Kinesiology Exam 2 [Wrist And Hand]

Front 1

this joint is also known as a zone of architectural transition between the two bones of the forearm and the 5 metacarpals

Back 1

wrist

Front 2

what type of joint is the wrist?

Back 2

ellipsoidal/biaxial

Front 3

what are the two components of the wrist joint?

Back 3

(1) radiocarpal
(2) midcarpal

Front 4

this carpal bone is in the shape of a peanut

Back 4

scaphoid

Front 5

what carpal bone bridges across the midcarpal joint, making it more susceptible to injury?

Back 5

scaphoid

Front 6

what carpal bone is the most commonly fractured and is most slow to heal?

Back 6

scaphoid

Front 7

the surface of the scaphoid bone is mostly covered with __ cartilage

Back 7

hyaline

Front 8

this carpal bone is the keystone of the bones in the proximal row

Back 8

lunate

Front 9

is the volar or dorsal pole of the lunate thicker?

Back 9

volar

Front 10

in what direction does the lunate tend to dislocate?

Back 10

volarly

Front 11

this disease is avascular necrosis of the lunate

Back 11

Keinbock's

Front 12

during ulnar deviation, what carpal bone glides distally on the hamate?

Back 12

triquetrum

Front 13

what are the four carpal bones of the proximal row?

Back 13

scaphoid, lunate, triquetrum, pisiform

Front 14

what carpal bone is the only one with an insertion from a forearm muscle?

Back 14

pisiform

Front 15

what forearm muscle inserts on the pisiform?

Back 15

flexor carpi ulnaris

Front 16

what other carpal bone does the pisiform function with?

Back 16

triquetrum

Front 17

which way does the pisiform move during radial deviation and extension?

Back 17

distally

Front 18

which way does the pisiform move during ulnar deviation and flexion (due to the pull of the FCU?)

Back 18

proximally

Front 19

this carpal bone has a hook on the palmar side that forms the medial wall of the carpal tunnel

Back 19

hamate

Front 20

what carpal bone forms the medial wall of the carpal tunnel?

Back 20

hamate

Front 21

what carpal bone forms the lateral wall of Guyon's canal?

Back 21

hamate

Front 22

this structure is located between the neurovascular bundle and the flexor tendons in the carpal tunnel

Back 22

hook of the hamate

Front 23

what structure attaches at the hook of the hamate, that forms the roof of the carpal tunnel?

Back 23

flexor retinaculum

Front 24

the axis of rotation for RD, UD, flexion and extension goes through what carpal bone?

Back 24

capitate

Front 25

the capitate is firmly attached to the base of what metacarpal?

Back 25

3rd

Front 26

this carpal bone articulates with the scaphoid, capitate, trapezium, and the second metacarpal

Back 26

trapezoid

Front 27

what are the four carpal bones of the distal row?

Back 27

trapezium, trapezoid, capitate, hamate

Front 28

this carpal bone is the most important link between the carpals and the mobile thumb metacarpal

Back 28

trapezium

Front 29

what type of joint does the trapezium form when it articulates with the 1st MC?

Back 29

saddle

Front 30

the tubercle of what carpal bone makes up the lateral wall of the carpal tunnel?

Back 30

trapezium

Front 31

how much hand function would you lose if you lost the function of your thumb?

Back 31

40-60%

Front 32

what carpal bone is contained in the lateral column of the hand?

Back 32

scaphoid

Front 33

what carpal bones are contained in the central column of the hand?

Back 33

lunate and entire distal row (trapezium, trapezoid, capitate, hamate)

Front 34

what carpal bone is contained in the medial column of the hand?

Back 34

triquetrum

Front 35

what column of the hand is mobile and allows thumb movement?

Back 35

lateral

Front 36

what column of the hand corresponds to the axis of the hand?

Back 36

central

Front 37

what column of the hand allows rotation of the 5th metacarpal?

Back 37

medial

Front 38

when palmar concavity deepens, the carpal tunnel deepens due to movement at what joints?

Back 38

intercarpal

Front 39

what are the components of the carpal tunnel?

Back 39

(1) all FDS tendons
(2) all FDP tendons
(3) flexor pollicis longus tendon
(4) median nerve

Front 40

the concavity of the carpal tunnel plays an important role in balancing the forces of the long finger __ across the wrist with the wrist __

Back 40

flexors, extensors

Front 41

the surface of the radius has articulations for what two carpal bones?

Back 41

scaphoid and lunate

Front 42

does the triquetrum articulate with the distal ulna?

Back 42

NO! articulates with the articular disc

Front 43

how many degrees of palmar tilt is the articular surface of the radius in at the wrist?

Back 43

12º

Front 44

how many degrees of medial angulation is the articular surface of the radius in at the wrist?

Back 44

15º

Front 45

the palmar tilt of the radius at the wrist allows more movement into what motion?

Back 45

more flexion than extension

Front 46

does the radius or the ulna extend further at the wrist joint?

Back 46

radius

Front 47

when the scaphoid, lunate, and triquetrum extend on the distal end of radius and articular disc, in what directions are the roll and glide?

Back 47

posterior roll, anterior glide

Front 48

what shape are the articulating surfaces of the scaphoid, lunate, and triquetrum at the wrist?

Back 48

convex

Front 49

what shape are the distal end of the radius and articular disc of the ulna at the wrist?

Back 49

concave

Front 50

what type of joint is the medial side of the midcarpal joint?

Back 50

compound saddle joint

Front 51

what type of joint is the lateral side of the midcarpal joint?

Back 51

plane

Front 52

at the medial side of the midcarpal joint, what shape are the capitate and hamate?

Back 52

convex

Front 53

at the medial side of the midcarpal joint, what shape are the scaphoid, lunate, and triquetrum?

Back 53

concave

Front 54

at the lateral side of the midcarpal joint, what shape are the trapezium and trapezoid?

Back 54

concave

Front 55

at the lateral side of the midcarpal joint, what shape is the scaphoid?

Back 55

convex

Front 56

what are the thicker and stronger ligaments of the wrist, dorsal or volar?

Back 56

volar

Front 57

the dorsal ligaments of the wrist are reinforced by what structures?

Back 57

extensor retinacular tunnels

Front 58

what are the four extrinsic ligaments of the wrist?

Back 58

(1) dorsal radiocarpal
(2) palmar radiocarpal
(3) TFCC
(4) radial collateral ligament

Front 59

in what position is the palmar radiocarpal ligament taut?

Back 59

full wrist extension

Front 60

what are the three types of intrinsic ligaments of the wrist?

Back 60

(1) short
(2) intermediate
(3) long

Front 61

what are the most commonly injured intrinsic ligaments of the wrist?

Back 61

intermediate

Front 62

what are the three intermediate intrinsic ligaments of the wrist?

Back 62

(1) lunotriquetral
(2) scapholunate
(3) scaphotrapezial

Front 63

this long intrinsic ligament of the wrist is an inverted V, and controls the scaphoid

Back 63

palmar intercarpal

Front 64

this intrinsic ligament of the wrist helps to coordinate movements between the scaphoid and lunate

Back 64

scapholunate

Front 65

this extrinsic ligament of the wrist (which is part of the palmar radiocarpal ligament) guides scaphoid kinematics; it goes across the waist of the scaphoid so it dorsiflexes and volarflexes around this ligament

Back 65

radioscaphocapitate

Front 66

when the wrist extends, does the dorsal pole of the scaphoid go anterior or posterior?

Back 66

posterior/dorsally

Front 67

when the wrist flexes, does the dorsal pole of the scaphoid go anterior or posterior?

Back 67

anterior/volarly

Front 68

this ligament, which is part of the palmar radiocarpal ligament, acts as a volar sling for the lunate, preventing it from dislocating anteriorly

Back 68

radiolunate

Front 69

what three muscles act as important collateral support at the wrist?

Back 69

(1) ECU
(2) EPB
(3) APL

Front 70

what are the three functions of the TFCC?

Back 70

(1) major stabilizer of distal radioulnar joint
(2) stabilizer of ulnar capsule
(3) cushion for load bearing between ulnar carpals and distal ulna

Front 71

what are the five ligaments that provide support/stabilization to the scaphoid?

Back 71

(1) radioscaphocapitate
(2) radioscapholunate
(3) scapholunate
(4) radial collateral
(5) V ligaments

Front 72

what ligament limits the extremes of volarflexion of the scaphoid?

Back 72

radioscapholunate

Front 73

what bones do the V ligaments run between?

Back 73

scaphoid to capitate and triquetrum to capitate

Front 74

what is the close packed position of the wrist?

Back 74

full extension

Front 75

what is functionally the most important motion at the wrist?

Back 75

extension

Front 76

what is the normal range of wrist extension motion?

Back 76

60-75º

Front 77

during wrist extension, which way does the scaphoid move (which locks the joint)?

Back 77

dorsiflexes

Front 78

what is the normal range of wrist flexion motion?

Back 78

70-85º

Front 79

during wrist flexion, which way does the scaphoid move (which unlocks the joint)?

Back 79

volarflexes

Front 80

what are three structures that limit wrist extension?

Back 80

(1) thick palmar ligaments
(2) anterior tilt of articular surface of distal radius
(3) muscles that flex wrist and fingers

Front 81

what is the normal range of motion of radial deviation/abduction at the wrist?

Back 81

15-20º

Front 82

At what joint does radial deviation movement occur primarily?

Back 82

midcarpal

Front 83

during radial deviation, which way do the scaphoid and lunate move (causing the midcarpal joint to be unlocked)?

Back 83

volarflexed

Front 84

during radial deviation, which way does the distal row of carpals slide?

Back 84

radially

Front 85

during radial deviation, which way does the proximal row of carpals slide?

Back 85

ulnarly

Front 86

what is the normal range of motion of ulnar deviation/adduction at the wrist?

Back 86

35-40º

Front 87

in what forearm position is there greater ROM into ulnar deviation?

Back 87

supinated

Front 88

during ulnar deviation, which way does the scaphoid move (causing the midcarpal joint to be locked)?

Back 88

dorsiflexed

Front 89

what two movements does the triquetrum do during ulnar deviation?

Back 89

(1) telescopes distally on hamate
(2) dorsiflexes

Front 90

during ulnar deviation, which way does the proximal row of carpals slide?

Back 90

radially

Front 91

during ulnar deviation, which way does the distal row of carpals slide?

Back 91

ulnarly

Front 92

what is the minimum range of wrist flexion required for most ADLs?

Back 92

40º

Front 93

what is the minimum range of wrist extension required for most ADLs?

Back 93

40º

Front 94

what is the minimum range of wrist RD required for most ADLs?

Back 94

10º

Front 95

what is the minimum range of wrist UD required for most ADLs?

Back 95

30º

Front 96

this instability at the wrist occurs when the lunate stays relatively dorsiflexed due to injury of the scapholunate ligament; allows less flexion ROM

Back 96

DISI (dorsal intercalated segmental instability)

Front 97

this instability at the wrist occurs when the lunate remains in a relatively volarflexed position due to injury of the lunotriquetral ligament

Back 97

VISI (volar intercalated segmental instability)

Front 98

in DISI, is the lunate concavity facing dorsally or volarly?

Back 98

dorsally

Front 99

in VISI, is the lunate concavity facing dorsally or volarly?

Back 99

volarly

Front 100

what is the normal loading pattern for the wrist?

Back 100

82% born by radius
18% born by ulna

Front 101

this results from a lengthened ulna

Back 101

positive ulnar variance

Front 102

this results from a shortened ulna

Back 102

negative ulnar variance

Front 103

what are two things that can increase positive ulnar variance (make ulna longer)?

Back 103

(1) forearm pronation
(2) strong grip

Front 104

during static activities, what are the two positions of the wrist?

Back 104

(1) 20-30º extension
(2) slight UD

Front 105

this muscle at the wrist flexes and radially deviates, and also assists with elbow flexion and forearm pronation

Back 105

flexor carpi radialis

Front 106

what muscle of the wrist contracts during RD to counterbalance the extensor component of the ECRL?

Back 106

FCR

Front 107

what type of muscle is the FCR?

Back 107

fusiform

Front 108

what nerve innervates the FCR?

Back 108

median

Front 109

a weakness of what muscle may cause a decrease in forearm pronation and wrist flexor strength?

Back 109

FCR

Front 110

this muscle of the wrist flexes and UD the wrist, and assits in elbow flexion

Back 110

flexor carpi ulnaris

Front 111

this muscle powers activities such as axing, power stroke, karate chop, dart throwing

Back 111

FCU

Front 112

what nerve innervates the FCU?

Back 112

ulnar

Front 113

this muscle is a pure wrist flexor that tenses the palmar fascia and assists in elbow flexion

Back 113

palmaris longus

Front 114

during active finger extension, what muscles stabilize to prevent excessive wrist extension?

Back 114

wrist flexors

Front 115

what are five muscles that assist in wrist flexion?

Back 115

(1) FDS
(2) FDP
(3) FPL
(4) APL
(5) EPB

Front 116

overall, the extensors of the wrist have __% of the strength of the flexors

Back 116

50%

Front 117

this muscle extends and radially deviates the wrist; it is the main RD

Back 117

ECRL

Front 118

what muscle is most active as a synergist for fist making or prehension?

Back 118

ECRL

Front 119

what muscle is named as a wrist extensor, but has a larger moment arm for elbow flexion and RD of the wrist?

Back 119

ECRL

Front 120

the ECRL is most effective as a wrist extensor with the elbow in what position?

Back 120

extended

Front 121

this extrinsic muscle of the wrist solely extends the wrist

Back 121

ECRB

Front 122

this muscle extends and UD the wrist

Back 122

ECU

Front 123

the ECU is a better wrist extensor with the forearm in what position?

Back 123

supination

Front 124

what muscle is a stabilizer of the wrist during thumb abduction?

Back 124

ECU

Front 125

this muscle works synchronously with the ECRL and ED during wrist extension

Back 125

ECU

Front 126

what mucsle's tendon helps stabilize the head of the ulna?

Back 126

ECU

Front 127

what nerve innervates the ECU, ECRL, and ECRB?

Back 127

radial

Front 128

what are four muscles that assist wrist extension?

Back 128

(1) ED
(2) EDM
(3) EI
(4) EPL

Front 129

the ED assists wrist extension if the fist is in what position?

Back 129

clenched

Front 130

injury to this nerve results in wrist flexion during active finger flexion

Back 130

radial

Front 131

efficiency of the finger flexors with the wrist flexed is only __% of that with the wrist extended

Back 131

25%

Front 132

what are the seven radial deviators of the wrist?

Back 132

(1) ECRL
(2) ECRB
(3) FCR
(4) APL
(5) EPL
(6) EPB
(7) FPL

Front 133

what are the two primary ulnar deviators of the wrist?

Back 133

(1) FCU
(2) ECU

Front 134

what are three muscles that assist in ulnar deviation of the wrist?

Back 134

(1) FDP
(2) FDS
(3) ED

Front 135

what type of joint is the CMC joint of the thumb?

Back 135

saddle

Front 136

how many degrees of freedom are there at the CMC Joint of the thumb?

Back 136

2

Front 137

during adduction at the CMC joint of the thumb, what are the directions of roll and slide?

Back 137

posterior roll, anterior glide

Front 138

during abduction at the CMC joint of the thumb, what are the directions of roll and slide?

Back 138

anterior roll, posterior glide

Front 139

during flexion at the CMC joint of the thumb, what are the directions of the roll and slide?

Back 139

ulnar roll and ulnar glide

Front 140

during extension at the CMC joint of the thumb, what are the directions of the roll and slide?

Back 140

posterior roll, posterior glide

Front 141

the MC is what shape for thumb CMC ab/adduction?

Back 141

convex

Front 142

the MC is what shape for thumb CMC flexion/extension?

Back 142

concave

Front 143

in the capsular pattern of the CMC of the thumb, what motion is most limited, and followed by what other motion?

Back 143

abduction most limited, followed by extension

Front 144

what is the closepacked position of the thumb CMC joint?

Back 144

full opposition

Front 145

what is the resting position of the thumb CMC joint?

Back 145

midway between flex/ext and ab/add

Front 146

what are the five ligaments that reinforce the capsule of the CMC joint of the thumb?

Back 146

(1) strong UCL
(2) anterior oblique
(3) posterior oblique
(4) RCL
(5) 1st intermetacarpal

Front 147

what three movements cause the anterior oblique ligament of the CMC joint of the thumb to be taut?

Back 147

(1) abduction
(2) extension
(3) opposition

Front 148

what three movements cause the ulnar collateral ligament of the CMC joint of the thumb to be taut?

Back 148

(1) abduction
(2) extension
(3) opposition

Front 149

what two movements cause the 1st intermetacarpal ligament of the CMC joint of the thumb to become taut?

Back 149

(1) abduction
(2) opposition

Front 150

what two movements cause the posterior oblique ligament of the CMC joint of the thumb to be taut?

Back 150

(1) abduction
(2) opposition

Front 151

what movements cause the radial collateral ligament of the CMC joint of the thumb to be taut?

Back 151

all movements to varying degrees, except extension

Front 152

when the thumb is used in these two positions, the ligaments of the CMC joint of the thumb need the assistance of the balanced forces from the muscles to maintain optimal joint alignment

Back 152

adduction and flexion

Front 153

what range of thumb CMC flexion is available?

Back 153

45-50º

Front 154

what range of thumb CMC extension is available?

Back 154

10-15º

Front 155

what range of thumb CMC abduction is available?

Back 155

45º (from the palm)

Front 156

what range of thumb CMC adduction is available?

Back 156

to palm of hand

Front 157

thumb CMC opposition is a combination of what three movements?

Back 157

(1) abduction
(2) medial rotation
(3) flexion

Front 158

what type of joints are the 2nd and 3rd CMC joints?

Back 158

plane

Front 159

what are the articulating bones that form the 2nd and 3rd CMC joints?

Back 159

trapezium, trapezoid and capitate articulate with the base of the 2nd and 3rd metacarpals

Front 160

what is usually the only motion allowed at the 2nd and 3rd CMC joints?

Back 160

gliding

Front 161

what type of joint is the 4th CMC Joint?

Back 161

plane

Front 162

what type of joint is the 5th CMC joint?

Back 162

saddle/pseudosaddle

Front 163

what are the articulating bones that form the 4th and 5th CMC joints?

Back 163

hamate and capitate articulate with the bases of the 4th and 5th MCs

Front 164

how much flexion/extension ROM is allowed at the 4th CMC?

Back 164

20º

Front 165

how much flexion/extension ROM is allowed at the 5th CMC?

Back 165

28º

Front 166

what type of joint are the intermetacarpal joints?

Back 166

irregular or plane

Front 167

what are the articulating surfaces of the intermetacarpal joints?

Back 167

between 2nd-5th MC bases

Front 168

what movement is allowed at the intermetacarpal joints?

Back 168

sliding (helps with hand cupping)

Front 169

what side of the hand does more sliding occur at the intermetacarpal joints?

Back 169

ulnar

Front 170

what type of joint are the 2nd-5th MP joints?

Back 170

condyloid, biaxial

Front 171

at the MP joints of the 2-5th fingers, what shape is the MC head?

Back 171

convex

Front 172

at the MP joints of the 2-5th fingers, what shape is the proximal phalanx surface?

Back 172

concave

Front 173

where is the axis of motion of the 2-5th MP joints?

Back 173

through the head of the MCq

Front 174

this is a thick, dense fibrocartilaginous plate on the palmar surface of the joint between the collateral ligaments

Back 174

volar plate

Front 175

what movement does the volar plate prevent?

Back 175

hyperextension

Front 176

the thickness of the volar plate increases the moment arm for what tendons by increasing the distane between the tendon and the joint axis?

Back 176

finger flexor tendons

Front 177

these are strong rounded cords along the sides of the joints of the fingers

Back 177

collateral ligaments

Front 178

what positions are the upper collateral ligaments of the 2-5th fingers taut and slack in?

Back 178

slack in extension (allowing finger ab/add) and taut in flexion (stability for grip)

Front 179

what positions are the accessory collateral ligaments of the 2-5th fingers taut and slack in?

Back 179

taut in extension, and slack in flexion

Front 180

these ligaments are wide bands that connect the volar plates of the 2-5th MP joints, and they limit abduction of the metacarpals

Back 180

deep transverse metacarpal ligament

Front 181

what positions are the deep transverse metacarpal ligaments taut and slack in?

Back 181

slack in adduction, taut in abduction

Front 182

what muscles are located anterior to the deep transverse MC ligament?

Back 182

lumbricales

Front 183

what muscles are located posterior to the deep transverse MC ligament?

Back 183

interossei

Front 184

what ligament of the hand helps to preserve the MC arch?

Back 184

deep transverse metacarpal ligament

Front 185

the capsule at what joint of the finger is the loosest?

Back 185

MP

Front 186

what is the close packed position of the hand?

Back 186

MP flexed, IPs extended

Front 187

what range of flexion is allowed at the 2-5th MP joints?

Back 187

90º (increases at pinky)

Front 188

what range of extension is allowed at the 2-5th MP joints?

Back 188

+10-20º actively

Front 189

what range of radial deviation is allowed at the 2-5th MP joints?

Back 189

9-19º

Front 190

what range of ulnar deviation is allowed at the 2-5th MP joints?

Back 190

20-43º

Front 191

what are the directions of the roll and glide at the 2-5th MP joints during flexion?

Back 191

anterior roll, anterior glide

Front 192

what are the directions of the roll and glide at the 2-5th MP joints during extension?

Back 192

posterior roll, posterior glide

Front 193

what carpal bones do the fingers orient toward when flexed (with NORMAL MP joint motion)?

Back 193

scaphoid

Front 194

is there a tighter grip on the radial or ulnar side of the hand?

Back 194

ulnar

Front 195

what type of joint is the MP of the thumb?

Back 195

condyloid

Front 196

how many degrees of freedom are there at the MP joint of the thumb?

Back 196

2

Front 197

what is the closepacked position of the thumb MP joint?

Back 197

flexion

Front 198

what ligament is more easily stretched/injured at the thumb MP joint, RCL or UCL?

Back 198

UCL

Front 199

this injury is a stretch of the thumb UCL

Back 199

Gamekeeper's thumb

Front 200

what two tendons on the palmar side of the MP joint of the thumb contain sesamoid bones?

Back 200

(1) flexor pollicis brevis
(2) adductor pollicis

Front 201

what range of flexion is allowed at the thumb MP joint?

Back 201

45-90º

Front 202

what range of extension is allowed at the thumb MP joint?

Back 202

0º

Front 203

what type of joints are the IP joints at the fingers?

Back 203

hinge/uniaxial

Front 204

what is the shape of the proximal segment at the IP joints of the fingers?

Back 204

convex

Front 205

what is the shape of the distal segment at the IP joints of the fingers?

Back 205

concave

Front 206

at the IP joints, when are the collateral ligaments taut?

Back 206

remain taut throughout range because of broad transverse dimension of head of proximal phalanx

Front 207

what positions are the accessory collateral ligaments of the IP joints of the fingers taut and slack in?

Back 207

slack in flexion, taut in extension (like volar plate)

Front 208

at the MP joints of the 2-5th fingers, which collateral ligaments are longer, contributing to increased ulnar deviation?

Back 208

radial collateral

Front 209

what range of flexion is allowed at the PIP joint of the fingers?

Back 209

100-120º

Front 210

what range of flexion is allowed at the DIP joint of the fingers?

Back 210

70-90º

Front 211

what range of extension is allowed at the IP joints of the fingers?

Back 211

0º actively (DIP can get more passively)

Front 212

what is the range of flexion allowed at the thumb IP joint?

Back 212

70º

Front 213

what is the range of extension allowed at the thumb IP joint (passively)?

Back 213

20º (increases throughout life)

Front 214

what is the most stable arch of the hand (located at the level of the carpal tunnel)?

Back 214

tranverse carpal arch

Front 215

what is the keystone of the transverse carpal arch of the hand?

Back 215

capitate

Front 216

this arch of the hand is formed by the MCs and phalanges; stability of the MP joints and volar plates are essential to preserve this arch

Back 216

longitudinal arch

Front 217

what are the five extrinsic muscles of the fingers?

Back 217

(1) ED
(2) EI
(3) EDM
(4) FDP
(5) FDS

Front 218

this muscle extends the MP joints of the fingers via attachment into sagittal bands, and assists with IP extension of MPs are not fully extended; assists in abduction of fingers and with wrist extension and RD

Back 218

extensor digitorum

Front 219

if the ED muscle is unopposed, what would occur at the fingers?

Back 219

MP joints hyperextended (claw)

Front 220

what is the only muscle that extends the MP joints of the fingers?

Back 220

ED

Front 221

what muscle is active during making a fist to slow down MP flexion so the FDP and FDS can flex the IP joints before using up their excursion?

Back 221

ED

Front 222

what two positions of the hand would indicate shortness of the ED?

Back 222

(1) hyperextension of MPs if wrist flexed
(2) extension of wrist if MPs flexed

Front 223

this muscle extends the index finger MP joint and assists with IP extension and adduction of the index finger

Back 223

EI

Front 224

this muscle extends the 5th MP joint, assists in IP extension and abduction of the 5th finger

Back 224

EDM

Front 225

this muscle flexes the DIP of fingers, assists in flexion of PIP, MP, CMC, and wrist; assists in adduction

Back 225

FDP

Front 226

this arch of the hand is formed by the MCs and phalanges; stability of the MP joints and volar plates are essential to preserve this arch

Back 226

longitudinal arch

Front 227

what are the five extrinsic muscles of the fingers?

Back 227

(1) ED
(2) EI
(3) EDM
(4) FDP
(5) FDS

Front 228

this muscle extends the MP joints of the fingers via attachment into sagittal bands, and assists with IP extension of MPs are not fully extended; assists in abduction of fingers and with wrist extension and RD

Back 228

extensor digitorum

Front 229

if the ED muscle is unopposed, what would occur at the fingers?

Back 229

MP joints hyperextended (claw)

Front 230

what is the only muscle that extends the MP joints of the fingers?

Back 230

ED

Front 231

what muscle is active during making a fist to slow down MP flexion so the FDP and FDS can flex the IP joints before using up their excursion?

Back 231

ED

Front 232

what two positions of the hand would indicate shortness of the ED?

Back 232

(1) hyperextension of MPs if wrist flexed
(2) extension of wrist if MPs flexed

Front 233

this muscle extends the index finger MP joint and assists with IP extension and adduction of the index finger

Back 233

EI

Front 234

this muscle extends the 5th MP joint, assists in IP extension and abduction of the 5th finger

Back 234

EDM

Front 235

this muscle flexes the DIP of fingers, assists in flexion of PIP, MP, CMC, and wrist; assists in adduction

Back 235

FDP

Front 236

which muscle has a larger moment arm at the PIP, FDP or FDS?

Back 236

FDP

Front 237

which muscle has a larger moment arm at the wrist and MP, FDP or FDS?

Back 237

FDS

Front 238

which finger flexor is more active during light finger flexion?

Back 238

FDP

Front 239

which finger flexor contributes more to finger flexion when there is a load placed?

Back 239

FDS

Front 240

what is the only muscle that flexes the DIP joints of the fingers?

Back 240

FDP

Front 241

what two positions will the hand be in if there is shortness of the FDP?

Back 241

(1) flexion of fingers if wrist extended
(2) flexion of wrist if fingers extended

Front 242

which finger flexor muscle needs stabilization of all other fingers during the MMT?

Back 242

FDS (becasue you prevent FDP from working on tested finger because FDP is connected)

Front 243

this muscle flexes the PIP of fingers, assists in MP, CMC, and wrist flexion

Back 243

FDS

Front 244

this muscle functions alone only when DIP flexion of the fingers is not required

Back 244

FDS

Front 245

this muscle powers the most individual finger motion

Back 245

FDS

Front 246

what would be the presentation of a contracture of the FDP muscle?

Back 246

flexion deformity of DIP joints

Front 247

what would be the presentation of a contracture of the FDS muscle?

Back 247

flexion deformity of the PIP joints

Front 248

what two positions would the hand be in if the FDS was short?

Back 248

(1) flexion of PIP if wrist extended
(2) flexion of wrist if PIPs extended

Front 249

for tendon gliding, during a straight fist, what muscle glides maximally with respect to the sheath and bone?

Back 249

FDS

Front 250

for tendon gliding, during a hook fist, there is maximum gliding between what structures?

Back 250

the tendons of the FDS and FDP

Front 251

for tendon gliding, during a regular fist, there is maximum gliding of what muscle with respect to the sheath and bone?

Back 251

FDP

Front 252

if there is no counterbalancing extensor force at the wrist, then when the finger flexors contract, what will they cause the wrist to do?

Back 252

flex

Front 253

what are the four extrinsic muscles of the thumb?

Back 253

(1) APL
(2) EPB
(3) EPL
(4) FPL

Front 254

this muscle abducts and extends the CMC joint of the thumb, and assists in RD and flexion at the wrist

Back 254

abductor pollicis longus

Front 255

what muscle maintains the arch of hte pinch by preventing collapse of the thumb MC under the influence of adductors?

Back 255

APL

Front 256

what would a contracture of the APL muscle present as?

Back 256

abducted and slightly extended position of 1st MC with slight RD of wrist

Front 257

what muscle is found in the 1st extensor compartment of the wrist?

Back 257

APL

Front 258

to test the length of the APL, what would you do?

Back 258

flex thumb, UD wrist, and slightly extend wrist

Front 259

this muscle extends the thumb MP joint, extends and abducts CMC of thumb, assists in RD and flexion of the wrist

Back 259

EPB

Front 260

weakness of what thumb muscle decreases the ability to extend the thumb MP joint and may result in a position of thumb MP flexion?

Back 260

EPB

Front 261

this muscle extends the IP joint of the thumb, assists in thumb MP and CMC extension, and assists in RD and extension of the wrist

Back 261

EPL

Front 262

at the thumb CMC joint, what muscle is an extensor and adductor

Back 262

EPL

Front 263

to test the integrity of this muscle, you would see if someone could lift their thumb off the table

Back 263

EPL

Front 264

if the thumb adducts as the person is extending it, what muscle is working too much and what is not working enough?

Back 264

EPL too much, APL not enough

Front 265

this muscle flexes the IP joint of the thumb and assists in flexion of the MP, CMC of the thumb and may assist in wrist flexion

Back 265

FPL

Front 266

if there is marked weakness of this muscle, you may develop a hyperextension deformity of the IP joint of the thumb

Back 266

FPL

Front 267

what is the only thumb IP joint flexor?

Back 267

FPL

Front 268

to test the length of the FPL, what would you do?

Back 268

(1) extend thumb
(2) extend wrist
(3) slight UD
if short, IP joint will flex

Front 269

this muscle abducts the 5th MP and assists in opposition of CMC and flexion of 5th MP; may assist in IP extension of 5th due to small insertion into extensor expansion

Back 269

ADM

Front 270

in normal hand cupping, the ADM contraction is accompanied by contraction of what other muscle in order to stabilize the pisiform bone?

Back 270

FCU

Front 271

this muscle flexes the MP of the 5th finger and may assist in opposition of CMC of 5th finger

Back 271

FDM

Front 272

this muscle flexes and rotates the CMC of the 5th finger

Back 272

opponens digiti minimi

Front 273

a weakness in this muscle causes flattening of the palm (makes it difficult to oppose little finger)

Back 273

ODM

Front 274

this muscle abducts index, middle, and ring finger, assists in flexion of MPs and extension of IPs

Back 274

dorsal interossei

Front 275

this muscle may assist in adduction of the thumb

Back 275

1st dorsal interosseous

Front 276

what intrinsic hand muscles are active in power grip?

Back 276

dorsal interossei

Front 277

what shape are the dorsal interossei muscles?

Back 277

bipennate

Front 278

which muscle has 4x as much force as the lumbricales?

Back 278

dorsal interossei

Front 279

are the dorsal interossei volar or dorsal to the axis of motion at the MP joints of the fingers?

Back 279

volar

Front 280

are the dorsal interossei volar or dorsal to the axis of motion at the IP joints of the fingers?

Back 280

dorsal

Front 281

the moment arm for flexion for the dorsal interossei increases as the MP does what motion?

Back 281

flexes

Front 282

the angle of pull of this muscle is such that it would stabilize the base of the 1st MC from dorsoradial subluxation

Back 282

1st dorsal interosseous

Front 283

these muscle adduct the thumb, index, ring, and small fingers; assists in MP flexion and IP extension, and are unipennate

Back 283

palmar interossei

Front 284

what shape are the palmar interossei muscles?

Back 284

unipennate

Front 285

what position would you put the hand in to test the length of the interossei muscles?

Back 285

flex IPs, extend MPs

Front 286

these muscles extend IPs and simultaneously flex MPs of finger, and extend the IPs with the MPS extended

Back 286

lumbricales

Front 287

these muscles are rich in sensory organs to balance flexor and extensor tension; and suppress flexor tension to correct clawing

Back 287

lumbricales

Front 288

what side of the finger are the lumbricales located on?

Back 288

radial side

Front 289

what muscles in the hand have a longer excursion and are farther fro the joint axis than the interossei, but don't produce as much force because the interossei have more fibers?

Back 289

lumbricales

Front 290

this muscle pulls the extensor mechanism proximally, which increases tension in the extensor hood

Back 290

lumbricales

Front 291

this muscle abducts the CMC and MP at the thumb, and assists in thumb IP extension

Back 291

APB

Front 292

what would weakness of the APB cause?

Back 292

difficulty grasping large objects due ot difficult abducting thumb

Front 293

this muscle flexes both the MP and CMC joints of the thumb, and assists in IP extension and opposition

Back 293

FPB

Front 294

what would a contracture of the FPB muscle present as?

Back 294

flexion deformity of MP joint of thumb

Front 295

this muscle opposes the MC joint of the thumb, rotates the thumb into pronation

Back 295

opponens pollicis

Front 296

what would a weakness of the opponens pollicis present as?

Back 296

flattening of thenar emminence and difficulty holding a pencil for writing or grasping objects firmly between thumb and fingers

Front 297

this muscle adducts the CMC joint of the thumb, adducts and assists flexion of MP of thumb, and assists thumb IP extension

Back 297

adductor pollicis

Front 298

what nerve innervates the adductor pollicis?

Back 298

ulnar nerve

Front 299

what muscle has the best torque potential of any other thumb CMC muscle?

Back 299

adductor pollicis

Front 300

most commonly during function, the thumb is in what two positions?

Back 300

adduction and flexion

Front 301

what are five forces that contribute to alteration in the mechanical forces at the CMC Joint of the thumb?

Back 301

(1) adduction and flexion during function
(2) insufficient function of APL, APB, 1st DI to stabilize CMC
(3) shortness and overuse of MP flexors and adductor of thumb
(4) weak EPB
(5) ligament laxity

Front 302

the MP extension at the fingers occurs via what structure in the extensor mechanism?

Back 302

sagittal bands

Front 303

PIP extension at the fingers occurs via what structure in the extensor mechanism?

Back 303

central slip

Front 304

DIP extension at the fingers occurs via what structure in the extensor mechanism?

Back 304

terminal tendon

Front 305

what are the five components of the extensor mechanism (muscles)?

Back 305

(1) ED
(2) EI
(3) EDM
(4) lumbricales
(5) interossei

Front 306

this part of the extensor mechanism attaches at the base of the middle phalanx

Back 306

central slip

Front 307

this part of the extensor mechanism attaches at the base of the distal phalanx

Back 307

terminal tendon

Front 308

normally, the lateral bands of the extensor mechanism are volar or dorsal to the PIP and DIP joints at the fingers?

Back 308

dorsal

Front 309

this deformity of the hand occurs when the central slip of the extensor mechanism is avulsed, causing DIP hyperextension and PIP flexion (because lateral bands slip volarly)

Back 309

Boutonneire deformity

Front 310

shortness of what ligament of the finger contributes to a Boutonneire deformity?

Back 310

oblique retinacular ligament

Front 311

this deformity is when the volar plate is too lax and the interossei are short, causing MP flexion, PIP hyperextension, and DIP flexion

Back 311

swan neck deformity

Front 312

this deformity occurs from rupture of the terminal tendon of the extensor mechanism, causing a loss of active DIP extension

Back 312

mallet finger

Front 313

in a mallet finger deformity, the extensor mechanism may retract, causing increasing tension on the central slip and creating a secondary deformity of what type?

Back 313

swan neck (PIP hyperextension)

Front 314

this deformity occurs when there is a loss of intrinsic muscle stabilization; the ED is no longer balanced by the intrinsics resulting in MP hyperextension and IP flexion (Because ED cannot extend IP joints)

Back 314

clawing

Front 315

a clawhand deformity can occur due to what nerve injury?

Back 315

ulnar

Front 316

during an ulnar nerve injury, which fingers claw the worst since they are solely innervated by the ulnar nerve?

Back 316

4th and 5th

Front 317

this apparatus prevents bowstringing of the flexor tendons

Back 317

flexor apparatus

Front 318

how many annular and cruciate pulleys are there in the flexor apparatus of the fingers?

Back 318

4 annular, 3 cruciate

Front 319

what are the two most important pulleys in the flexor apparatus of the fingers?

Back 319

A2 and A4

Front 320

this is when the flexor tendons relatively lengthen with respect to the skeleton, decreasing their efficiency and not allowing you to make a full fist

Back 320

bowstringing

Front 321

the flexor tendons of the fingers cross the MP joint at what type of angle?

Back 321

ulnar angle

Front 322

these finger flexor tendons insert on the distal phalanx

Back 322

FDP

Front 323

these finger flexor tendons insert by two slips at the base of the middle phalanx

Back 323

FDS

Front 324

how do you stretch the oblique retinacular ligament of hte finger?

Back 324

simultaneously extend PIP and flex DIP

Front 325

what is the normal sequence of finger flexion?

Back 325

PIP then MP then DIP

Front 326

what is the normal sequence of finger extension?

Back 326

MP then DIP then PIP

Front 327

if there is a short arc of motion for finger flexion, what muscle is not working?

Back 327

interossei

Front 328

Froment's sign is a quick test for injury to this nerve; a person grasps a piece of paper, and their IP joint flexes instead of staying in extension

Back 328

ulnar

Front 329

in Froment's sign, when the IP flexes, what muscle is working too much and what is working too little?

Back 329

FPL too much, adductor pollicis too little

Front 330

an injury to what nerve would cause loss of the FDP, causing inability to actively flex DIP and MP joints of small and ring fingers?

Back 330

ulnar

Front 331

an injury to what nerve would cause atrophy of the hypothenar muscles?

Back 331

ulnar

Front 332

an injury to what nerve would cause loss of power grip and a poor pinch grip?

Back 332

ulnar

Front 333

an injury to what nerve would cause atrophy of the thenar emminence?

Back 333

median

Front 334

an injury to this nerve would result in inability to flex DIP and PIP joints of index and middle fingers and weak PIP flexion of ring and small

Back 334

median

Front 335

an injury to what nerve would cause loss of abduction and opposition of the thumb?

Back 335

median

Front 336

an injury to what nerve owuld cause loss of the lumbricales, causing inability to completely actively extend IP joints of middle and index fingers?

Back 336

median

Front 337

an injury to what nerve would cause a loss in wrist flexion and pronation strength?

Back 337

median

Front 338

an injury to what nerve presents with wrist drop?

Back 338

radial

Front 339

what is a quick test for the integrity of the radial nerve?

Back 339

ask someone to extend fingers; will only extend at IPs, not MCP

Front 340

an injury to what nerve would cause a loss of wrist, finger, and thumb extensors?

Back 340

radial

Front 341

an injury to what nerve would cause active insufficiency of finger flexors due to loss of wrist extensors?

Back 341

radial

Front 342

an injury to what nerve would cause a flexion posture of the thumb?

Back 342

radial

Front 343

what muscle is active during the three jaw chuck pinch?

Back 343

opponens pollicis

Front 344

what muscle is active during the key pinch (and is the strongest pinch)?

Back 344

adductor pollicis

Front 345

what muscle is active during tip to tip pinch?

Back 345

flexor pollicis longus

Front 346

what force results at the elbow during resisted shoulder medial rotation?

Back 346

valgus

Front 347

if there is a positive ulnar variance at the wrist, are there higher or lower compressive forces at the joint?

Back 347

higher

Front 348

what kind of stress is placed at the volar plate of the PIP joint with a swan neck deformity?

Back 348

tension

Front 349

what thenar muscles are active during a gentle grasp (opposition of thumb with any of the other fingers)?

Back 349

opponens pollicis predominates
APB>FPB

Front 350

what thenar muscles are active with firm opposition of thumb to the index or middle finger?

Back 350

FPB>Opponens
AdPollicis>AbPB

Front 351

what thenar muscles are active with firm opposition of the thumb to the ring finger?

Back 351

Opponens increases but still AbPB increases but still

Front 352

what thenar muscles are active with firm opposition of the thumb to the small finger?

Back 352

opponens=FPB
abductor pollicis brevis=adductor pollicis

Front 353

this is the type of grip one has when holding a tennis racket

Back 353

cylindrical grip

Front 354

this is the type of grip one has when holding a baseball

Back 354

spherical grip

Front 355

this is the type of grip one has when holding a brief case handle

Back 355

hook grip

Front 356

this is the type of grip one has when holding a cigarette

Back 356

lateral prehension

Front 357

what are the four types of power grips?

Back 357

(1) cylindrical
(2) spherical
(3) hook
(4) lateral prehension

Front 358

this is the type of grip someone has when holding a quarter

Back 358

pad to pad prehension

Front 359

this is the type of grip someone has when holding a straight pin

Back 359

tip to tip prehension

Front 360

this is the type of grip someone has when pinching a key

Back 360

pad to side prehension

Front 361

what are the three types of precision handling grips?

Back 361

(1) pad to pad prehension
(2) tip to tip prehension
(3) pad to side prehension

Front 362

in the cylindrical grip, what finger flexor is active in the dynamic phase?

Back 362

FDP

Front 363

in the cylindrical grip, what finger flexor is active in the static phase?

Back 363

FDS

Front 364

in the cylindrical grip, what muscles are active and function as MP flexors, abductors, and adductors?

Back 364

interossei

Front 365

in the cylindrical grip, what finger intrinsics are relatively silent?

Back 365

lumbricales

Front 366

in the power grip, what muscle acts as a stabilizer to increase joint stability and compression?

Back 366

ED

Front 367

are the thenar muscles active during cylindrical grip?

Back 367

yes (FPL and thenar muscles all active)

Front 368

a distinguishing characteristic between power grip and precision handling is that what muscle is very active in power grip?

Back 368

adductor pollicis

Front 369

are the hypothenar muscles active in cylindrical grip?

Back 369

yes

Front 370

the main difference in this grip from the cylindrical grip is that the finger spread leads to increased interosseous activity

Back 370

spherical grip

Front 371

what is the major muscle activity during a hook grip?

Back 371

FDP and FDS (some interosseous)

Front 372

does a hook grip ever include the thumb?

Back 372

NO, may include palm

Front 373

during lateral prehension, what is the position of the MP and IP joints?

Back 373

extension, MP simultaneously abducted or adducted

Front 374

during lateral prehension, these muscles help extend the fingers

Back 374

lumbricales, ED

Front 375

during lateral prehension, these muscles help ab/adduct the fingers

Back 375

interossei

Front 376

what type of muscular activity occurs during precision handling?

Back 376

isotonic

Front 377

what type of fine grip accounts for about 80% of precision handling?

Back 377

pad to pad prehension

Front 378

what muscle is used if the DIP is flexed in a grip?

Back 378

FDP

Front 379

what muscle is used if the DIP is extended in a grip?

Back 379

FDS

Front 380

what muscles supplement MP flexion force and ab and adduction at the MP joints during a grip?

Back 380

interossei

Front 381

the activity of what muscle increases with the pressure of the pinch?

Back 381

adductor pollicis

Front 382

what muscle controls IP flexion of the thumb during a grip?

Back 382

FPL

Front 383

what is the most precise form of grasp?

Back 383

tip to tip prehension

Front 384

what is the difference between pad to pad and tip to tip prehension?

Back 384

need full IP joint flexion, and MP must ulnarly deviate

Front 385

what three muscles are used during tip to tip prehension?

Back 385

FDP, FPL, interossei

Front 386

what 7 muscles are used during pad to pad prehension?

Back 386

(1) FDP if DIP flexed
(2) FDS if DIP extended
(3) interossei
(4) opponens pollicis
(5) FPB
(6) APB
(7) adductor pollicis

Front 387

what is the least precise form of pinch?

Back 387

pad to side prehension

Front 388

what is the difference between pad to side prehension and other forms of prehension?

Back 388

thumb more adducted and less rotated

Front 389

during pad to side prehension, the activity of what muscles increases?

Back 389

FPB, adductor pollicis

Front 390

during pad to side prehension, the activity of what muscle decreases?

Back 390

opponens

Front 391

what type of grip can be performed using tenodesis with paralysis of the hand muscles by extending the wrist?

Back 391

pad to side prehension