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KIN: Wrist and Hand

QuestionAnswer
Do you have more UD or RD and why? UD because there is not as much stopping the ulna
Why is the wrist being a two-joint system a good thing? Can withstand more pressure
What makes up the proximal part of the radiocarpal joint? Radius Radioulnar disk TFCC
What makes up the distal part of the radiocarpal joint? Scaphoid Lunate Triquetrium
T/F: The proximal radiocarpal joint is biconcave True
What does the lateral radial facet articulate with? Scaphoid
What does the medial radial facet articulate with? Lunate and TFCC
How is the joint surface of the radiocarpal joint angled? Why? Volarly and ulnarly because the radius is longer than the ulna
What does the inferior surface of the radiocarpal joint articulate with? Triquetrium
What is the radioulnar disk? TFC
What makes up the TFCC? TFC Dorsal RU ligament Volar RU ligament UCL complex Meniscus homologue
What is the function of the TFCC? Stabilize distal RUJ Cushion ulna on carpus Allow axial loading of ulnar aspect of forearm Increased articular surface for capus Stabilize ulnar side of carpus
What does the TFCC have attachments with? ECU tendon Triquetrium Hamate Base of 5th MCP through UCL
What makes up the proximal row of carpals? Scaphoid Lunate Triquetrium
What type of bone is the pisiform? Sesmoid bone
What muscle does the pisiform increase the MA for? FCU
Is the proximal row of carpals crossed by any muscles? How does it move? No, movement is dependent on proximal and distal movements
Do we have great wrist flexion or extension Flexion, but for the most part they are equal
What is ulnar negative variance? Short ulna in comparison with the radius at their distal ends
What can ulnar negative variance be associated with? Kienbock's disease
What is Kienbock's disease? AVN of lunate
Is + ulnar variance associated with a thin or thick TFCC? - ulnar variance? + ulnar variance = thinner TFCC - ulnar variance = thicker TFCC
What bones receive the majority of axial compression when a load is applied to the wrist? Scaphoid and lunate
What makes up the proximal part of the midcarpal joint? Scaphoid Lunate Triquetrium
What makes up the distal part of the midcarpal joint? Trapezium Trapezoid Capitate Hamate
How do the bones of the midcarpal joint move? As a fixed unit
Where are the extrinsic ligaments? Connect the carpals to the radius or ulna proximally or to the metacarpals distally
Where are the intrinsic ligaments? Innterconnect the carpals themselves
Which ligaments are more likely to fail: Extrinsic or Intrinsic? Extrinsic
Which ligaments have a better potential for healing: extrinsic or intrinsic? Why? Extrinsic due to vascularity
How do intrinsic ligaments get nutrition? Synovial fluid
Why don't the intrinsic ligaments heal as well? Because the blood gets diluted by the synovial fluid and it can't clot as well
What word tells us that ligaments are intrinsic rather than extrinsic? Interosseous
Where is the pattern of convergence in the hand? Middle
Are the volar (palmar) or dorsal ligaments thicker and stronger? Why? Volar because we are more functional with wrist flexion
What ligaments form the V that helps stabilize the hand? Dorsal intercarpal ligaments
What happens during ulnar deviation with regards to the double V system? Passive tension rises diagonally across the wrist by the stretch placed in the lateral leg of the volar intercarpal ligament and fibers of the volar ulnocarpal ligament
What is the other V of the double V system? Fibers of the volar ulnocarpal and volar radiocarpal ligaments
What happens during radial deviation with regards to the double V system? Passive tension rises in the opposite diagonal across the wrist by the stretch placed in the medial leg of the volar intercarpal ligament and fibers of the volar radiocarpal ligament
What bone is the keystone of the wrist? Why? Capitate because motion in both planes bisects this bone
What is considered the central column of the wrist joint? Radius Capitate Base of the 3rd MC
What happens to the middle segment of the when compressive forces are applied and what bone does this affect? Moves the scaphoid in the opposite directions of the segments above and below
Arthrokinematics of the movement of radiocarpal? Convex on concave Roll and slide opposite
Arthrokinematics during wrist flexion? Rolls palmarly Slides dorsally
Arthrokinematics during wrist extension? Rolls dorsally Slides palmarly
Arthrokinematics during UD? Rolls ulnarly Slides radially
Arthrokinematics during RD? Rolls radially Slides ulnarly
What does full range of UD cause the triquetrium to contact? Articular disc
What type of activity does the compression caused by UD help stabilize the wrist for? Large gripping forces
Where does most RD occur? Midcarpal joint
When is the wrist in a closed pack position? Extension
When is the wrist in a loose pack position? Flexion
What position allows the greatest force of IPJ? UD
What position allows for the least force of IPJ? Wrist flexion
What are the only muscles that do not pass under flexor retinaculum? PL FCU
O of palmaris longus? Medial epicondyle
N of FCR? Median N
A of FCR? Flexion RD
O of FCR? Medial epicondyle
I of FCR? Base of 2nd MC
N of FCU? Ulnar N
O of FCU? Medial epicondyle
I of FCU? Pisiform
A of FCU? Flexion UD
A of FDS? Wrist flexion
I of FDS? Middle phalanges of 4 fingers
O of FDS? Medial epicondyle
A of FDP? Wrist flexion
O of FDP? 2/3 medial and anterior surface of ulna Interosseous membrane
A of FPL? Flexion RD
O of FPL? Middle half of anterior radius Interosseous membrane
I of FPL? Thumb
What muscles have primary actions at the wrist? PL FCR FCU
What muscles have primary actions at the digits and secondary actions at the wrist? FDS FDP FPL
What is the purpose of both the flexor and extensor retinaculum? Prevents bowstringing of the long flexor tendons
What is another name for the flexor retinaculum? Transverse carpal ligament
When you grip, what other muscles besides your flexors are you using and why? Your extensors to keep you from actually going into wrist flexion
Which muscle is able to exert the greatest tension of all the wrist muscles? FCU
What muscles together make up the largest part of the dorsal wrist extensor mass? ECRL ECRB
Which muscle is used more: ECRL or ECRB? ECRB
I of ECRB? 3rd MCP
I of ECRL? 2nd MCP
How do you test for lateral epicondylitis? Resisted wrist extension Resisted 3rd digit extension
A of extensor indicis? 2nd MCP extension Wrist extension
O of ECU? Lateral epicondyle Posterior border of ulna
A of ECU? Extension UD Also active in wrist flexion
What position would make the ECU less effective as a wrist extensor? Why? Pronation because the radius crosses over the ulna causing a reduction in MA of ECU
O of extensor digitorum? Lateral epicondyle
What muscles does the extensor digitorum lie between? ECRB ECU
What do the digitorum tendons have on them to help keep them functioning as a unit? Intertendinous connections
What is the short extensor of the thumb? EPB
A of EPB? RD (minor)
I of EPB> Base of proximal phalanx of thumb
What is the long extensor of the thumb? APL
What tendon forms the anterior border of the anatomical snuffbox? APL
Which muscles pass under the extensor retinaculum? All 9 of them
T/F: Each tendon is incased within its own tendon sheath to prevent friction between tendons friction on retinaculum True
How many bones are in the hand? 19
What is the distal carpal row also called? Midcarpal joint
What are the articulations for the 2nd CMCJ? Trapezoid Trapezium Capitate 3rd MC
What are the articulations for the 3rd CMCJ? Capitate 2nd MC 4th MC
What are the articulations for the 4th CMCJ? Capitate Hamate 3rd MC 5th MC
What are the articulations for the 5th CMCJ? Hamate Ulnar side of 4th MC
What is the proximal transverse arch formed by? Trapezoid Trapezium Capitate Hamate
What does the carpal tunnel contain? Median nerve 9 flexor tendons Extrinsic finger and thumb flexors
What are the arches of the volar side of the hand? Oblique palmar arch Longitudinal palmar arch
Created by: 1185240090