wrist and hand test questions Flashcards
What is the importance of the articulating disk in the distal radioulnar joint?
it is the primary stabilizer and separates the distal radoulnar joint from the radiocarpal joint
primary stabilizer in the distal radoulnar joint and separates the distal radioulnar joint from the radiocarpal joint
what is the distal link to the upper extremities open kinetic chain?
the hand
what forms the radiocarpal joint?
articulation of the radius and ulna with the proximal row of carpal bones
- concave surface of radial facets and TFCC disc with convex surface of the scaphoid, lunate and triquetrum
- -radius articulates with the scaphoid and lunate
- -TFCC articulates with the lunate and triquetrum
where is the attachment site for the TFCC?
Ulna
what forms the distal radioulnar joint?
convex ulnar head and concave ulnar notch of the radius
-includes TFCC and articulating disc
what is the function of the Triangular fibrocartilage complex? (TFCC)
- transmits the axial load from the hand to the forearm, cushions weight-bearing forves, and is an attachment site for ligaments
- provides stability in the distal radioulnar joint
when can the TFCC be injuired?
falls and repetitive movements
how can you develop carpal tunnel?
structural changes (heredity or trauma) postural changes (overuse or wrist position during functional activities) volume changes (synocitis, irritation, or overuse causing swelling)
what does the first CMC joint articulate with?
base of the 1st metacarpal and the distal surface of the trapezium
when are the medial and lateral collareral ligaments tight? (in the hand)
Tight: abduction and adduction
what prevents hyperextension in the MCP, PIP and DIP joints?
the volar plate
function of the transverse metacarpal ligament
connects the heads of the metacarpals
what is the palmar aponeurosis
dense fibrous structure that continues with the palmaris longus tendon
what does the palmar aponeurosis cover?
thenar and hypothenar muscles
what is dupuytren’s contracure?
pathological scarring of the palmar aponeurosis
what creates the middle and lateral bands of the extensor hood? where do each band insert into?
middle: tendon of the extensor digitorum (inserts into the base of the middle phalax)
lateral: continuation of the lumbricals and the interossei insertions (inserts into the distal phalanx)
what creates the proximal transverse arch
CMC motion of the thumb
what creates the distal transverse arch?
flexion of the 2nd and 3rd digit
what is the significance of the arches of the hand?
allows the hand to conform to a variety of objects
what resists excess movement during 1st CMC add/abduction
intermetacarpal ligament, anterior oblique ligament, and adductor pollicis
what resists excess movement during 1-5 MCP flexion
dorsal capsule and radial carpal ligament
what resists excess movement during1-5 MCP extension
palmar plate
what resists excess movement during 1-5 MCP abduction
ulnar collateral ligament
what resists excess movement during 1-5 MCP adduction
radial collateral ligament
what resists excess movement during IP, PIP, DIP flexion
dorsal capsule
what resists excess movement during IP, PIP, DIP extension
volar plate
what is Ape hand? what is affected/weak?
(1) median nerve lesion
(2) no flexion in the index and middle fingers
(2) weak flexion in the 4th and 5th digit
(2) 2nd and 3rd lumbricals will not work affecting extension at MCP joints
(2) thenar muscles will not fire=atrophy
what is wrist drop? what is affected/weak?
(1) radial nerve lesion
(2) loss of wrist extensor muscle innervation
(2) unable to extend the MCP joints
(2) grip strength lost
what is claw hand? what is affected/weak?
(1) ulnar nerve lesion
(2) 4-5 MCP joints held in extension and PIP joints flex
(2) finger abduction and adduction are lost
(2) atrophy of the hypothenar eminence with an inability to adduct the thumb
(2) wrist flexion power decreases
what is swan neck deformity?
- hyperextension of the PIP, flexion of DIP
- spasm or contracture of intrinsic muscles
what is boutonniere deformity?
- MCP extension, PIP flexion and DIP extension
- caused by rupture of central band
what is intrinsic minus hand?
- paralysis of the intrinsic muscles
- leads to hyperextension of the MCP joints and flexion of the IP joints
- occurs with combined ulnar and median nerve injuries
