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Rec and Eval Lower Body > WHF > Flashcards

WHF Flashcards

1
Q

Mechanical purpose of shoulder, elbow, WFH

A

shoulder - mobility and gross placement of hand

elbow - stability

WHF - strength and precision

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2
Q

How may carpals, metacarpals, and phlanges

A

8 carpals, 5 metacarpals, 14 phalanges

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3
Q

name the carpals

A

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

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4
Q

1st Metacarpal lines up with

A

Trapezium

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5
Q

2nd metacarpal lines up with

A

trapezoid

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6
Q

3rd MC lines up with

A

Capitate

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7
Q

4 and 5 MC lines up with

A

Hamate

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8
Q

Pisiform floats on

A

triquetrum

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9
Q

commonly fractured

A

scaphoid

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10
Q

commonly dislocated

A

lunate

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11
Q

proximal articulating surfaces of long bones

A

concave

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12
Q

distal articulating surfaces of long bones

A

convex

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13
Q

purpose of sesamoid bones on first MC

A

improve mechanical line of pull of the flexor pollicis brevis, abductor pollicis brevis, adductor pollicis muscles

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14
Q

Distal radioulnar joint - degrees of freedom - movements

A

ulnar head/ulnar notch
1 degree of freedom
pronation and supination

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15
Q

Radiocarpal joint

A 
ellipsoid joint
2 degrees of freedom
flexion and extension
radial and ulnar deviation
fibrous carapl

formed by distal radius and the scaphoid and lunate

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16
Q

RCL

A

radial collateral ligament

limits ulnar deviation becomes taut when the wrist is at the extreme ranges of flexion and extension

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17
Q

Palmar radiocarpal ligament

A

controls motion and wrist stability

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18
Q

Dorsal radiocarpal ligament

A

limits flexion

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19
Q

TFCC

A

triangular fibrocartilanginous complex

  • articular disc
  • dissipates stress imposed on forearm during loading
  • stabilizes distal radioulnar joint
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20
Q

Intercarpal joints

A

allow for gliding movements

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21
Q

First CMC joint

A

2 degrees of freedom
synovial saddle joint
flexion and extension, abduction and adduction
accessory motion: oppositiona nd reposition

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22
Q

CMC joints 2-4

A

plane synovial joint
1 degree of freedom
flexion and extension

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23
Q

CMC joint 5

A

2 degrees of freedom
flexion and extension
abduction and adduction

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24
Q

MCP joints

A

condyloid joints
2 degrees of freedom
flexion and extension
abduction and adduction

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25
Q

collateral ligaments at fingers

A

protect against valgus and varus forces

make gripping less dependent on dynamic stability

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26
Q

IP joints

A

1 degree of freedom

flexion and extension

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27
Q

natural position of hand

A

slight flexion

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28
Q

Extensor muscles

A

Extensor muscles

  • location: posterolateral forearm
  • 6 compartments
  • radial nerve innervation
  • extensor carpi radialis longus/brevis
  • extensor carpi ulnaris
  • extensor digitorum communis
  • extensor pollicis longus
  • extensor pollicis brevis
  • abductor pollicis longus
  • extensor indicus
    • all secured by extensor retinaculum
      • increase efficiency of the muscles’ pull and prevents “bow stringing” when the wrist is extended
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29
Q

Flexor muscles

A 
Flexor Muscles
-Location: anteromedial forearm
-2 compartements
-flexor carpi radialis, 
-palmaris longus (absent in 12-15% of population)
-flexor carpi ulnaris
-flexor digitorum superficialis
-flexor digitorum profundus
-flexor pollicis longus
-median nerve innervation
	(fourth and fifth - ulnar nerve)
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30
Q

Palmar muscles groups

A

thenar central, hypothenar, adductor interosseous compartments

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31
Q

muscles of thenar eminence

A

abductor pollicis brevis, flexor pollicis brevis, opponens pollicis

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32
Q

muscles of hypothenar eminence

A

abudctor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi muscles

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33
Q

To prevent bowstringing

A

series of pulleys restrain and guide the tendons

during flexion and extension of the fingers

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34
Q

flexor tendons require how much more excursion than extensor tendons

A

4x

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35
Q

annular pulleys

A

tunnels for tendons

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36
Q

cruciate pulleys

A

pliable, allow annular pulleys to move towards each other in flexion

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37
Q

4 Lumbrical muscles

A

flex MCP, extend PIP and DIP

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38
Q

Palmar aponeurosis equals

A

volar plate

39
Q

Ulnar

A

passes through tunnel of guyon.

palmar/dorsum - 1/2 ring finger, pinky finger.

40
Q

median

A

runs through carpal tunnel
lateral palm, 1/2 ring finger, fingers 3-1.
dorsum - fingers 1,2 and half of ring finger

41
Q

Radian nerve

A

base of thumb, back of hand near thumb below 1st and 2nd fingers

42
Q

Carpal tunnel

A

fibro-osseus structure
floor formed by proximal carpal bones
roof - transverse carpal ligaments

43
Q

PVD

A

peripheral vascular disease (Raynaud’s)

44
Q

Russell’s signs

A

abrasions, small cuts, callosities over dorsal surface of MCP or IP joints
-outward signs of bullimia

45
Q

Drop wrist associated with

A

radial nerve

46
Q

Trigger finger

A

stenosing tenosynovitis
nodule in flexor tendon
affects MCP flexion and extension

47
Q

Ape Hand

A

median nerve pathology
weakness in thenar eminence
pulls thumb medially

48
Q

Bishop’s Deformity

A

ulnar nerve, hypothenar muscles, flexion in PIP and DIP joints, extension limited

49
Q

Claw Hand

A

ulnar and median nerve

extension of MCP, flexion of PIP and DIP

50
Q

Dupuytren’s Contracture

A

excessive flexed resting position
can’t extend MCP and PIP joints
shortening or adhesion of palmar fascia

51
Q

Swan Neck Deformity

A

flexion of MCP and DIP
hyperextension of PIP
volar plate injuries,
malunion, trauma, arthritis

52
Q

Volkmann’s Ischemic Contracture

A

flexion contraction of wrist and fingers,
limited extension
decreased blood supply

53
Q

Jersey Finger

A

avulsion of extensor digitorum longus tendon

-can’t actively extend distal phalanx

54
Q

Mallet Finger

A

avulsion of extensor digitorum longus tendon

can’t actively extend distal phalanx

55
Q

Boutonniere Deformity

A

rupture of central extensor tendon
rupture of volar plate
-extension of MCP and DIP joints
-flexion of PIP joint

56
Q

Hard end feels

A

radial deviation, MCP flexion, PIP flexion

57
Q

Soft end feels

A

thumb flexion, thumb adduction

58
Q

numbness on dorsal hand correlates with what nerve pathology

A

ulnar nerve in elbow

59
Q

numbness on palmar side of hand correlates with

A

ulnar nerve near tunnel of guyon

60
Q

distal forearm fractures common in

A

children

61
Q

Colles fracture

A

any fracture of distal radius

62
Q

scaphoid fracture common in

A

15-30 year olds and younger males

63
Q

concerns with scaphoid fracture

A

blood supply from radial artery compromised - necrosis

Preiser’s disease - osteoporosis of scaphoid

nonunion

64
Q

MOI of schaphoid fracture

A

foosh, land on palm, hyperextension of wrist

65
Q

Hamate fractures, MOI

A

hook of hamate
MOI - foosh or trauma from golf club or bat,
axial load
could compress ulnar nerve - symptoms in fingers 4 and 5.

66
Q

concerns with hamate fractures

A

nonunion, vascular supply

can be removed

67
Q

Lunate dislocation

A

lunate is disassociated from other carpals

68
Q

perilunate dislocation

A

proximal carpal row being stripped from around the lunate

69
Q

Lunate MOI

A

high energy forced hyper extension of wrist

70
Q

Murphy’s sign

A

depressed third knuckle - lunate dislocation

71
Q

Wrist sprains

A

scapholunate ligaments - most commonly sprained

72
Q

Watson test

A

positive for tear - clunk with pain

73
Q

TFCC injury

A

traumu, or repeated injury

74
Q

MOI of TFCC

A

forced hyperextension w/ pronating force; rotary force, repeated weight bearing

75
Q

Carpal tunnel syndrom

A

compression of median nerve

  • fibrosis of the synovium of flexor tendons secondary to tenosynovitis
  • repeptive microtraumau

-caused by poor biomechanics, poor posture, obesity, pregnancy, typing, work related activities, diabetes,

76
Q

CTS signs and symptoms

A

numbness or pain and thumb, index, middle, lateral half of ring finger (median nerve)

77
Q

Boxer’s fracture

A

common in young men, punching something

fracture of 5th MC

78
Q

Collateral ligament injuries

A

unilateral stress applied to extended finger

79
Q

Dequeravain’s syndrome

A

finkelstein’s test
-tenosynovitis of the extensor pollicis brevis, abductor pollicis longus tendons
women 20-40
repetitive radial deviation

80
Q

UCL sprain

A

limits opposition and decreases grip strength

hyperabduction or hyper extenstion

“gamekeeper’s thumb”
pain on ulnar side, can’t pinch or grasp

81
Q

Bennett’s fracture

A

base of first MC

82
Q

Splinting jersey finger

A

DIP joint in flexion

83
Q

Splinting mallet finger

A

dIP joint in extension

84
Q

Splinting boutonniere finger

A

PIP and DIP joints in extension

85
Q

radial collateral and ulnar collateral ligament stress tests

A

UCL - test with valgus stress

RCL - test with varus stress

86
Q

Valgus and Varus IP tests

A

tests for collateral ligament sprain

avulsion fracture

87
Q

Laxity of thumb MCP collateral ligaments

A

valgus stress to thumb UCL

sprain or avulsion fracture

88
Q

Watson’s test

A

arm in arm wrestling position

  • apply dorsal pressure with thumb at scapholunate area
  • move hand from ulnar deviation to radial deviation

tests for: scapholunate dissociation

89
Q

Phalen’s Test

A

test for carpal tunnel
-tingling from irritation of median nerve

  • patient is standing
  • overpressure applied though wrist flexion for 1 minute
90
Q

Finkelstein’s

A

dequervain’s syndrome

91
Q

the pisiform improves what?

A

mechanical efficiency of the flexor carpi ulnaris

92
Q

history

A 
where is the pain
MOI
previous history
general medical health
Sounds or sensations
how long?
type of pain, pain scale
changes in activity
93
Q

keystone of carpal group

A

lunate

Rec and Eval Lower Body (6 decks)

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