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K&B Test 1 > Wrist > Flashcards

Wrist Flashcards

0
Q

Why does the position of the wrist significantly affect the function of the hand

A

Because many of the muscles and tendons which control the digits originate extrinsic to the hand in the forearm

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1
Q

What is the most impotent function of the wrist

A

Provide adequate function of the hand as well as stability

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2
Q

A weak or painful wrist often assumes a position which will interre with the optimal _____

A

Length tension relationship

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3
Q

What are the two primary articulations in the wrist

A

Mid carpal and radiocarpal joints and there are numerous Intercarpal articulations

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4
Q

_____ serves as a spacer between the distal radioulnar joint and the hand

A

The wrist

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5
Q

_____ separates the extensor Carpi radialis brevis tendon from the extensor pollicis longus

A

Lister’s tubercle or dorsal tubercle

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6
Q

Where does the radial collateral ligament attach

A

Radial styloid process that projects from the lateral side of the distal radius

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7
Q

The surface of the radius is ______ with an ulnar angulation of _____ and a palmar angulation of ______

A

Concave
25 degrees
10 degrees

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8
Q

What is the functional significance of the distal osteology of the radius

A

You has more ulnar deviation and it creates stability because of the way we function

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9
Q

_____ styloid is sharper and smaller

A

Ulnar

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10
Q

What muscle goes around the styloid process of the ulna

A

Extensor Carpi ulnaris

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11
Q

What are the proximal and distal rows of the carpal bones

A

Proximal–scaphoid lunate triquetrum pisiform

Distal– trapezium trapezoid capitate hamate

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12
Q

____ has a proximal and distal pole separated by a waist

A

Scaphoid

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13
Q

How does the scaphoid articulate with the radius

A

Convex proximal surface

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14
Q

Most blood vessels enter the scaphoid through the___

A

Distal pole

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15
Q

_____ is vulnerable to fractures

A

Scaphoid

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16
Q

_____ fractures to the proximal part of this bone often have long healing times and frequently require surgery

A

Scaphoid

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17
Q

How does the lunate articulate with the radius

A

Convex proximally to articulate with the radius

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18
Q

What is the most unstable carpal

A

Lunate

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19
Q

_____ is the most medial in the proximal row of carpal bones

A

Triquetrum

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20
Q

__ is the sesamoid bone

A

Pisiform

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21
Q

_____ is embedded in the flexor Carpi ulnaris tendon

A

Pisiform

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22
Q

_____ serves as an attachment for the abductor digiti minimi and transverse carpal ligament.

A

Pisiform

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23
Q

_____ is concave proximally to articulate with the distal scaphoid

A

Trapezium

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24
Q

How does the trapezium articulate with the thumb

A

The distal end articulates with the base of the first metacarpal and is saddle shaped.

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25
Q

_____ articulates with the scaphoid proximally and second metacarpal distally

A

Trapezoid

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26
Q

____ is the largest bone and is located in the center of the wrist

A

Capitate

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27
Q

What does the capitate articulate with

A

Articulates proximally with the scaphoid and lunate and distally with the third metacarpal

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28
Q

What is the attachment for the transverse carpal ligament

A

Hook of the hamate

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29
Q

____ articulates with the 4th and 5th metacarpals distally

A

Hamate

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30
Q

____ proximally projects towards the lunate

A

Hamate

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31
Q

_____ provides the functional mobility of the ulnar side of the hand

A

Hamate

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32
Q

______ is the space on the palmar side of the wrist between the transverse carpal ligament which arches over the concavity formed by the carpal bones

A

Carpal tunnel

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33
Q

_____ serves as an attaché nt for a number of muscles inside the hand

A

Transverse carpal ligament

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34
Q

What does the carpal tunnel contain

A

The median nerve and extrinsic finger flexor tendons

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35
Q

What is carpal tunnel syndrome

A

Compression of the median nerve within the carpal tunnel

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36
Q

Causes of carpal tunnel are

A

Trauma
Repetitive activity
Systemic illness

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37
Q

Carpal tunnel syndrome leads to

A

Pain
Paresthesias
Numbness
Atrophy of thenar eminance and weakness of median nerve Innervated muscles

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38
Q

What are the two primary articulations of the wrist

A

Radiocarpal joint

Mid carpal joint

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39
Q

_____ row movement depends on ____ row movement for movements of the wrist

A

Proximal

Distal

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40
Q

Proximal row stability and range depend greatly on ____

A

Ligament integrity and articular surface anatomy

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41
Q

The ____ is the linkage between the distal and proximal rows

A

Scaphoid

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42
Q

How does the radiocarpal joint articulate

A

The concave surface of the radius articulates with the convex surface of the scaphoid and lunate. There is also an adjacent articular disc known as the triangular Fibrocartilage.

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43
Q

Stability of the radiocarpal joint is provided by _____

A

Radiocarpal ligaments

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44
Q

_____ resist palmar and ulnar displacement of the scaphoid and lunate

A

Radiocarpal ligaments

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45
Q

How is force transferred during weight bearing on the radiocarpal joint

A

80% through the scaphoid and lunate to the radius

20% transferred to the ulna through the articular disc

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46
Q

_____ articulation between the proximal and distal rows of carpals

A

Mid carpal joint

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47
Q

What is the medial compartment

A

Convex head of the capitate articulates with concave surface of the scaphoid, lunate and triquetrum

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48
Q

What is the lateral compartment

A

Concave surface of the trapezium and trapezoid articulates with the convex distal pole of the scaphoid.

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49
Q

Which compartment has less movement

A

Lateral

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50
Q

Ligaments are classified into which two types

A

Intrinsic and extrinsic

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51
Q

What are the functions of the ligaments

A

Maintain alignment of the carpal bones
Transfers forces between carpal bones
Transfers forces across the proximal and distal rows
Provide sensory feedback

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52
Q

What are the extrinsic ligaments

A

Dorsal radiocarpal
Radial collateral
Palmar radiocarpal

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53
Q

_____ reinforces the posterior radiocarpal joint, guides motion in the proximal row

A

Dorsal radiocarpal ligament

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54
Q

The dorsal radiocarpal ligament restrains____

A

Anterior dislocation of the lunate

55
Q

_____ restrains ulnar deviation

A

Radial collateral ligament

56
Q

_____ made up of three ligaments that are stronger and thicker than the dorsal ligaments

A

Palmar radiocarpal ligaments

57
Q

______ restrain wrist extension

A

Palmar radiocarpal ligament

58
Q

_____ bindw the radius and the ulna together while allowing the radius to rotate around the fixed ulna.

A

Triangular Fibrocartilage complex

59
Q

What does the TFCC stabilize

A

The distal radioulnar joint

60
Q

What does the TFCC reinforce

A

The ulnar side of the wrist

61
Q

TFCC is a _____ disc that is in a triangular shape

A

Biconcave

62
Q

What does the TFCC articulate with

A

Proximally with the ulna

Distally with the lunate and triquetrum

63
Q

The central portion of the TFCC disc is _____ a vascular

A

80 percent

64
Q

What are the ligaments in the ulnocarpal space

A

Palmar ulnocarpal ligament

Ulnar collateral ligament

65
Q

_____ reinforce the ulnar side of the wrist while allowing pronation and supination

A

Palmar ulnocarpal ligament

Ulnar collateral ligament

66
Q

____ fills the gaps in the ulnocarpal space

A

Meniscus “homologue”

67
Q

_____ link the bones in the sme row

A

Intrinsic wrist ligaments

68
Q

The intrinsic wrist ligaments are stronger ____ than ____

A

Volarly

Dorsally

69
Q

What are the ligaments of the intrinsic wrist

A

Short ligaments
Long ligaments
Intermediate ligaments

70
Q

_____ connects the bones of the distal row and provides stability and allows them to function as a single mechanical row.

A

Short ligaments

71
Q

What are the intermediate ligaments

A

Lunatotriquetral
Scapholunate
Scaphotrapezium

72
Q

What are the long ligaments

A

Dorsal and palmar intrinsics

73
Q

The long ligaments help to ____

A

Guide motion

74
Q

What are the ranges for flexion and extension

A

Flexion is 0-85 with normal values around 70-85

Extension is 0-75

75
Q

Ranges for ulnar and radial deviation

A

Ulnar deviation is 0-40 with 35-40 being normal

Radial deviation is 0-20 with normal being 15-20

76
Q

Where is the axis of rotation for the wrist

A

Through the capitate

77
Q

Extension combines with

A

Radial deviation

78
Q

Flexion is combined with

A

Ulnar deviation

79
Q

Extension and radial deviation can be limited by

A

Tightness in the palmar radiocarpal ligament

80
Q

What is the closed packed position for the radiocarpal joint

A

Extension combines with radial deviation

81
Q

What is the functional position of the hand and wrist

A

Wrist 20-30 extension
10 ulnar deviation

Fingers:
Mp-40
Pip-30
Dip-slight flexion

82
Q

Forces across the ____ reach amounts of ten times greater then the force applied at the _____

A

Distal carpal row

Fingertips

83
Q

The central column concept is from what plane of motion

A

Sagittal

84
Q

What is the central column concept

A

Radiocarpal joint: radius and lunate

Mid carpal: lunate and capitate

Carpometacarpal: capitate and 3rd metacarpal

85
Q

Where does active move to begin in Sagittal plane motion

A

At the distal carpal row

86
Q

When do the proximal carpal row move in Sagittal plane motion

A

When the tension is created by the ligaments crossing the midcarpal joints

87
Q

Arthrokinematics of extension at the radiocarpal joint

A

Convex surface of the lunate rolls Dorsally and slides palmarly on the concave surface of the radius

88
Q

Arthrokinematics of extension at the midcarpal joint

A

Capitate rolls Dorsally on the lunate and slides palmarly

89
Q

What is the closed packed position of extension

A

Palmar ligaments and muscles stretch into tension and stabilize the wrist

90
Q

Arthrokinematics of flexion at the radiocarpal joint

A

Convex surface of the lunate rolls palmarly and slides Dorsally on the concave radius

91
Q

Arthrokinematics of flexion at the midcarpal joint

A

Convex head of the capitate rolls palmarly and slides Dorsally on the concave lunate

92
Q

Arthrokinematics of flexion at the scaphoid joint

A

Rolls similarly to the lunate, displacement restrained by the scapulolunate ligament.

93
Q

Arthrokinematics of ulnar deviation at the radiocarpal joint

A

Scaphoid lunate and triquetrum roll ulnarly and slide radially

94
Q

Arthrokinematics of flexion at the midcarpal joint

A

Capitate rolls ulnarly and slides radially

95
Q

What happens at full range of ulnar deviation in regards to arthrokinematics

A

Triquetrum contacts the articular disc

Hamate compressed against the triquetrum

Proximal row pushed against the styloid process of the radius

96
Q

_____ helps stabilize the wrist for gripping

A

Ulnar deviation

97
Q

Arthrokinematics of radial deviation at the radiocarpal joint

A

Scaphoid lunate and triquetrum roll radially and slide ulnarly

98
Q

Arthrokinematics of radial deviation at the midcarpal joint

A

Capitate rolls radially and slides ulnarly

99
Q

What is the closed packed position of radial deviation

A

Full radial deviation

100
Q

During radial deviation the ____ flexes but the ____ stays neutral due to the extension moment exerted by the triquetrum if all the ligaments are intact

A

Scaphoid

Lunate

101
Q

_____ attach distally to the carpus and extend only the wrist

A

Primary wrist extensors

102
Q

_____ cross the carpus and attach to the metacarpals of digits and extend the wrist and the digits

A

Secondary wrist extensors

103
Q

Where does the axis of rotation pass

A

Through the capitate bone

104
Q

What are the primary wrist extensors

A

Ecrl
Ecrb
Ecu

105
Q

What are the secondary wrist extensors

A

Ed
EI
EDM
EPL

106
Q

All wrist muscles produce torques in what plane(s)

A

Sagittal and frontal

107
Q

What is the action of ecrl

A

Wrist extension and radial deviation

108
Q

_____ originates proximally at the lateral epicondyle and attaches distally on the second metacarpal

A

Ecrl

109
Q

_____ gives a greater moment arm for radial deviation

A

Ecrl

110
Q

______ originates on the lateral epicondyle and attaches distally to the third metacarpal

A

Ecrb

111
Q

_____ gives a greater moment arm for extension

A

Ecrb

112
Q

Injury to_____ will cause decreased grip strength and decreased strength in wrist extension and radial deviation

A

Ecrl and ecrb

113
Q

Action of the ecu

A

Extends and ulnarly deviates the wrist with the forearm supinated, less effective as a wrist extensor with the forearm pronated

114
Q

_____ assists the TFCC in providing stability to the ulnar side of the wrist

A

Ecu

115
Q

What is the main function of wrist extensors

A

To position and stabilize the wrist during finger activity

116
Q

Making a fist requires synergistic muscle activity between?

A

Long finger flexors and wrist extensors

117
Q

____ is recruited first in the light grip

Moderate is _____

Strong is _____

A

Ecrb
Ecrl
Ecu

118
Q

What is the best position for strong grip

A

In 30-35 degrees of wrist extension and 5 degrees of ulnar deviation. This optimizes the length tension relationship

119
Q

Why is flexion not the best position to have string grip

A

With the wrist flexed, the fingers cannot generate any torque because they are in a shortened position and are fighting against passive extensor torque.

120
Q

What are the primary wrist flexors

A

Flexor Carpi radialis
Flexor Carpi ulnaris
Palmaris longus

121
Q

What are the secondary wrist flexors

A

FDP
FDS
FPL

122
Q

____ originate on the medial epicondyle and work synergistically during wrist flexion

A

FCU and FCR

123
Q

_____ attaches to the palmar surface of the second and third metacarpal and does flexion and radial deviation

A

FCR

124
Q

_____ attaches to the pisiform, pisohamate and pisometacarpal ligament, and the 5th metacarpal. Does flexion and ulnar deviation

A

FCU

125
Q

______grnerates the most torque of the wrist flexors

A

FCU

126
Q

____ anchors the skin and cassia of the hand

A

Palmaris longus

127
Q

What are the radial deviatiors

A 
ECRB
ECRL 
FCR
EPL
EPB
APL 
FPL
128
Q

______ produce the greatest torque into radial deviation

A

ECRL and APL

129
Q

_____ provide stability to the radial side of the wrist augument in the radial collateral ligament

A

APL and EPB

130
Q

____ work synergistically as prime generators of radial deviation

A

ECRL and FCR

131
Q

_____ is inflammation of degenerative tendinopathy of the APL and EPB (first dorsal compartment).

A

DeQuervain’s synovitis

132
Q

Hoe does dequervain’s synovitis occur

A

Due to then overduse or repetitive strain injury

133
Q

Dequervain’s is common in who

A

Mothers with new babies

134
Q

What is finkelstein’s test

A

Ulnar deviation with the thumb flexed inside of the fist= severe pain

135
Q

What are the secondary ulnar deviatiors

A

FDP
FDS
Ed

K&B Test 1 (4 decks)

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