OCTH 712 exam 4
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| action of elbow needed for may self-care tasks, including hygiene, self-feeding, and bathing | flexion
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| action of elbow involved with weight-bearing through upper extremity such as pushing down on armrests of chair to stand up | extension
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| functional link between shoulder and arm | elbow
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| has a trochlea, capitellum, medial epicondyle, lateral epicondyle, medial and lateral supracondylar ridges, coronoid fossa, radial fossa, and olecranon fossa | humerus
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| aspect of humerus, articular surface for ulna, medial and distal | trochlea
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| aspect of humerus, articular surface between ulna and radius, lateral and distal | capitellum
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| aspect of humerus, origin for flexor mm. of forearm, wrist, and fingers | medial epicondyle
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| aspect of humerus, origin for extensor mm. of forearm, wrist, and fingers | lateral epicondyle
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| what is the typical degree of valgus | 5 - 15
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| what two types of people have a greater degree of valgus | women and throwing athletes
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| body position where distal portion is further from body in extension, UCL | valgus
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| aspect of humerus, superior to trochlea, ulnar side, provides stability | coronoid fossa
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| aspect of humerus, proximal to capitellum, radial side, provides stability | radial fossa
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| aspect of humerus, posterior surface proximal to trochlea | olecranon fossa
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| bone that has trochlear notch, olecranon process, coronoid process, radial notch, head, styloid, and attachment points for interosseous membrane | ulna
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| bone that is stable base for elbow flexion and forearm rotation | ulna
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| aspect of ulna, ulnar socket that articulates with trochlea of humerus | trochlear notch
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| aspect of ulna, posterior projection of ulna at proximal portion | olecranon process
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| aspect of ulna, lower portion of trochlear notch, projects anteriorly | coronoid process
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| aspect of ulna, lateral surface of coronoid process, shallow articular surface for head of radius | radial notch of ulna
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| aspect of ulna, distal end of ulna, articulates with radius and intra-articular disc of wrist joint | head of ulna
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| aspect of ulna, distal beyond head of ulna | ulnar styloid
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| goes between ulna and radius, protects humeroradial joint from excessive compression and going proximally, transmits any forces across ulna, attaches to interosseous border of ulna, stabilizes ulna and radius | interosseous membrane
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| bone that has head, neck, bicipital tuberosity, styloid, ulnar notch | radius
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| aspect of radius, bony cylinder that allows for rotation of radius around ulna | head of radius
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| bone that rotates around the other bone of the forearm with pronation and supination | radius
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| aspect of radius, ends where medial surface of shaft bulges to form radial/bicipital tuberosity, 2-3 cm long | radial neck
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| aspect of radius, insertion site of biceps tendon | radial/bicipital tuberosity
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| aspect of radius, distal end of radius, extreme lateral outward and downward bulge | radial styloid
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| aspect of radius, medial surface of distal radius, shallow depression, articulates with head of ulna, part of distal radioulnar joint | ulnar notch of radius
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| joint of elbow, structural: hinge, functional: uniaxial, flexion and extension, primary hinge of elbow, more bony congruity, bony surfaces interlocked, virtually no translation | humeroulnar joint
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| joint of elbow; structural: modified hinge; functional: biaxial; flexion, extension, rotation; flexes and extends around capitellum; less bony congruity; radial head pivots to capitellum with forearm rotation | humeroradial joint
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| joint of elbow, structural: pivot, functional: uniaxial, pronation and supination, annular ligament holds the bones together | proximal radioulnar joint
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| ligament that holds radial head in the radial notch of ulna, wraps around radial head, allows rotation of radius around ulna, prevent inferior displacement (Nursemaid's elbow) | annular ligament
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| ligament of elbow, extends from medial epicondyle to olecranon and coronoid processes, prevents excessive valgus (lateral angulation) at elbow | ulnar collateral ligament
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| ligament of elbow, lateral epicondyle to annular ligament of radius, prevents varus (medial angulation) at elbow | radial collateral ligament
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| angulation of elbow positioning forearm closer to body, RCL | cubitus varus
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| angulation of elbow positioning forearm further away from body, can affect extension, UCL | cubitus valgus
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| biceps brachii, brachialis, brachioradialis | flexors of elbow
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| primary function is elbow flexion, strongest supinator at proximal radioulnar joint, bicipital aponeurosis | biceps brachii
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| tendinous expansion of biceps brachii, fibers insert into deep fascia on anteromedial forearm | bicipital aponeurosis
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| deep m., flexes elbow joint, arises from anterior humeral shaft to distal deltoid tuberosity, only crosses elbow joint and attaches to ulna, crosses elbow to coronoid process and anterior ulnar shaft, works hardest with forearm supinated | brachialis
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| flexor of elbow joint, can rotate forearm to neutral from supinated or pronated position, no further than neutral | brachioradialis
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| triceps brachii and anconeus | extensors of elbow
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| which head of biceps brachii crosses glenohumeral joint and does flexion of the joint | long head
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| extensor of elbow, medial and lateral heads do moderate extension, long head does high-resistance extension | triceps brachii
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| weak elbow extensor, proximal posterior elbow, accessory m., anomaly m. | anconeus
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| supinator, pronator teres, pronator quadratus | primary rotators of elbow
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| deep to extensor mm., supinates forearm, more strength for supination vs. pronation due to force generated by biceps brachii | supinator
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| pronates forearm | pronator teres
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| active during all forearm pronation, pronation with elbow flexed | pronator quadratus
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| ex) self-feeding compensatory movements: scapular elevation, contralateral trunk flexion | elbow flexion
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| ex) standing up from a chair by pushing on armrests compensatory movements: shoulder extension, ipsilateral trunk flexion | elbow extension
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| ex) carrying a dish compensatory movements: shoulder adduction and external rotation | supination
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| ex) meal prep compensatory movements: shoulder abduction and internal rotation | pronation
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| what m. is recruited first when forearm supination starts with shoulder flexed and elbow extended | supinator
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| numbness and tingling in ring and small fingers, increased pressure and tension on ulnar n. with elbow in a flexed position, cubital fascia compresses ulnar n. | cubital tunnel syndrome
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| repetitive forceful elongation of UCL may lead to plastic deformation, instability and loss of velocity for throwing athletes, partial or complete tears, treat with rest and mobility | ulnar collateral ligament injury
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| which collateral ligament is stronger than the other | UCL
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| irritation of wrist extensor mm., tennis elbow | lateral epicondylosis
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| irritation of wrist flexor mm., golfer's elbow | medial epicondylosis
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| bony landmarks are radial styloid, ulnar styloid, and Lister's tubercle | distal radius and ulna
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| bony landmark of dorsal distal radius that is small and rounded and is a pulley for extensor pollicis longus tendon | Lister's tubercle
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| scaphoid, lunate, triquetrium, pisiform | proximal carpal row
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| trapezium, trapezoid, capitate, hamate | distal carpal row
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| which carpal bone is a keystone for wrist movement | capitate
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| attachment for flexor carpi ulnaris, ulnar aspect, distal to wrist crease, sesamoid bone | pisiform
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| distal radial aspect, base of anatomical snuff box, communicates with radial styloid | scaphoid
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| provides protection for ulnar a. and n. | hook of hamate
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| just superficial to scaphoid, made up of 3 tendons | anatomical snuff box
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| joint of wrist; structural: ellipsoid; functional: biaxial; flexion, extension, radial and ulnar deviation; primary articulation between distal forearm and proximal carpal bones; takes 80% of force within wrist | radiocarpal joint
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| ligament of wrist, cushion between distal ulna and carpals, stability on ulnar side of wrist, injuries can occur with forceful rotation | triangular fibrocartilage complex
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| mm.: extensor carpi radialis longus and brevis ex) playing tennis normal ROM: 70 compensatory movements: elbow flexion and finger extension | wrist extension
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| mm.: flexor carpi radialis and flexor carpi ulnaris ex) holding a dish normal ROM: 80 compensatory movements: elbow and finger flexion | wrist flexion
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| mm.: extensor carpi radialis longus and brevis, flexor carpi radialis ex) typing normal ROM: 20 compensatory movements: elbow flexion, finger and thumb abduction | radial deviation
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| mm.: extensor carpi ulnaris and flexor carpi ulnaris ex) using a hammer normal ROM: 30 compensatory movements: elbow extension, finger abduction | ulnar deviation
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| joint of wrist, structural: pivot, functional: uniaxial, pronation and supination, supported by volar and dorsal radioulnar ligaments | distal radioulnar joint
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| what joints are the distal transverse arches on | metacarpophalangeal
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| what joints are the proximal transverse arches on | carpometacarpal
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| where is the longitudinal arch of the hand | between second and third metacarpals
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| how many joints are in the wrist and hand | 20 +
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| joints of hand, structural and functional: gliding, volar/dorsal gliding, stabilized by multiple ligaments | carpometacarpal joints of fingers
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| joints of hand; structural: ellipsoid; functional: biaxial; flexion, extension, abduction, adduction; flexion is volar gliding and extension is dorsal gliding | metacarpophalangeal joints
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| joints of hand, structural: hinge, functional: uniaxial, flexion and extension, collateral ligaments limit lateral translation, proximal and distal | interphalangeal joints
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| joint of hand; structural: saddle; functional: biaxial; flexion, extension, abduction, adduction; one of the most mobile joints; a.k.a. basilar joint; osteoarthritis common | carpometacarpal joint of thumb
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| cartilage of CMC joint of thumb wears away and causes bone-on-bone contact which damages bone, body tries to fix by creating more bone which calcifies | CMC osteoarthritis
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| originate proximally to wrist, generate a greater force | extrinsic mm.
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| contained entirely within hand, precise control | intrinsic mm.
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| does wrist flexion and radial deviation, ex) writing and self-feeding | flexor carpi radialis
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| extrinsic flexor m., does wrist flexion and ulnar deviation, ex) hammering | flexor carpi ulnaris
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| extrinsic flexor m., flexes elbow, tenses palmar fascia, absent in ~10% of people, ex) object grasp | palmaris longus
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| extrinsic flexor m., flexes each joint that it crosses (MCP and PIP of digits 2-5), functional grasp and pinch, ex) brushing teeth and combing hair | flexor digitorum superficialis
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| extrinsic flexor m.; flexes MCP, PIP, and DIP; functional grasp and pinch; ex) playing racket sports and drawing | flexor digitorum profundus
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| extrinsic flexor m., which flexor digitorum m. splits to insert on middle phalynx to flex the PIP joints of the 2-5 fingers | flexor digitorum superficialis
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| extrinsic flexor m., which flexor digitorum m. emerges between the others' tendons to insert on the distal phalynx to flex the DIP joints of the 2-5 fingers | flexor digitorum profundus
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| part of digital pulley system, five per finger, pull tendons close to bones to allow for intricate hand movements | annular pulleys
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| part of digital pulley system, three per finger | cruciate pulleys
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| extrinsic flexor mm.; flexes all joints of thumb; also slightly flexes wrist; ex) texting, sewing, tip pinch | flexor pollicis longus
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| extrinsic extensor mm., radial side, ex) playing pickleball and painting a wall | extensor carpi radialis longus and brevis
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| extrinsic extensor m., on ulnar side, ex) hammering and playing violin | extensor carpi ulnaris
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| extrinsic extensor m., crosses MCP and IP joints, ex) typing or swiping up on a phone | extensor digitorum
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| extrinsic extensor m., accessory m. that affects one finger, ex) pointing | extensor indicis
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| extrinsic extensor m., affects one finger, ex) "rock on" symbol | extensor digiti minimi
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| m. that affects the thumb, ex) texting or picking up an infant | abductor pollicis longus
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| extrinsic extensor mm., both affect one finger, ex) giving a thumbs-up or flipping a coin | extensor pollicis longus and brevis
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| made up of extensor pollicis longus, extensor pollicis brevis, and abductor pollicis longus tendons | anatomical snuff box
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| abductor pollicis brevis, flexor pollicis brevis, opponens pollicis; ex) grasping spherical objects | thenar mm.
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| abductor digiti minimi, flexor digiti minimi, opponens digiti minimi; ex) grasping around an object | hypothenar mm.
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| adducts digits, MCP flexion with PIP and DIP extension causes these to be the most active, ex) holding a book or sandwich | palmar interossei
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| abducts digits, ex) cutting with scissors or typing | dorsal interossei
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| adducts thumb; stabilizes CMC joint of thumb; ex) brushing hair, turning a key, swiping a credit card | adductor pollicis
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| balance flexion and extension forces within fingers, active with PADs, ex) holding a book or sandwich | lumbricals
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| ligament known as flexor retinaculum, ventral surface of carpals, creates carpal tunnel | transverse carpal ligament
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| thick layer of fascia, over palm, protects neurovascular structures, has synovial sheaths that lubricate tendons and reduce friction during movement | palmar aponeurosis
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| separates tendons travelling over the wrist into 6 compartments | extensor retinaculum
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| classified by zone, 5 distinct zones | tendon injuries
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| generally caused by lacerations of extensor muscles, classified by zone | extensor tendon injuries
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| stenosing tenosynovitis; leads to locking of finger in flexed position; inflammation of A1 pulley; can be caused by constant gripping, tunnel injuries, or diabetes | trigger finger
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| PIP flexion, DIP hyperextension, can be caused by extensor tendon injuries | Boutonniere deformity
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| PIP hyperextension, DIP flexion, lax PIP volar plate, terminal tendon damage, can be caused by extensor tendon injuries | swan-neck deformity
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| sensory and motor deficits, loss of lateral (key) pinch, occasional numbness or tingling in ring and pinky fingers | ulnar n. injury
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| increased pressure in tunnel of wrist, decreases blood flow to small arteries that supply median n., affects fingers 1-3 and part of finger 4 | carpal tunnel syndrome
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| abnormal thickening of palmar aponeurosis, contracture of ring and small fingers | Dupuytren's contracture
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| texting thumb, common with new mothers, cumulative trauma disorder of tendons of 1st dorsal compartment | De Quervain's tenosynovitis
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| movements of fingers muscles: dorsal interossei and palmar interossei ex) playing piano ROM: 20 compensatory movements: radial and ulnar deviation | finger MCP abduction and adduction
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| movement of fingers muscles: extensor digitorum, extensor indicis, and extensor digiti minimi ex) catching a football ROM: 45 compensatory movements: wrist extension | finger MCP extension
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| movements of fingers muscles: flexor digitorum superficialis and flexor digitorum profundus ex) holding a cup of coffee ROM: PIP = 100, DIP = 90 compensatory movements: PIP = wrist, MCP, and DIP flexion; DIP = wrist, MCP, and PIP flexion | finger PIP and DIP flexion
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| movement of fingers muscles: lumbricals, interossei, flexor digitorum superficialis, and flexor digitorum profundus ex) holding a sandwich ROM: 90 compensatory movements: wrist flexion and tenodesis | finger MCP flexion
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| movement of thumb muscles: flexor pollicis longus and flexor pollicis brevis ex) playing video games ROM: 15 compensatory movements: wrist ulnar deviation, thumb MCP and IP flexion | thumb CMC flexion
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| movement of thumb muscles: extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus ex) playing video games ROM: 20 compensatory movements: wrist radial deviation, thumb MCP extension | thumb CMC extension
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| movement of thumb muscles: abductor pollicis longus, abductor pollicis brevis, extensor pollicis longus, and extensor pollicis brevis ex) making a finger L ROM: 70 compensatory movements: wrist radial deviation | thumb CMC radial abduction
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| movement of thumb muscles: abductor pollicis longus and abductor pollicis brevis ex) holding a bottle ROM: 70 compensatory movements: wrist flexion | thumb CMC palmar abduction
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| movement of thumb muscles: flexor pollicis longus and flexor pollicis brevis ex) swiping on a phone ROM: 50 compensatory movements: wrist ulnar deviation, thumb CMC and IP flexion | thumb MCP flexion
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| movement of thumb muscles: extensor pollicis longus and extensor pollicis brevis ex) swiping on a phone ROM: 0 compensatory movements: wrist radial deviation, thumb IP and CMC extension | thumb MCP extension
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| movement of thumb muscle: flexor pollicis longus ex) swiping on a phone ROM: 80 compensatory movements: wrist ulnar deviation, thumb MCP and CMC flexion | thumb IP flexion
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| movement of thumb muscles: extensor pollicis longus ex) swiping on a phone ROM: 0 compensatory movements: wrist radial deviation, thumb MCP and CMC flexion | thumb IP extension
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| purposeful use of hands begins with sensory input from median, radial, and ulnar nerves; vision, touch, and proprioception guide hand placement | sensorimotor function of hands
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| aspect of hand; thumb, index, and middle fingers; fine motor control; ex) threading a needle | radial aspect of hand
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| aspect of hand, ring and small fingers, forceful grasp and pinch, provides stability, ex) carrying a heavy bag | ulnar aspect of hand
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| passive finger flexion created by active wrist extension, functional grip for individuals with paralysis of finger flexors, ex) spinal cord injury at C6 | tenodesis
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| diagonal patterns of wrist motion, combines flexion and ulnar deviation or extension and radial deviation, more stable motion of wrist | dart thrower's motion
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| all fingers forcefully contract together, most functional and strongest, ex) wringing out a washcloth | composite grasp
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| muscles that respond to sensory feedback; provide functional balance of forces needed for object manipulation, grasp, and release | extrinsic and intrinsic mm.
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| independent motion of fingers | fractionation
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| allow palm to fold inward, enhance object manipulation | palmar arches
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| position of hand, MCP flexion and PIP/DIP extension | intrinsic plus
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| position of hand, clawing of fingers, IP flexion, MCP hyperextension | intrinsic minus
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| can be used to assess grip and pinch strength, comparisons can be made to typical strength based on age and sex or nonaffected hand | dynamometry
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| grasp and pinch | prehensile patterns
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| use of entire hand to hold an object | grasp
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| varying use of thumb, index finger, and middle finger for precise object manipulation | pinch
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| cylindrical, hook, spherical, composite | grasp patterns
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| grasp pattern, midrange flexion of digits, tube-shaped objects, ex) turning a steering wheel | cylindrical
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| grasp pattern, simultaneous flexion of PIPs and DIPs, extension of MCPs, ex) carrying a basket | hook
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| grasp pattern, varied flexion of digits, rounded object, ex) holding underside of bowling ball | spherical
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| grasp pattern, maximal flexion of all digits, ex) wringing out a towel | composite
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| tip, lateral/key, three-jaw chuck | pinch patterns
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| pinch pattern, precise movements, distal tips of thumb and index finger, ex) threading needle | tip
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| pinch pattern, pad of thumb against radial side of index finger, ex) using a key or fork | lateral / key
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| pinch pattern, tripod pinch, tip of thumb against tips of index and middle, ex) using a pencil | three-jaw chuck
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| volar displacement of distal radial bone | Smith's fracture
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| dorsal displacement of distal radial bone | Colles' fracture
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| wear-and-tear arthritis, CMC joint of thumb is most common site on hand, painful and debilitating | osteoarthritis
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| disorders that develop over time due to microtrauma from repetitive use, ex) de Quervain's tenosynovitis | cumulative trauma disorders
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| peripheral nerve injury, ability to identify an object based on somatosensation alone without visual input, ex) finding a quarter in your pocket among other change | stereognosis
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| peripheral nerve injury; radial n. motor impairment; loss of wrist, digit, and thumb extension | wrist drop
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| peripheral nerve injury, ulnar n. motor impairment, hyperextension of MCPs, loss of IP extension in ring and small fingers | claw hand
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| peripheral nerve injury; inability to flex thumb, index finger, and middle finger; loss of web space of thumb; median n. injury | hand of benediction
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