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