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Biomechanics & Kinematics > Kines Wrist > Flashcards

Kines Wrist Flashcards

1
Q

what is normal values of wrist flexion & extension?

A

80-90 flexion & 70-80 extension

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2
Q

what is the normal value of radial & ulnar deviation?

A

20-25 radial, 30-35 ulnar deviation

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3
Q

what Is the proximal portion of the radiocarpal joint?

A

articulation of radius & radioulnar disk/ TFC

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4
Q

what is the distal portion of the radiocarpal joint?

A

the scaphoid, lunate & triquetrum

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5
Q

what does the lateral radial facet articulate with?

A

scaphoid (46%)

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6
Q

what does the medal radial facet articulate with?

A

lunate

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7
Q

what does the inferior radioulnar disk articulate with?

A

triquetrum

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8
Q

true/ false is there a formal carpal articulation with ulna

A

false

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9
Q

what is the pisiform carpal bone?

A

sesamoid bone
function to increase MA of FCU

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10
Q

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

A

true

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11
Q

how does the motion at the radiocarpal joint happen?

A

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

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11
Q

does more extension or flexion come from the radiocarpal joint?

A

flexion

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12
Q

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

A

ulnar deviation

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13
Q

describe the functional unit of the mid carpal joint?

A
  • 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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14
Q

how many DF does the midcarpal joint have?

A
  • 2 DF, Condyloid Joint = Extension > Flexion, Radial Deviation > Ulnar Deviation
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15
Q

what is the intercarpal joints an articulation between?

A

all the carpal bones

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16
Q

what does the inter carpal joints allow?

A

Allow minimal movement to accommodate hand & wrist positioning

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17
Q

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

A

many ligaments, ulnar side is more mobile

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18
Q

which ligament is stronger palmar or dorsal?

A

palmar ligament `

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19
Q

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

A

-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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20
Q

describe the dorsal radiocarpal ligament?

A

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

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21
Q

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

A

check rein for frontal plane motions

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22
Q

describe the volar (palmar) radiocarpal ligament?

A

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

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23
Q

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

A

50 (MC) & 35 (RC)

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24
Q

what motion is coupled with flexion?

A

ulnar deviation

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25
Q

what motion is coupled with extension?

A

radial deviation

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26
Q

what are the arthrokinematics of the radiocarpal joint for flexion?

A

anterior roll & posterior slide

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27
Q

what are the arthrokinematics of the radiocarpal joint for extension?

A

posterior roll, anterior glide

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28
Q

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

A

lateral roll, medial glide

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29
Q

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

A

medial roll, ulnar glide

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30
Q

what is check rein to radial deviation?

A

radial styloid impacting into carpals

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31
Q

what is the closed pack position for radiocarpal joint?

A

palmar & intercarpal II become taut in full extension

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32
Q

why does counter rotation which increase ligaments tension occur?

A

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

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33
Q

what occurs at the intercalated segments during extension?

A

the scaphoid glides posterior & lunate and triquetrum glides anterior

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34
Q

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

A

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

35
Q

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

A

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

36
Q

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

A

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

37
Q

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

A

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

38
Q

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

A

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

39
Q

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

A

radial deviation

40
Q

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

A

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

41
Q

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

A
  • 45 degrees wrist extension & slight radial deviation
42
Q

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

A

-Slight flexion w/slight ulnar deviation

43
Q

what are the primary wrist flexors?

A

Palmris longus, FCR, & FCU

44
Q

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

A

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

45
Q

what are the digit flexors with secondary wrist action?

A

-FDS, FDP, & FPL

46
Q

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

A

-FDS b/c spurt muscle

47
Q

what are the primary wrist extensors?

A

-ECRL, ECRB & ECU

48
Q

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

A

ECRB, b/c of central insertion at MCP 3

49
Q

what are the digit extensors with secondary wrist action?

A

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

50
Q

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

A

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

51
Q

describe FCU & ADM muscle synergies?

A
  • ADM originated on pisiform
    -FCU contraction stabilizes pisiform to allow abduction of 5th digit
    -Proximal stability for mobility
52
Q

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

A

-During thumb extension ECU maintains hand in neutral position

53
Q

describe wrist & finger flexion muscle synergies?

A

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

54
Q

what is tenodesis?

A

-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

55
Q

when does FCU & ECU allow pure ulnar deviation?

A

if same torque output

56
Q

when FCU > ECU what occurs?

A

flexion & ulnar deviation

57
Q

when ECU > FCU what occurs?

A

extension & ulnar deviation

58
Q

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

A

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

59
Q

what type of joint is CMC 5?

A

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

60
Q

what type of joint is CMC 1?

A

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

61
Q

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

A

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

62
Q

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

A

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

63
Q

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

A

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

64
Q

what are the arthrokinematic for CMC 2-5?

A

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

65
Q

what type of joints are the MCP 2-5?

A

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

66
Q

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

A

-flexion
collateral lig & capsule are taut in flexion

67
Q

what is the open pack position for MCP joints?

A

neutral to slight flexion

68
Q

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

A

90 degrees radialy to 110 degrees ulnarly

69
Q

what is the range of extension of the MCP joint?

A

30-40

70
Q

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

A

30-40

71
Q

what type of joint is MCP 1?

A

-Condyloid
-2 DF

72
Q

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

A

-Synovial, hinge jt
1 DF
Concave on convex

73
Q

what is PIP 2 rom?

A

100-110

74
Q

what is DIP 2 ROM?

A

80

75
Q

what is PIP 5?

A

135

76
Q

what is DIP 5?

A

90

77
Q

what is power grip?

A

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

78
Q

what is precision grip>

A

-Delicate
-Contour of object neede
-use all finger

79
Q

what is power grip?

A

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

80
Q

what is precision pinch?

A

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

81
Q

what is hook grip?

A

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

82
Q

what is swan neck deformity?

A

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

83
Q

what is boutonniere deformity?

A

opposite of swan neck

84
Q

what is functional hand position?

A

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

85
Q

what is the position of immobilization most often?

A

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

Biomechanics & Kinematics (10 decks)

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