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MOVEMENT SCIENCE > wrist complex (test 2) > Flashcards

wrist complex (test 2) Flashcards

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1
Q

what makes up the wrist complex

A

radiocarpal and midcarpal joint s

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2
Q

the wrist complex is a ___ compound joint

A

2

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3
Q

the wrist complex contributes to controlling the ____ _____ relationship in multiarticular hand muscle

A

length tension

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4
Q

the wrist complex is a ____ joint and has ___ DOF

A

biaxial
2

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5
Q

what are the motions of the wrist and what axis are they on

A

flexion/extension - coronal axis
rad/ ulnar dev - AP axis

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6
Q

how many degrees of flex/ext is there at the wrist complex

A

flex: 65-85
ext: 60-85

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7
Q

how many degrees of rad/ulnar dev is there at the wrist complex

A

rad: 15-21
ulnar: 20-45

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8
Q

what is the radiocarpal joint structure formed by proximally and distally

A

prox: radius + TFCC disc
distal: scaphoid, lunate , triquetrum

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9
Q

the lateral radial facet articulates with w carpal

A

scaphoid

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10
Q

the medial radial facet articulates with w carpal

A

lunate

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11
Q

the TFCC articulates with w carpal

A

triquetrum

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12
Q

the radius is ____ and angles _____

A

oblique
volvarly/ulnarly

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13
Q

the TFCC is connected medially via what ligaments

A

dorsal and volar radioulnar lig

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14
Q

the TFCC connect distally to what tendon, what carpals and what metacarpal

A

ECU tendon
triquetrum and hamate
base of 5th MC

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15
Q

what is the proximal row of carpals of the radiocarpal joint

A

scaphoid lunate triquetrum

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16
Q

the proximal carpal row is connect by the _____ interosseous and ____ interosseous ligaments

A

scapholunate
lunotriquetral

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17
Q

____ is in the proximal carpal row but not supporting the radius

A

pisiform

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18
Q

what does the pisiform work as

A

a seasmoid bone to increase the moment arm of the FCU

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19
Q

which is sharper and acts an an incongruent joint ? the distal or proximal radiocarpal segment

A

distal

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20
Q

how much axial load does the scaphoid and lunate receive ? TFCC?

A

80~
20~

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21
Q

what is ulnar negative variance ? ulnar positive variance ?

A

short ulna
long ulna

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22
Q

if someone has a short ulnar what disease can they have

A

keinbocks disease ( necrosis of the lunate)

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23
Q

if someone has a long ulna is can lead to what type of FX

A

radial

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24
Q

Most ligaments and muscles that cross radiocarpal joint also contribute to stability of _____ joint

A

midcarpal

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25
Q

Most ligaments and muscles that cross radiocarpal joint also contribute to stability of midcarpal joint, however what muscle is an exception and where does it attach

A

FCU
atttaches to the pisiform , hook of hammy , base of 5th MC

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26
Q

proximally the midcarpal joint structure articulates with what carpal bones

A

scaphoid
lunate
triquetrum

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27
Q

distally the midcarpal joint structure articulates with what carpal bones

A

trapezium , trapezoid, capitate and hammate

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28
Q

the midcarpal joint structure has a _____ _____ configuration

A

concave -convex

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29
Q

are the dorsal or volar ligaments of the wrist complex thicker/stronger

A

volar

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30
Q

what ligaments connect carpals to radius/ulna proximally or metacarpals distally

A

extrinsic ligaments

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31
Q

which ligaments interconnect carpals themselves

A

intrinsic (within the hand)

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32
Q

what are the volar radio-carpal ligaments

A

Radioscaphocapitate, radiolunate, and radioscapholunate

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33
Q

what volar carpal ligaments provides extension of volar radiocarpal lig

A

radial collateral lig

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34
Q

what is part of the ulnocarpal ligament complex which is part of the volar carpal ligaments

A

TFCC, ulnolunate ligament, and ulnar collateral ligament

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35
Q

what are the extrinsic volar carpal ligaments

A

volvar radiocarpal ligaments
radial collateral lig
ulnocarpal ligament complex

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36
Q

what are the intrinsic volar carpal ligaments

A

scapholunate interosseous lig
lunotriquetral interosseous lig
v-deltoid

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37
Q

what does the scapholunate interosseous lig do

A

maintains scapho-lunate stability

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38
Q

what does the lunotriquetral interosseous lig do

A

maintains lunate-triquetral stability

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39
Q

the dorsal radiocarpal ligament converges on the ____

A

triquetrum

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40
Q

what ligament Possibly helps to offset sliding of proximal carpal condyle on inclined radius

A

dorsal radiocarpal ligament

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41
Q

the dorsal intercarpal ligaments courses horizontally from what carpal bones

A

triquetrum, lunate, scaphoid, and trapezium

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42
Q

what does the dorsal radio carpal lig and the dorsal intercarpal lig form together ?

A

horizontal V” to stabilize scaphoid during wrist ROM

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43
Q

does the volar or dorsal carpal ligaments become tight during wrist extension

A

dorsal

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44
Q

what is the mechanical link between the radius and distal carpals

A

proximal carpal row

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45
Q

the proximal carpal row is considered a ___ segment

A

intercalated

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46
Q

what carpal is the keystone to the wrist

A

capitate

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47
Q

what carpal is thought ti be center of rotation of wrist complex

A

capitate

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48
Q

what is the biggest carpal bone and contacts 7 other carpals

A

capitate

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49
Q

what are the 7 carpal bones that contact the capitate

A

lunate
scaphoid
hammy
trapezoid
2nd,3rd, 4th MC

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50
Q

if the wrist is in full flexion how does ext begin

A

distal carpal row glides posteriorly on the proximal row to neutral which is when capitate and scaphoid become close packed

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51
Q

when the wrist begans extension the distal carpal row glides posteriorly on the proximal row to neutral which is when capitate and scaphoid become close packed and then what happens

A

the distal row and scphoid move on lunate and triquetrium to 45 degrees when scaphoid and lunate lock

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52
Q

during extention the distal carpal row glides posteriorly on the proximal row to neutral which is when capitate and scaphoid become close packed and then the distal row and scphoid move on lunate and triquetrium to 45 degrees when scaphoid and lunate lock.. finallly …

A

the proximal row extends on radius/disc to fully extent closed packed positon

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53
Q

if the wrist is going into flexion from full extension what is the order of the scaphoid moivng on carpals

A
  1. scaphoid moves on radius/disc
    2/ scaphoid moces on lunate
  2. scaphoid moves on capitate
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54
Q

in radial deviation the carpals slide how? prox row? distal row?

A

ulnarly on radius
flexion of proximal row
extension of distal row
closed packed position

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55
Q

during ulnar deviation the carpals slide how ? proximal row? distal row?

A

slide radially
proximal row ext
distal row flex

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56
Q

is wrist deviation the least when the wrist is in flexion or extension

A

extension (closed packed)

when the wrist is in flexion the bones are splayed (loose packed)

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57
Q

dorsal intercalated segmental instability comes from ligamentous laxity/tear of the _____ ligament which causes the lunate to ___ or move dorsally , separating the ____ from the ___-

A

scapholunate
extend
lunate from the scaphoid

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58
Q

progressive degenerative problem from dorsal intercalated segmental instability is called what

A

scapholunate advanced collapse

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59
Q

volar intercalated segmental instability comes from ligamentous laxity/tear of the _____ ligament which causes the lunate to ___ or move volarly with the ___ seperating ___ from ____

A

lunotriquetral
flex
flex
scaphoid
lunate from triquetrum

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60
Q

what is the optimal position for the wrist complex

A

slight wrist EXT and ulnar deviation in order to maximize grip strength

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61
Q

what are the primary volar wrist muscles (flexors)

A

palmaris longus
flexor carpi radialis
flexor carpi ulnaris

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62
Q

what are the primary dorsal wrist muscles (extensors)

A

extensor carpi radialis longus
extensor carpi radialis brevis
extensor carpi ulnaris

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63
Q

what is the distal carpal row and the base of the 2nd-5th MC joints called

A

carpaometacarpal joint

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64
Q

the deep transverse metacarpal ligament tethers what together and what does it limit

A

tethers 2-4 MC head together and limits abduction

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65
Q

what is the proximal transverse(carpal) arch created by

A

curve shape of carpals , transverse carpal ligament , and inter carpal ligaments

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66
Q

the proximal transverse arch also forms what

A

the carpal tunnel

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67
Q

what nerve travels thru the carpal tunnel

A

median

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68
Q

what hand deformity is a result of carpal tunnel syndrome

A

bishops hand and ape hand

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69
Q

does the CMC joint have increased mobility on radial or ulnar side

A

ulnar

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70
Q

what type of joint is the 2-4th CMC joint and how many DOF does it have

A

plan synovial joint and 1 DOF (flex/ext)

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71
Q

which CMC joint are fixed and stable with the thumb and which move

A

2nd and 3rd are fixed
4th nd 5th move

72
Q

what type of joint is the 5th CMC joint and how many DOF does it have

A

saddle joint with 2 DOF (flex/ext and add/abd)

73
Q

which arch of the hand is Concavity formed by carpal bones results in proximal transverse arch of palm of hand; and fixed

A

proximal arch

74
Q

the distal arch of the palmar arch system is formed from adjustable positions of ___ ,___ and ___ metacarpal heads around a fixed CMC joint at __/___

A

1st, 4th and 5th
2nd/3rd`

75
Q

the longitudinal arch of the palmar arch system is ____ to ____ including all the fingers … is it mobile or fixed

A

proximal to distal
mobile

76
Q

is the distal arch of the palmar arch system mobile or fixed

A

mobile

77
Q

which arch allows the palm and digits to conform to objects during grasp/grip

A

the palmar arches

78
Q

the palmar arches allow the palm to have ___ surface contact

A

max

79
Q

the palmar arches enhances ____ and increases ___ feedback

A

stability
sensory

80
Q

the palmar arch is assisted by what muscles

A

finger flexors
opponens digiti minimi
flexor carpi ulnaris

81
Q

how many metacarpalphalangeal joints are there

A

4

82
Q

each MCP joint has a ____ head which is ___ and a ___ base of the 1st phalanx ___

A

concave
prox
convex
distal

83
Q

what type of joint is the MCP joint and how many DOF

A

condyloid joint with 2 DOF (flex/ext and abd/add)

84
Q

in the MCP joint is the capsule taut or lax in extension to allow passive axial rotation of the proximal phalanx

A

lax

85
Q

how many collateral ligaments does the MCP joint have

A

2

86
Q

if the concave phalanx of the MCP moves on the convex head of the metacarpal they will roll and slide in the ___ direction

A

same

87
Q

the volar plate of the MCP joint support the ____ arch

A

longitudinal

87
Q

the volar plate of the MCP joint limits _____

A

hyperextension

88
Q

the volar plate of the MCP joint resists tensile stress in ____

A

extension

89
Q

the volar plate of the MCP joint resist ____ forces from objects

A

compressive

90
Q

the volar plate of the MCP joint glides ___ during flexion

A

down

91
Q

the volar plate of the MCP joint prevents pinching of ____ tendons

A

flexor

92
Q

the collateral ligament proper of the MCP joint is more taut in ___

A

flexion

93
Q

the accessory collateral ligament of the MCP joint is more taut in ___

A

extensions

94
Q

the collateral ligaments of the MCP is limited in ___ during flex due to collaterals and bicondylar metacrpal head

A

abduction

95
Q

there is Fibrocartilage projections into MCP, PIP, and DIP joints from ____

A

dorsal extensor hood

96
Q

joint ROM for the MCP joint ranges from each finger but increases ___ to ____

A

radially to ulnarly

97
Q

what is the MCP joint ROM during flexion for the 2nd MCP and 5th MCP

A

90°
110°

98
Q

where is MCP joint add/abd most available

A

in extension at the 2nd and 5th MCP joint

99
Q

what type of joints are the PIP and DIP and how many DOF

A

true synovial joints with 1 DOF

100
Q

each PIP and DIP joint has what 3 things

A

joint capsule
volar plate
2 collateral ligaments

101
Q

the base of the phalanx has 2 shallow __- facets with a central ridge

A

concave

102
Q

does the DIP have any. hyperextension ?

A

some

103
Q

what is the ROM for flexion at the PIP and DIP joints

A

PIP: 100-135
DIP: 80-90

104
Q

do you have more flexion range of of the DIP and PIP at the ulnar or radial side

A

ulnar ; tigher grip

105
Q

finger flexors are dependent on what to counterbalance for good length tension

A

wrist ext

106
Q

what type of grip is tool larger on ulnar side for greater length and force

A

pistol grip

107
Q

smaller grip ulnarly allows for ____ ROM but ___ force

A

greater
less

108
Q

the tendons of the flexors must glide freely thru what

A

flexor retinaculae , bursa , digital tendon sheaths

109
Q

what structures tether tendons to hand and prevent bowstringing while bursa and sheaths facilitate gliding

A

retinaculae structures

110
Q

the ulnar bursa envelops the ___ and ___-

A

flexor digitorum profundus
flexor digitorum superficials

111
Q

the radial bursa covers the

A

flexor pollics longus

112
Q

how many annular pulleys are there ? cruciate pulleys ?

A

5 annular
3 cruciate and a plamar apenurosis pulley

113
Q

____ filled sheaths promote gliding

A

synovial

114
Q

which extrinsic finger extensors all pass under extensor retinaculae and have individual bursa or sheaths

A

EDC (extensor digitorum communis)
EIP (extensor indicis proprius)
EDM (extensor digiti minimi)

115
Q

at the MP joint what tendon merges with the extensor expansion hood

A

extensor digitorum communis

116
Q

the ___ and the ___ enter into the EDC tendons of the index and 5th allowing independence of those digitis

A

extensor indicis
extensor digiti minimi

117
Q

___, ___ & ___ are only MP extensors via their crossing of the MP and
attachment into the extensor hood and sagittal bands (help prevent
bowstringing)

A

EDC, EI & EDM

118
Q

EDC, EI & EDM are also synergists for what

A

wrist extension

119
Q

which tendon of the extensor mechanism extends the PIP

A

central tendon

120
Q

the ___ bands blend into the terminal tendon with triangular ligament and extend the ___

A

lateral
DIP

121
Q

Interphalangeal extension requires ___ plus ____ and ___

A

extensor digitorum communis
interossei and lumbricals

122
Q

lumbricals come from the ___ tendons to the ___ band

A

FDP to the lateral bands

123
Q

where does the oblique retinacular ligament come from and where does it attache

A

comes from prox phalanx, annular and cruciate pulleys and attaches distally to lateral bands past PIP

124
Q

the dorsal and volar interossei (DABS and PADS) attache to the sides of the ___ , distally attach to the ___ phalanx and dorsal ___

A

MC
prox
hood

125
Q

what tendons are dorsal to MP and pull on the sagittal bands

A

extensor tendons

126
Q

simultaneous interphalangeal extension requires active forces from what 3 muscles

A

DI
VI
lumbricals

127
Q

isolated extensor digitorum communis causes active and passive what

A

active MP hypertension with passive IP flexion

128
Q

Isolated EDC causes active MP hyperextension with passive IP flexion causes what position of the fingers

A

clawing or intrinsic minus position

129
Q

___ and ___ extension is interdependent via
extensor mechanism

A

DIP and PIP

130
Q

Isolated contraction of interossei and
lumbricals results in MP ___ with IP
___

A

flexion
extension

131
Q

So, IP extension can come from active
force of intrinsics or EDC or passive
stretch of EDC with MP flexion; what
contribute to passive tension?

A

ORLs

132
Q

if intrinsics are weak (ulnar nerve
injury), splint to fix MP in slight ___
allows EDC to ext IPs

A

flexion

133
Q

___ flexes both joints and passively pulls extensor hood up and into
relaxed position

A

FDP

134
Q

what happens are the DIP and PIP when ORLs are dorsal to PIP

A

DIp flex with PIP ext

135
Q

If FDS flexes PIP, DIP cannot be actively ___ due to distal pull of
the dorsal hood

A

extended

136
Q

in the intrinsic finger musculature there are ___ dorsal interossei and ___ volar interossei

A

4
3

137
Q

the DI proximal attachemnts act on the ___ and the distal affect the ___ and __

A

MP
IP and MP

138
Q

what muscles abd the 5th digit

A

abductor digiti minimi

139
Q

When MP is EXT, interossei MA is ineffective for ___ (yet can help prevent clawing) but MA is good
for ____

A

flexion
abd/add

140
Q

When MP is FLX, interossei have good MA for ____; collateral ligaments become taut and prevent ____; good grip strength

A

flexion
ABD/ADD

141
Q

where is ext weaker in the Ip joints? and why

A

index and 5th bc only one interossei

142
Q

where do the lumbricals originate from prox and distally

A

prox: FDP tenon
dis: lateral band of the extensor expansion

143
Q

Contraction of Lumbricals tenses the ___ band resulting in PIP and DIP
___

A

lateral
extension

144
Q

are lumbricals or interossei more effective in MP extension ?

A

lumbricals bc of their more distal attachments

145
Q

describe the intrinsic plus positon

A

lumbricals and interossei activation without extrinsic finger flexors or extensors

146
Q

describe the intrinsic minus position

A

Activation of extrinsic
finger flexors and extensors
w/o lumbricals or interossei

147
Q

what is the carpometacarpal joint of the thumb called

A

trapeziometacarpal joint

148
Q

trapeziometacarpal joint is a ___ joint with ___ DOF and ___ portion near the anterior radial tubercle

A

saddle
2 (flex/ext and add/abd)
spherical

149
Q

how much ROM is at the trapeziometacarpal joint during flex/ext and around what axis

A

motion is parallel to palm but 53° and around the oblique AP axis

150
Q

how much ROM is at the trapeziometacarpal joint during add/abd and around what axis

A

motion is perpendicular to palm and 42° and around the oblique coronal axis

151
Q

how much ROM is at the trapeziometacarpal joint during opposition

A

17°

152
Q

the trapeziometacarpal joint is common for what disease

A

OA

153
Q

the trapeziometacarpal joint is in closed pack during extreme

A

add/abd

154
Q

what motion is opposition sequentially

A

abd. add. flex

155
Q

what makes up the thumb MP joint

A

head of 1st MC with base of proximal phalanx

156
Q

what type of joint is the thumb MP and how many DOF

A

condyloid with 2 DOF (flex/ext an abd/add)

157
Q

what kind of bones is in the thumb MP

A

seasmoid

158
Q

what is the function of the thumb MP

A

add flex range to thumb in opposition

159
Q

sesamoids in the thumb develop with friction by what age

A

12

160
Q

what makes up the thumb IP

A

head of proximal phalanx with base of distal phalanx

161
Q

what are the 4 extrinsic muscles of the thumb

A

flexor pollicis longus
extensor pollicis brevis
extensor pollicis longus
abductor pollicis longus

162
Q

the EPL, EPB and APL make up what near the thumb

A

the snuff box (3 extensors)

163
Q

the extrinsic thumb musculature are subject to ____ insufficiency

A

active

164
Q

what are the 4 intrinsics muscles of the thumb ?

A

OP
ABD PB
FPB
ADD POL

165
Q

what is grasping of fingers and thumb

A

prehension

166
Q

what is power grip used for

A

open hand , position fingers , grasp object and maintain static grip

167
Q

cylindrical, spherical , hook and lateral prehension are all examples of what type ofr grip

A

power

168
Q

what is precision handling

A

same as power grip but no static phase

169
Q

pad to pad , tip to tip , and pad to side are examples of what

A

precision handling

170
Q

how many deg is wrist extension

A

20

171
Q

how many deg is ulnar dev

A

10 deg

172
Q

how many degrees does the MPs go into

A

45

173
Q

how many degrees for the PIP and SIP go into

A

pip : 30
dip: slight flexion

174
Q
A

MOVEMENT SCIENCE (13 decks)

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