Movements

Question 1

Movements allowed at radiocarpal/midcarpal joint

Answer 1

• Flexion - 60% at mid carpal
• Extension - 60% at radiocarpal
• Radial deviation (abduction) - mainly at radiocarpal
• Ulnar deviation (adduction) - mainly at radiocarpal

Question 2

Flexion of wrist (RCJ/MCJ)
Plane/axis
Range + limits
Muscles

Answer 2

> Sagittal plane/frontal axis
Range: 85 degrees
limits: tension in extensors and dorsal radiocarpal ligament
Muscles: FCU, FCR
assisted by FDP, FDS, palmaris longus and flexor pollucis longus

Question 3

Extension of the wrist (RCJ/MCJ)
Plane/axis
Range + limits
Muscles

Answer 3

> Sagittal plane/frontal axis
Range: 85 degrees
limits: tension in flexors and palmar radiocarpal ligament
Muscles: ECRL, ECRB, ECU,
assisted by: ED, EDM, Extensor indicis, EPL, EPB

Question 4

Radial deviation at wrist (RCJ/MCJ)
Plane/axis
Range + limits
Muscles

Answer 4

> Frontal plane/ sagittal axis
> Range: 15 degrees
limits: ulnar collateral ligament, bony approximation of scaphoid and radial styloid process
> Muscles: FCR, ECRB, ECRL
assisted by APL and EPB

Question 5

Ulnar deviation at wrist (RCJ/MCJ)
Plane/axis
Range + limits
Muscles

Answer 5

> Frontal plane/sagittal axis
Range: 45 degrees
limits: radial collateral ligament, apposition of triquetrum and ulnar styloid process/tfcc
Muscles: ECU, FCU

Question 6

Movements allowed at the carpometacarpal joints

Answer 6

> 1st: flexion/extension
: adduction/abduction
(opposition is combo movement)
Others (2-5): gliding/sliding

Question 7

Flexion at 1st Carpometacarpal joint
Plane/axis
Range + limits
Muscles

Answer 7

> Frontal plane/sagittal axis
Range: 40-50 degrees (Total RoM)
limits: oblique ligaments, and tension in extensors
Muscles: FPB,FPL,OP

Question 8

Extension at 1st CMC
Plane/axis
Range + limits
Muscles

Answer 8

> Frontal plane/sagittal axis
Range: 40-50 degrees (Total RoM)
limits: radial carpometacarpal ligament, and tension in flexors
Muscles: EPL, EPB, AbPL

Question 9

Abduction at 1st CMC
Plane/axis
Range + limits
Muscles

Answer 9

> Sagittal plane/frontal axis
Range: 80 degrees (total RoM)
limits: tension in antagonists and posterior oblique ligament
Muscles: APL, APB

Question 10

Adduction at 1st CMC
Plane/axis
Range+limits
Muscles

Answer 10

> Sagittal plane/frontal axis
Range: 0-80 degrees (total RoM)
limits: tension in antagonists and soft tissue of approximation of thumb hitting palm
Muscles: Adductor pollicis, 1st palmar interosseous

Question 11

Opposition of thumb

Answer 11

> Combo movement of flexion, abduction then medial rotation and adduction
range is measured in kapandji scale
1 = PIP of index finger, 2 = DIP, 3 = fingertip
4 = middle fingertip, 5 = ring finger tip, 6 = little tip
7 = little DIP, 8 = little PIP, 9= MCP, 10 = anything beyond
Muscles: FPL, FPB, APL, OP, AddP

Question 12

Movements at MCP joints

Answer 12

Flexion/extension

Adduction/Abduction

Question 13

Flexion at MCP
Plane
Range
Muscles

Answer 13

> Sagittal plane/ frontal axis
> Range = 90 degrees
limited by tension in extensors
> Muscles: thumb: FPB, FPL
                 : 2-5: FDS, FDP, lumbricals, FDMB (5th only)

Question 14

Extension at MCP
Plane
Range
Muscles

Answer 14

> Sagittal plane/frontal axis
> Range = 10-30 degrees
limited by palmar ligaments
Muscles: thumb: EPB, EPL
               : 2-5: ED, EI (2nd only), EDM (5th only)

Question 15

Abduction at MCP
Plane
Range
Muscles

Answer 15

> Frontal plane/ sagittal axis
> Range: 20-30 degrees
> Muscles: thumb: AbPB
                 : 2-4: dorsal interossei
                 : 5th: AbDM

Question 16

Adduction at MCP
Plane
Range
Muscles

Answer 16

> Frontal plane/ sagittal axis
Range: 0 degrees
Muscles: thumb: AddP, 1st palmar interosseous
: 2,4,5, palmar interosseous

Question 17

Movements at IP joints

Answer 17

flexion/extension

Question 18

Flexion at IP joints
Plane
Range
Muscles

Answer 18

> Sagittal plane/ frontal axis
Thumb: 90 - FPL
PIP: 100 - FDS, FDP
DIP: 80- FDP

Question 19

Extension at IP joints
Plane
Range
Muscles

Answer 19

> Sagittal plane/ frontal axis
Thumb: 10 degrees - EPL
PIP + DIP 0 - 5 degrees - ED, lumbricals, dorsal interossei (2-4), EI (2 only), palmar interossei (2,4,5), EDM (5th only)