Week 1 Flashcards
What patient population scenarios would benefit from upper extremity orthotic intervention?
Stroke MVA TBI Spinal cord injuries Carpal tunnel CP Burns Fractures Congenital Infections Suicide Arthritis
Where does our orthotic treatment planning and implementation develop from?
Physicians Notes
Biomechanics
What are the differences between Lower extremity Orthotic Treatment and Upper extremity Orthotic Treatment?
Lower extremity- weight bearing, gait, balance
Upper extremity- prehension, reach, transitional movements, carrying, object release, in-hand manipulation
How many carpal bones are in the wrist?
8
What is the order of decision making for a device and treatment?
Biomechanics Patient assessment Fabrication Device Delivery Adjustments
What are the 8 carpal bones of the wrist?
Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate
How many metacarpals are in each hand?
5
What are the names of the Metacarpal?
Metacarpal I-V starting lateral
How many phalanges are on each hand?
14
What is the longitudinal arch?
Extends from the distal phalange to the carpals.
Easiest view from the medial border of the hand.
What is the Distal Transverse arch?
Located at the Metacarpophalangeal (MCP) joint level
The 1st, 4th, and 5th metacarpals rotate around the 2nd and 3rd metacarpals to either flatten or increase its arc.
What is the proximal transverse arch?
Level of the carpometacarpal joint (CMC).
Remains arched even when the hand is open.
Which transverse arch is mobile?
Distal Transverse arch
Which transverse arch is stable?
Proximal transverse arch
Which metacarpals are more stable?
The second and third metacarpals
Which muscles are responsible for changing the shape of the hand for grasping objects?
Extrinsic muscles
Which muscles are responsible for maintaining the three arches of the hand?
Intrinsic muscles
Where are the pressure points on the hand?
DIPs PIPs MCP IP CMC and Thenar Eminence Carpal Relief Ulnar Styloid Radial Styloid
What are the creases of the hand?
DIP crease PIP crease Palmar Digital crease Distal Palmar crease Proximal palmar crease Thenar crease Wrist crease
What do the creases of the hand and fingers have to do with anything?
Important for trimlines and how they relate to your orthosis.
Which joint goes between the carpal bones and the radius and ulna?
Radiocarpal joint
Which joint is between the ulna and radius close to the hand?
Distal radioulnar joint
Which joint goes between the carpal joints?
Midcarpal joint
Which joint goes between the humerus and radius?
Humeroradial joint
Which joint goes between the humerus and ulna?
Humero-ulnar joint
Which joint goes between the radius and ulnar close to the humerus?
Proximal radioulnar joint
What is abduction of the thumb?
Thumb in neutral position moving away from the other phalanges
What is adduction of the thumb?
Thumb in neutral position moving towards the other phalanges
What is extension of the thumb?
Thumb in anatomical position moving laterally away from the other fingers.
What is flexion of the thumb?
Thumb in anatomical position moving towards the palm and other fingers.
What is opposition of the thumb?
Thumb moving towards the pinkie.
What is reposition of the thumb?
Thumb moving away from the pinkie.
For forearm pronation and supination which bone rotates around the other?
The radius rotates around the ulna.
What types of synovial joints are found in the upper extremities?
Hinge joint
Ball in Socket
Condyloid Joint
Saddle Joint
What is a condyloid joint?
Oval articular surface of one bone fits into complementary depression in another.
Biaxial joints permit all angular motions
What are examples of condyloid joints?
Radiocarpal joints
MCP joints
What is a saddle joint?
Similar to condyloid joints but allow greater movement. Each articular surface has both a concave and convex surface.
What is an example of a saddle joint?
Carpometacarpal joint of the thumb
What is a hinge joint?
Cylindrical projections of one bone fits into a trough-shaped surface on another.
Single plane of motion
uniaxial joints permit flexion and extension only.
What are examples of hinge joints?
Elbow
Interphalangeal joints
What is the functional position of the thumb?
Thumb in abduction and opposition with the pads of the 1st and 2nd fingers in line with the pad of the thumb.
What occurs when the wrist becomes flexed?
The extensor tendons tighten and the distal transverse arch flattens.
What muscles cause flexion of the elbow?
Brachialis Biceps brachii Brachioradialis Pronator teres Extensor carpi radialis longus Flexor carpi radialis Flexor carpi ulnaris
What muscles cause extension of the elbow?
Triceps brachii
Anconeus
What is a ball in socket joint?
A spherical or hemispherical head of one bone articulates with a cuplike socket of another.
Multiaxial joints permit the most freely moving synovial joints
What is an example of a ball in socket joint?
Glenohumeral joint
What is the functional position of the hand?
30-40 degrees wrist extension 45-50 degrees MCP flexion 35-45 degrees PIP Flexion 10-25 degrees DIP Flexion 0-10 degrees Ulnar deviation
What are the pronator muscles of the forearm?
Pronator teres
Pronator quadratus
What are the supinator muscles of the forearm?
Biceps brachii
Supinator
What are the flexor muscles of the wrist?
Flexor carpi radialis Flexor carpi ulnaris Palmaris longus Flexor digitorum superficialis Flexor digitorum profundus
What are the extensor muscles of the wrist?
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor digitorum
What are the Radial deviator muscles of the wrist?
Extensor carpi radialis longus Extensor carpi radialis brevis Extensor Pollicis Longus Extensor Pollicis Brevis Flexor Carpi Radialis Abductor pollicis longus
What causes flexion of the thumb?
Flexor pollicis brevis
What causes extension of the thumb?
Extensor pollicis brevis
Abductor pollicis
What causes abduction of the thumb?
Abductor pollicis longus
Abductor pollicis brevis
What causes adduction of the thumb?
Adductor pollicis
1st dorsal interosseous
What causes flexion of the proximal interphalangeal joint?
Flexor digitorum superficialis
Flexor digitorum profundus
What causes extension of the proximal interphalangeal joint?
Interossei
Lumbricals
What causes flexion of the distal interphalangeal joint?
Flexor digitorum profundus
What causes extension of the distal interphalangeal joint?
Interossei
Lumbricals
What causes flexion of the metacarpophalangeal joint?
Dorsal interossei
Palmar Interossei
Lumbricals
What causes extension of the metacarpophalangeal joint?
Extensor digitorum
Extensor indicis
Extensor digiti minimus
What should be remembered about the Interossei?
Dorsal interossei (D.A.B.=Dorsal abducts the fingers) Palmar Interossei (P.A.D.= Palmar adducts the fingers)
What should be remembered about the lumbricals?
Flex MCP and extends the IP joints