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Wrist and Hand
Functional Anatomy
145
Anatomy
Graduate
10/07/2014

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Term
If the ulna is longer, it demonstrates positive variance meaning
Definition
more likely to entrap a feature
Term
If the ulna is shorter, it demonstrates negative variance meaning
Definition
less likely to entrap a feature
Term
A long ulna demonstrates what
Definition
positive variance
Term
a shorter ulna demonstrates what
Definition
negative variance
Term
what are the 3 arches of the hand
Definition
longitudinal, proximal transverse, distal transverse
Term
what makes up the longitudinal arch of the hand
Definition
wrist to finger tips, lunate, capitate, and third metacarpal
Term
the longitudinal arch of the hand lows what
Definition
power grasp
Term
the proximal transverse arch of the hand is made up of what?
Definition
across the carpal tunnel
Term
the distal transverse arch of the hand is made of what?
Definition
across the metacarpals
Term
the distal transverse arch of the hand allows for what
Definition
mobile, adaptation to different shapes
Term
the scaphoid has what angulation?
Definition
45
Term
what are the 7 components of the fibrous anatomy of the hand?
Definition
dorsal ligaments, volar ligaments, triangular fibrocartilage complex (TFCC), Flexor Retianculum, Collateral ligaments, pulley system, palmar fascia
Term
which is stronger volar or dorsal carpal ligaments
Definition
volar carpal
Term
what is the role of the volar carpal ligaments
Definition
prevent wrist/hand extension
Term
the volar carpal ligaments are made up of what
Definition
radiocarpal, ulnocarpal ligaments both intrinsic and extrinsic
Term
the dorsal carpal ligaments are made up of what
Definition
radiocarpal and radial and ulnar collateral ligaments, intercarpal ligaments
Term
what is the role of the dorsal carpal ligaments
Definition
stabilize carpus, check flexion of teh wrist and hand
Term
the triangular fibrocartilage complex-TFCC is made up of what (7)
Definition
dorsal/volar radioulnar ligaments, ulnar collateral ligament, articular disc, ulnolunate, ulnotriquetral ligaments, sheath of extensor carpi ulnaris
Term
What is the role of the TFCC
Definition
stabilizes radioulnar joint/carpals, cushion for the ulna
Term
Flexor Retinaculum/Transverse Carpal Ligament spans what
Definition
carpal gutter and form a tunnel
Term
the flexor retinaculum/transverse carpal ligament provides what
Definition
extrinisic flexor tendons with a pulley to maximize tendon function
Term
if teh flexor retinaculum/transverse carpal ligament is disrupted what happens
Definition
creates a bowstringing effect on tendons, reducing grip strength
Term
What is the lateral attachment of the transverse carpal ligament/flexor retinaculum
Definition
scaphoid and trapezium
Term
What is the medial attachment of the transverse carpal ligament/flexor retinaculum
Definition
pisiform, hook of hammate
Term
the collateral ligaments are taught in flexion at which joint
Definition
MCP
Term
at the MCPs the collateral ligaments are taught during
Definition
flexion
Term
the collateral ligaments are taught in extension at which joint
Definition
PIP, DIP
Term
at the PIP and DIP the ligaments are taught during
Definition
extension
Term
How should the fingers be positioned to immobilize the collateral ligaments
Definition
60-70 MCP flexion, extension of IPs
Term
What makes up the digital pulley system
Definition
annular and cruciate pulleys
Term
How many annular pulleys are tehre
Definition
5
Term
how many cruciate pulleys are there
Definition
3
Term
which pulley is at the joint?
Definition
annular
Term
where are the cruciate pulleys located
Definition
inbetween the annular pulleys
Term
Which annular pulleys contribute significantly to grip strength
Definition
A2, A4
Term
Proximal to distal, what is the order of the annular and cruciate pulleys
Definition
A1, A2, C1, A3, C2, A4, C3, A5
Term
Loss of a pulley creates what
Definition
bowstringing effect
Term
the digital pulley system is responsible for what (3)
Definition
increasing moment arm, increasing torque, decreasing ROM
Term
what are the components of the palmar fascia
Definition
superficial fascia, palmar compartments, deep palmar and dorsal components
Term
what is the function of the palmar fascia
Definition
to house, and protect tendons and neurovascular structures of the hand
Term
if the palmar fascia becomes contracted what happens
Definition
Dupuytren's disease
Term
How many flexor tendon zones are there
Definition
5
Term
What is zone 1 of the flexor tendons?
Definition
B/w insertion of flexor digitorum profundus and flexor digiti superficialis tendons
Term
What is Zone 2 of the flexor tendons?
Definition
b/w insertion of flexor digitorum superficialis and proximal end of annular pulley 1
Term
Zone 2 of the flexor tendons is also known as what
Definition
surgical no man's land
Term
zone 3 of the flexor tendons is made up of what
Definition
b/w Annular 1 pulley and distal transverse carpal ligament
Term
flexor tendon zone 4 is made up of what
Definition
carpal tunnel area
Term
zone 5 of the flexor tendons is made up of what
Definition
b/w proximal edge of transverse carpal ligament and musculotendinous junction of flexor tendons
Term
the synovial sheaths are located where
Definition
deep to fibrous sheaths of fingers and wrist
Term
what is the role of the synovial sheaths
Definition
reduce friction to optimize tendon sliding, provide nutrition to tendons
Term
motion is lotion for what
Definition
synovial sheaths
Term
how many extensor compartments/tunnels are there
Definition
6
Term
Extensor compartments/tunnels 1
Definition
Abductor pollicis longus, extensor pollicis brevis
Term
Extensor compartments/tunnels 2
Definition
extensor carpi radialis longus and extensor carpi radialis brevis
Term
Extensor compartments/tunnels 3
Definition
extensor pollicis longus
Term
extensor compartment tunnels 4
Definition
extensor digitorum communus, extensor indicic
Term
extensor compartment 5
Definition
extensor digiti minimi
Term
extensor compartment 6
Definition
extensor carpi ulnaris
Term
How many extensor tendon zones are there
Definition
7
Term
extensor tendon zones 1&2
Definition
insertion of extensor digitorum communus, & retinacular ligaments into extensor digitorum comminus
Term
extensor tendon zones 3&4
Definition
central slip to middle phalanx, PIP, retinacular ligaments, extensor hood, lateral bands
Term
extensor tendon zones 5
Definition
PIP to MC neck
Term
extensor tendon zone 6
Definition
MC neck to Carpimetacarpal joints
Term
extensor tendon 7
Definition
area over the carpals
Term
the extensor mechanism allows for what action with flexion of MCP
Definition
extension of PIP and DIP
Term
what transmits tension for active motion of the fingers and stabilizes joints of fingers
Definition
extensor mechanism
Term
Allen's Test
Definition
Examining the palmar surface during radial and ulnar arterial compression, and how quickly color returns to the hand
Term
where can the median nn be compressed
Definition
carpal tunnel
Term
median nn supplies sensory to which digits
Definition
1-3
Term
the median nn supplies motor to which muscles
Definition
flexor pollicis brevis, opponens pollicis brevis, abductor pollicis brevis, lateral two lumbricals
Term
How does one diagnosis median nn dysfunction in the hand
Definition
anterior interosseous test (pinch test)
Term
A negative anterior interosseous (pinch) test would produce what sort of results?
Definition
thumb and pointer finger form ok sign normally
Term
a positive anterior interosseous (pinch test) would look like what
Definition
thumb and pointer finger make a triangular ok sign
Term
the ulnar nn may be compressed where
Definition
guyans canal
Term
the ulnar nn provides sensory to which digits
Definition
4,5
Term
the ulnar nn provides motor to which muscle
Definition
abductor digiti minimi, flexor digiti minimi, opponens digiti minimi, medial 2 lumbricals, all 7 interosseous, adductor pollicis, flexor pollicis brevis
Term
How does one test for ulnar nn weaknes
Definition
froment's test
Term
how is a froment's sign test conducted?
Definition
ptnt grips paper with thumb and forefinger, PT pulls on paper, if thumb is not straight, positive sign
Term
the radial nn provides sensory to where
Definition
dorsum of hand, thumb radially
Term
wrist rom: flexion
Definition
0-80
Term
wrist rom: extension
Definition
0-70
Term
wrist rom: radial deviation
Definition
0-15
Term
wrist rom: ulnar deviation
Definition
0-30-45
Term
wrist rom: supination/pronation
Definition
0-80
Term
wrist functional position
Definition
slight extension (20), slight ulnar deviation (10), fingers slightly flexed at all joints, thumb at midrange
Term
wrist resting position
Definition
neutral with slight ulnar deviation
Term
wrist close packed position
Definition
full extension and radial deviation
Term
wrist capsular pattern
Definition
equal loss of flexion and extension
Term
arthrokinematics: three units of the wrist
Definition
radiocarpal (proximal carpal row), midcarpal (distal carpawl row), intercarpal joint
Term
proximal surface of the radiocarpal joint
Definition
distal radius and triangulofibrocartilage complex (TFCC)
Term
the proximal surface of the radiocarpal joint has what shape
Definition
biconcave-ovoid
Term
the distal surface of the radiocarpal joint has what shape
Definition
biconvex
Term
what makes up the distal surface of the radiocarpal joint
Definition
proximal carpal row (scaphoid, lunate, triquetrum)
Term
the midcarpal joint is made up of what
Definition
proximal and distal carpal rows
Term
the medial side of the midcarpal joint is what shape
Definition
ovoid
Term
the medial side of the midcarpal joint is ovoid shaped and articulates with which concave metacarpals
Definition
scaphoid, lunate, triquetrum
Term
the lateral side of the midcarpal joint is what kind of joint
Definition
sellar joint
Term
the proximal surface of trapezii is convex on what surfaces
Definition
med/lat
Term
the proximal surface of trapezii is concave on what surfaces
Definition
ant/post
Term
what is the 1st type of intercarpal joint
Definition
joints b/w bones of proximal carpal row
Term
what is the 2nd type of intercarpal joint
Definition
joints b/w bones of distal carpal row
Term
what is the 3rd type of intercarpal joint
Definition
midcarpal joints
Term
what is the 4th type of intercarpal joint
Definition
synoival joint b/w pisiform and triquetrum
Term
how mnany types of intercarpal joints are there
Definition
4
Term
which joint provides the greatest contribution to wrist flexion
Definition
midcarpal
Term
which joint is the greatest contributor to wrist extension
Definition
radiocarpal
Term
which joint provides the greater contribution to radial deviation
Definition
midcarpal joint
Term
which joint provides the greatest contribution to ulnar deviation
Definition
radiocarpal joint
Term
what type of joints are the interphalangeal joints
Definition
uniaxial hinge joints
Term
articular surface of the distal phalanx
Definition
two facets
Term
articular surfaces of the proximal phalanx
Definition
two condyles
Term
where is the volar/fibrocartilage plate located
Definition
inner surface of capsule
Term
where is the volar/fibrocartilage plate attached
Definition
base of distal phalanx via fibrous bands
Term
in full extension the volar/fibrocartilage plate articulates with what
Definition
head of proximal phalanx
Term
what happens to the volar/fibrocartilage plate in flexion of the finger
Definition
glides into capsular recesses
Term
what is the role of the volar/fibrocartilage plate
Definition
checks extension
Term
interphalangeal joints resting position
Definition
slightly flexed
Term
interphalangea joints closed packed position
Definition
full extension
Term
interphalangeal joints rom flexion
Definition
120 PIP, 90 DIP
Term
interphalangeal joints rom extension
Definition
0-5 PIP, 10-30 DIP
Term
the metacarpalphalngeal have what shape
Definition
spheroidal
Term
what is the proximal surface of the metacarpalphalangeal joints
Definition
metacarpal head
Term
the metacarpal head of the metacarpalphalangeal joints takes what shape
Definition
biconvex
Term
the distal surface of the metacarpalphalangeal joint is what?
Definition
proximal phalanx
Term
what shape does the proximal phalanx of the metacarpalphalangeal joint take
Definition
biconcave
Term
the metacarpalphalangeal joints of the thumb are made up of this bone shape
Definition
sesamoid
Term
metacarpalphalangeal joints resting position
Definition
slight flexion
Term
metacarpalphalangeal joints close packed position
Definition
full flexion
Term
metacarpalphalangeal joints ROM flexion
Definition
90 fingers, 75-80 thumb
Term
metacarpalphalangeal joints ROM extension
Definition
30 fingers, 60 thumb
Term
metacarpalphalangeal joints abduction
Definition
80 fingers, 30 thumb
Term
metacarpalphalangeal joints adduction rom
Definition
0 fingers, 20 thumb
Term
the carpometacarpal joints of digits 2-5 are what kind of joint
Definition
amphiarthrosis joint
Term
amphiarthoris joint
Definition
continuous, slightly movable joint
Term
which digits have very little carpometacarpal joint movement
Definition
3,4
Term
whihc digits have more movement in the carpometacarpal joints
Definition
2,5
Term
which carpometacarpal joints move more like sellar joints
Definition
2,5
Term
the carpometacarpal joint of the thumb is what kind of joint
Definition
sellar
Term
what is the proximal surface of the carpometacarpal joint of the thumb
Definition
trapezium
Term
the distal surface of the carpometacarpal joint of the thumb is what
Definition
distal surface of 1st metacarpal
Term
the carpometacarpal joint of the thumb is what shape med/laterally
Definition
concave
Term
what is the shape of the carpometacarpal joint of the thumb ant/post
Definition
convex
Term
the concave portions of the carpometacarpal joint of the thumb allow for what action
Definition
flex/ext
Term
the convex portion of teh thumb carpometacarpal joint allow for what movement
Definition
abd/add
Term
what is the resting position of the thumb carpometacarpal joint
Definition
midway between flex/ext and abd/add
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