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Kinesiology Term 1 > Wrist / Hand Complex > Flashcards

Wrist / Hand Complex Flashcards

1
Q

Wrist (Carpus) Complex

A

The radiocarpal and midcarpal joints

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2
Q

Major contribution of the Wrist Complex

A

-Control length-tension relationship in the multiarticular hand muscles
-Allow fine adjustment of grip

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3
Q

Wrist muscles designed for …

A

balance and control vs force production

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4
Q

Radiocarpal joint composed of:

A

Proximally:
Radius
Radioulnar disc

Distally:
Scaphoid
Lunate
Triquetrum

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5
Q

Radiocarpal joint articulation

A

Scaphoid w/ lateral radial facet
Lunate w/ medial radial facet
Triquetrum w/ triangular fibrocartilage complex TFCC)

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6
Q

Midcarpal joint composed of:

A

Scaphoid
Lunate
Triquetrum
Trapezium
Trapezoid
Capitate
Hamate

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7
Q

Wrist complex

A

Biaxial

Flexion/extension around coronal axis
Radial / Ulnar Deviation around A-P axis

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8
Q

Radiocarpal joint surface is…

A

Oblique and angles slightly volarly and ulnarly

Normal angle inclination: 23 deg (Ulnar)
11 deg (Volar)

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9
Q

Palmer / Volar Ligaments

A

-Palmer Radiocarpal Ligament
-Radial Collateral Ligament
-Palmer Intercarpal Ligament
-Transverse Carpal Ligament

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10
Q

Dorsal Ligaments

A

-Dorsal Radiocarpal Ligament
-Dorsal Intercarpal Ligament
-Ulnar Collateral Ligament

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11
Q

Importance of the Scaphoid

A

-Greatest mobility of the proximal carpal bones
-Acts as a link between the proximal and distal carpal rows

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12
Q

Triangular Fibrocartilage Complex (TFCC)

A

-Articulates with triquetrum and partially with the lunate
-Radioulnar disc is a continuation or the articular cartilage of the radius

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13
Q

Wrist Movement

A

Open packed-neutral between flex/ ext

Closed packed-full ext and radial deviation

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14
Q

Wrist flexion Normal Range

A

65-85 deg

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15
Q

Wrist Extension Normal Range

A

60-85 deg

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16
Q

Radial deviation Normal Range

A

15-21 deg

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17
Q

Ulnar deviation Normal Range

A

20-45 deg

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18
Q

Volar Wrist Musculature

A

6 muscles cross volar surface of wrist and contribute to wrist flexion

PL, FCR, FCU, FDS, FDP, FPL

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19
Q

Carpal Tunnel

A

FDS tendons
FDP tendons
FPL tendon
Median nerve

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20
Q

Dorsal Wrist Musculature

A

9 muscles cross the dorsal aspect of wrist and contribute to wrist extension

Extensor retinaculum provides 6 distinct compartments for these muscles

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21
Q

Compartment 1 and 2

(dorsal)

A
  1. APL, EPB
  2. ECRB, ECRL
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22
Q

Compartment 3 and 4

(dorsal)

A
  1. EPL
  2. ED, EI
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23
Q

Compartment 5 and 6

(dorsal)

A
  1. EDM
  2. ECU
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24
Q

Flexion/Extension

A

Carpals on radius = convex on concave
Opposite roll and glide

Flexion; scaphoid tends to move with the distal carpal row with the proximal row following
Extension initiated by distal carpal row

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25
Radial/ Ulnar Deviation
*Ex: With Radial Deviation -Carpal complex slides ULNARLY on the radius -Flexion of PROXIMAL carpal rows -Extension of DISTAL carpal rows -Full Radial Deviation puts the radiocarpal and midcarpal joints in close-packed
26
FOOSH (Fall on an Outstretched Hand)
Most common trauma to the radiocarpal joint
27
Kienbock's Disease
-Avascular necrosis of the lunate -Usually seen in relation with ulnar negative variance -Due to abnormal force distribution across the radiocarpal
28
Ulnar Positive Variance
-POSITIVE variance: often seen after a distal radius fx with healing in a shortened position -Present with pain at end range ulnar deviation / pronation
29
Dorsal Intercalated Segmental Instability (DISI)
-injury to ligaments stabilizing lunate + scaphoid -Scaphoid (flex), lunate (extend) -Subluxation of scaphoid occurs with compressive loading of wrist
30
Volar Intercalated Segmental Instability (VISI)
-lunate and triquetrum lose ligamentous stability
31
Scapholunate Advanced Collapse Wrist (SLAC)
-Degenerative changes at the radioscaphoid joint -progression to intercarpal joints -capitate can eventually sublux
32
Hand Complex
Comprised of: -5 digits -19 bones distal to the carpus
33
Digits include:
-Carpometacarpal joint (CMC) -Metacarpophalangeal joint (MP) -2 interphalangeal joint (IP); proximal and distal -Thumb has only one (IP)
34
Extrinsic Muscle Group of Thumb
FCL, EPL, EPB, AbPL
35
Intrinsic Muscle Group of Thumb
OP, FPB, AbPB, AdP, 1ST palmar interossei
36
Thumb Structures
1st CMC Joint Saddle joint with 2 DOF Flex/ ext ABd/ ADd Primary function is opposition = abd followed by flex followed by add Almost all Prehension; Fine motor and grasp
37
CMC arthritis
-Most common pathology -Trapezium and 1st metacarpal affected due to degenerative changes -Pain with prehension Common elective surgery of the hand
38
CMC - Deep Transverse Metacarpal Ligament
-Base of metacarpal and distal carpal row -Spans btw 2nd and 4th metacarpal heads -Helps w/ CMC stab and limits abd Blends with ant. joint capsule of e/digit -Prevents entrapment of the FDP with MCP flex and maintains the interossei in a position dorsal to the ligament
39
CMC - Opponens Digiti Minimi (ODM)
-only muscle to exclusively impact movement of a CMC joint -flex and rotate the 5th metacarpal along it long axis Acts on CMC joint ALONE
40
Palmer Arches of Hand
Proximal, distal and longitudinal arches Allow palm and digits to conform to objects being held -Max surface contact -Greatest stab -Increasing sensory feedback
41
Metacarpophalangeal (MCP) Joints
2 DOF: Flex/ ext ABd/ ADd Metacarpal head -convex Base of prox phalanx -concave Reinforced by Deep Transverse Metacarpal Ligament
42
Flexion/ extension of MCP joint
Flexion- volar roll and volar glide of phalanx on MC Extension- dorsal roll and dorsal glide of phalanx on MC
43
Interphalangeal (IP) Joints
Synovial hinge joint 1 DOF Volar plates reinforce IP joint capsules
44
IP ligaments
Collateral lig. proper -taut with MCP flex Accessory collateral lig. -taut with ext
45
What other functions IP ligaments have?
Stability to MCP and IP during AROM Stability with varus and valgus stress
46
Volar plate
reinforces IP joint capsule improves stab limits hyperext.
47
Sagittal Bands
Help to stabilize the volar plates over the 4 MC heads Connects volar plate to the extensor digitorum communis tendon and extensor expansion
48
Anatomical pulleys of the fingers and thumb
5
49
Extrinsic Finger Flexors
FDS-more torque at MCP jt than FDP FDP-more active than FDS/flexes all 3 jts of fingers/more superficial at PIP than FDS
50
Intrinsic Finger Musculature
Dorsal and Palmar Interossei DABs and PADs Lumbricals FPB-palmar interossei AbDM-dorsal interossei
51
Intrinsic Finger Musculature
ED, EI, EDM
52
Extensor Mechanism formed by:
EDC, EIP and EDM tendons Extensor hood Central Tendon Lateral Bands Terminal Tendon Triangular lig Oblique retinacular lig Sagittal bands
53
Extensor Mechanism Influence on MCP and IP Joint Function
ED contracts=tension created on sagittal bands ProPhalanx rolls and glides dorsally on MC Interossei, dorsal, volar, lumbricals help IP extension
54
Functional Position of the Hand
Wrist in slight extension 20deg Slight ulnar deviation 10deg Fingers moderate flexion at MCP 45deg and PIP jts 30deg Slight flexion at DIP jts
55
2 categories of Prehension
Power Grip: involves full hand Precision Handling: utilizes finger and thumb
56
Power grip - Cylindrical
-Finger flexors primary -FDP main contributor
57
Power grip - Spherical
-Similar to cylindrical -Fingers in more ABd. -Interossei more active in this grip
58
Power grip - Hook grip
-FDS, FDP, -No thumb involvement -Often allows greater endurance
59
Power grip - Lateral prehension
-static hold of an object btw 2 fingers
60
Precision Handling - Tip to Tip
-Similarities in muscle activity to pad to pad -Requires more joint flexion for tip to tip contact
61
Precision Handling - Pad to Pad
-Opposition of pad of thumb to pad of finger -80% prehension handling in life -FDP, APB, FPL among others active
62
Precision Handling - Pad to Side
-Key/lateral grip -ADP, FPD, OP

Kinesiology Term 1 (16 decks)

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