Term
what are the 4 joints of the elbow and forearm? |
|
Definition
humeroulnar, humeroradial, proximal radioulnar, distal radioulnar |
|
|
Term
what type of joints are humeroulnar and radial? How many dof? |
|
Definition
|
|
Term
what type joints are prox/dist radioulnar? How many dof? |
|
Definition
|
|
Term
is the elbow joint stable? |
|
Definition
|
|
Term
what are the roles of the elbow complex? |
|
Definition
provide mobility for hand by adjusting arm length, assist shoulder in application of forces |
|
|
Term
what is the true elbow joint? |
|
Definition
|
|
Term
why is the humeroulnar joint the true elbow joint? |
|
Definition
this is where we get articulation |
|
|
Term
what gives humeroulnar joint stability? |
|
Definition
bony puzzle pieces that fit together: olecranon/olecranon fossa, coronoid process/coronoid fossa, trochlear notch/trochlea |
|
|
Term
what gives humeroulnar joint mobility? |
|
Definition
large surface area: trochlea spans 300 deg |
|
|
Term
which trochlea projects further distally? |
|
Definition
medial side of trochlea is more distal than lateral trochlea |
|
|
Term
what is the poser elbow joint? |
|
Definition
|
|
Term
what are the articulatoins of humeroradial? |
|
Definition
head of radius, capitulum of humerus |
|
|
Term
does the humeroradial joint provide bony stability to the elbow? |
|
Definition
|
|
Term
what is the fovea of the radius? |
|
Definition
|
|
Term
what does the humeroradial joint do? |
|
Definition
provides a bony block to valgus motion at elbow |
|
|
Term
|
Definition
angle between midlines of humerus and forearm with elbow in extension |
|
|
Term
what is the average carrying angle? |
|
Definition
|
|
Term
what is function of carrying angle |
|
Definition
helps clear hand away from body; you can carry a load without it running into your thigh |
|
|
Term
what causes cubital valgus? |
|
Definition
medial side of trochlea is more distal than lateral trochlea.forearm lines up with slanted humerus |
|
|
Term
what happens to forearm when you flex? |
|
Definition
|
|
Term
what joints are in the elbow capsule? |
|
Definition
humeroulnar, humeroradial, proximal radioulnar |
|
|
Term
|
Definition
|
|
Term
what are the weakest parts of elbow capsule? |
|
Definition
|
|
Term
what reinforces elbow capsule medial/laterally? |
|
Definition
|
|
Term
what are the ligaments of the elbow? |
|
Definition
annular, medial/ulnar collateral ligament, lateral/radial collateral ligament |
|
|
Term
why is the elbow capsule weak ant/post? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
what are the 3 parts of the medial collateral ligament? |
|
Definition
anterior, posterior transverse |
|
|
Term
|
Definition
primary restraint to valgus stress |
|
|
Term
|
Definition
weak restraint to valgus stress |
|
|
Term
|
Definition
assists with restraint to valgus stress |
|
|
Term
when is valgus force greatest? |
|
Definition
neutral supination pronation (like pitching) |
|
|
Term
when does MCL work the hardest? |
|
Definition
neutral supination pronation (like pitching) |
|
|
Term
does MCL work more in extension or in flexion? |
|
Definition
|
|
Term
when is the anterior bundle of MCL tightest? |
|
Definition
|
|
Term
when is the posterior bundle of MCL tightest? |
|
Definition
|
|
Term
besides MCL, what else helps restrain valgus? |
|
Definition
portions of capsule + bony contact between radius and humerus |
|
|
Term
|
Definition
resist varus force, assist with resisting distraction, supports annular ligament, helps restrain excessive supination |
|
|
Term
what does annular ligament do? |
|
Definition
|
|
Term
what is nursemaid's elbow |
|
Definition
radius comes out of annular ligament |
|
|
Term
what is close packed elbow position? |
|
Definition
|
|
Term
loose packed elbow position |
|
Definition
70 deg flexion, 10 deg supination |
|
|
Term
where is elbow most stable |
|
Definition
|
|
Term
where are ligaments and bony structures best at resisting varus? |
|
Definition
|
|
Term
what provides resistance to distraction? |
|
Definition
|
|
Term
what is most unstable position of elbow |
|
Definition
|
|
Term
arthrokinematics of elbow in flexion |
|
Definition
concave ulna rolls and slides anteriorly on convex humerus |
|
|
Term
arthrokinematics of elbow in extension |
|
Definition
concave ulna rolls and slides posteriorly on convex humerus |
|
|
Term
arthrokinematics of pushup at humeroulnar joint |
|
Definition
convex on concave: humerus rolls and glides in opposite directions |
|
|
Term
what are the primary flexors of the elbow? |
|
Definition
|
|
Term
what is the secondary flexor of the forearm and when does it work best? |
|
Definition
brachioradialis, in mid position |
|
|
Term
what are the elbow extensor muscles? |
|
Definition
|
|
Term
how does triceps act as synergist in forceful supination? |
|
Definition
prevents biceps from flexing elbow as it supinates |
|
|
Term
what is the proximal radioulnar joint? |
|
Definition
head of radius fits into radial notch of ulna |
|
|
Term
what type of joint is proximal radioulnar, how many dof |
|
Definition
|
|
Term
what ligament stabilizes proximal radioulnar joint and guides accessory motion? |
|
Definition
|
|
Term
what are the articulations of distal radioulnar? |
|
Definition
ulnar notch, articular disc, head of ulna |
|
|
Term
where is compression through forearm initially loaded |
|
Definition
|
|
Term
how is force from radius transmitted to ulna |
|
Definition
through interosseous membrane |
|
|
Term
where is the higher load of force in proximal forearm? |
|
Definition
|
|
Term
total rom of pronation/supinatoin |
|
Definition
|
|
Term
what is the functional ROM of supination/pronation |
|
Definition
50 deg in either direction |
|
|
Term
why is supination/pronation assessed with elbow flexed to 90 deg |
|
Definition
avoid internal/external rotation from shoulder |
|
|
Term
at radioulnar joints, is radius convex or concave? |
|
Definition
|
|
Term
arthrokinematics of supination |
|
Definition
concave radius rolls and glides posteriorly on convex ulna |
|
|
Term
arthrokinematics of pronation |
|
Definition
concave radius rolls and glides superiorly on convex ulna |
|
|
Term
arthrokinematics of pronation in terms of ulna |
|
Definition
convex ulna rolls anteriorly and slides posteriorly on concave radius |
|
|
Term
arthrokinematics of supination in terms of ulna |
|
Definition
convex ulna rolls posteriorly and slides anteriorly on concave radius |
|
|
Term
|
Definition
pronator teres, pronator quadratus |
|
|
Term
how does pronator teres affect superior radioulnar joint? |
|
Definition
pronator teres compresses superior radioulnar joint |
|
|
Term
how does pronator quadratus affect distal radioulnar joint? |
|
Definition
pronator quadratus helps maintain stability on distal radioulnar joint through compression |
|
|
Term
where is biceps brachii most effective at supination |
|
Definition
|
|
Term
what other muscles provides supination at all positions of elbow or forearm? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
what also looks like lateral epicondylitis with lateral forearm pain? |
|
Definition
radial nerve entrapment/radial tunnel syndrome |
|
|
Term
what is ulnar nerve entrapment called? |
|
Definition
|
|
Term
|
Definition
optimize length-tension relationships of external finger flexors/extensors; help manipulate location of hand/fingers |
|
|
Term
what are the 3 joints of the wrist? |
|
Definition
radiocarpal, midcarpal, carpometacarpal |
|
|
Term
how is the radius angled in the frontal plane? |
|
Definition
|
|
Term
how is radius angled in sagittal plane? |
|
Definition
|
|
Term
what is the shape of the radius medial-laterally and anterior-posteriorly? |
|
Definition
|
|
Term
what fills the space between distal radius and ulna? |
|
Definition
fibrocartilaginous disc: triangular fibrocartilage complex |
|
|
Term
which bone makes most contact with carpal bones? |
|
Definition
|
|
Term
what does the radius's angle towards ulna mean? |
|
Definition
more ulnar deviation than radial deviation |
|
|
Term
what does radius's angle towards palm mean? |
|
Definition
more flexion than extension |
|
|
Term
functions of triangular fibrocartilage complex |
|
Definition
extension of distal radius, articulates with triquetrum, receivs about 20% of axial load |
|
|
Term
|
Definition
scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate |
|
|
Term
describe structure of triangular fibrocartilage complex |
|
Definition
radioulnar disc, dorsal and palmar radioulnar ligaments, ties into sheath around extensor carpi ulnaris tendon |
|
|
Term
describe radioulnar disc that is part of triangular fibrocartilage complex |
|
Definition
fibrocartilaginous extension of the articular cartilage from the radius |
|
|
Term
is scaphoid medial or lateral? |
|
Definition
|
|
Term
is trapezium lateral or medial? |
|
Definition
|
|
Term
60% of all carpal fractures are to what bone? |
|
Definition
|
|
Term
what causes scaphoid fractures? |
|
Definition
forceful hyperextension of wrist |
|
|
Term
what is a factor in scaphoid healing |
|
Definition
|
|
Term
how are proximal or distal scaphoid fractures treated? |
|
Definition
|
|
Term
where is there more vascularization of scaphoid? |
|
Definition
on thumb side (laterally) than on wrist side (medially) |
|
|
Term
what do extrinsic wrist ligaments do? |
|
Definition
connect carpals to radius/ulna or metacarpals |
|
|
Term
do palmar or dorsal wrist ligaments provide more stability? |
|
Definition
|
|
Term
do you bear weight in wrist flexion or extension |
|
Definition
|
|
Term
what are the palmar wrist ligaments |
|
Definition
radial collateral, ulnar collateral, palmar radiocarpal |
|
|
Term
what is the dorsal wrist ligament? |
|
Definition
|
|
Term
what do intrinsic wrist ligaments do? |
|
Definition
|
|
Term
|
Definition
|
|
Term
what are palmar surface intrinsic wrist ligaments? |
|
Definition
transverse carpal, lunotriquetral, scapholunate |
|
|
Term
what are dorsal surface intrinsic wrist ligaments? |
|
Definition
|
|
Term
what causes carpal instability? |
|
Definition
|
|
Term
what are 2 common types of carpal instability? |
|
Definition
translocation of the carpus, rotational collapse |
|
|
Term
what happens in translocation of the carpus? |
|
Definition
|
|
Term
|
Definition
Rheumatoid Arthritis: ulnar drift |
|
|
Term
what causes rotational collapse? |
|
Definition
|
|
Term
in rotational collapse, what does scaphoid want to do? |
|
Definition
|
|
Term
what direction does lunate naturally want to go into? |
|
Definition
|
|
Term
if the connection between scaphoid and lunate is ruptured in rotational collapse, what happens? |
|
Definition
scaphoid flexes and lunate extends (lunate goes to dorsal side = dorsal intercalated segment instability = DISI) |
|
|
Term
if lunate and scaphoid stay connected, what happens during rotational collapse? |
|
Definition
volar intercalated segment instability = VISI; lunate goes to palmar side |
|
|
Term
primary extrinsic extensors |
|
Definition
extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris |
|
|
Term
secondary extrinsic extensors |
|
Definition
extensor digitorum, extensor indicis, extensor digiti minimi, extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus |
|
|
Term
what are the primary extrinsic flexors of the wrist? |
|
Definition
flexor carpi radialis, flexor carpi ulnaris, palmaris longus |
|
|
Term
what are the secondary extrinsic flexors of the wrist? |
|
Definition
flexor digitorum profundus and superficialis, flexor pollicis longus |
|
|
Term
what goes through the carpal tunnel? |
|
Definition
4 FDP, 4 FDS, Flexor pollicis longus, flexor carpi radialis, median nerve |
|
|
Term
what is the distribution of the median nerve? |
|
Definition
|
|
Term
what type of joint is the wrist? |
|
Definition
|
|
Term
how many dof in an ellipsoid joint? |
|
Definition
|
|
Term
osteokinematics of wrist joint |
|
Definition
|
|
Term
where does motion occur in wrist joint? |
|
Definition
radiocarpal joint, midcarpal joint, minimal motion at carpo-metacarpal joint |
|
|
Term
where is axis of rotation of wrist? |
|
Definition
|
|
Term
is the proximal row of carpals convex or concave at the radiocarpal joint? |
|
Definition
|
|
Term
is the radius convex or concave at the radiocarpal joint? |
|
Definition
|
|
Term
describe the arthrokinematics of extension at the radiocarpal joint |
|
Definition
convex carpals roll dorsally, slide palmarly |
|
|
Term
describe what the radius does at the radiocarpal joint in extension |
|
Definition
concave radius slides dorsally |
|
|
Term
are the distal carpals convex or concave at the midcarpal joint? |
|
Definition
|
|
Term
are the proximal carpals convex or concave at the mid-carpal joint? |
|
Definition
|
|
Term
what are the arthrokinematics of extension at the midcarpal joint? |
|
Definition
convex distal carpals roll dorsally, slide palmarly |
|
|
Term
what are the arthrokinematics of extension at the midcarpal joint in terms of proximal row? |
|
Definition
concave proximal carpals slide dorsally |
|
|
Term
where is close packed position for radiocarpal and midcarpal joints? |
|
Definition
|
|
Term
arthrokinematics of flexion at radiocarpal joint |
|
Definition
convex carpals roll palmarly, slide dorsally |
|
|
Term
arthrokinematics of flexion at radiocarpal joint in terms of radius |
|
Definition
|
|
Term
arthrokinematics of flexion at midcarpal joint |
|
Definition
convex distal carpals roll palmarly, slide dorsally |
|
|
Term
arthrokinematics of flexion at midcarpal joint in terms of proximal caprals |
|
Definition
concave proximal carpals slide palmarly |
|
|
Term
in arthrokinematics, are rolls or slides the same for concave and convex? |
|
Definition
rolls are the same direction; slides are opposite |
|
|
Term
is wrist more stable in flexion or extension? |
|
Definition
|
|
Term
do we get more midcarpal joint movement in flexion or extension? |
|
Definition
|
|
Term
do we get more radiocarpal joint movement in flexion or in extension? |
|
Definition
|
|
Term
arthrokinematics of radial deviation at radiocarpal joint? |
|
Definition
carpals roll radially, glide ulnarly |
|
|
Term
arthokinematics of radial deviation at midcarpal joint |
|
Definition
distal carpals roll radially, glide ulnarly |
|
|
Term
what limits radial deviation? |
|
Definition
|
|
Term
arthrokinematics of ulnar deviation at radioulnar joint |
|
Definition
carpals roll ulnarly, glide radially |
|
|
Term
arthrokinematics of ulnar deviation at midcarpal joint |
|
Definition
distal carpals roll ulnarly, glide radially |
|
|
Term
what do muscles on anterior side of hand do? |
|
Definition
|
|
Term
what do muscles on posterior side of hand do? |
|
Definition
|
|
Term
what do muscles on lateral side of hand do? |
|
Definition
|
|
Term
what do muscles on medial side of hand do? |
|
Definition
|
|
Term
what causes Colles fracture |
|
Definition
|
|
Term
what breaks in colles fracture |
|
Definition
distal radius, usually displaces dorsally |
|
|
Term
what are the joints of the hand |
|
Definition
carpometacarpal, metacapalphalangeal, interphalangeal |
|
|
Term
shape of metacarpals/phalanges |
|
Definition
proximal concave base, shaft distal convex head |
|
|
Term
what kind of joints are carpo-metacarpal joints? Dof? |
|
Definition
|
|
Term
what are the movements of carpometacarpal joints? |
|
Definition
flex/ext if anything, some abd/add in 5th CMC |
|
|
Term
which 2 CMC joints have no movement? |
|
Definition
|
|
Term
what does mobility of 4th, 5th CMC do? |
|
Definition
|
|
Term
where are there ligaments in the CMC joints? |
|
Definition
between bases of metacarpals and between base of metacarpals and distal carpals |
|
|
Term
are the CMC ligaments stronger on palmar or dorsal side? |
|
Definition
|
|
Term
what is the proximal transverse arch? |
|
Definition
arch of the base of the metacarpals |
|
|
Term
what is the distal transverse arch |
|
Definition
arch of the heads of the metacarpals |
|
|
Term
what is the longitudinal arch? |
|
Definition
arch that centers at midline of hand |
|
|
Term
what kinds of joints are metacarpal-phalangeal joints? |
|
Definition
|
|
Term
how many dof in MCP joints? |
|
Definition
|
|
Term
how does base of phalanx comare to head of metacarpal? |
|
Definition
base of phalanx is smaller than head of metacarpal |
|
|
Term
which MCP has the most ROM? |
|
Definition
|
|
Term
which MCP has the least ROM? |
|
Definition
|
|
Term
what is close packed MCP? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
increase joint congruence and articular surface, resist hyperextension, prevent "pinching" of flexor tendons |
|
|
Term
what are the ligaments of the MCP? |
|
Definition
|
|
Term
when are MCP collateral ligaments taut? |
|
Definition
|
|
Term
how is MCP immobilized and why? |
|
Definition
60-70 deg flexion to prevent shortening of collateral ligaments |
|
|
Term
at MCP, is metacarpal head convex or concave? |
|
Definition
|
|
Term
at MCP, is proximal phalanx convex or concave? |
|
Definition
|
|
Term
in fingers, how does distal part move on proximal part? |
|
Definition
concave distal phalanx rolls/slides in same direction on convex proximal phalanx or convex metacarpal head |
|
|
Term
what type of joints are interphalangeal joints? |
|
Definition
|
|
Term
how are IP joints similar to MCP joints? |
|
Definition
volar plates, collateral ligaments, concave moves on convex |
|
|
Term
what is the concern in immobilizing IP joints? |
|
Definition
finger flexor tendons; immobilize in extension |
|
|
Term
what is coupled motion of DIP and PIP joints? |
|
Definition
hard to flex one without flexing the other |
|
|
Term
what are the extrinsic finger flexors? |
|
Definition
flexor digitorum profundus and superficialis |
|
|
Term
what does flexior digitorum superficialis flex? |
|
Definition
|
|
Term
|
Definition
|
|
Term
are extrinsic flexors or extensors stronger? |
|
Definition
|
|
Term
how many annular pulleys on each finger? |
|
Definition
|
|
Term
which annular pulleys are most important? |
|
Definition
|
|
Term
how many cruciate pulleys on each finger? |
|
Definition
|
|
Term
what reduces friction of finger flexors? |
|
Definition
bursa at flexor retinaculum, digitil tendon sheaths |
|
|
Term
what happens if you have bowstringing in finger? |
|
Definition
can't go through full ROM |
|
|
Term
what are the extrinsic finger extensors? |
|
Definition
extensor digitorum, extensor indicis, extensor digiti minimi |
|
|
Term
what do intrinsic muscles of hand insert into? |
|
Definition
|
|
Term
|
Definition
extend IP joints, assist with MCP flexion |
|
|
Term
action of palmar interosseous |
|
Definition
adduct fingers, flex MCP joints, extend IP joints |
|
|
Term
action of dorsal interossei |
|
Definition
abduct fingers, flex MCP, extend IP |
|
|
Term
what happens to fully extend fingers? |
|
Definition
intrinsics flex MCP, extend IP. Extrinsic extensors extend MCP. |
|
|
Term
what happens in closing hand |
|
Definition
intrinsics flex MCP, extend IP. Extrinsic flexors flex IP |
|
|
Term
where is grip strength strongest and why? |
|
Definition
slight extension: reduce active insufficiency of flexors |
|
|
Term
|
Definition
a person with quadriplegia who has C6 working will have wrist extension with extensor carpi radialis longus. When your wrist is extended, your fingers close. They can close hand around something by extending wrist |
|
|
Term
what kind of joint is the carpometacarpal joint of the thumb? |
|
Definition
|
|
Term
what are the movements of the thumb's CMC joint? |
|
Definition
flex/ext + abd/add = opposition/reposition |
|
|
Term
what movements combine to opposition? |
|
Definition
|
|
Term
what movements combine to reposition? |
|
Definition
|
|
Term
what is the CMC joint of the thumb? |
|
Definition
trapezium and base of 1st metacarpal |
|
|
Term
when is the trapezium convex? |
|
Definition
|
|
Term
when is the trapezium concave? |
|
Definition
|
|
Term
when is the base of 1st metacarpal convex? |
|
Definition
|
|
Term
when is the base of 1st metacarpal concave? |
|
Definition
|
|
Term
where is the CMC joint of thumb open packed? |
|
Definition
midway between flex/ext and abd/add |
|
|
Term
where is cmc of thumb close packed? |
|
Definition
|
|
Term
arthrokinematics of flex/ext at CMC thumb |
|
Definition
|
|
Term
arthrokinematics of cmc thumb in abd/add |
|
Definition
|
|
Term
arthrokinematics of all joints in fingers except cmc thumb in abd/add |
|
Definition
|
|
Term
arthrokinematics of exension at CMC thumb |
|
Definition
concave 1st met rolls and slides laterally |
|
|
Term
arthrokinematics of cmc thumb in abduction |
|
Definition
convex 1st met rolls and slides in opposite directions |
|
|
Term
is the CMC thumb susceptible to OA |
|
Definition
|
|
Term
how many pounds of compression at CMC for each pound of pinch? |
|
Definition
|
|
Term
what kind of joint is MCP joint of thumb? |
|
Definition
|
|
Term
how many dof of MCP thumb? |
|
Definition
|
|
Term
arthrokinematics of IP, MCP joints of thumb: |
|
Definition
concave on convex, roll and slide in same direction |
|
|
Term
|
Definition
flexor pollicis longus, extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus |
|
|
Term
intrinsic thumb muscles in the thenar eminence |
|
Definition
abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, 1st palmar interossei, adductor pollicis |
|
|
Term
what things are in anatomical snuffbox? |
|
Definition
radial artery, radial nerve, scaphoid |
|
|
Term
best position for wrist in hand immobilization |
|
Definition
wrist 20-30 deg ext, slight ulnar deviation. If we flex/extend too far, we'll have shortening |
|
|
Term
best position for MCP in hand immobilization |
|
Definition
flex so that we don't lose ROM of collateral ligaments, which stretch in flexion |
|
|
Term
best position of IP in immobilization |
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Definition
straight to prevent shortening of extrinsic flexors |
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Term
what is sacrificed by immobilizing hand with flexed MCP and extended IP |
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Definition
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Term
what is best position for thumb in hand immobilization |
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Definition
open packed: 45 deg abduction |
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Term
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Definition
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Term
what is holding a cell hone |
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Definition
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Term
what is carrying a suit case |
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Definition
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Term
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Definition
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Term
what is holding a cigarette |
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Definition
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Term
what is precision handling |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
what causes swan neck deformity |
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Definition
volar plate disruption at PIP: lateral bands sublux dorsally, increasing moment arm of the intrinsics to extend PIP |
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Term
what is the joint position of swan neck deformit |
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Definition
PIP extension, DIP flexion |
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Term
how is swan neck deformity treated |
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Definition
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Term
what happens in boutonniere deformity |
|
Definition
central band ruptures, lateral band slip to palmar side of PIP |
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Term
joint position in boutonniere deformity |
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Definition
PIP flexed, DIP hyper extended |
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Term
how is boutonniere deformity fixed |
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Definition
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Term
what are zig zag deformities? |
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Definition
swan neck in one finger, boutonniere in the next |
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|
Term
|
Definition
unable to extend DIP bc terminal band ruptures |
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|
Term
what is the mechanism of injury for mallet finger? |
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Definition
forced DIP flexion, laceration, compression |
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