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533 final > the wrist and hand > Flashcards

the wrist and hand Flashcards

1
Q

what are the 8 carpel bones

A

scaphoid, lunate, triquetium, pisiform, trapezium, trapezoid, capitate, hamate

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2
Q

physiologic motion of the wrist

A

flexion and extension; radial and ulnar deviation

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3
Q

what kind of lever is the brachioradialis

A

type 2; elbow is the fucrum, load is the hand or the weight in the hand.

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4
Q

anconeus is not working properly what should you work on

A

quick motions of flexion and extension

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5
Q

why does radial deviation go less then ulnar deviation and why does ulnar deviation have a soft end feel

A

radial styloid process extends further then the ulnar styloid process and their is a menisci on the ulnar side that gives a softer end feel

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6
Q

medial mass muscles

A

pronator teres and the wrist flexors

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7
Q

lateral mass muscles

A

supinator and the wrist extensors

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8
Q

what position is the ulnar nerve stretched (tension)

A

in elbow flexion

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9
Q

what position is the radial and median nerve stretched (tension)

A

in extension

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10
Q

when do most neuro problems start to happen?

A

once the plexus leaves the axilla

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11
Q

common sites of nerve entrapments

A

ulnar at the cubital tunnel (funny bone)
medial at the pronator and supinator (anterior portion of the forearm)
radial at the superior and supracondylar ridge extensor carpi radialis and brachioradialis

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12
Q

what is a sign of a medial nerve entrapment?

A

a dip in the palm of the hand

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13
Q

what causes throwers elbow

A

repetitive valgus stress

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14
Q

little league elbow

A

stress on the growth plate of the medial humeral epicondyle

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15
Q

nursemaids elbow

A

a slip of the annular ligament caused by distraction elbow extension and pronation (can be fixed my quickly moving the arm in flexion and supination)

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16
Q

the “cock up muscles” for hand function

A

wirst extensors and finger flexors

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17
Q

what should PTs bias when working with elbows

A

flexion and supination

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18
Q

what is a sign of a radial nerve injury

A

wrist drop

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19
Q

what does ulnar deviation have more of when compared to radial deviation?

A

more mobility, less stability
more ROM
-this can leas to ulnar drift and chronic conditions of instability

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20
Q

the hand rule of 1/2

A

the thumb is 1/2 of hand function
sensation is 1/2 of hand function

21
Q

how to stretch the triceps

A

arm by the ear with a flexed elbow

22
Q

how to stretch the biceps

A

elbow extension and pronation behind the back

23
Q

rheumatoid arthritis

A

eats away at the tendons and tendon shafts that lead to joint instability and ulnar drift

24
Q

the articulations of the carpal bones compared to the elbow

A

week articulation

25
Q

why are you unable to make a strong fist in wrist flexion

A

due to active insufficiency: the wrist flexors are too shortened and the myofiliments have nowhere to go

26
Q

radial nerve palsy

A

paralysis of the wrist extensors from the lateral epicondyle; will need a splint to hold the hand in extension and hold a grasp

27
Q

function of the hand

A

control and sensation

28
Q

MP joint in the hand motions

A

flexion and extension
abduction and adduction

29
Q

DIP joint motions

A

flexion and extension

30
Q

digit alignment

A

when the fingers flex all together they will all point to the lunate without overlapping eachother

31
Q

carpal metacarpal motions (opposible thumb)

A

abduction/adduction
flexion/extension
circumlocution

32
Q

ligaments at the hand

A

collateral ligaments and transverse ligament across the hands of the finger metacarpals

33
Q

CAM configerations

A

-loose pack postion allows for distraction and joint play with MP joint in extension
-mobility in extension due to axis of rotation being close to the proximal pharynx
-stability in flexion due to the axis of rotation being further away from the proximal pharynx

34
Q

saddle joint (carpel/metacarpal)

A

flexion/extension: distal concave on convex
abduction and adduction: distal convex on concave

35
Q

thenar crease

A

crease for thumb opposition
allows for us to easily find the CMC
need to split around the thenar crease to allow for thumb motion

36
Q

distal and proximal palmer crease

A

allows for freedom the the MP joints

37
Q

static split

A

split at distal palmer crease, allows for MP flexion

38
Q

resting hand position splint (pismo clam)

A

-30 degrees of wrist extension
-80 degrees of MP flexion and full IP extension
-allows for cam ligaments to stay lengthened
-maintain the transverse arches
-thumb is opposed

39
Q

intrinsic muscles of the hand

A

lumbricals and interossei

40
Q

lumbricals

A

innervated by the median and ulnar nerve. action MP flexion and IP extension

41
Q

Extrinsic thumb muscles

A

flexor pollicis longus, abductor pollicis longus, extensor pollicis longus and brevis

42
Q

intrinsic thumb muscles

A

thenar eminence

43
Q

muscles that help with grip

A

extrinsic- long finger flexors
intrinsic - abductions and opposable thumb

44
Q

what goes through the carpal tunnel

A

median n, flexor tendons, transverse ligament

45
Q

what goes through the dorsal tunnel

A

extensors and radial nerve

46
Q

carpal tunnel syndrome

A

median nerve entrapment can be detected by pressing down in the flexor (palmer) retinaculum (positive tinel sign)

47
Q

entrapment of the ulnar nerve

A

in the tunnel of guyon (between the hook of hamate and pisiform)

48
Q

circulation at the hand

A

the radial artery is bigger then the ulnar and goes to the digits

49
Q

what is required for normal movement

A

P1 at or after R2; accessory and joint play

533 final (5 decks)

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