wrist and hand test questions

Question 0

What is the importance of the articulating disk in the distal radioulnar joint?

Answer 0

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

Question 1

what is the distal link to the upper extremities open kinetic chain?

Answer 1

the hand

Question 2

what forms the radiocarpal joint?

Answer 2

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

Question 3

where is the attachment site for the TFCC?

Answer 3

Ulna

Question 4

what forms the distal radioulnar joint?

Answer 4

convex ulnar head and concave ulnar notch of the radius

-includes TFCC and articulating disc

Question 5

what is the function of the Triangular fibrocartilage complex? (TFCC)

Answer 5

• 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

Question 6

when can the TFCC be injuired?

Answer 6

falls and repetitive movements

Question 7

how can you develop carpal tunnel?

Answer 7

structural changes (heredity or trauma)
postural changes (overuse or wrist position during functional activities)
volume changes (synocitis, irritation, or overuse causing swelling)

Question 8

what does the first CMC joint articulate with?

Answer 8

base of the 1st metacarpal and the distal surface of the trapezium

Question 9

when are the medial and lateral collareral ligaments tight? (in the hand)

Answer 9

Tight: abduction and adduction

Question 10

what prevents hyperextension in the MCP, PIP and DIP joints?

Answer 10

the volar plate

Question 11

function of the transverse metacarpal ligament

Answer 11

connects the heads of the metacarpals

Question 12

what is the palmar aponeurosis

Answer 12

dense fibrous structure that continues with the palmaris longus tendon

Question 13

what does the palmar aponeurosis cover?

Answer 13

thenar and hypothenar muscles

Question 14

what is dupuytren’s contracure?

Answer 14

pathological scarring of the palmar aponeurosis

Question 15

what creates the middle and lateral bands of the extensor hood? where do each band insert into?

Answer 15

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)

Question 16

what creates the proximal transverse arch

Answer 16

CMC motion of the thumb

Question 17

what creates the distal transverse arch?

Answer 17

flexion of the 2nd and 3rd digit

Question 18

what is the significance of the arches of the hand?

Answer 18

allows the hand to conform to a variety of objects

Question 19

what resists excess movement during 1st CMC add/abduction

Answer 19

intermetacarpal ligament, anterior oblique ligament, and adductor pollicis

Question 20

what resists excess movement during 1-5 MCP flexion

Answer 20

dorsal capsule and radial carpal ligament

Question 21

what resists excess movement during1-5 MCP extension

Answer 21

palmar plate

Question 22

what resists excess movement during 1-5 MCP abduction

Answer 22

ulnar collateral ligament

Question 23

what resists excess movement during 1-5 MCP adduction

Answer 23

radial collateral ligament

Question 24

what resists excess movement during IP, PIP, DIP flexion

Answer 24

dorsal capsule

Question 25

what resists excess movement during IP, PIP, DIP extension

Answer 25

volar plate

Question 26

what is Ape hand? what is affected/weak?

Answer 26

(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

Question 27

what is wrist drop? what is affected/weak?

Answer 27

(1) radial nerve lesion
(2) loss of wrist extensor muscle innervation
(2) unable to extend the MCP joints
(2) grip strength lost

Question 28

what is claw hand? what is affected/weak?

Answer 28

(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

Question 29

what is swan neck deformity?

Answer 29

• hyperextension of the PIP, flexion of DIP

- spasm or contracture of intrinsic muscles

Question 30

what is boutonniere deformity?

Answer 30

• MCP extension, PIP flexion and DIP extension

- caused by rupture of central band

Question 31

what is intrinsic minus hand?

Answer 31

• 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