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37 Cards in this Set
- Front
- Back
What causes active insufficiency of the wrist?
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fist in full wrist flexion
-flexors are actively insufficient -extensors are passively insufficient |
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What motions have greatest ROM in the wrist?
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Ulnar deviation: 30 degrees (as opposed to only 15 degrees of radial deviation)
Flexion: 65 degrees (as opposed to 55 degrees of extension) *due to ulnar and palmar tilts in wrist |
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Extrinsic Ligaments of the wrist
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Dorsal Radiocarpal ligament: taut during flexion
Radial Collateral ligament: taut during ulnar deviation Palmar Radiocarpal ligament: taut during extension Triangular Fibrocartilage Complex (TFCC): taut during radial deviation |
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What nerve is compressed during carpal tunnel syndrome?
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median nerve
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What is the central column theory?
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arthrokinematics of the wrist based on the central column theory
3rd metacarpal, capitate, lunate, radius |
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What are the arthrokinematics of the radiocarpal & midcarpal joints?
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radiocarpal extension: convex on concave
*lunate rolls dorsally, slides palmarly midcarpal extension: convex on concave *capitate rolls dorsally, slides palmarly |
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Which direction do you mobilize a joint to increase ROM?
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mobilize distal bone in direction of the glide
ie: pt lacks wrist extension: mobilize lunate palmarly w/radius stabilized |
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What are the arthrokinematics of ulnar and radial deviation?
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convex on concave
roll towards direction of deviation *motion of distal row dictates motion of proximal row |
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Innervation of wrist muscles
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Radial nerve: ECRL, ECRB, ECU
Median nerve: FCR and Palmaris longus Ulnar nerve: FCU |
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Agonists & Synergists of wrist extension
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Agonists:
ECRB, ECRL & ECU Synergists: Ext Dig Comm, Ext Dig Min, Ext Pol Long (finger extensors are synergists) |
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Agonists & Synergists of wrist flexion
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Agonists:
FCR & FCU Synergists: FDP, FDS, Flex Pol Long (finger flexors are synergists) |
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Arches of the hand
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2 transverse arches: at CMC and MCP joints
1 longitudinal arch: formed by shape of metacarpal bones |
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Motions of the thumb in the frontal plane
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Flexion: towards midline
Extension: away from midline |
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Motions of the thumb in the sagittal plan
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Adduction: towards palm
Abduction: away from palm |
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Which digits are most important in grip?
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1st, 4th & 5th
allow hand to change shape 1st digit rotated 90 degrees to help grasp |
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CMC arthrokinematics of 1st digit
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saddle joint: allows for opposition of the thumb
*much more mobile than other CMC joints Convex on concave in sagittal plan Concave on convex in frontal plane |
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CMC arthrokinematics of digits 2-5
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flexion/extension only
limited motion due to strong ligaments |
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MCP arthrokinematics of 1st digit
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flexion/extension only since most motion comes from CMC
****flexion/extension happens in frontal plane since MCP is rotated 90 degrees *concave on convex ie: flexion: roll/slide ulnarly |
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MCP arthrokinematics of digits 2-5
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2 DOF- flex/ext & ab/adduction
Concave on convex in frontal plane Concave on convex in sagittal plane |
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Extrinsic flexors of the digits
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FDP- flexes PIP & DIP joints (only one that flexes DIPs)
FDS- flexes PIP joints FPL- flexes IP joint of 1st digit |
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Action of lumbricles
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Flex MCP
Extend PIP & DIP "wave bye" |
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Action of Interosseous muscles
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PADs adduct
and DABs abduct flex MCP Extend IP |
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What muscles are needed to fully extend digits?
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EDC w/PADs, DABs & lumbricles
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Bowstringing of flexors
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when tunnel that flexor tendon runs through breaks, tendon bowstrings
= decreased ROM at PIP joint but larger internal moment arm (greater mechanical advantage |
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What is Osteoligamentus support?
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when a person doesn't use muscles to support body weight-relies on bones and ligaments to maintain posture
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3 articulations of vertebrae
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Intervertebral joint (w/disk btw sup and inf vertebrae)
Superior facets (w/inf facets of superior vertabrae) Inferior facets (w/sup facets on inf vertebrae) |
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4 stages of disk herniation
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Protrusion: slight bulge of nucleus pulposus
Prolapse: nucleus almost breaks through annulus Extrusion: annular fibers distrupted Sequestration: free nuclear material outside of disk |
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Nerve root compression secondary to disk problem
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can occur with prolapse, extrusion or sequestration
*initially loss of sensation **after 6 weeks, muscle weakness ***spacticity if spinal cord is compressed |
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What are the transverse and alar ligaments?
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ligaments of the axis
-stabilize dens transverse=wraps around posterior part of dens alar=connect dens to skull |
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Motion of cervical spine:
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Rotation: 90 (45 from upper, 45 from lower)
Flexion: 50 (15 from upper, 35 from lower) Extension: 85 (15 from upper, 70 from lower) Lateral Flexion: 40 (5 from upper, 35 from lower) |
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Facets of lower C spine
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facets at 45 degrees, allows for rotation
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Motion of thoracic spine
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Flexion: 40
Extension: 25 Rotation: 30 |
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Motion of lumbar spine
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Flexion: 50
Extension: 15 Rotation: 5 Lateral Flexion: 20 |
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Lumbopelvic rhythm
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analogous to scapulohumeral rhythm
=ratio of relative motion from lumbar spine and hips during sagittal motions normal is equal flexion from lumbar spine and hips |
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Nutation/counternutation
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nutation: flexion of Si joint
*top of sacrum moves anterior and inferior counternutation: extension of SI joint *top of sacrum moves posterior and inferior |
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Anterior pelvic tilt
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"sway back"
hyperextension of lumbar spine |
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Posterior pelvic tilt
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"tucked under"
flexion of lumbar spine |