Wrist and hand

Question 1

Wrist Joint

Answer 1

Radiocarpal Joint
 Biaxial condyloid joint

Question 2

Motions of the wrist joint

Answer 2

 Extension
 Flexion
 Radial deviation
 Ulnar deviation
 Circumduction

Question 3

ROM

Answer 3

40 degrees of extension and flexion
 40 degrees composite ulnar and radial deviation

Question 4

Extrinsic Motions of the Hand

Answer 4

Thumb, which has 3 joints
 Thumb is also called digit #1
 Fingers, which have 3 joints
 Each finger is numbered digits #2 through #5

Question 5

Joints of the Thumb Include

Answer 5

 Carpometacarpal (CMC) joint
 Metacarpophalangeal (MCP) joint
 Interphalangeal (IP) joint

Question 6

Joints of the Fingers Include

Answer 6

 Metacarpophalangeal (MCP) joint
 Proximal interphalangeal (PIP) joint
 Distal interphalangeal (DIP) joint

Question 7

Motions of the Thumb Include

Answer 7

 Carpometacarpal (CMC) joint
 Flexion
 Extension, also called radial abduction
 Abduction, also called palmar abduction
 Adduction
 Opposition
 Reposition
 Metacarpophalangeal (MCP) joint
 Flexion and extension
 Interphalangeal (IP) joint
 Flexion and extension
 Hyperextension

Question 8

Opposition of the thumb also occurs when

Answer 8

the tip of the thumb
comes in contact with the tip of a finger.
 Thumb opposition is a combination of thumb flexion and abduction.
 Reposition is the movement of the thumb as it returns from
opposition

Question 9

Extrinsic Motions of the fingers include

Answer 9

 Metacarpophalangeal (MCP) joint
 Flexion and extension
 Hyperextension
 Proximal interphalangeal (PIP) joint
 Flexion and extension
 Distal interphalangeal (DIP) joint
 Flexion and extension

Question 10

Distal Radius Fractures

Answer 10

 There are different types of distal radius fractures.
 Most occur from falls on outstretched arms. FOOSH stands for
fall on outstretched hand.
 Most common type of distal radius fracture is a Colles’ Fracture

Question 11

Colles’ Fracture

Answer 11

A distal radius fracture with dorsal displacement of the distal
fragment
 Medical treatment may include
 Closed reduction followed by casting
 Percutaneous pin fixation
 External fixation
 Open reduction with internal fixation

Question 12

Occupational therapy goals should be to maximize pain-free ROM for the

Answer 12

Forearm and wrist
 Finger and thumb
 Elbow and shoulder

Question 13

Colles’ Fracture Complications

Answer 13

 Carpal tunnel syndrome
 Malunion
 Complex regional pain syndrome (CRPS), also called RSD
 Tendon rupture

Question 14

de Quervain’s Disease

Answer 14

inflammation of tendon sheaths
- Repetitive motion of thumb and wrist
 Pain, swelling, and tenderness over anatomical snuff box
 Finkelstein’s Test
 Treatment may include activity modification, splinting, adaptive
equipment, exercise, surgery

Question 15

TFCC Tear

Answer 15

Triangular Fibrocartilage Complex
 May result from FOOSH
 Ulnar wrist pain, swelling, decreased grip strength
 Treatment may include splinting, activity modification, adapted
equipment, surgery, scar and edema management, exercise

Question 16

Fractures of the Scaphoid

Answer 16

 May be caused by FOOSH
 Pain, swelling, tenderness over snuff box
 Diagnosis made by X-ray, bone scan and/or MRI
 Treatment may involve casting, surgery, splinting, gentle AROM,
PROM, strengthening exercises

Question 17

Muscles that primarily move the wrist but do not cross into the hand and fingers

Answer 17

 Flexor carpi ulnaris (FCU)
 Flexor carpi radialis (FCR)
 Palmaris longus (PL)
 Extensor carpi radialis longus (ECRL)
 Extensor carpi radialis brevis (ECRB)
 Extensor carpi ulnaris (ECU

Question 18

Muscle Actions of the Wrist

Answer 18

 Flexor carpi ulnaris (FCU)-Prime mover in wrist flexion and ulnar deviation
 Flexor carpi radialis (FCR)-Moves the wrist in flexion and radial deviation
 Palmaris longus (PL)-Third wrist flexor, but small and weakest flexor
 Extensor carpi radialis longus (ECRL)-Prime mover in wrist
extension and radial deviation
 Extensor carpi radialis brevis (ECRB)-A strong wrist extensor but only assists with radial deviation
 Extensor carpi ulnaris (ECU)-Moves the wrist in extension and ulnar deviation

Question 19

Extrinsic Muscles of the Hand

Answer 19

anatomical snuffbox
 Abductor pollicis longus (APL)
 Extensor pollicis longus (EPL)
 Extensor pollicis brevis (EPB)

Question 20

Nerve Innervation of the Wrist

Answer 20

 Flexor carpi ulnaris (FCU)
 Ulnar nerve, C8 and T1
 Flexor carpi radialis (FCR)
 Palmaris longus (PL)
 FCR and PL- median nerve, C6 and C7
 Extensor carpi radialis longus (ECRL)
 Extensor carpi radialis brevis (ECRB)
 Extensor carpi ulnaris (ECU)
 ECRL, ECRB, ECU- radial nerve, C6, C7, and C8

Question 21

Extrinsic ligament

Answer 21

 Palmar radiocarpal ligament-limits extension
 Dorsal radiocarpal ligament-limits flexion
 Ulnar and radial collateral ligaments-limit radial and ulnar
deviation
 Ulnocarpal complex

Question 22

Intrinsic ligament

Answer 22

 Palmar and dorsal midcarpal ligaments
 Interosseous ligaments
 All intrinsic ligaments stabilize carpal bones

Question 23

Transverse Carpal Ligament

Answer 23

 Also referred to as flexor retinaculum
 Supports carpal arch
 Creates carpal tunnel