Wrist and Hand Flashcards
4 characteristics of hand function
assume variety of postures
change positions (able to accommodate different sizes of same shape)
Versatility: power and fine motor
Accommodate unique shapes
How many bones in the hand
27
what wrist bone is most commonly broken with a FOOSH
scaphoid
What carpal bones attach to the transverse carpal ligament
scaphoid
triquetrum
What is the keystone of the proximal row
what is the keystone of the distal row
lunate (proximal)
Capitate (distal)
What is the normal degree of radial inclination
how much shorter/longer can the ulna be compared to the radius while still being functional
22-23 degrees
2mm
The MCP collateral ligaments are elongated during ______
The IP collateral ligaments are elongated during _______
flexion
ext
(this is why a resting hand splint has MCP flexion and IP ext, same position as lumbricals!)
What is the proper resting hand splint position?
MCP flexion
IP ext
What are the most important pulleys in the hand?
A2 and A4
What are the structures that go through the carpal tunnel
4 tendons of FDS
4 tendons of FDP
Median nerve
FPL tendon
(10 structures total)
What are the 2 structures that go through guyon’s canal?
Ulnar Nerve
Ulnar artery
What muscles are in compartment 1 of the extensor tendons?
Abductor Pollicis Longus (APL)
Extensor Pollicis Brevis (EPB)
What is in the second extensor compartment
Extensor Carpi Radialis Brevis and Longus
t
What is in compartment 6 of the extensors
Extensor carpi ulnaris
The radiocarpal joint contributes more to ___________, the midcarpal joint contributes more to ____________
Radio-carpal: wrist flexion
Midcarpal: wrist extension
How many muscles attach to the proximal row of the carpal bones?
none!!
When you have wrist flexion, the distal row moves as a unit and the proximal row _________________
rotates in same direction as the distal row and slides in opposite direction
If you lose A2 flexor pulley, how much of your ROM will be lost?
10% or 26 degrees
For what precautions would we want to discontinue edema treatment
DVT/Thrombosis
Discoloration
Change in sensation
At what 2 levels of the hand grip dynomometer will a pt be the strongest
What shape should the strength curve be in?
At level 2 and 3 (best at 2)
Bell curve
Wrist drop sign is a problem of what nerve
Radial
Pt with a radial nerve injury will have problems with what task
power grip
limited ability to receive objects
inability to perform prehensile grip patterns
Hand of benediction is a sign of what nerve problem
median
Claw hand is a problem of what nerves? d/t what 2 muscles?
ulnar nerve
loss of 3rd and 4th lumbricals
Whats the difference between claw hand and hand of benediction?
Claw hand= 4th and 5th MCP is in hyperextension
What hand sign will people with median nerve injuries be unable to do?
OK sign
To treat carpal tunnel we want to __________
stretch the muscles of the carpal tunnel
T or F: immobilization is recommended for trigger finger
T, it stops the pt from continually making it more inflamed through use
Which way do you glide the proximal carpal row for increasing wrist EXT?
Towards flexion (toward the palm)
What are 2 methods to measure swelling in the hand
Figure 8 measurement
Volumentric (water displaced)
