wrist/hand

Question 1

Percentage of upper limb function comprised by the hand

Answer 1

90%- 40-50% thumb

Question 2

number of joints/ligaments in wrist?

Answer 2

more than 20 joints, 26 ligaments

Question 3

joint of TFCC

Answer 3

ulnocarpal

Question 4

proximal row of carpals

Answer 4

scaphoid lunate triquetrum pisiform

Question 5

distal row of carpals (radial to ulnar)

Answer 5

trapezium, trapezoid, capitate, hamate

Question 6

describe the two types of ligaments within the carpal bones

Answer 6

extrinsic volar ligaments: wrist stability

intrinsic ligaments: rotation restraints

Question 7

ligaments of the finger

Answer 7

Ulnar/radial collateral
transverse retinacular: holds extensor mechanism at PIP joint
oblique retinacular ligament:

Question 8

function of pulley system?

Answer 8

restrain flexor tendons sfrom bowstrining- completed by the annular (A1-A5 and thumb (A1, A@) and the cruciate (C1-C3)

Question 9

function of the velar plate

Answer 9

attaches to base of proximal phalanx- strong capsulogliamentous support- resists hyper extension

Question 10

extensor compartments

Answer 10

1: abductor pollicis longus, extensor pollicis brevis
2: extensor carpi radialis longus and brevis
3: extensor pollicis longus
4: extensor digitorum, extensor indicis
5: extensor digiti minimi
6: extensor carpi ulnaris

Question 11

attachments of the transverse carpal ligament

Answer 11

radial: tubercle of trapezium and scaphoid
ulnar: hook of hamate and pisiform
**serves as attachment site for muscles, maintains transverse carpal arch and restrains bowstringing protects median nerve
(carpal tunnel site_

Question 12

function of TFCC

Answer 12

improves joint congruency, cushions against compressive forces: transmits~20% of axial load from hand to forearm

Question 13

intrinsic hand muscles (all of the rest are extrinsic )

Answer 13

abductor digiti minimi, fexor digiti minimi, interossei, lumbricals, adductor pollicis brevis, flexor pollicis brevis, opponens pollicis, adductor pollicis

Question 14

Flexor tendon zones (fingers)

Answer 14

1: DIP joint distal
2: DIP joint to Distal Palmar Crease
3: distal palmar crease proximal to transverse carpal ligament
4: carpal tunnel
5: carpal tunnel to musculotendionous junction of flexor tendons

Question 15

Flexor tendon zones (thumb)

Answer 15

1: IP joint distal
2: IP joint proximal to MP joint
3: MP joint proximal to transverse carpal ligament

Question 16

Extensor tendon zones

Answer 16

1: DIP joints
2: middle phalanx
3: PIP joints
4: proximal phalanx
5: MP joints
6: metacarpals
7: carpals

Question 17

extensor tendon zones (thumb)

Answer 17

IP joint
middle phalanx
MP joint
1st metacarpal
carpals

Question 18

limitations of pronation/supination

Answer 18

pronation: limited by impaction between radius and ulna
supination: limited by interossious membrane

Question 19

flexion at the wrist

Answer 19

60% midcarpal joint

Question 20

extension at wrist

Answer 20

66.5% radiocarpal joint

Question 21

radial deviation

Answer 21

occurs at mid carpal joint

Question 22

ulnar deviation

Answer 22

occurs primarily at radiocarpal joint

Question 23

wrist ROM

Answer 23

pronation 0-75
supination 0-85
flexion 80
extension 70
radial deviaion 15
ulnar deviation 45

Question 24

distal radio ulnar joint

Answer 24

ulnar convex
radial concave
radius on ulna- rolls and glides in SAME direction

Question 25

radiocarpal

Answer 25

biconcave- convex carpals roll and glide in opposite direction for flexion/extension/radial/ulnar deviation

Question 26

during radial deviation and ulnar deviation what happens at the proximal row?

Answer 26

radial deviation: flexes

ulnar deviation: extends

Question 27

midcarpal joints

Answer 27

all distal convex moving on concave proximal EXCEPT concave trapezium/trapezoid moving on convex scaphoid

Question 28

thumb ROM

Answer 28

radial abd: 55-60
palmar abd: 55-60
opposition: 0
MP flexion50-55
Ip flexion: 85-90

Question 29

finger ROM

Answer 29

MP: 85-90
MP extension 30--45
MP abduction :20-30
PIP flexion: 100-115
DIP flexion: 80-90 
DIP  extension: 20
composite flexion: pulp to distal palmar crease 0 cm- funcitonal 1-2 cm

Question 30

MCP and interphalangeal joints

Answer 30

concave on convex