Term
What is collectively called the metacarpus? |
|
Definition
|
|
Term
|
Definition
Each metacarpal + the phalanges associated with it |
|
|
Term
Each finger has ___ IP joints. Thumb has ___ IP joints. |
|
Definition
Finger 2 IP joints (proximal and distal)
Thumb has 1 IP joint |
|
|
Term
What metacarpal is the shortest and the thickest? |
|
Definition
|
|
Term
What metacarpal is the longest? |
|
Definition
|
|
Term
The palmar surface of the shaft of the metacarpal is ____ longitudinally? (concave/convex) |
|
Definition
|
|
Term
The base of the metacarpal is the proximal end or the distal end? |
|
Definition
|
|
Term
What metacarpals have a facet for articuation with the adjacent metacarpal? |
|
Definition
|
|
Term
The head of the metacarpal is the proximal end or the distal end of the metacarpal shaft? |
|
Definition
|
|
Term
The posterior tubercle of the metacarpal is where the ___ ligaments attach. |
|
Definition
|
|
Term
In anatomic position, the thumb metacarpal is rotated almost 90 degrees ____ (medially/laterally)? |
|
Definition
|
|
Term
The palmar side of the thumb faces towards the ____ of the hand. |
|
Definition
|
|
Term
The position of the metacarpal and trapezium is created by ? |
|
Definition
Palmar projection of the distal pole of the scaphoid |
|
|
Term
This orientation allows the thumb to sweep across the hand freely |
|
Definition
|
|
Term
How many phalanges in a hand? |
|
Definition
|
|
Term
The proximal and middle phalanx of each finger has a _____ base (convex/concave) |
|
Definition
|
|
Term
The proximal and middle phalanx of each finger has a _____ head. (convex/concave) |
|
Definition
|
|
Term
The distal phalanx has a ___ base and _____ distal tuberosity. |
|
Definition
Concave base and rounded distal tuberosity |
|
|
Term
How many transverse arches of the hand are there? |
|
Definition
1. Proximal Transverse Arch 2. Distal Transverse Arch |
|
|
Term
What forms the proximal transverse arch? |
|
Definition
|
|
Term
What is the keystone of the proximal transverse arch? |
|
Definition
|
|
Term
Where is the distal transverse arch? |
|
Definition
Passes through the MCP joints |
|
|
Term
The distal transverse arch consists of mobile ____ metacarpals and stable ____ metacarpals (peripheral/central) |
|
Definition
mobile peripheral metacarpals: 1, 4, 5 Stable central metacarpals: 2, 3 |
|
|
Term
What is the keystone of the distal transverse arch? |
|
Definition
MCP joints of the 2nd and 3rd metacarpals |
|
|
Term
What is the longitudinal arch of the hand? |
|
Definition
Follows the shape of the 2nd and 3rd rays |
|
|
Term
The proximal end (CMC) joints are firmly linked to the carpus while the distal end (phalangeal) is very mobile |
|
Definition
|
|
Term
What is the keystone of the longitudinal arch? |
|
Definition
|
|
Term
The 2nd and 3rd MCP joints serve as a keystone in both the ____ and ____ arches |
|
Definition
Longitudinal and Distal Transverse Arches |
|
|
Term
|
Definition
Articulation between the distal carpal row and the bases of the metacarpals |
|
|
Term
CMC joint: ___ and ___ CMC joints are stable and rigid ___, ___, and ____ CMC joints are mobile and fold |
|
Definition
2nd and 3rd CMC are stable/rigid 1st, 4th, and 5th, are mobile/fold |
|
|
Term
Name the components of the 2nd CMC joint. |
|
Definition
Base of the 2nd metacarpal, trapezoid, capitate, and trapezium |
|
|
Term
Name the components of the 3rd CMC joint. |
|
Definition
Base of 3rd metacarpal and capitate |
|
|
Term
Name the components of the 4th CMC joint |
|
Definition
Base of 4th metacarpal, hamate, and capitate |
|
|
Term
Name the componenets of the 5th CMC joint |
|
Definition
Base of 5th metacarpal and hamate |
|
|
Term
What makes up the stability of the 2nd-5th CMC joints? |
|
Definition
Articular Capsule Dorsal, palmar and interosseous ligaments |
|
|
Term
2nd and 3rd CMC joints are what kind of joints? |
|
Definition
Complex saddle joints
They have a jagged interlocking articular surface and little mobility |
|
|
Term
4th and 5th CMC joints...the ____ base of the metacarpal articulates with the ____ hamate ? (convex or concave) |
|
Definition
Convex base of the metacarpal
Concave hamate |
|
|
Term
How much does the 4th CMC joint flex? |
|
Definition
|
|
Term
How much does the 5th CMC joint flex? |
|
Definition
|
|
Term
What type of joint is the 1st CMC joint? What bones comprise this joint? |
|
Definition
Saddle Joint
Bones: Base of 1st Metacarpal and Trapezium |
|
|
Term
What are the 5 different ligaments involved in 1st CMC stability? |
|
Definition
1. Anterior Oblique 2. Ulnar Collateral 3. 1st intermetacarpal 4. Posterior oblique 5. Radial Collateral |
|
|
Term
What positions is the anterior oblique ligament taut in? |
|
Definition
|
|
Term
What positions is the ulnar collateral ligament taut in? |
|
Definition
|
|
Term
What positions is the 1st intermetacarpal ligament taut in? |
|
Definition
|
|
Term
What positions is the posterior oblique ligament taut in? |
|
Definition
|
|
Term
What positions is the radial collateral ligament taut in? |
|
Definition
|
|
Term
the longitudinal diameter of the trapezium (palmar to dorsal) is ____ concave or convex? |
|
Definition
|
|
Term
The transverse diameter of trapezium (medial to lateral) is ___ convex or concave? |
|
Definition
|
|
Term
The longitudinal diameter of the 1st metacarpal (palmar to dorsal) is ____ convex or concave |
|
Definition
|
|
Term
Transverse diameter of the 1st metacarpal (medial to lateral) is _____ convex or concave? |
|
Definition
|
|
Term
Arthrokinematic of 1st CMC ABD? |
|
Definition
Convex base of metacarpal rolls palmarly and slides dorsally on the concave trapezium |
|
|
Term
Arthrokinematic of 1st CMC ADD? |
|
Definition
Convex surface of metacarpal base rolls dorsally and slides palmarly on concave surface of trapezium |
|
|
Term
Arthrokinematic of 1st CMC Flexion? |
|
Definition
Concave surface of 1st metacarpal rolls and slides ulnarlly |
|
|
Term
Arthrokinematic of 1st CMC Extension? |
|
Definition
concave surface of 1st metacarpal rolls and slides radially |
|
|
Term
Summary: ABD/ADD is convex metacarpal moving on concave trapezium (transverse diameter)
Flexion/Extension is the concave metacarpal moving on the convex trapezium (longitudinal diameter) |
|
Definition
|
|
Term
Opposition involves ABD, flexion and 1st metacarpal medially rotating |
|
Definition
|
|
Term
2nd- 5th MCP joint involve the articulation of the ____ head of the metacarpal and the ____ proximal surface of the proximal phalange (concave or convex?). |
|
Definition
convex head of metacarpal Concave proximal phalange |
|
|
Term
What comprises the ligamentous support of the 2nd-5th MCP joints? |
|
Definition
Joint Capsule Collateral ligaments--Radial and ULnar Palmar Plate |
|
|
Term
What is the proximal attachment for both the radial collateral ligament of MCP and ulnar collateral ligament of MCP? |
|
Definition
Posterior tubercles of metacarpal head |
|
|
Term
The radial collateral ligament and ulnar collateral ligament cross the MCP joint in a _____ _____ direction (direction of fiber; palmar/dorsal) |
|
Definition
cross in oblique, palmar direction |
|
|
Term
What are the two portions of the RCL and UCL of MCP? |
|
Definition
1. Cord portion 2. Accessory Portion |
|
|
Term
What is the cord portion? |
|
Definition
thick, strong, attaches to palmar aspect of the phalanx |
|
|
Term
what is the accessory portion? |
|
Definition
fan shaped, attaches along edges of the palmar plate |
|
|
Term
What is the palmar plate? |
|
Definition
dense thick fibrocartilage palmar to MCP joint |
|
|
Term
Flexion/Extension _____ gradually from 2nd to 5th MCP (increases/decreases) |
|
Definition
|
|
Term
2nd MCP has ___ degrees of flexion; ____ degrees of hyperextension? |
|
Definition
90 flexion 30 hyperextension |
|
|
Term
5th MCP has ___ degrees of flexion; ____ degrees of hyperextension? |
|
Definition
110-115 degrees of flexion 45 degrees of hyperextension |
|
|
Term
The 2nd-5th MCP joints have approximately 20 degrees of ABD/ADD on either side of midline reference |
|
Definition
|
|
Term
2nd-5th MCP joint arthrokinematics based on ___ phalanx moving on the ____ metacarpal head (convex/concave?) |
|
Definition
Concave phalanx Convex metacarpal head |
|
|
Term
2nd-5th MCP Extension: base of proximal phalanx rolls ___, slides ___ |
|
Definition
rolls dorsally Slides dorsally |
|
|
Term
2nd-5th MCP Flexion: base of proximal phalanx rolls ___, slides ___ |
|
Definition
Proximal phalanx rolls palmarly Slides palmarly |
|
|
Term
2nd-5th MCP ABD: base of proximal phalanx rolls ___, slides ___ |
|
Definition
Proximal Phalanx rolls and slides radially on 2nd finger
4th and 5th fingers roll and slide ulnarly |
|
|
Term
2nd-5th MCP ADD: base of proximal phalanx rolls ___, slides ___ |
|
Definition
2nd MCP: Proximal phalanx rolls and slides ulnarly
4th and 5th MCP: rolls and slides radially |
|
|
Term
What is the 1st MCP joint made up of? |
|
Definition
Convex head of metacarpal Concave proximal phalanx of thumb |
|
|
Term
In the 1st MCP joint there is usually a pair of sesamoid bones located within the palmar side of the joint capsule |
|
Definition
|
|
Term
Is the ROM of the 1st MCP joint significantly more or less than the 2nd-5th MCP? |
|
Definition
|
|
Term
1st MCP joint has ___ degrees of freedom |
|
Definition
|
|
Term
1st MCP can flex ___ degrees |
|
Definition
|
|
Term
Hyperextension of 1st MCP is ____ |
|
Definition
|
|
Term
1st MCP Arthrokinematics: Flexion |
|
Definition
Concave proximal phalanx is rolling and sliding ULNARLY on convex metacarpal head |
|
|
Term
1st MCP Arthrokinematics: Extension |
|
Definition
Concave proximal phalanx rolls and slides radially on convex 1st metacarpal head |
|
|
Term
How many degrees of freedom do the PIP and DIP joints have? |
|
Definition
|
|
Term
|
Definition
Head of proximal phalanx Base of middle phalanx |
|
|
Term
|
Definition
Head of middle phalanx, base of distal phalanx |
|
|
Term
PIP joints can flex ___ degrees. DIP joint _____. |
|
Definition
PIP=100-120 DIP=70-90 Flexion: PIP > DIP |
|
|
Term
How much hyperextension do the PIP/DIP joints allow? |
|
Definition
PIP= minimal hyperextension DIP= 30 degrees of hyperextension |
|
|
Term
2nd through 5th PIP Arthrokinematics: Flexion |
|
Definition
Concave base of middle phalanx rolls and slides palmarly on the proximal phalanx |
|
|
Term
2nd through 5th DIP Arthrokinematics: Flexion |
|
Definition
Concave base of distal phalanx rolls and slides palmarly on the convex head of the middle phalanx |
|
|
Term
Thumb IP flexion____ deg. Hyperextension ____? |
|
Definition
Thumb IP flexion 0-70deg Hyperextension up to 20 degrees |
|
|
Term
What are the intrinsic muscles of the thenar eminence? |
|
Definition
Abductor pollicis brevis Flexor pollicis brevis Opponens Pollicis |
|
|
Term
What are the intrinsic muscles of the Hypothenar eminence? |
|
Definition
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
Palmaris Brevis |
|
|
Term
Other intrinsic muscles of the hand? |
|
Definition
Adductor Pollicis (2 heads) Lumbricals (4) Interossei--(4) palmar, 4 dorsal |
|
|
Term
Palmar interossei ___ the hand |
|
Definition
|
|
Term
Dorsal Interossei ___ do what motion? |
|
Definition
|
|
Term
Median nerve motor to the hand? |
|
Definition
FDP (lateral half) Thenar eminence Lumbricals 1 and 2 (lateral) |
|
|
Term
Ulnar nerve motor innervation in the hand? |
|
Definition
hypothenar eminence
lumbricles 3 and 4
FDP medial half
Interosseous Muscles (all) |
|
|
Term
Joint innervation: what nerve root innervates joints of the thumb and index finger? |
|
Definition
|
|
Term
Joint innervation: what nerve root innervates joints of the middle finger? |
|
Definition
|
|
Term
Joint innervation: what nerve root innervates joints of the ring and little finger? |
|
Definition
|
|
Term
What is the fibrous digital sheath? |
|
Definition
tunnel that guides the extrinsic flexor tendons to their insertion |
|
|
Term
The fibrous digital sheath is a continuation of ____ |
|
Definition
|
|
Term
The fibrous digital sheath is anchored to _____? |
|
Definition
|
|
Term
The sheath secretes synovial fluid to lubricate the pulleys that are embedded within the sheaths |
|
Definition
|
|
Term
Talk about the locations of the 5 annular pulleys in the flexor digital sheath. |
|
Definition
A1=MCP A3= PIP A5= DIP A2= shaft of the proximal phalanx A4= shaft of middle phalanx |
|
|
Term
Talk about the 3 cruciate pulleys. What are they? Where can you find them? |
|
Definition
THey are flexible fibers that crisscross the tendons in regions where digital sheaths bend during flexion
C1= between A2 and A3 C2= between A3 and A4 C3= between A4 and A5 |
|
|
Term
What is the function of the flexor pulleys? |
|
Definition
hold the flexor tendons a relatively fixed distance from the joints |
|
|
Term
What would happen without the flexor pulleys? |
|
Definition
contraction of finger flexors would pull the tendons away from the axis of rotation of the joint (bowstringing) |
|
|
Term
The distal attachment of the finger extensors lacks the defined insertion the flexor tendons display |
|
Definition
|
|
Term
The extensors form a fibrous expansion of connective tissue along the entire dorsum of the finger which is referred to as? |
|
Definition
Extensor mechanism or extensor hood |
|
|
Term
Small slip of extensor digitorum tendon attaches at the base of the dorsal side of the proximal phalanx with remaining band of extensor digitorum tendon flattening out into ____ . |
|
Definition
|
|
Term
Where does the central band attach to? |
|
Definition
Dorsal base of middle phalanx |
|
|
Term
Prior to the central band crossing the PIP, _____ diverge from the central band? |
|
Definition
|
|
Term
The lateral bands are dorsal to the axis of rotation of the DIP and PIP and they fuse into a terminal tendon that inserts? |
|
Definition
Into dorsal base of the distal phalanx |
|
|
Term
The extensor mechanism also attaches to the palmar surface of the fingers through 2 structures |
|
Definition
1. Dorsal hood 2. Oblique retinacular fibers |
|
|
Term
Dorsal hood has 2 types of fibers |
|
Definition
|
|
Term
dorsal hood transverse fiber do? |
|
Definition
Hold extensor digitorum tendon over the dorsal surface of MCP |
|
|
Term
Dorsal hood oblique fibers do? |
|
Definition
Join with lateral and central bands |
|
|
Term
What muscles attach into the extensor mechanism through the oblique fiber? |
|
Definition
Lumbricals and Interossei |
|
|
Term
What is the course of the oblique retinacular ligament?
When is it taut? |
|
Definition
runs palmar to PIP and Dorsal to DIP
Taut: PIP extension, DIP flexion |
|
|
Term
Function of the oblique retinacular ligaments? |
|
Definition
They help coordinate movement between the PIP and DIP
PIP flexion (ligament is lax) allows DIP flexion
PIP extension (tightens ligament) facilitates DIP extension |
|
|
Term
How many lumbricals do we have? |
|
Definition
|
|
Term
Where do the lumbricals originate from? |
|
Definition
Tendons of the Flexor Digitorum Profundus |
|
|
Term
What innervates the 2 lateral lumbricals? |
|
Definition
|
|
Term
What innervates the 2 medial lumbricals? |
|
Definition
|
|
Term
Lumbricals attach to the ___ fibers of the dorsal hood which allows them to exert pull through central and lateral bands of extensor mechanism |
|
Definition
|
|
Term
Contraction of lumbricals produces? |
|
Definition
flexion at MCP extension at PIP and DIP
lumbricals are palmar to MCP and dorsal to PIP,DIP |
|
|
Term
How are the interossei named? |
|
Definition
According to their located between the shafts of the metacarpals |
|
|
Term
3 palmar interossei to the fingers attach proximally on the palmar surface and to the sides of the ___, ___ and ___ metacarpals |
|
Definition
|
|
Term
Palmar interossei attach distally to the ___ fibers of the ____. |
|
Definition
oblique fibers of the dorsal hood |
|
|
Term
Palmar interossei ___ the 2nd 4th and 5th MCP (what motion?) |
|
Definition
|
|
Term
Palmar interossei of the thumb attaches distally to the ulnar side of the proximal phalanx of the thumb. Function of the thumb palmar interossei? |
|
Definition
flexes MCP joint of thumb |
|
|
Term
Dorsal interossei is a ___ muscle |
|
Definition
|
|
Term
Dorsal interossei has a distal attachment into the side of the base of the proximal phalanx and into the oblique fibers of the dorsal hood |
|
Definition
|
|
Term
Dorsal interossei ___ the MCP joint of what fingers? |
|
Definition
ABD index middle and ring fingers |
|
|
Term
Innervation of Extensor Digitorum? |
|
Definition
|
|
Term
Innervation of extensor digiti minimi? |
|
Definition
|
|
Term
Innervation of extensor indicis? |
|
Definition
|
|
Term
Innervation of Extensor Pollicis Longus? |
|
Definition
|
|
Term
Innervation of Extensor Pollicis Brevis? |
|
Definition
|
|
Term
Innervation of Abductor Pollicis Longus? |
|
Definition
|
|
Term
Innervation of Flexor Digitorum Superficialis? |
|
Definition
|
|
Term
Innervation of lateral half of flexor digitorum profundus? |
|
Definition
|
|
Term
Innervation of Flexor Pollicis longus? |
|
Definition
|
|
Term
Innervation of pronator quadratus? |
|
Definition
|
|
Term
Innervation of flexor pollicis brevis? |
|
Definition
|
|
Term
Innervation of abductor pollicis brevis? |
|
Definition
|
|
Term
innervation of opponens pollicis? |
|
Definition
|
|
Term
innervation of medial half of FDP? |
|
Definition
|
|
Term
innervation of flexor digiti minimi? |
|
Definition
|
|
Term
innervation of abductor digiti minimi? |
|
Definition
|
|
Term
innervation of opponens digiti minimi? |
|
Definition
|
|
Term
Innervation of palmaris brevis? |
|
Definition
|
|
Term
inervation of lateral 2 lumbricals? |
|
Definition
|
|
Term
innervation of medial 2 lumbricals? |
|
Definition
|
|
Term
innervation palmar interossei? |
|
Definition
|
|
Term
innervation dorsal interossei? |
|
Definition
|
|
Term
innervation of adductor pollicis? |
|
Definition
|
|