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Kines Exam 1 > Wrist/Hand Complex > Flashcards

Wrist/Hand Complex Flashcards

1
Q

What are the two points of consensus in regards to the wrist complex?

A
  1. Structure and biomechanics of wrist and hand vary tremendously from person to person
  2. Even subtle variations can produce differences in the way a given function occurs
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2
Q

What are the bones of the radiocarpal joint, and midcarpal joints?

A

Radiocarpal - radius with scaphoid, lunate, triquetrum

Midcarpal - schaphoid, lunate, triquetrum with trapezium, trapezoid, capitate, and hamate

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3
Q

What is joint type of wrist joint?

A

Conyloid

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4
Q

What is the benefit of have a 2 joint system (radiocarpal and midcarpal joints)?

A
  1. Permits large ROM with less exposed articular surface and tighter joint capsules
  2. Less tendency for structural pinch at extremes of motion
  3. Allows for flatter multi-joint surfaces that are more capable of withstanding imposed pressures
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5
Q

What is the radiocarpal joint structure?

A

Proximal - concave surface of radius

Distal - convex proximal surfaces of scaphoid and lunate, triquetrum

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6
Q

The small and difficult to isolate wrist ligaments are essential for?

A
  1. Maintaining intercarpal alignement

2. Transferring forces within and across carpals

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7
Q

True/False: wrist has only extrinsic ligaments

A

False: Described as extrinsic (proximal attachment on forearm and attach distally at wrist) and intrinsic (both proximal/distal attachment in wrist complex)

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8
Q

What is the triangular fibrocartilage complex (TFCC)?

A
  • Functions to bind distal ends of ulna and radius while allowing radius to rotate (pronate/supinate) around fixed ulna
    1. Reinforces ulnar side of the wrist
    2. Transfers compression forces
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9
Q

What is the purpose of the extensor retinaculum?

A

-Functions to prevent bowstringing with active movement of wrist

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10
Q

What is the purpose of the the palmar carpal ligament?

A

-Stabilized wrist flexor tendons and prevents excessive bowstringing during flexion

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11
Q

What are factors that contribute to carpal tunnel syndrome?

A
  1. Overcrowding
  2. Excessive mechanical stress (occupation related)
  3. Fibrotic changes of CT
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12
Q

What structures in general pass through the carpal tunnel?

A

9 Extrinsic flex tendons and median nerve

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13
Q

Describe the osteo of the radiocarpal and midcarpal joints.

A

Flex/ext

Radial/ulnar deviation

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14
Q

Describe the arthrokinematics of the radiocarpal and midcarpal joints.

A

-Convex on concave
Flex - anterior roll/posterior glide
Ext - posterior roll/anterior glide
Radial deviation - lateral roll, medial glide
ulnar deviation - medial roll, lateral glide

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15
Q

What is the open pack position and capsular pattern for the radiocarpal joint?

A

Open pack = neutral frlex/ext with slight ulnar deviation

Capsular pattern = flexion = extension, slight radial and ulnar deviation

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16
Q

What is the main function of wrist extensors?

A
  • Position and stabilize wrist within activities that require active flexion of digits
  • Act to counterbalance wrist flexion torque produced by finger flexor muscles
17
Q

What degree of extension do you have max grip?

A

30 - optimizes the length tension relationship of extrinsic finger flexors

18
Q

How do flexor carpi ulnaris and radialis work synergistically?

A

To oppose ulnar and radial deviation during active wrist flexion

19
Q

Peak wrist flexion torque is what degree of wrist flexion?

A

40

20
Q

What are the joints of the hand?

A

CMC, MCP, PIP, DIP

21
Q

What type of joints are the 5 carpometacarpal joints?

A 
1st = saddle
2nd-5th = plane
22
Q

Describe the osteo of the 1st CMC joint

A

1st = flex/ext, abd/add, opposition/reposition

23
Q

Describe arthro of 1st CMC joint

Abduction/Adduction

A

-Convex surface of thumb MC moving on concave trapezium
Abduction = anterior roll, posterior glide
Adduction = posterior roll, anterior glide

24
Q

Describe arthro of 1st CMC joint

Flexion/extension

A

-Concave surface of MC moving on convex diam or trapezium
Flex = medial roll and glide
Ext = lateral roll and glide

25
Q

Describe arthro of 1st CMC joint

opposition/reposition

A 
Opposition = abduction/ flex
reposition = adduction/ext
26
Q

Describe the osteo and arthro of the 2nd-5th CMC joint

A 
Osteo = Flex/ext
Arthro = undetermined
27
Q

What is the open pack and capsular pattern for the 1st CMC joint?

A

Open pack = mid flex/ext and mid abd/add

Capsular pattern = abduction

28
Q

What is the open pack for the 2nd-5th CMC joint?

A

Open pack = Mid flex/ext

29
Q

What are the osteo of the metacarpophalangeal joints?

A

Flex/ext

abd/add

30
Q

What are the arthrokinematics of the metacarpophalangeal joints?

A 
-Concave phalanx moving on convex MC head
Flex - anterior roll and glide
Ext - posterior roll and glide
Abd - roll and glide away from 3rd digit
Add - roll and glide toward 3rd digit
31
Q

What are the osteo of the interphalangeal joints?

A

Flex/ext

32
Q

What are the arthrokinematics of the interphalangeal joints?

A

-Concave on convex
Flex = roll anterior, glide anterior
Ext = roll posterior/glide posterior

33
Q

What are the open pack positions and capsular pattern of the metacarpophalangeal joints?

A

Open pack = Slight flex

Capsular pattern = flex = ext

34
Q

hat are the open pack positions and capsular pattern of the interphalangeal joints?

A

Open pack = slight flex

Capsular pattern = flex = ext

35
Q

Describe the function of the flexor mechanism.

A

Flexor pulleys embedded within fibrous digital sheath

-Functions to prevent bowstringing of tendons with contraction of extrinsic finger flexors

36
Q

Clinical application of flexor mechanism:

A

Trigger finger - flex finger and when unflex, one gets stuck

37
Q

Describe the anatomy of the extensor mechanism.

A

Anatomy - distal to wrist, ext lack digital sheath or pulley system

  • tendons become integrated into extensor expansion
  • remaining tendon flattens into a central band -> divides into 2 lateral bands before crossing PIP -> reconverge into single terminal tendon
38
Q

Describe the function of the extensor mechanism.

A

Function - stabilizes ED tendon, forms sling that assists ED to extend MCP joint and transfers force from lumbricals/interossei to lateral bands to assist with PIP and DIP ext

Kines Exam 1 (15 decks)

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