Mrs G's Final (Hand only)
What hand muscle does not have a bony attachment? To what two tendons does it attach?
Lumbricals, flexor digitorum profundus and extensor digitorum muscle.
Which joint is condyloid, biaxial, sagittal and frontal planes, sagittal and frontal axis
MCP
What muscle extends the MP joints 2nd-5th fingers?
extensor digitorum
_____ extends the MCP, PIP and DIP of the 2nd-5th
extensor digitorum
______ originates on the lateral epicondyle, passes under the extensor retinaculum to attach on the distal phalanx of the 2nd-5th fingers.
extensor digitorum
DIPs and PIPs motions are _____ and _____
flexion and extension
Thumb opposition is a combination of what motions?
flexion and palmar abduction
MCPs motions are ______, ______,_______,______ and __________
flexion, extension, hyperextension, abduction, and adduction
What muscles make up the hypothenar eminence?
flexor digit minimi abductor digiti minimi opponens digiti minimi
List the intrinsic muscles of the hand.
flexor pollicis brevis abductor pollicis brevis opponens pollicis adductor pollicis flexor digiti minimi abductor digiti minimi opponens digiti minimi interossei lumbricals
_____ is a fibrous band that spans the wrist on the anterior side in a horizontal position. It holds the wrist flexors close to the wrist to prevent bowstringing when it flexes.
flexor retinaculum ligament
All abduction and adduction occur in the ____ and the ____ axis.
frontal, sagittal
Pulling a red wagon?
hook grip
Pad of thumb is pressed against the radial side of the index finger. It is how you hold a key... what grip?
lateral pinch or key pinch
Turning pages of a book?
pad to pad or pad to side
What muscle adducts the fingers?
palmar interossei (PAD)
____ are used when an object needs to be held FORCEFULLY while being moved about by the more proximal joint muscles
power grip
____ usually involves an isometric contraction of the fingers and thumb.
power grip
What are the three types of power grips:
the cylindrical, the spherical and the hook
Thumb pad to index and middle finger pads... what grip?
three jaw chuck or tripod
____ is a test for CTS that is tapping over the tunnel will cause sharp pain, reproducing symptoms
tinel's sign
fastening a snap or button?
tip to top
Tip of thumb to tip of another finger, usually index finger... what grip?
tip-to-tip or pinch grip
Number of bones in the thumb?
3
Number of joints in the thumb?
3
Number of joints in the finger?
4
Number of bones in the finger?
5
The two muscles that oppose the thumb are ____ and the ______
Abductor Pollics Brevis and the Opponens Pollicis
What is an extrinsic muscle?
An extrinsic muscle had its proximal attachment above the wrist and its distal attachment below the wrist.
_____ deformity hyperextension of the MCP, flexion of PIP and hyperextension DIP (Josh)
Boutonniere
In the ____ joint the trapezium articulates with the base of the first metacarpal of the thumb. It allows flexion, extension, abduction, adduction, opposition and reposition
CMC
Which joint is plane, nonaxial, gliding.
CMC
which joint of the THUMB is a saddle joint, "modified" biaxial joint.
CMC
Names of the joints in the thumb?
CMC, MCP, PIP
Names of the joints in the finger?
CMC, MCP, PIP, DIP
First wrist cock up splint to provide rest to the area by stopping wrist flexion. Also, use ice pack 20 mins 3 times a day and NSAIS's to reduce inflammation ARE ALL WAYS TO PROVIDE RELIEF FOR _____
CTS
_______ is what happens when the median nerve becomes compressed in the carpal tunnel. The client may experience tingling and numbness in the THUMB, INDEX, and MIDDLE fingers. It may be serve enough to wake them up at night. It will eventually cause them to drop things
Carpal Tunnel Syndrome
Which joints are hinge, uniaxial, sagittal plane, frontal axis?
DIP and PIP
To test for _____ have client place thumb in fist and perform ulnar deviation. Reproduce pain
DeQuervain's
______ disease is inflammation or tenosynovitis of the two muscles on the lateral border of the snuffbox. (APL and EPB)
DeQuervain's
What 3 muscles surround the anatomical snuffbox?
Extensor Pollicis Brevis (lateral) Extensor Pollicis Longus (medial) Abductor Pollicis Longus (lateral)
What muscles makeup the thenar eminence?
Flexor Pollicis Brevis Abductor Pollicis Breivs Oppnens Pollicis
What are extrinsic muscles?
Has proximal attachment above the wrist and distal attachment below the wrist.
What is the purpose of the retinaculum?
Holds the extrinsic and intrinsic muscles close to the wirst
which joints of the THUMB is hinge and uniaxial?
IP and MCP
What muscle of the hand does not originate or insert on bone?
Lumbricals
What muscle performs the table-top?
Lumbricals
What structures make up the carpal tunnel? Which tendons and nerve run through the carpal tunnel?
The floor of the carpal tunnel is made up of the carpal bones, the ceiling is the transverse carpal ligament portion of the flexor retinaculum. The flexor digitorum superficials and profundus, the flexor pollicis longus and the median nerve.
Explain the difference between thenar muscles and hypothenar muscles.
Thenar muscles are intrinsic and on the thumb side of the hand. with pollicis in name. AFO Hypothenar muscles are on the little finger side. with digiti minimi. AFO
The _____ is responsible for palmar abduction of the thumb, which is needed for opposition
abductor pollicis brevis
_____ acting alone this muscle abducts the thumb in the radial directions or extends the thumb at the CMC joint. It is also on the LATERAL BORDER of the snuffbox.
abductor pollicis longus (APL)
The ____ and ____ for the lateral border of the snuffbox.
abductor pollicis longus (APL) extensor pollicis brevis (EPB)
The ______ is the only muscle that adducts the thumb and is THE BULK OF THE WEB SPACE
adductor pollicis
What muscle forms the bulk of the web space on the anterior surface of the hand?
adductor pollicis
Which nerve innervates the deltoid and the teres minor?
axillary nerve
List the muscle that flexes the elbow in neutral?
brachioradials
The _________ is formed by carpal bones on the bottom, the median nerve, and the extrinsic muscle tendons in the middle and the transverse ligament on top.
carpal tunnel
Picking up a CD
combo cylindrical and lumbrical
What is the shape of the proximal end of the proximal phalanges of the fingers?
concave
What is the shape of the distal end of the finger metacarpals?
convex
Holding a hammer, racquet or wheelbarrow are examples of what grip?
cylindrical grip
Holding a skillet?
cylindrical grip
Holding onto a barbell?
cylindrical grip
Which grip do the fingers wrap around in one direction and the thumb in the other direction
cylindrical grip
_____ formed by the metacarpal heads.
distal carpal arch
What muscle abducts the fingers?
dorsal interossei (DAB)
To test if the client is performing at maximum strength during _______ testing have them test on each rung. If plotted it should form a bell shaped curve.
dynamometer
What do you use to test cylindrical grip?
dynamometer
_____ is the tool used to measure grip strength. The rung must be changed to fit the client's hand.
dynamometer
____ extends the MCP, PIP, and DIP of the little finger or 5th finger
extensor digiti minimi
______ superficial muscle on the posterior surface of the forearm and hand.
extensor digitorum
____ extends the MCP, PIP, and DIP of the INDEX finger or 2nd finger
extensor indicis
____ extends the thumb at the CMC and MCP joints.
extensor pollicis brevis (EPB)
What three muscles surround the anatomical snuffbox?
extensor pollicis brevis (epb) extensor pollicis longus (epl) abductor pollicis longus (apl)
The _____ forms the medial border of the snuffbox.
extensor pollicis longus (EPL)
____ extends the thumb at the CMC, MCP, and IP joints. It is on the MEDIAL SIDE of the snuffbox.
extensor pollicis longus (EPL)
_______ is a fibrous band on the posterior side of the wrist. It holds the extensor tendons close to the wrist, epically during wrist extension to prevent bowstring. It is proximal to the intrinsic muscles.
extensor retinaculum ligament
What muscle flexes the MCP, PIP, DIP joints of the 2-5th finger?
flexor digitorum profundus
The _____ is deep to the flexor digitorum superficialis (FDS). It runs deep or beneath to the FDS.
flexor digitorum profundus (FPS)
The _____ muscle passes through the FDS split and continues distally to attach to the base of the distal phalanx of the 2nd-5th finger.
flexor digitorum profundus (FPS)
_____ flexes the MCP, PIP, DIP joints of the 2nd-5th fingers.
flexor digitorum profundus (FPS)
What are the extrinsic muscles of the fingers?
flexor digitorum superficialis flexor digitorum profundus extensor digitorum extensor digiti minimi extensor indicis
The _____ lies DEEP to the wrist flexors.
flexor digitorum superficialis (FDS)
The ______ flexes the MCP and PIP joints of the fingers
flexor digitorum superficialis (FDS)
The _______ originates on the medial epicondyle, divides into 4 tendons and crosses the wrist with one tendon going to each finger. When it gets to the middle phalanx it splits into TWO PARTS and attaches on each side of the bone. (this allows the FDP to run to run through and go all the way to the end of the finger)
flexor digitorum superficialis (FDS)
What muscles are in the carpal tunnel?
flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus
What muscle flexes the PIP and MCP joints of the 2-5th finger?
flexor digitorum superficials
Name the extrinsic muscles:
flexor digitorum superficials flexor digitorum profundus extensor digitorum extensor digiti minimi extensor indicis flexor pollicis longus abductor pollicis longus extensor pollicis longus extensor pollicis brevis
List the extrinsic muscles of the hand. (finger)
flexor digitorum superficials flexor digitorum profundus extensor digitorum extensor digiti minimi extensor indicis
List the extrinsic muscles of the hand. (thumb)
flexor pollicis longus abductor pollicis longus extensor pollicis longus extensor pollicis brevis
Extrinsic muscles of the thumb?
flexor pollicis longus abductor pollicis longus extensor pollicis longus extensor pollics brevis
____ moves the CMC, MCP, and IP of the thumb into flexion.
flexor pollicis longus (FPL)
The optimal position for the wrist and hand to be most effective in terms of strength and precision. The wrist is slightly extended the MCP and PIP joints of the fingers are slightly flexed and thumb is in opposition.
functional position of the hand
When the muscles that flex the wrist are inflamed, this condition is called...
golfer's elbow
What is an intrinsic muscle?
has both attachments below the wrist.
The following are examples of the what grip? holding onto a handle like a suitcase, a wagon, a bucket, or plastic bag of groceries.
hook grip
____ grip involves the 2nd-5th fingers flexed at the PIPs, and DIPs BUT MCPs are extended. The thumb is usually NOT involved.
hook grip
What is the anatomical snuffbox? Which muscles act as the borders of this area?
it is the indent formed between two tendons of the abductor pollicis longus and extensor pollicis brevis laterally AND extensor pollicis longus medially.
Carrying a coffee mug by its handle?
lateral
List the prime moves of the shoulder adduction.
latissimus dorsi teres major pectoralis major subscapularis
______ begins are wrist and runs the length of the metacarpals and phalanges. It is perpendicular to the other 2 arches.
longitudinal arch
If the musculocutaneous is damaged what movement can not be performed?
loss of elbow flexion when supinated
Holding playing cards?
lumbrical grip
The MCPs are flexed and the PIPs and DIPs are extended as when you hold a plate.. what grip?
lumbrical grip
The _____ do NOT originate or insert on bone.
lumbricals
The _____ flex the MCP joints and keep the PIP and DIP extended at the same time to form a TABLETOP
lumbricals
______ is distal phalanx cannot be extended, tendon is ruptured
mallet finger
APE HAND is a clinical sign of damage to the ____ nerve.
median
The POPE'S BLESSING is a clinical sign of damage to the ______ nerve.
median
What are the extrinsic muscles?
muscles that have a proximal attachment about the wrist and distal attachment below the wrist.
Which nerve innervates 2 of the elbow elbow flexors, the biceps and the brachialis?
musculocutaneous nerve
What 2 muscles are responsible for the opposition of the thumb?
opponens pollicis abductor pollicis brevis
List the prime movers of the scapula protraction?
pectoralis minor serratus anterior
____ is a test for CTS where the client flex wrist 1 minute and symptoms will reproduce.
phalen's sign
______ grips tend to hold objects between the tips of the thumb and the fingers. They are used for precision movements. They are measured by a pinch meter
precision
__________ formed by the proximal end of the metacarpals and the carpal bones
proximal carpal arch
What are the 3 arches of the hand?
proximal carpal arch, distal carpal arch, longitudinal arch
WRIST DROP is a clinical sign of damage to the ____ nerve
radial
_____ is the same as thumb extension
radial abduction
Which of the thumb opposition motions is an accessory motion?
rotation
All flexion and extension occur in the ____ and ____ axis.
sagittal, frontal
Is the joint surface of the proximal phalanges moving in the same or opposite direction as the finger in MCP flexion/extension
same
If the Axillary Nerve is damaged what movement can not be performed?
shoulder abduction and weak shoulder external rotation
Requires adduction of two fingers together to hold an object. How you hold a cigarette... what grip?
side to side pinch
Holding an apple?
spherical grip
The following are examples of what grip? holding an apple, doorknob or opening a mayo jar.
spherical grip
______ grip is the palm of hand often not involved. All fingers and thumb are spread out and adducted around the object.
spherical grip
_____ deformity is MCP flexed, PIP hyperextended, DIP flexed
swan neck
When the muscles that extend the wrist are inflamed, this condition is called....
tennis elbow
The three types of pinch measured by the pinch meter are:
three jaw chuck-tripod grip tip tip-pinch grip lateral pinch-key pinch grip side to side grip lumbrical grip
The _____ ligament is the ligament that forms a tunnel through which the MEDIAN NERVE and the NINE EXTRINISIC tendons pass
transverse
What ligament is cut during carpal tunnel surgery and what nerve does it reduce pressure for
transverse and median
The flexor retinaculum ligament is made up of what two ligaments?
transverse carpal ligament and palmar carpal ligament
All pivoting motions occur in the ____ plane and the___ axis
transverse, vertical
