Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OCS Exam > Wrist & Hand > Flashcards

Wrist & Hand Flashcards

1
Q

Which rays of the hand are most mobile?

A

thumb, ring, and pinky finger

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is thumb metacarpal positioned relative to rest of hand?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the role of sesamoid bones?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What carpal bone is most susceptible to fracture?

A

scaphoid
-makes up ~ 68% of carpal fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the common MOI for scaphoid fracture?

A

FOOSH
-wrist extended and radially deviated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which carpal bone is most often dislocated?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the 2nd most commonly fractured carpal bone?

A

Triquetrum
~ 18% of carpal fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most stable carpal bone?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Largest carpal bone?

A

Capitate
“keystone” of the transverse arch of the wrist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the normal slope of radial inclination?

A

15-20 degrees

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is normal radial tilt?

A

~15 degrees
-volar or dorsal tilt of radial head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

AROM norm forearm pronation

A

85-90 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AROM norm forearm supination

A

85-90 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

AROM norm wrist flexion

A

90 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AROM norm wrist extension

A

70 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

AROM norm wrist radial deviation

A

15-20 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

AROM norm wrist ulnar deviation

A

30-45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

AROM norm MCP flexion

A

85-90 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

AROM norm MCP extension

A

30-45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

AROM norm MCP abduction

A

20-30 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

AROM norm MCP adduction

A

0 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

AROM norm PIP flexion

A

100-110 degrees

24
Q

AROM norm PIP extension

A

0 degrees

25
Q

AROM norm DIP flexion

A

80-90 degrees

26
Q

AROM norm DIP extension

A

0 degrees

27
Q

AROM norm Thumb CMC flexion

A

20 degrees

28
Q

AROM norm Thumb CMC radial abduction

A

50-55 degrees

29
Q

AROM norm Thumb CMC palmar abduction

A

50-55 degrees

30
Q

AROM norm Thumb MCP flexion

A

50-55 degrees

31
Q

AROM norm Thumb MCP extension

A

0 degrees

32
Q

AROM norm Thumb IP flexion

A

80-85 degrees

33
Q

AROM norm Thumb IP extension

A

0 degrees

34
Q

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

A

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

35
Q

Sensory distribution of median nerve

A

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

36
Q

Muscles innervated by median nerve

A

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

37
Q

Muscles innervated by ulnar nerve

A

FCU, FDP to ring and small fingers

38
Q

Sensory distribution of ulnar nerve

A

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

39
Q

Muscles innervated by ulnar nerve

A

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

40
Q

Muscles innervated by radial nerve

A

ECRL is only directly innervated

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

41
Q

Zones 1-5 of flexor tendon injury at the hand

A

zone 1: fingertip to PIP joint crease
zone 2: PIP joint crease to distal palarm crease
zone 3: distal palmar crease to distal margin of flexor retinaculum
zone 4: carpal tunnel
zone 5: area proximal to wrist crease in forearm

42
Q

early rehab for 2 strand flexor tendon repair

A

early PROM protocol

43
Q

early rehab for 4 strand flexor tendon repair

A

tolerates 40N of force
-allows for early PROM and limited AROM

44
Q

early rehab for 6 strand flexor tendon repair

A

tolerates 50-60N of force
-better early PROM and limited AROM

45
Q

what is tendon gapping?

A

a separation or gap that occurs between 2 areas of repair of the torn tendon

> 2mm is a factor in greater resistance to tendon glide
3mm even greater resistance and propensity to catch on edge of pulleys

46
Q

Early stage immobilization protocol for flexor tendon repair

A

generally 3-4 weeks if pt is unable to follow complex rehab program, but immobilization less and less common

wrist 20-25* flexion
MP joint 50-60* flexion
IP joints in mild flexion

for children-early mobilization with therapist, but immobilization outside of therapy
-teenagers encouraged to follow adult protocols

47
Q

intermediate stage immobilization protocol for flexor tendon repair

A

-pt progresses to neutral wrist orthosis
-begins passive finger flexion and active extension of IP joints w/ MP joints flexed 60-70*

within 1-2 weeks following immobilization, pt beings AROM and tendon glides w/ wrist extended 10*

if difference between AROM and PROM is >50* there are likely considerable adhesions
-this indicates progression to late stage

48
Q

late stage immobilization protocol for flexor tendon repair

A

dependent on tendon glide
-usually 4-6 weeks
-orthosis is DC

-pt begins gentle isolated joint exercises(blocking of PIP joint or other fingers to isolate FDS and FDP)

light resistance ~8 weeks s/p repair to improve composite flexion

if muscle/tendon unit shortening is an issue
-orthosis for finger and wrist extension, Low load long duration stretch

NO HEAVY(>10 pounds) resisted activities until >10-12 weeks s/p repair

49
Q

protected mobilization protocol

A

early AROM and PROM
-generally preferred over immobilization
-recommending 3-5 days after surgery to begin therapy

50
Q

immediate postop position protected mobilization protocol

A

slight flexion or neutral, progressing to slight extension over several weeks

fingers in intrinsic plus position(MP flexed 70-90* and IP joints fully extended)
-work towards full IP extension if not initially available

51
Q

additional force required for tendon glide with pt who has edema

A

mild 1.7N
mod 7N
severe 9N

may need to delay AROM in presence of edema

52
Q

weeks 1-3 rehab protected mobilization

A

-passive IP joint flexion w/ active IP extension
-half composite fist via AROM

53
Q

weeks 3-6 rehab protected mobilization

A

-passive IP joint flexion maintained w/ wrist moving from flexion to extension
-combined wrist tenodesis and finger motion
-AROM exercises progress from half fist toward full fist

extension of MP joint increased incrementally
differential tendon gliding if not already started

LIGHT ADLS generally tolerated well

generally orthosis is DC at 6 weeks
-allows initiating full MP and IP joint extension

resistance exercises at 8 weeks
return to work usually ~12 weeks(even manual laborers)

54
Q

difference between zones of flexor tendon injury

A

zone 1 only involves FDP tendon

zone 2 most difficult and likelihood for adhesions due to FDP and FDS presence

zones 3-5 less concern about tendon gliding in fibro-osseous tunnel or restriction at pulleys

-multiple repairs in zone 5 may have significant scarring and subsequent limited tendon excursion at fingers or wrist
-potential for neurovascular compromise as well as zone 5

55
Q
A

OCS Exam (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions