Wrist and Hand Complex Flashcards
How many DOF does the wrist have ?
2 DOF
Normal ROM of wrist?
80/70 flx/ext
20/30 rad/ulnar dev
wrist end feels
flx/ext- capsular
rad dev-hard (radial styloid process)
uln dev- capsular
what is the capsular pattern of the wrist?
flexion and extension are equally limited
Most unstable carpal bone?
lunate
Ligaments damaged makes it easier for bones to luxate
Shape of the carpal bones
scaphoid- like a boat
lunate-moon
triquetem- triangular
pisiform- shaped like a pea
capitate- captain of the carpals(largest)
trapezium-assymetric shape
trapezoid-like a table
hamate-like a hook
Triangular fibrocartilage complex (TFCC)
securely bind distal ends of the radius and ulna
Kinematics of wrist flexion and extension
convex on concave
flexion : palmary roll dorsal slide
extension: dorsal roll palmar glide
Kinematics of wrist in deviation
convex on concave
proximal capral row slides opposite of motion
What is they keystone of the proximal transverse arch?
capitate
proximal transverse arch
forms tunnel for which the long finger flexors and median nerve to travel
how many DOF in metacarpophalengeal and kinematics
2 dof
flx /ext concave phalynx on convex metacarpal
add/abd concave phalanyx on convex metacarpal
IP joint
1 DOF- flx /ext
true synovial joint
lumbricals and interossei
contraction produces MCP flx and IP/DIP ext
thumb
2 DOF
flx/ext abd/add circumduction=opposition
saddle joint
kinematics of the thumb flx/ext
flexion: convex metacarpal rolls and slides in ulnar with slight medial rot
extension: concave surface of metacarpal rolls and slides in radial direction with slight lateral rotation
kinematics of thumb abd/add
abd: convex metacarpal rolls in a plamar direction and slides dorsal
add: convex metacarpal rolls dorsal and slides palmar
prehesion
grasping or taking hold
ex . grabbing baseball bat
power grip
full hand prehension
precision handling
finger thumb prehension
cylindrical grip
uses finger flexors to postion fingers around and maintain grasp on object
spherical grip
the greater spread pf fingers to encompass the object
hook grip
briefcase grip
never includes thumb
lateral prehension
contact between two adjacent fingers
pad to pad prehension
distal phalynx or pad of thumb to another finger
tip to tip prehension
nearly identical to pad to pad
pad to side
key grip
functional position of the hand
20 deg ext
10 deg ulndar deviate
slight dlexion at PIP and DIP
boutonniere deformity
failure of the extensor hood mechanism
extension of pip
swan neck deformity
damage to attathcment of extensor tendon
trigger finger
caused by edema and subsequent narrowing of A1 pulley on typically third or fourth finger
4x more likely in diabetics
what is the sesamoid bone of the wrist?
pisiform
MCP kinematics
MCP flexion palmar roll palmar glide
MCP extension dorsal roll dorsal glide
What planes of motion are done in the thumb?
ext/flx done parallel to hand
add/ abd perp to hand
what is convex and what is concave?
carpals are convex , radius is concave
