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Kinesiology > The wrist and hand > Flashcards

The wrist and hand Flashcards

1
Q

What are the bones in the wrist?

A
  • distal radius
  • distal ulna
  • Carpals (lateral to medial)
  • scaphoid, lunate, triquetrum, pisiform, trapzeoid, capitate, hamate
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2
Q

What are the 2 joints of the wrist?

A

Distal radioulnar joint: pivot joint, between distal radius and ulna

Radiocarpal: seperate capusle from the distal radioulnar, between radious and proximal row of carpals

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3
Q

What is the TFCC?

A

The triangular fibrocartilage complex
* between the ulna and proximal carpals
* Cartilaginous disc
* acts a a sort of meniscus

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4
Q

What are the movements of the wrist?

A
  • flexion (palm to wrist)
  • extension (wrist back)
  • radial deviation (point hand to radius)
  • ulnar deviation
  • circumduction
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5
Q

What are the ligaments of the wrist?

A
  • Radial collateral (lateral aspect)
  • Ulnar collateral (medial aspect)
  • Transverse carpal (palmar aspect): runs over the top of the wrist anteriorly and gives a roof over the carpal tunnel

[carpal tunnel syndrome: the median nerve gets compressed]

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6
Q

What are the anterior muscles in the wrist?

A

Flexor carpi radialis
* O: medial epicondyle, I: 2nd metacarpal, A: flex wrist and radial deviation
Flexor carpi ulnaris
* O: medial epicondyle, I: 5th metacarpal, A: flex wrist and ulnar deviation
Palmaris longus:
* O: medial epicondyle, I: palmar aponeurosis, A: tenses skin of wrist

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7
Q

What are the muscles of the wrist/hand posterior side?

A

Extensor carpi radialis longus:
* O: supracondylar area and lateral epicondyle
* I: 2nd mc
* A: extension and radial deviation
Extensor carpi radialis brevis
* O: lateral epicondyle
* I: 3rd mc
* A: extension and radial deviation
Extensor carpi ulnaris
* O: lateral epicondyle
* I: base fo 5th mc
* ulnar deviation and extension

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8
Q

What are the forearm muscles?

A
  • Ext carpi radialis longus and brevis
  • Extensor digitorum
  • extensor carpi ulnaris
  • pronator teres
  • felxor carpi radialis
  • Palmaris longus
  • Flexor carpi ulnaris
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9
Q

What joints do wrist flexion and extension and what % each?

A

Occurs at both radiocarpal and midcarpal joints
* Flexion: RC 60%, MC 40%
* Extension: RC 80%, MC 20%

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10
Q

What does the radiocarpal do in flexion/extension?

A
  • Extension and flexion occurs with convex lunate on concave radius, so they slide and roll in differnet directions
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11
Q

What does the radiocarpal joint do with ulnar/radial deviation?

A

There is a convex proximal row of carpals on a concave radius, which causes them roll and slide in opposite directions

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12
Q

What are the bones of the hand and how many in each category?

A
  • 8 carpal
  • 5 metacarpals
  • 14 phalanges

Also metacarpal phalanage joints, PIP and DIP on digits 2-5 and IP on 1st digit

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13
Q

What are the movements of the hand?

A
  • Flexion (make a fist)
  • Extension (open fist)
  • Abduction: splay fingers
  • Adduction: bring fingers back together
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14
Q

What are the movements of the fingers?

A
  • Abduction: “lego hand” like holding a coffee cup
  • Adduction: bring thumb back to hand
  • Flexion: from neutral bring thumb down to hand
  • Extension: from neutral bring thumb up like a thumbs up
  • Circumduction: circles
  • Opposition: bring thumb to pinky
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15
Q

What are the extrinsic muscles of the hand/fingers

A
  • Extensor digiti minimi: O: lateral epicondyle, I: 5th phalange
  • Extensor digitorum: O: lateral epicondyle, I: 2, 3, 4
  • Extensor indicis: O: distal ulna: 2nd phalange (index)
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16
Q

What do the flexor digitorum profundus and flexor digitorum superficialis do?

A
  1. FDP: O: proximal ulna, I: distal phalanges 2-5, A: phalangeal flexor
  2. FDS: O; medial epicondyle, I: middle phalange, A: phalnageal flexor
17
Q

How do you isolate the flexor digitorum superficilais?

A

Stabilize all adjacent finger and try to flx teh 3rd phalange

18
Q

What are the extrinisc muscles of thum (no OI)

A
  1. Abductor pollicis longus
  2. Extensor pollicis brevis
  3. extensor pollicus longus
  4. flexor pollicis longus
19
Q

What are the intrinsic muscles of the thumb? no OI

A
  • adductor pollciis
  • Abductor pollicis brevis
  • Flexor pollicis brevis
20
Q

What is the anatomical snuffbox and what is inside it?

A

IT is created by the extrinisc (extensor tendons)
* portion of the scaphoid can be palpated
* the division of the radial nerve and radial artery can be found here (get a pulse)

21
Q

What is the thenar eminence?

A

palm side near the thumb
3 intrinsic muscles involved but you can identofy them individually by palpatation
1. opponens pollicis
2. flexor pollicis brevis
3. abductor pollciis brevis

22
Q

What is the hypothenar eminence? and what is the central compartment

A

on palm side, medial to body; also 3 intriniscs but cant identify by palpation
1. opponens digiti minimi
2. flexor digiti minimi
3. abductor digiti minimi
* the central compartment is the valley in the middle between the two emineces (the adductor pollicis is here)

23
Q

What cmc joints are strong and which are mobile?

A
  • 2nd and 3rd cmc joints are very strong
  • 1, 4, 5th cmc joints are mobile
  • mid carpal joint is not strong
24
Q

What does the mobility of the CMC joints allow for (when gripping)?

A
  • opposition and tight gripping
25
Q

What are the functional grip movements of the hand?

A

Gripping
* power: add thumb to hook grip essentially
* cylinder (thumb goes into abduction (lego hand)
* sphericle (baseball)
* hook (thumb is not involved)

Prehension pinch
* tip to tip
* lateral (power pinch): strongest prehension grip (the thumb comes to the 2nd digit
* pulp to pulp (pads of fingers together)

26
Q

Are the wirst flexor or extensors more dominant in the “opening” mechanism?

A

Wrist flexors are dominant

27
Q

What is the role of wrist extensors in the opening/closing mechanism?

A
  • extensors help leverage the flexors
  • they neutralize the strong weifts felxor tendancy of the extrinsic finger flexors
  • maintains optimum lenth for the extrinsic finger extensors while closing the hand
28
Q

What is the dorsal hood?

A

Connector of fascial tissue sitting on dorsal aspect of hand
* bridge between intrinisc and extrinsic muscles of the hand
* maintain that relationship and gives us fine motor control
* boutinere deformity of fingers is caused from dorsal hood

29
Q

Explain the opening and closing mechanism?

A

Opening:
* ?
Closing:
* wrist extensors are active
* extensor digitorum controls flexion at MCP

Kinesiology (16 decks)

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