wrist Flashcards
radiocarpal joint allows movement in two planes
sagital plane and dorsovolar axis
features of the sagittal plane in the radiocarpal joint movement
flexion and extension
has a degree of 170
extension is the volar glide
flexion is the dorsal glide
features of the dorsovolar axis in the radiocarpal joint movement
ulnar and radial deviation
has a degree of 50-80
what is the shape of the carpal bones on the palmar side
concave
what makes up the carpal tunnel
concave arc and transverse carpal ligament
what is the Connection point for palmaris longus and wrist flexor muscles
carpal tunnel
the 3 plane movement of the carpometacarpo joint
abduction
adduction
flexion and extension
rotation
features of metacarpophalangeal joints
flexion and extension
90 100
abduction and adduction
45 60
proximal distal ip joints
hinge type
pip
flexion - extension
90 1000
dip
flexion extension
60 70
ligaments of the wrist joint
ulna………
radial
volar dorsal group
in the ulnar styloid process what muscle stretches in radial deviation
psiform
in the radius styloid what muscle stretches in the ulnar deviation
scaphoideum
volar stretches in what
supinaion and extension
dorsal stretches in what
pronation and flexion
what is the functional position of the hand
15-30 extension
10-12 ulnar deviation
in making a fist what muscles create a flexor torque in the wrist
flexor digitorium profondus and superficialis
in making a fist what muscles creates extension in the wrist
extensor carpi radialis brevis
what post surgery tendons are difficult to heal without surgical intervention
flexor tendon injuries
what is the zone 1 in the flexor zones of the hand
btw the attachment of the flexor digitorium superficialis in the middle phalanx and the fingertip
zone 2 of the flexor zones of hand
zone 3
zone 4
zone 5
mcp joint and middle pharlanx 3. carpal tunnel 4.proximal and distal transverse carpal ligament 5. Extends from 1/3 distal of the forearm to the proximal flexor retinaculum multipl tendon injury, median and ulnar artery and nerve injury
the pulley system is made up of
thickened areas of the flexor tendon sheath
important roles of the pulley system
.flexion .accurate tracking of tendons .maintaining apposition of tendons and bones across joints, and provides fulcrum to elicit movement (flexion and extension)
Factors Affecting Functional Recovery After Flexor Tendon Repair
1….The level of injury
¨ 2- Type of injury: Blunt, sharp, avulsion.
¨ 3- Accompanying injury: Vascular, nerve, bone, skin defect.
¨ 4- Surgical technique
¨ 5- Recovery potential and motivation of the patient
¨ 6- The patient’s tendency to scar tissue
¨ 7- Rehabilitation program
The goals of tendon rehabilitation
Prevent tendon rupture ¨ Prevent contracture ¨ Fascilitate tendon healing ¨ Provide PROM and AROM Achieve pre-injury functional level
what is the goal of the early phase rehab thats for 1-6 weeks
The goals of this phase
to prevent tendon rupture,
provide tendon sglide and
prevent flexion contures
what muscles are affected in carpal tunnel syndrome
flexor didgitorium superficialis
flexor digitorium profondus
flexor policis longus
what nerve is affected in the carpal tunnel syndrome
median nerve
causes or etiology of carpal tunnel syndrome
overuse pregnancy occupation and hobby related syndrome diabetes obesity rehumatoid arthritis pregnancy menopause
clinical signs and symptoms of the carpal tunnel syndorme
pain burning tingling and numbness
using the hand increases the symptoms
complaints are bilateral and are seen in the dominant hand
night time it gets worse
what is a sign seen at the late stage of carpal ……syndr,,
tenar atrophy
post op goals
reduce pain and edema
gaining of function
desensitization training
