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DPT 502 > wrist and hand > Flashcards

wrist and hand Flashcards

1
Q

what is the job of the wrist?

A

to fine tune hand position

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2
Q

what are the 3 parts of the distal ulna?

A

ulnar styloid process

fovea

pole

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3
Q

what 2 parts of the ulna are attachment sites for fibrocartilage?

A

the fovea and pole

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4
Q

t/f: the distal ulna is not in direct contact with the carpals

A

true

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5
Q

what forms the roof of the RC joint?

A

the TFCC

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6
Q

what is the function of the TFCC?

A

act as stabilizer at ulna

hold ulnar side of the wrist in place

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7
Q

what is the primary bone of the wrist?

A

the distal ulna

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8
Q

where is Lister’s tubercle and what does it do?

A

on the dorsal side of the hand

redirects the pull of the ECL

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9
Q

which is more distal, the radial or ulnar styloid process?

A

the radial styloid process

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10
Q

the radial styloid process is the attachment site for _____ _____ ligaments and the ulnar styloid process is the attachment sites for _____ _____ ligaments

A

radial collateral, ulnar collateral

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11
Q

what are the distal articulating RU joint surfaces?

A

the ulnar head and ulnar notch

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12
Q

what carpal bones does the distal radius articulate with?

A

the scaphoid and lunate

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13
Q

what is the most commonly fractured carpal bone?

A

scaphoid

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14
Q

what is the most frequently dislocated carpal bone?

A

lunate

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15
Q

what carpal bone occupies the central position?

A

capitate

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16
Q

what carpal bone provides the FCU attachment?

A

pisiform

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17
Q

what is unique about the hamate?

A

it has a hook feature

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18
Q

what are the most mobile carpal bones?

A

scaphoid, trapezium, lunate, and triquetrum

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19
Q

what carpal bone provides the axis for radial/ulnar deviation and flexion/extension at the wrist?

A

capitate

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20
Q

what 2 carpal bones make up the boundaries of the snuff box?

A

scaphoid and trapezium

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21
Q

what are the articulating surfaces of the radiocarpal jt?

A

concave distal radius and convex proximal carpals

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22
Q

what kind of joint is the RC jt?

A

ellipsoid-2DF

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23
Q

what are the actions at the RC jt?

A

flexion/extension

radial/ulnar deviation

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24
Q

t/f: the TFCC is at risk for damage

A

true

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25
Q

what is OPP of the RC jt?

A

0-20 deg flexion

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26
Q

what is the CPP of the RC jt?

A

full radiation deviation and extension

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27
Q

what is (+) ulnar variance?

A

longer ulna compared to radius; indicates TFCC injury

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28
Q

what is (-) ulnar variance?

A

shorter ulna compared to radius (normal)

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29
Q

what kind of joint is the midcarpal jt?

A

nonaxial gliding planar jt

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30
Q

what motions are allowed at the midcarpal jt?

A

wrist flexion/extension

radial/ulnar deviation

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31
Q

what are the jt surfaces of the midcarpal jt?

A

b/w the proximal and distal row of carpal bones

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32
Q

what do the intrinsics connect?

A

the carpal bones to each other

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33
Q

what do the extrinsics connect?

A

carpal bones to radius and ulna

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34
Q

are the TFCC structures part of the extrinsics or intrinsics?

A

extrinsics

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35
Q

what are the flexor and extensor retinaculums?

A

contain the tendons and sometimes nerves that go to fingers

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36
Q

what do the retinaculums create?

A

transverse carpal arch

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37
Q

what creates the carpal tunnel?

A

the transverse carpal ligament connecting the hook of the hamate and pisiform as well as the pisiform, trapezium, and scaphoid

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38
Q

during flexion at the wrist, where does the axis migrate?

A

distally

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39
Q

what is the end feel for wrist flexion?

A

firm

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40
Q

where does the axis migrate during wrist extension?

A

proximally

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41
Q

what is the end feel of wrist extension?

A

firm

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42
Q

what is the ML axis for wrist flexion/extension?

A

the capitate

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43
Q

what is the AP axis for radial/ulnar deviation?

A

the capitate

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44
Q

t/f: the scaphoid doesn’t move as much as the lunate

A

true

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45
Q

t/f: the largest amount of deviation comes from the distal row of carpals?

A

true

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46
Q

what is the end feel for radial deviation?

A

bony

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47
Q

what jts are responsible for radial deviation?

A

1/2 midcarpal
1/2 radiocarpal

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48
Q

what is the end feel for ulnar deviation?

A

firm

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49
Q

what jts are responsible for ulnar deviation?

A

1/3 midcarpal
2/3 radiocarpal

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50
Q

what are the arthrokinematics at the wrist during extension?

A

posterior roll

anterior glide

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51
Q

what are the arthrokinematics at the wrist during flexion?

A

anterior roll

posterior glide

52
Q

what are the arthrokinematics at the wrist during radial deviation?

A

proximal carpals glide in ulnar direction

roll in radial direction

53
Q

what are the arthrokinematics during ulnar deviation?

A

roll in ulnar direction

glide in radial direction

54
Q

what is CPP at the wrist?

A

full extension

55
Q

the distal row of carpals is ____ and the proximal row is ____

A

concave, convex

56
Q

what are the thumb motions?

A

flexion/extension, abduction/adduction, opposition

57
Q

what motion is allowed at the CMC joints of digits 2-5?

A

gliding

58
Q

what digits are the stable pillars at the CMC?

A

2nd and 3rd

59
Q

what digits have significant motion at the CMC?

A

4th and 5th

60
Q

what is the function of the palmarly curved shafts of the metacarpals?

A

fit of objects in the hand

61
Q

where is the volar plate located?

A

at the MCP and IP jts

62
Q

where does the volar plate migrate during extension?

A

proximally

63
Q

what is the role of the volar plate?

A

congruency and protection against hyperextension

64
Q

is the collateral lig more lax with extension or flexion?

A

extension

65
Q

is the collateral lig more tight with extension or flexion?

A

flexion

66
Q

what part of the phalanges are bi-concave with 2 facets?

A

bases

67
Q

what part of the phalanges are bi-condylar (convex)?

A

heads

68
Q

how many phalanges does each digit have?

A

thumb-2
all other digits-3

69
Q

what kind of jt is the MCP jt?

A

biaxial condyloid with 2 DF

70
Q

what are the actions of the MCP jts?

A

flex/ex, abd/add

71
Q

what are the jt surfaces of the MCP jts?

A

convex metacarpal heads

concave phalange bases

72
Q

what kind of jt is the IP jt?

A

uniaxial with 1 DF

73
Q

what actions do the IP jts allow?

A

flex/ex

74
Q

how many IP joints do each digit have?

A

thumb-1

digits-2

75
Q

what digit is the reference for abd/add?

A

the middle finger

76
Q

when the MCPs are extended, the fingers can ____

A

abduct

77
Q

when the MCPs are flexed, the fingers can _____

A

adduct

78
Q

when you close your first, where do the fingers converge toward?

A

toward the scaphoid

79
Q

what is the end feel at the MCPs for flex/ex?

A

firm

80
Q

what is the CPP of the MCPs?

A

full MCP flexion

81
Q

why is abduction allowed with with extension?

A

bc the collaterals become loose with extension

82
Q

why is no abduction allowed with flexion?

A

bc the collaterals become tight with flexion

83
Q

what ligament helps control the volar plate?

A

the accessory ligament

84
Q

is the volar plate on the palmar or dorsal side?

A

palmer

85
Q

what ligament attaches to volar plate and runs b/w the metacarpals heads?

A

the deep transverse ligament

86
Q

what kind of jt in the MCP of the thumb?

A

hinge jt

87
Q

what is the role of the sesamoid bones

A

dynamic rotation of the thumb segment

fine tuning grip

increased tendon leverage

88
Q

what attaches to the radial sesamoid bone?

A

flexor pollicus brevis and adductor pollicus brevis

89
Q

what attaches to the ulnar sesamoid bone?

A

adductor pollicus brevis

90
Q

what kind of jts are the DIPs and PIPs?

A

hinge jts with 1 DF

91
Q

what are the supporting structures of the IP jts?

A

jt capsule, collateral ligs, volar plate

92
Q

what does the deep transverse metacarpal ligament attach to?

A

the metacarpal heads

93
Q

what is the OPP of the MCP and IPs?

A

20 deg flexion ???

94
Q

what is the tendinous system?

A

3 bands/tendons of the extensor

1 central band and 2 lateral bands on either side

95
Q

what is the retinacular system?

A

thickened fascia holding tendons in place

96
Q

what are the flexor pulleys?

A

palmar fascia and annular ligaments

97
Q

what is the palmar fascia?

A

instrinsic- triangular structure in the palm that covers the underlying neurovascular structures, tendons, and ligaments

98
Q

what do the annular ligaments do?

A

maintain tendons w/in their positions during flexion

99
Q

what is vow stringing?

A

strong contraction causing tendon to be pulled away from the jt axis of rotation

100
Q

what allows for function of the hand?

A

synergistic activity of the wrist and finger functions

101
Q

what happens when you close your fist?

A

finger flexion with wrist extension and finger adduction

102
Q

what happens when you open your fist?

A

finger extension with wrist flexion and finger abduction

103
Q

what is a power grip?

A

more extrinsic force with less emphasis on precision

104
Q

what is the non-prehensile grip/hook?

A

holding a bag without the thumb use

105
Q

what are the prehensile grips?

A

cylinder

sphere

fist

106
Q

what is the cylinder grip?

A

grabbing a water bottle

107
Q

what is the sphere grip?

A

holding a ball

108
Q

what is the fist grip?

A

holding a thinner object like a hammer

109
Q

what are the precision grips?

A

lateral pinching, 3 prong chuck, and tip to tip grips

110
Q

what are the power grips?

A

non-prehensile (hook) and prehensile (cylinder, sphere, and fist) grips

111
Q

what is a precision grip?

A

intrinsic controls for precision and less force

112
Q

what is the lateral pinch grip?

A

key pinch

pad of thumb along the lateral aspect of the index finger

113
Q

what is the 3 prong chuck grip?

A

holding a pen

thumb opposing index and middle finger

114
Q

what is the tip to tip grip?

A

holding a USB

thumb and index finger pads facing each other

115
Q

power grip

A

gross grasp

partially flexed fingers and counterpressure from the thumb

finger flexion w/wrist stabilized in extension

optimal wrist: 20-30 deg ext with slight ulnar deviation

significantly weakened with wrist flexion

116
Q

precision grip

A

accuracy and refinement

object manipulation

uses thumb and one or more digits to improve grip security or to add variable amounts of force

117
Q

grip strength is ____ times greater in males

A

2

118
Q

grip strength is ___ % stronger on the dominant hand

A

6

119
Q

what is the sensory innervation of the hand?

A

superficial branches of the median, ulnar, and radial nerves

SC segments C5-T1

120
Q

what does the radial nerve innervate?

A

wrist extensors

121
Q

what does the median nerve innervate?

A

most wrist flexors (not FCU)

122
Q

what does the ulnar nerve innervate?

A

most small muscles in the hand (not FDP or thenar muscles)

123
Q

what does radial injury result in?

A

wrist drop

124
Q

what does median injury result in?

A

hand of benediction

inability to oppose

finger cant go into flexion

paralyzed thenar muscles

125
Q

what does ulnar injury result in?

A

claw hand

injury in 4th and 5th digits

paralyzed intrinsics

126
Q

what is the intrinsic plus position?

A

MCP flexion with IP extension

shortest interossei and lumbrical position

contracture of intrinsic muscles

127
Q

what is the intrinsic minus position?

A

MCP extension with IP flexion

paralysis of interossei and lumbricals

“claw hand”

DPT 502 (9 decks)

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