Wrist & Hand

Question 1

Which rays of the hand are most mobile?

Answer 1

thumb, ring, and pinky finger

-this is seen in cupping motions and relaxed fist vs tight fist

Question 2

How is thumb metacarpal positioned relative to rest of hand?

Answer 2

flexed & pronated position of ~80 degrees to compared to metacarpals of the fingers

Question 3

What is the role of sesamoid bones?

Answer 3

alleviate or redistribute weight or stress along a tendon or joint surface

Question 4

What carpal bone is most susceptible to fracture?

Answer 4

scaphoid
-makes up ~ 68% of carpal fractures

Question 5

What is the common MOI for scaphoid fracture?

Answer 5

FOOSH
-wrist extended and radially deviated

Question 6

Which carpal bone is most often dislocated?

Answer 6

Lunate
-most dependent on ligamentous support
-weak area of volar ligaments

Question 7

What is the 2nd most commonly fractured carpal bone?

Answer 7

Triquetrum
~ 18% of carpal fractures

Question 8

What is the most stable carpal bone?

Answer 8

Trapezoid
-very stable articulations w/ 2nd metacarpal, capitate, and trapezium

Question 9

Largest carpal bone?

Answer 9

Capitate
“keystone” of the transverse arch of the wrist

Question 10

Which is the most mobile carpal bone(distal row)?

Answer 10

Trapezium
-forms saddle joint w/ thumb
-at least the most mobilie relative to other distal row carpals

Question 11

What is the normal slope of radial inclination?

Answer 11

15-20 degrees

-measured from distal articular surface vs line perpendicular to midshaft of radius
-essential tilted toward ulna

Question 12

What is normal radial tilt?

Answer 12

~15 degrees
-volar or dorsal tilt of radial head

Question 13

AROM norm forearm pronation

Answer 13

85-90 degrees

Question 14

AROM norm forearm supination

Answer 14

85-90 degrees

Question 15

AROM norm wrist flexion

Answer 15

90 degrees

Question 16

AROM norm wrist extension

Answer 16

70 degrees

Question 17

AROM norm wrist radial deviation

Answer 17

15-20 degrees

Question 18

AROM norm wrist ulnar deviation

Answer 18

30-45 degrees

Question 19

AROM norm MCP flexion

Answer 19

85-90 degrees

Question 20

AROM norm MCP extension

Answer 20

30-45 degrees

Question 21

AROM norm MCP abduction

Answer 21

20-30 degrees

Question 22

AROM norm MCP adduction

Answer 22

0 degrees

Question 23

AROM norm PIP flexion

Answer 23

100-110 degrees

Question 24

AROM norm PIP extension

Answer 24

0 degrees

Question 25

AROM norm DIP flexion

Answer 25

80-90 degrees

Question 26

AROM norm DIP extension

Answer 26

0 degrees

Question 27

AROM norm Thumb CMC flexion

Answer 27

20 degrees

Question 28

AROM norm Thumb CMC radial abduction

Answer 28

50-55 degrees

Question 29

AROM norm Thumb CMC palmar abduction

Answer 29

50-55 degrees

Question 30

AROM norm Thumb MCP flexion

Answer 30

50-55 degrees

Question 31

AROM norm Thumb MCP extension

Answer 31

0 degrees

Question 32

AROM norm Thumb IP flexion

Answer 32

80-85 degrees

Question 33

AROM norm Thumb IP extension

Answer 33

0 degrees

Question 34

How do proximal and distal carpal rows move w/ wrist movements?

Answer 34

Radial deviation
-proximal row flexes slightly and glides ulnarly
-distal row moves radially

Ulnar deviation
-proximal row extends slightly and glides radially
-distal row slides ulnarly

Question 35

Sensory distribution of median nerve

Answer 35

volar surface of thumb, index, middle and half of ring finger;

a portion of dorsal surface of fingers EXCEPT pinky and thumb
-typically from tips to PIP joint crease

Question 36

Muscles innervated by median nerve

Answer 36

pronator teres, FCR, palmaris longus, FDS muscles
-AIN branch innervates FPL, FDP to index and long fingers, pronator quadratus
-small motor component to lumbricals 1 and 2

Question 37

Muscles innervated by ulnar nerve

Answer 37

FCU, FDP to ring and small fingers

Question 38

Sensory distribution of ulnar nerve

Answer 38

anterior and posterior aspect of ULNAR side of hand and distal forearm
-by palmar and dorsal cutaneous branches

pinky and ulnar side of ring finger
-by superficial sensory branch

Question 39

Muscles innervated by ulnar nerve

Answer 39

hypothenar intrinsic muscles(ADM, ODM, FDM)
-all palmar and dorsal interossei
-lumbricals 3 and 4
-deep head of FPB
-AP(adductor pollicis)

Question 40

Muscles innervated by radial nerve

Answer 40

ECRL is only directly innervated

PIN(motor nerve only)
-ECRB, ECU
-ED, EI, EDQ
-APL, EPB, EPL)