Kinesio Hand/wrist 1 Test 3

Front 1

Radiocarpal joint:

Back 1

Proximal: radius, radioulnar disk and TFCC (biconcave)
Distal: scaphoid, lunate and triquetrum
Lateral radial facet with scaphoid
Medial radial facet- lunate and TFCC
TFCC- triquetrium and some with lunate

Front 2

Midcarpal joint:

Back 2

Proximal: scaphoid, lunate, triquetrum
Distal: trapezium, trapezoid, capitate and hamate

Front 3

CMC joint:

Back 3

1st MC with trapezium (saddle joint 2 df) can do opposition
2nd MC with trapezoid, trapezium, and 3rd MC
3rd MC with capitate, 2nd and 4th MCs
4th MC with capitate, hamate, 3rd and 5th MCs
5th MC with hamate and ulnar side of 4th MC

Front 4

Radiocarpal and midcarpal OKC:

Back 4

: convex distal rows on concave proximal rows
Flexion- palmar roll with dorsal slide
Extension- dorsal roll with palmar slide, 60 degrees total
Radial deviation- roll radially slide ulnarly, more motion at midcarpal join
Ulnar deviation- Scaphoid, lunate, triquetrium roll ulnarly and slide radially, capitates rolls ulnarly and slides radially (more than radial deviation)

Front 5

Thumb MC joint OKC:

Back 5

Trapezium concave sagittal (abduction/adduction): convex 1st MC on concave trapezium opposite roll and slide
Trapezium convex frontal plane (flexion/extension): concave 1st MC on convex trapezium, same direction roll and slide

Front 6

Ape Hand-

Back 6

median n. injury, flat thenar area, no opposition of thumb

Front 7

Claw hand

Back 7

median and ulnar nerve, tightening of flexor muscles (if only ring and little finger it is just an injury to ring and little finger

Front 8

Clawing (intrinsic minus):

Back 8

Proximal phalanx hyperextends on MC below while middle and distal phalanx flex
Can occur when intrinsic muscles are weak or paralyzed (ulnar nerve injury) this position can occur with EDC activity and at rest
Also known as intrinsic minus position (absence of intrinsic muscles)

Front 9

Bishops Hand

Back 9

- ulnar nerve injury, little and ring finger flexed

Front 10

Wrist drop-

Back 10

radial nerve injury, wrist extensors do not function

Front 11

Intrinsic plus of hand

Back 11

Flexion at MCP with extension at PIP and DIP, ED not firing

Front 12

Ulnar drift-

Back 12

ulnar muscles are stronger and tighter than radial muscles pulling hand into ulnar deviation

Front 13

Swan neck

Back 13

PIP is hyperextended and DIP is flexed

Front 14

Boutonneire-

Back 14

flexed PIP and DIP hyperextension (usually due to trauma of the extensor hood)

Front 15

Mallet finger

Back 15

flexion of DIP, avulsion of extensor digitorum at distal phalanx

Front 16

Trigger finger

Back 16

nodule in flexor tendons, as finger is pulled into extension nodule snaps

Front 17

Dupuytren’s contracture-

Back 17

contracture of flexor muscles, genetic

Front 18

Extrinsic muscles

Back 18

palmarus longus, flexor carpi radialis, flexor carpi ulnaris- primary actions at wrist
flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus- secondary actions at wrist
extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor indicis, extensor pollicis longus and brevis, abductor pollicis longus, extensor digitorum

Front 19

Extrinsic muscles that contribute to finger flexion-

Back 19

FDS (primarily PIP) and FDP (MP, PIP, DIP)

Front 20

Extrinsic muscles that contribute to finger extension

Back 20

EDC, EI, and EDM

Front 21

Extrinsic muscles that contribute to thumb movements

Back 21

flexor pollicis longus, extensor pollicis longus (extends IP and MCP of thumb), extensor pollicis brevis (CMC abduction, thumb extension), abductor pollicis longus

Front 22

Dorsal interossei & Volar interossei

Back 22

arise between MC and attach to proximal phalanges or extensor hood
produce MCP abduction/adduction
Flex MCP joint- greater MA when already in flexion

Front 23

4 dorsal interossei

Back 23

1st DI inserts entirely into proximal phalanx and extensor hood
Middle and ring have proximal and distal attachments
NO DI on 5th finger
Abduct index, middle and ring fingers

Front 24

3-4 ventral interossei

Back 24

Only distal attachments
Adduct the 2nd, 4th and 5th MCP

Front 25

Lumbricals:

Back 25

arise from FDP in palm attach to lateral band of extensor retinaculum

Front 26

Oponens pollicis:

Back 26

only intrinsic muscle to have distal attachment on first MC

Front 27

Intrinsic thumb muscles:

Back 27

Oponens pollicis, Abductor pollicis brevis, flexor pollicis brevis, adductor pollicis

Front 28

Radial deviation:

Back 28

extensor carpi radialis longus, flexor carpi radialis (helps prevent extension with radial deviation of ECRL) & flexor pollicis longus (some), extensor pollicis brevis (minor)

Front 29

Ulnar deviation:

Back 29

flexor carpi ulnaris, extensor carpi ulnaris

Front 30

• Flexion with ulnar deviation-

Back 30

flexor carpi ulnaris

Front 31

• Flexion of thumb with some wrist flexion

Back 31

flexor pollicis longus

Front 32

• Extension with radial deviation

Back 32

extensor carpi radialis longus

Front 33

• Extension of third finger only

Back 33

extensor carpi radialis brevis

Front 34

• Extension of wrist with ulnar deviation

Back 34

extensor carpi ulnaris

Front 35

• Extensor carpi radialis longus and extensor carpi ulnaris

Back 35

active during forceful finger or wrist flexion to keep wrist from flexing

Front 36

• Flexor digitorum profundus

Back 36

: gentle pinch, or fix all but DIP

Front 37

• Flexor digitorum superficialis:

Back 37

with more finger force needed

Front 38

• EDC alone:

Back 38

MP joint hyperextension with IP flexion

Front 39

Wrist flexors-

Back 39

medial epicondyle via common flexor tendon

Front 40

Wrist extensors-

Back 40

lateral epicondyle via common extensor tendon

Front 41

Supinators-

Back 41

lateral epicondyle

Front 42

Pronators-

Back 42

medial epicondyle (pronator teres)

Front 43

Ulnar Negative Variance

Back 43

: short ulna in comparison with radius at their distal ends
Abnormal force distribution, Kienbock’s disease: AVN of lunate
TFCC thicker

Front 44

Ulnar Positive Variance

Back 44

long distal ulna in comparison with the radius at their distal ends
Common after distal radius fracture, pain common with ulnar deviation due to pinching of structures
TFCC impingement btwn triquetrum and distal ulna
Thinner TFCC

Front 45

Axial compression applied to wrist:
Radiocarpal joint:

Back 45

Scaphpoid and lunate receives approximately 80% of load
TFCC receives approximately 20% of load

Front 46

Axial compression applied to wrist:
Midcarpal joint:

Back 46

Almost equal distribution of loads across joint
80% of compression through radius at distal radioulnar joint, 20% of compression through ulna at distal radioulnar joint

Front 47

Radius angled 23 degrees ulnarly-

Back 47

radius 12mm greater on radial side than on ulnar side

Front 48

Radius angled 11 degrees volarly

Back 48

posterior radius slightly longer than the volar radius

Front 49

TFCC complex:

Back 49

triangular fibrocartilage, dorsal radioulnar ligament, volar radioulnar ligament, ulnar collateral ligament complex, meniscus homologue

Front 50

dorsal and volar radioulnar ligaments

Back 50

are generally dense and attach ulnar head to ulnar styloid

Front 51

ulnocarpal ligament

Back 51

arises from the TFC
Stabilize distal radioulnar joint, Cushion ulna on carpus, Allows axial loading of ulnar aspect of forearm, Increased articular surface for carpus, Stabilize ulnar side of carpus

Front 52

Proximal carpal rows:

Back 52

interosseous ligaments-
scapholunate interosseous: scaphoid stability
lunotriquetral interosseous: lunate and triquetrum stability

Front 53

Extrinsic ligaments:

Back 53

carpals to the radius or ulna proximally or metacarpals distally
More likely to fail
Better healing due to vascularity
Protect intrinsic
Ulnar and radial collateral ligaments

Front 54

Volar (palmar) ligaments

Back 54

thicker and stronger than dorsal, more functional activities volarly

Front 55

3 bands

Back 55

radioscaphocapitate, short and long radiolunate, radioscapholunate

Front 56

Intrinsic ligaments

Back 56

: interconnect the carpals to themselves (intercarpal or interosseous)
Poor vascularity, poor healing, rely on synovial fluid for nutrition

Front 57

Wrist ligaments

Back 57

proximal converge on lunate, distal converge on capitates

Front 58

Radial collateral ligament more developed palmarly-

Back 58

tight with ulnar deviation and wrist extension

Front 59

Volar ligament

Back 59

tight with extension

Front 60

Dorsal intercarpal ligament

Back 60

horizontally from triquetrum to lunate, scaphoid and trapezium, horizontal v, tight with flexion

Front 61

Proximal V

Back 61

volar (palmar) ulnocarpal and volar (palmar) radiocarpal ligaments

Front 62

Distal V

Back 62

volar intercarpal ligament (medial and lateral leg)

Front 63

Ulnar deviation

Back 63

passive tension on lateral leg of volar intercarpal and volar ulnocarpal ligament

Front 64

Radial deviation

Back 64

passive tension on medial leg of volar intercarpal ligament and volar radiocarpal ligament

Front 65

Transverse carpal ligament

Back 65

part of flexor retinaculm, pisiform to hook of hamate medially; scaphoid and trapezium laterally, help form proximal transverse arch