

opposite of swan neck

what is functional hand position?

-Wrist extension 20 ulnar deviation 10 MCP flexion 45 PIP flexion 30 Slight DIP flexion

what is the position of immobilization most often?

-Decrease wrist extension (<20) -Increased MCP flexion (70) -IP jts neutral Thumb (CMC wide abd, MCP slight flexion, IP neutral)