Lectire 14A: Wrist And Hand Fucntinla Anatomy And Biomechanics Review

Question 1

How many bones is in the forearm/wrist.hand

Answer 1

29 bones
• 2 forearm bones
• 8 carpal bones
• 5 metacarpal bones
• 14 finger bones

Question 2

What forearm bone touches the carpal bones

Answer 2

Radius

Ulna does not touch it bc the TFLC is on that side

Question 3

What is the CPP and OPP of the distal radio ulnar joint

Answer 3

• CPP: 5° supination
• OPP: 10° supination

Question 4

What are the active structures of the distal radio ulnar joint

Answer 4

• pronator
• Supinator

Question 5

What is ulnar variance determined by

Answer 5

• age
• genetic
• load
• elbow pathologies

Question 6

What is (+) and (-) variance

Answer 6

• (+) ulnar variance = ulna >2 mm
distal to radius (longer)
• (-) ulnar variance = ulna >2 mm
proximal to radius (shorter)

Question 7

What is the OPP and CPP of the radio carpal joint

Answer 7

• CPP: full ext w/ radial deviation
• OPP: neutral w/ slight ulnar deviation (joint plat in there)

Question 8

What kind of joint is teh radio carpal joint

Answer 8

Biaxial , ellipsoid joint

Question 9

What is the capsular pattern of the radiology carpal joint

Answer 9

Flex motion loss = ext motion loss

Question 10

What is the passive structures of the radio carpal joint

Answer 10

• Ligaments
• Capsule
• Triangular Fibrocartilage Complex (TFCC)

Question 11

What is the active structures of the radio carpal joint

Answer 11

• Wrist flexor mm.
• Wrist extensor mm.
• Radial deviator mm.
• Ulnar deviator mm

Question 12

What is in the proximal row of the carpal bones

Answer 12

Radial —> ulnar

Scaphoid , lunate , triquetrum , pisiform

Question 13

What is in the distal row of the carpal bones

Answer 13

Radial —> ulnar

Trapezium, trapezoid , capitate, hamate

Question 14

What carpal bone is most commonly damaged with baseball players

Answer 14

Hook of hamate

Question 15

What kind of joints are the intercarpal joints

Answer 15

Plane joints

Question 16

What is the CPP and OPP of the intercarpal joints

Answer 16

CPP: full extension
OPP: neutral to slight flexion

Question 17

T/F: no active structures in the intercarpal joints

Answer 17

True

Question 18

What is the CPP and OPP of the mid carpal joints
*

Answer 18

• full extension w unlearn deviation
  OPP: neutral to slight flexion w ulnar deviation

Question 19

What kind of joint is the 1st CMC joint

Answer 19

Sellar joint (3 DOF)

Question 20

What is the CPP and OPP of the 1st CMC joint

Answer 20

• CPP: full opposition
• OPP: midway b/t abd & add & b/t flex & ext

Question 21

What is the capsular pattern of the 1st CMC joint

Answer 21

Abd loo > ext loss

Question 22

What are the active structures of the 1st CMC joint

Answer 22

AbdPL, AbdPB, EPL, EPB, FPL, FPB, AddP , OP
mm.

Question 23

What are the other CMC joints CPP and OPP

Answer 23

• CPP: full flexion
• OPP: midway b/t flex and ext

Question 24

Are there active structures in other CMC joints

Answer 24

No nun thru 2-5

Question 25

What joints in hand hands is immobile and mobile

Answer 25

• 2nd/3rd joints relatively immobile • 4th/5th joints relatively mobile

Question 26

What kind of joint is the MCP joint

Answer 26

Condyloid joints

Question 27

What is the CPP and OPP of the MCP joints

Answer 27

• CPP: full opposition (1st), full flexion (2nd -5th) • OPP: slight flexion

Question 28

What is the capsular pattern for MCP joint s

Answer 28

Flex loss > ext loss

Question 29

What plates are in the MCP joints

Answer 29

Dorsal hood and volar plate

Question 30

What are the active structures of the MCP joints

Answer 30

• Lumbrical mm. • AbdDM, FDM, ODM, AbdPB, FPB, OP, AddP mm

Question 31

What kind of joints are the PIP joins

Answer 31

Uniaxial hinge (1 DOF)

Question 32

What is the CPP and OPP of the PIP joints

Answer 32

• CPP: full extension • OPP: slight flexion

Question 33

What is the capsular pattern of the PIP joints

Answer 33

Flexion loss > ext loss

Question 34

What are the active structures of teh PIP joint

Answer 34

* FDS tendons * ED tendond

Question 35

What kind of joint is the DIP joints

Answer 35

Uniaxial hinge

Question 36

What is the CPP and OPP of the DIP joints

Answer 36

• CPP: full extension • OPP: slight flexion

Question 37

What is the capsular pattern of the DIP joints

Answer 37

Flexion loss > extenion loss

Question 38

What ligaments are in the distal radio ulnar joint

Answer 38

• Dorsal radio-ulnar ligament • Palmar radio-ulnar ligament

Question 39

How do the ligaments reinforce the capsule of the distal radio ulnar joint

Answer 39

Anteriorly and posteriorly

Question 40

Wa=hat ligaments do u sprain during a wrist sprain

Answer 40

• Dorsal radio-ulnar ligament • Palmar radio-ulnar ligament

Question 41

What are ligaments are the dorsal wrist ligament

Answer 41

* dorsal radio carpal ligament * UCL * RCL

Question 42

Where does teh drosal radio carpal ligament run

Answer 42

• From radial styloid process to lunate and triquetrum

Question 43

Where does teh ulnar collateral ligament run

Answer 43

From ulnar styloid process to pisiform and triquetrum

Question 44

Where does the RCL run

Answer 44

From radial styloid process to scaphoid, trapezium and 1st metacarpal

Question 45

Are the palmar or dorsal wrist ligaments stronger

Answer 45

The palmar is stronger

Question 46

What are teh 2 palmar wrist ligaments

Answer 46

* palmar radio carpal ligaments * palmar ulno carpal ligament complex

Question 47

What is the most importantly ligament for wrist motion and stability

Answer 47

Palmar radio carpal ligaments

Question 48

What is teh disc to lunate and triquetrum

Answer 48

Palmar ulno carpal ligament

Question 49

What does the dorsal and palmar intercarpal ligaments prevent

Answer 49

Separation of carpal bones

Question 50

What does the interosseous ligaments connect

Answer 50

Every carpal to adjac

Question 51

What does the interosseous ligaments connect

Answer 51

Every carpal to adjacent bone

Question 52

Where is there no interosseous ligament between

Answer 52

Distal row and proximal row

Question 53

What is included in the triangular fibrocartilage complex (TFCC)

Answer 53

• Palmar and dorsal ulno-carpal ligaments • Ulnar collateral ligament • Radio-ulnar disc • Extensor carpi ulnaris tendon sheath

Question 54

Where is the triangular fibrocartilage complex (TFCC)

Answer 54

On the ulna

Question 55

If the TFCC is removed what happens

Answer 55

Radius bears 95% of axial load

Question 56

Where does the extensor retinaculum occur

Answer 56

At point where tendons cross wrist joint

Question 57

Is the extensor retinaculum a passive or active strucutre

Answer 57

Passive

Question 58

What prevents the tendons from bowstringing w wrist motions

Answer 58

Extensor retinaculum

Question 59

What helps maintain transverse carpal arch

Answer 59

Flexor retinaculum

Question 60

What N passes thru the flexor retinaclum

Answer 60

median N

Question 61

What does the flexor retinculum serve as an attachment site for

Answer 61

Thenar and hypothenar mm

Question 62

What part of the hand has pulleys

Answer 62

The flexors not the extensors

Question 63

What is the anatomic snuffbox

Answer 63

Depression on hand’s dorsal surface at base of , just distal to radius

Question 65

What the borders of the anatomic snuff box Radial , ulnar , floor and sub floor

Answer 65

• Radial: APL and EPB tendons • Ulnar: EPL • Floor: deep branch of radial a. and ECRL tendon insertion • Sub-floor: scaphoid and trapezium

Question 66

What does the carpal tunnel serve as a channel from

Answer 66

• Median n. • 9 flexor tendons

Question 67

What are the borders of the carpla tunnel Floor, roof, sides

Answer 67

• Floor: palmar R-C ligament and ligament complex • Roof: transverse ligament/flexor retinaculum • Sides: hook of hamate and trapezium

Question 68

What n passes thru the carpal tunnel

Answer 68

Medial n except palmar branch that passes over

Question 69

What mm does the motor aspect of the median n innervate

Answer 69

* thenar * lateral 2 lumbricals * opponens pollicis * abd pol brevis * flex pol brevis

Question 70

Where is the sensory aspect of the median N

Answer 70

* radial side * palmar aspect of 1st - 3rd and lateral side of 4th hand/fingers as well as dorsal aspect of same digit is

Question 71

What N controls the fine movements of the hand

Answer 71

Ulnar N

Question 72

Where does the ulnar N pass thru in the hand

Answer 72

Guyon’s canal

Question 73

What mm does the motor aspect of the ulnar N INN

Answer 73

* hypothenar * interossei * medial 2 lumbricals * add pollicis * interossei * palmaris brevis

Question 74

Where is the sensory aspect of the ulnar N

Answer 74

Dorsal and palmar aspects of 5th and medial side of 4th finger

Question 75

What is the motor aspect of the radial N

Answer 75

Wrist and finger extensors

Question 76

What is the sensory aspect of the radial N

Answer 76

• Radial side, dorsum of 1st -3rd hand/fingers up until DIPs • Lateral side of thumb

Question 77

What is the blood supply of the forearm and wrist

Answer 77

Brachial artery bifurcates at elbow into radial and ulnar branches

Question 78

What is the key joint of the hand

Answer 78

Wrist

Question 79

What does the distal radio ulnar joint do

Answer 79

Pronation/supination

Question 80

What is the articulation of the distal radio ulnar joint

Answer 80

Concave radius on convex ulna

Question 81

What is the articulation of radiocarpal joint

Answer 81

Proxima row of carpal bones concave moving on convex radium