WH2

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問題一覧

Dorsal carpal major ligaments

dorsal radiocarpal, dorsal intercarpal

Obliquely oriented

dorsal radiocarpal ligament

Horizontal

dorsal intercarpal ligament

Stabilizes the radiocarpal joint and aids scaphoid stability during movement

dorsal intercarpal ligament

In flexion/extension of wrist, the _____ exhibits the greatest motion while ______ shows the least

scaphoid, lunate

Active extensuon begins at the distal carpal row, gliding over fixed proximal bones

initial phase

Sccapholunate ligament positions the scaphoid and lunate together

mid extension

Proximal surfaces moving as a unit on the radius and triangular fibrocartilage, with taut ligaments

extension completion

As the wrist moves from full extension to flexion, the scaphoid’s role varies while ligaments maintain the proximal carpal row’s integrity. Increasd dorsal contact during extension suggests complex interactions between the concave proximal carpal surface and hand motion

first statement is true, second is false

Radial deviation

proximal carpals flex, distal carpals extend

Ulnar deviation

proximal carpals extend, distal carpals flex

Full radial deviation maximized stability

close packed

Full extension restricts further deviation, while the greatest ROM occurs in a neutral wrist position

loose packed

ROM is greatest in

neutral position

Maximum stability occurs in

full radial deviation

Full flexion results in

loose packed position

Transitipn from full extension to full flexion

change roles of scaphoid, ligaments prevent crumpling of proximal carpals, full ROM

Radial deviation

ulnar glide carpals, extension distal carpals, flexion proximal carpals

Ulnar deviation

radial glide carpals, flexion distal carpals, extension proximal carpals

Injury to ligaments: Damage to scaphoid and lunate ligaments disrupts stabilization. Hamate collapses into flexion on the distal radius

first statement is true, second is false

lunate assumes an extebded posture; scaphoid subluxates

DISI

Increased contact pressures can lead to degenerative changes at the radioscaphlod joint

DISI

May progress to scapholunate advanced collapse (SLAC wrist)

DISI

Occurs when lunate-triquetrum ligament is disrupted

VISI

Both lunate and scaphoid flex, while triquetrum and distal carpal row extend

VISI

More prone to degeneration

Radioscaphoid joint

Optimal grip strength

20-25 deg extension, 5-7 deg ulnar deviation

Wrist flexors’ work capacity is over twice that of wrist extensors. Radial deviators have slightly higher work capacity than ulnar deviators

both statements are true

Wrist flexion RC and midcarpal degrees

RC 50 deg, Midcarpal 35 deg

Wrist extension RC and midcarpal degrees

RC 35 deg, Midcarpal 50 deg

How many bones and joints in hand complex

19, 19

CMC articulations

distal carpal row, MC bases

Plane joints, almost immobile

2nd-3rd CMC

More flexible

4th CMC

Saddle joint

5th CMC

Key for thumb opposition and grip

5th CMC

Supports grip and provides sensory feedback

palmar arches

Formed by carpal bones; contribute to palm’s concavity

proximal transverse arch

Formed by the metacarpal bones

distal transverse arch

Runs length of fingers

transverse arch

Key muscles of CMC jt

ODM, intrinsic hand muscles

MCP joint type

condyloid

MCP key structures

volar plate, collateral ligaments

Fibrocartilage enhancing joint stability, limits hyperextension, supports longitudinal arch

volar plate

Tightens in flexion

collateral ligament proper

Tightens in hyperextension

accessory collateral ligament

IP joint type

hinge

1st CMC joint type

saddle

1st CMC joint articulation

trapezium, 1st MC bone

PIP Normal flexion ROM

100-110 deg, up to 135 deg in 5th digit

DIP Normal flexion ROM

80 deg, up to 90 deg in 5th digit

Finger flexion and extension

same glide

Finger abduction and adduction

opposite glide

MCP articulation

metacarpal head, base of proximal phalanx

IP joint articulation

head and base of phalanx

IP joint degrees of freedom

Essential for grip

FDP

Flexes PIP jts and assists MCP flexion

FDS

Flexes MCP, PIP, and DIP jts

FDP

Encloses FDP and FDS tendons, reducing friction

ulnar bursa

Encases flexor pollicis longus tendon

radial bursa

Minimize friction, ensure smooth tendon gliding

bursae and sheaths

Tendon trapped under annular pulley; locking finger in flexed position

trigger finger

Solution is to passive extend to “unlock” the finger

trigger finger

Nodules form on flexor tendons due to repetitive trauma

trigger finger

Synovial membrane folds supplying blood to FDS and FDP tendons

vincula tendinum

Ensure tendon functionality despite limited direct vascularization

vincula tendinum

MCP hyperextension with IP flexion

clawing

Caused by EDC contracyion, unopposed by intrinsic muscles

clawing

Order of independent extension

index, little, middle, ring

Connect EDC tendons for passive extension of adjacent fingers

junctura tendinae

Ruptured lateral band

swan neck deformity

Ruptured central slip

boutenniere deformity

Prevents direct tendon to tendon contact and lessens the friction and allows smooth motion

digital tendon sheath

How many anatomical bands

How many cruciform pulleys?

Mechanical locking of the finger flexor tendons

trigger finger

Carpal tunnel

4 fdp, 4 fds, fpl, median nerve

Extensor tunnel lateral to medial

APL, EPB, ECRL, ECRB, EPL, EI, EDC, EDM, ECU

Grasping or holding objects using the hand, with the thumb often playing a key role

prehension

Fine placement of an object between fingers and thumb

precision handling

Involves the entire hand for forceful grasping

power grip

Fine manipulation using fibgers and thumb without palm movement

precision handling

Types of power grips

cylindrical, spherical, hook, lateral prehension

Move objects using proximal hand joints

power grip

Wrapping fingers around an object

cylindrical grip

Greater finger spread

spherical grip

Fingers without thumb

hook grip

Holding thin objects between adjacent fingers

lateral prehension

Types of precision handling

pad to pad, tip to tip, pad to side

Opposing pads of thumb and index finger

pad to pad

Tips of thumb and finger contact, requiring full joint flexion

tip to tip

Thumb pad presses against the side of a finger

pad to side

Fine control via reciprocal muscle activation

muscle synergy

Held in neutral or slighr extension to balance forces from finger flexors

wrist role

Wrist extension can flex fingers passively in paralyzed individuals

tenodesis effect

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INTRO 2

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STM

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ELBOW

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RESISTANCE

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WH3

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uhm

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topic6

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VC2

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vc3

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VC LAB

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CHEST

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CHEST

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METS

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KNEE

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KNEE

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KNEE2

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IMPAIRED BALANCE 2

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AF LAB

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GAIT

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BOBATH

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ROOD’S

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😔

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😔

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