What are the degrees of each functional position of the wrist and hand? - wrist ext - metacarpal flex - PIP flex - DIP flex - Ulnar deviation

- wrist ext: 20 - metacarpal flex: 45 - PIP flex: 30 - DIP flex: 10 - Ulnar deviation: 10

Test 2 Flashcards by Brittni Barnes

Describe Boutonnière Deformity

PIP is flexed and DIP extended.

Caused when ED tendon is avulsed (torn away) from its attachment at the base of the middle phalanx.

-^–

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Describe Mallet Finger

Disruption of the DIP extensor tendon.

You can still bend the finger but the distal end is permanently bent and won’t extend.

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Describe Swan Neck Deformity

Hyperextension of PIP, flexion of DIP

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Describe the Rheumatoid Arthritis deformity

There is an Ulnar Drift (angle towards ulna) of metacarpals due to the extensor tendon slip to the ulnar aspect of the metacarpal head.

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Describe the Radial Nerve Palsy deformity

Drop wrist

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Describe the Medial Nerve Palsy deformity

Can cause thenar eminence atrophy (can’t bend thumb)

“Ape hand”

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Describe the Ulnar Nerve Palsy deformity

Loss of ulnar nerve. Hyperextension of MCP and flexion of IP joints

“Claw hand”

Can’t use ring & pinky fingers

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Swan Neck and the Boutonnière deformities are usually are result of someone having what?

RA- Rheumatoid Arthritis

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What are the degrees of each functional position of the wrist and hand?

wrist ext
metacarpal flex
PIP flex
DIP flex
Ulnar deviation

wrist ext: 20*
metacarpal flex: 45*
PIP flex: 30*
DIP flex: 10*
Ulnar deviation: 10*

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Name the Plain and Axis this movement is happening: Deviation of the wrist

Frontal Plain

Sagittal Axis

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When you are lifting a weight from the floor and putting it on a shelf over head, what muscles are you using and is it concentric or eccentric?

Shoulder flexors

Concentric

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When you are lowering a weight from a shelf and putting it on the floor what muscles are you using and is it concentric or eccentric?

Shoulder Flexors

Eccentric

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Most work is done by what flexors or extensors?

Flexors

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What muscles make up the Thenar Eminance muscles

Flexor Policis brevis
Abd Policis brevis
Opponenus Pollicis

Thumb

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What muscles make up the Hypothenar Eminance muscles?

Flexor digiti minimi
Abd digiti minimi
Opponens digiti minimi

Pinky Finger

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What muscles and bone make up the Anatomical Snuff Box?

Ext. Pollicis Longus
Ext. Pollicis Brevis
Abd Pollicis Longus
Scaphoid bone forms the floor

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If you have an injury to C8-T1 intrinsics of the hand what nerve would be effected?

It is situated in the groove btw medial epi and Olecranon process.

Ulnar Nerve

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If you have an injury to C6-C7 the wrist extensors what nerve would be effected?

Triceps and brachioradialis

Radial Nerve

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If you have an injury to C6,7,8 Pollicis muscles what nerve would be effected?

Thenar muscles

Median Nerve

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Define Power Grip

When the objects are lead with great force

Isometric contraction of the fingers and hand

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What are the 4 Power Grips? Give an example.

Cylindrical: holding a can
Spherical: opening a jar (Palm of hand NOT used)
Hook: holding a bucket (fingers 2-5 NO thumb)
Lateral Prehension (side to side): holding a pencil btw 2 fingers

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Define Precision Grip

Motion limited to MCP joints

More precise movements

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What are the 4 Precision Grips? Give an example.

Pad to Pad: bringing pad of thumb together with the pad of another finger
Tip to Tip: bringing tip of thumb together usually with the tip of the index finger. Most PRECISE
Lateral Prehension (pad to side): the pad of the thumb and the side of the index finger. Turning a key to start the car
Lumbrical or Plate Grip: MCP flexed while PIP and DIP are extended. Carrying a plate.

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What is the most precise grip?

Tip to Tip

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Intrinsic Finger Muscles originate from where?

From the hand, below the wrist

Extensor Indicis moves what finger?

Index only

Extensor Digitorum Minimi moves which finger?

Pinky Only

What is closed pack position of the hand?

70* of flexion

What is closed back position for the wrist ?

Full wrist extension

If you pronate the hand what happens btw the ulna and radius?

Radius crosses over the ulna

In order to keep a neutral deviation, either ulnar or radial, what do the muscles have to be doing?

Muscles need to be flexed and extended at the same time

What causes Student Elbow?

An inflammation of the Olecranon bursa due to excessive leaning on the elbow.

Olecranon Bursitis is also known as what?

Student's Elbow

What causes Tennis Elbow?

An inflammation at the lateral epicondyle where the common wrist extensor tendon attaches.

Later Epicondylitis is also known as?

Tennis Elbow

What causes Golfer's Elbow or Little League Elbow?

An inflammation at the medial epicondyle where the common wrist flexor tendon attaches.

Medial epicondylitis is also known as what?

Golfer's Elbow or Little League Elbow

What causes Olecranon Bursitis?

Inflammation of the Olecranon bursa due to a traumatic blow to the Olecranon process

MCL (Medial Collateral Ligament) Laxity causes what?

Causes increase carrying angle which will increase compression of the lateral structures.

Medial collateral ligament weakness causes what?

Valgus

Lateral collateral ligament weakness causes what?

Varus

A carrying angel of 0* to -5* is considered what?

Varus

A carrying angle over 25* is considered what?

Valgus

Varus means?

Normal angle is Reduced or decreased

Valgus means?

Normal angle is Greater or increased

Define Carrying Angle

Is the angle btw the humerus and the ulna while is anatomical position

What is the normal carrying angle for men and women?

``` Men= 5* Women= 10-15* ```

A Gunstock deformity is a result of what?

Varus Decreased or reduced angle

What movement does the Medial Collateral Ligament prevent?

Prevents Valgus

What movement does the Lateral Collateral Ligament prevent?

Prevents Varus

Where is the Annular Ligament connect?

The Radius to the Ulna

What is Passive Insufficiency of the Triceps?

Shoulder and Elbow Flexion

What is Passive Insufficiency of the Biceps?

Shoulder and Elbow extension

What is Active Insufficiency of the Triceps?

Shoulder and Elbow Extension

What is the Interosseous Membrane

Runs the length of the radius and ulna (between them) providing stability for superior and inferior RU joints

If you have limited ER at the shoulder joint it will cause what to happen?

An increase need for supination at the elbow

If you have limited IR at the shoulder joint it will cause what to happen?

An increase need for pronation at the elbow

What 4 bones make up the Radiocarpal Joint?

Radius Scaphoid Lunate Triquetrum

What are the motions of the Radiocarpal Joint? What degrees of freedom?

Flex/ext Ulnar/radial deviation 2* of freedom Biaxial joint

Where is the Ulnar Collateral Ligament found?

Ulna to pisiform and triquetrum Pinky finger side

Where is the Radial Collateral Ligament found?

Radius to scaphoid, trapezium and 1st MC Thumb side

What are the 8 carpal bones in your hand?

So Long To Pinky Here Comes The Thumb Thumb Pinky Trapezium, trapezoid, capitate, hamate Scaphoid, lunate, triquetrum, pisiform

Convex and Concave rule

Convex moves in opposite directions Concave moves in the same direction

If I abduct my arm to 180* what movement is happening to the scapula?

Upward rotation

If I move my arm behind my back to the opposite hip what movement is happening to the scapula?

Downward rotation

What motion happens if the Quad. is moving in open kinetic chain?

Knee ext/flex

When starting in Full Flexion what movement occurs in the carpals?

The distal row of carpals moves on the proximal row to neutral Then proximal row moves on radius

When starting in Full Extension what movement occurs in the carpals?

The proximal row moves on radius to neutral Then distal row moves on proximal row to full flexion

What movement occurs to the carpals when doing Radial/Ulnar deviation?

Distal row moves on proximal row

How many arches are in the hand and what types are they?

3 total arches ``` 2 Transverse (metacarpal) 1 longitudinal (palm) ```

Describe the Flexor Retinaculum ligament

Serves as a support of the carpal arches and as the roof creating the carpal tunnel Medial nerve passes through the carpal tunnel

Describe the Extensor Retinaculum Ligament

This holds the extensor tendons down during wrist extension

Describe what Winging of the scapula is

Occurs when the vertebral border of the scapula moves off the thorax Associated with protraction/retraction of scapula

Describe what Tipping of the scapula is

Is normal movement associated with elevation and depression of the scapula

What is the prime function of the Deltoid muscles?

Shoulder abduction

What is the prime function of the Serratus Anterior?

Scapula protraction and upward rotation

What is the prime function of the levator scapulae?

Scapula elevation and downward rotation

What is the primary muscled used in horizontal movements?

Horizontal abduction/adduction

What movements occurs at the should and arm when you reach into your back pocket?

IR, abduction, elbow flexion

What movements occurs at the shoulder and arm when you reach into your reach behind your back to touch your scapula?

Adduction, IR, elbow flex

What movements occurs at the should and arm when you reach across your body?

IR, adduct, elbow flex

What is the only joint that attaches the shoulder girdle to the body?

Sternoclavicular joint

What motions happen at the Shoulder Girdle?

``` Protraction/retraction Elevation/depression of scapula Upward/downward rotation of scapula Winging of scapula Tipping of scapula ```

What bones make up the shoulder?

Scapula, clavicle, sternum, humerus

What is the most common dislocation at the Glenohumeral Joint?

Anterior inferior

What is closed pack position of the shoulder?

90* of abduction and 90* of external rotation

Describe the glenoid labrum

Is a fibrous cartilage that deepens the socket to increase joint stability. Accepts the head of the humerous.

Describe the Subacromial Bursa

One separates the supraspinatus from the Acromion and the other separates the Coracoid process, coracoacromial ligament and deltoid muscles. The bursa allows for smooth gliding btw the humerus and supraspinatus

Define Scapulothoracic Rhythm

Is a 2:1 ratio of Glenohumeral to scapula motion

What moves from 0-30* What moves from 30-90* What moves from 90-180*

ONLY Glenohumeral moves 30* Scapula upwardly rotates 30*/GH moves additional 30* Scapula moves another 30*/GH moves additional 60*

How many degrees does the scapula move during full shoulder ROM?

60*

How many degrees does the GH moves during full flexion of joint?

120*

What make up you Rotator Cuff Muscles?

SITS Supraspinatus Infraspinatus Teres Minor Subscapularis

What is the purpose of the Rotator Cuff Muscles

Stabilize the head of the humerus into the glenoid fossa Compresses and depresses to help facilitate infoeior glide so the deltoid muscle can effectively abduct the arm

If you have pain coming more posteriorly from around the shoulder what injury might you have?

Rotator Cuff Tendonitis Becomes inflamed from over usage

If you have pain more anterior/lateral around your shoulder what injury might you have?

An Impingement of the supraspinatus tendon

What is closed pack position of the elbow

Full extension

How much larger is the Humeral head than the fossa?

3-4x

What type of joint is the sternoclavicular?

Plane joint for gliding

What is the convex on concave rule for the clavicle?

The convex clavicle moves on the concave sternum

How many degrees can each move? ``` Elevation Depression Protraction Retraction Passive Posterior Rotation ```

``` Elevation: 45* Depression:15* Protraction: 15* Retraction: 15* Passive Posterior Rotation: 35-40* ```