wrist Flashcards
What are the 2 articulations of the wrist?
Radiocarpal
Midcarpal joints
T/F: wrist actions = flex/ext, radial/ulnar deviation, active rotation
F: NO active rotation
T/F: ulnar= lat side
F: medial
(radial/thumb= lat)
T/F: distal articular surface of radius= concave M/L and A/P
T
T/F: radiocarpal joint = betw distal end of radius and prox row of carpal bones
T
Midcarpal joint joins __ and ___
Prox and dis rows of carpal bones
What mvt do the radiocarpal and mid carpal joint do
Radial and ulnar deviation
Palmar and volar = ___, dorsal =___
Ant
Post
Dorsal (Lister’s) tubercle separates what 2 tendons
Extensor carpi radialis brevis
Extensor pollicis longus
T/F: ulnar tilt allows hand to rotate further into ulnar deviation than radial
T
How many degrees of ulnar tilt?
25 deg
Palmar tilt allows for greater mvt of __ than __ @ wrist
Flexion
Extension
How many degrees of palmar tilt?
10 deg
T/F: ulnar tilt limits radial dev, palar tilt limits ext
T
Carpal bones
Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate
Carpal bone mnemonic
Some Lovers Try Positions
That They Can’t Handle
What carpal bones make up the prox row
Scaphoid
Lunate
Triquetrum
Pisiform
What carpal bones make up the dis row
Trapezium
Trapezoid
Capitate
Hamate
T/F: proximal row= mobile, distal row= stable
T
Scaphoid pole: prox=___, distal=___
Scaphoid facet (radius)
Trapezium and trapezoid
T/F: triquetrum = central bone of prox row and is unstable/most mobile (no musc attachments)
F: lunate
T/F: scaphoid and triquetrum are avascularized
F: scaphoid and lunate
Proximal surface of lunate= ___, distal=___
Convex (similar to scaphoid)
Concave
What 3 carpal bones are fractured most (rank)
- scaphoid
- lunate
- triquetrum
T/F: scaphoid= most frequently dislocated
F: lunate
T/F: trapezoid = largest carpal bone
F: capitate
T/F: capitate head = AoR for all wrist mvt
T
Head capitate articulates w/ __&__
Distal attachment = ___
Scaphoid and lunate
3rd metacarpal
Trapezium attaches to which metacarpal?
1st
Palmar side of carpal bones =___
Concave
T/F: trapezium= saddle shaped
T
T/F: groove on trapezium for flexor carpi ulnaris
F: flexor carpi radialis
Trapezoid attaches to which metacarpal?
2nd
Hamate attaches to which metacarpal?
4 and 5
___ = attachment point for medial side of transverse carpal lig. Lat side?
Hook of hamate
Trapezium
Contents of carpal tunnel (under transverse carpal lig)
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Median n
Transverse carpal lig connects to 4 points
Radial: scaphoid and trapezium tubercles
Ulnar: pisiform and hook of hamate
T/F: inter carpal joints allow sm glides and rotations that contribute to overall ROM
T
Radiocarpal joint: concave ___, convex ___
Radius
Prox row carpal bones
Prox components of radiocarpal = ___ surface of radius and adjacent articular disc
Distal components of radoiocarpal = ___ surface of scaphoid and lunate
Concave
Convex proximal
20% compression forces that cross radoiocarpal joint passes through ___. What about remaining 80%?
Articular disc to ulna
Through scaphoid and lunate -> radius
T/F: radiocarpal joint contact area= greatest when wrist is partially extended and slightly deviated in radial direction
F: ulnar deviation
What is the pos of max grip strength?
Wrist partially extended, ulnar deviated
Proximal surface of prox row = ___ surface of radiocarpal joint?
Distal
(A-P and M-L convex)
Midcarpal joint = 2 compartments
Med and lat
Med compartment of mid carpal joint = formed by
Convex head of capitate and apex of hamate into concave recess (formed by distal surfaces of scaphoid, lunate and triquetrum)
(like ball in socket)
Lat compartment of mid carpal joint = formed by
Convex distal pole of scaphoid w/ slightly concave prox surface of trapezium and trapezoid
T/F: med compartment of mid carpal joint =less moveable
F: most mobile
(lat= less mvt)
T/F: wrist mvt = lat compartment of mid carpal
F: med
T/F: wrist lig help maintain natural intercarpal alignment and transfer forces w/in and across carpus
T
T/F: wrist lig= extrinsic/intrinsic
T
Extrinsic lig vs intrinsic lig
E: prox attachment on radius/ulna, attach distally w/in wrist
I: both prox and distal attachments w/in wrist
The dorsal radiocarpal ligament attaches primarily between ?
Distal radius and dorsal surfaces of lunate and triquetrum
Dorsal radiocarpal lig reinforces ___ side of radiocarpal joint and guides natural arthrokinematics of prox row
Post
Dorsal radiocarpal lig attaches to lunate restrains __ disloc
Ant (volar)
T/F; radial collateral lig provides med stability to wrist
F: lat
Dorsal radiocarpal ligament has a relatively dominant role in wrist proprioception, why?
Large number of mechanoreceptors
T/F: dorsal radiocarpal ligament provides greater overall mechanical stability to the wrist
F: Palmar radial carpal ligament
TFCC allows what wrist mvt?
Pron/sup
What is the primary component of the TFCC?
Triangular fibrocartilage (articulate disc)
The triangular fibrocartilage attaches @ base along ___, apex=___
Ulnar notch of the radius
Fovea on the distal surface of ulna
Central ___ of TFC is avascular
80%
The articular disc of TFCC = from ___ to ___
Ulnar notch (radius)
Styloid process (ulna)
T/F: ulnar collateral lig is tensioned in radial dev
T
Palmar ulnocarpal lig= important___
Stabilizer (for lunate)
What are the 3 classifications for intrinsic ligaments of the wrist?
Short
Intermediate
Long
Short intrinsic ligaments connect ___ row by palmar, dorsal or interosseous surface
Distal
(stabilize, and unite distal row)
Scapholunate ligament attaches to which carpal bone
Scaphoid
T/F: scapholunate lig= ruptured w/ foolish injury
T
Palmar intercarpal ligament, =2 discrete fiber groups that resemble shape of an inverted V
Lateral leg (attaches to scaphoid)
Media leg (triquetrum)
What do dorsal intercarpal ligament and dorsal radiocarpal ligament have in common?
Large number of mechanoreceptors (important sensory roll and coordinating wrist movement)
Axis of rotation for wrist movement occurs through the head of which carpal bone
Capitate
Axis for flexion and extension =___, radial and ulnar deviation=___
M-L
A-P
Flexion = assoc w/ ___, ext =___
Ulnar dev
Radial dev
The wrist rotates in the sagittal plane about ___ degrees
130-160
The wrist flexors from ___ degrees to ___ degrees, extends from ___degrees to ___degrees
0-70 or 85
0-60 or 75
Motion of selection at the wrist normally exceeds extension by about ___ degrees
10-15
What limits and range extension
Stiff and thick palmar radiocarpal ligaments
First rotates in the frontal plane approximately ___ degrees
50-60
Ulnar deviation occurs from ___ degrees to ___ degrees
0 to 35-40
Radial deviation occurs from ___ degrees to ___ degrees
0 to 15-20
ADLs can be comfortably performed using ___ degrees of flexion, ___ degrees of extension, ___ degrees of radial deviation, ___ degrees of ulnar deviation
40
40
10
30
Extension naturally occurs with ___ deviation, flexion with ___ deviation
Radial
Ulnar
T/F: the rest is a single joint system
F: double joint system
(movement occurring simultaneously at radiocarpal and midcarpal joint)
Central column is made up of what 4 parts?
Distal radius
Lunate
Capitate
3rd metacarpal
W/in central column, radoiocarpal joint = articulations betw ___, medial compartment: mid carpal joint= articulations betw ___, carpometacarpal joint?
Radius and lunate
Lunate and capitate
Capitate and base 3rd metacarpal
Extension occurs as ___ surface of lunate rolls ___ on the radius, and simultaneously slides in a ___ direction
Convex
Dorsally
Palmar
Full wrist ext, elongates ___ radiocarpal lig and all musc cross same side of wrist
Palmar
T/F: scaphoid on radius during flexion of central column follows same direction as lunate, but has a diff speed
T
T/F: during ulnar dev, radoiocarpal joint= contribute to overall wrist mvt
F: midcarpal
About __% of radial dev across wrist occurs @ midcarpal
85
Prox row ___ during radial dev, ___ during ulnar dev
Flex
Ext
Primary cause of carpal instability=
Laxity, rupture of lig
Carpal instability= ___ force tilts lunate (slides down on incline) –> zigzag deformity
Compression
T/F: prox row = susceptible to rotational collapse in zigzag
T
Ulnar translocation of carpus occurs bc
Radius = slanted
___ n innervates all musc cross dorsal side of wrist
Radial
___ n innervates all musc cross palmar side of wrist
Median and ulnar
Radiocarpal and mid carpal joint sensory innervation = _____ n root (in median and radial n)
C6 and C7
Midcarpal joint= also innervated by sensory n traveling to ___ spinal n root via deep branch of ulnar n
C8
T/F: some musc of wrist has line of force that passes precisely through either M-L and A-P AoR
F: NONE
(combination of mvts)
T/F: wrist extensors attach on lat epicondyle
T
ECRL= attaches to__ digit, ECRB? ECU?
L: 2
B: 3
U: 5
Tendons cross dorsal and dorsal-radial side of wrist = secured in place by ____
Extensor retinaculum
Extensor retinaculum prevents
Underlying tendons from bowstringing up and away fr radiocarpal joint during active mvts of wrist
Betw extensor retinaculum and underlying bones= 6 fibro-osseus compartments that house tendons along synovial sheath. How are these compartments referred?
Roman numerals I-VI
Each fibro-osseus compartment houses specific ___
Set of tendons
de Quervain’s tenosynovitis affects which fibro-osseus compartment?
I
What is the main func of wrist extensors?
Pos and stabilize wrist during activities involving active flexion of digits
T/F: injury to median n –> dec grip
F: radial n
Strong, static grip, wrist extensors hold wrist about ___ deg of ext, ___ deg ulnar dev
30-35
5-15
T/F: grip strength= reduced when wrist= fully flexed
T
Lat epicondylitis affects ___ 1st, then ___
ECRB
ECRL
T/F: repetitive forceful grip in flexion direction –> lateral epicondylitis
F: extension
T/F: flexors>extensors total torque @ wrist
T
ABD pollicis longus and extensor pollicis breves provide stability for ___ side wrist
Radial
T/F: ulnar dev>radial dev @ wrist
F: radial>ulnar
