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44 notecards = 11 pages (4 cards per page)

Viewing:

Biomech Exam #2: Hands

front 1

Palmar view: major bones + joints

back 1

front 2

Palmar view: external landmarks

back 2

front 3

Osteology: metacarpals

back 3

front 4

Radial view of bones in third ray

back 4

  • metacarpals
  • phalanges
  • capitate bone of wrist

front 5

Osteology: Phalanges

back 5

  • palmar and lateral view

front 6

Osteology: The Arches of the Hand

back 6

  • natural concavity of palm
    1. longitudinal arch system
    2. transverse arch system (x2)

front 7

AROM of hand

back 7

  1. finger motion (A-D)
  2. thumb motion (E-I)
    1. finger adduction // thumb flexion // thumb exension
  3. Thumb abduction
  4. Thumb adduction
  5. thumb opposition

front 8

Arthrology: CMC joints (moblity)

back 8

  • mobility across 5 carpometacarpal joints
    • peripheral joints (1,4,5) MORE MOBILE than central 2 joints

front 9

Arthrology: CMC joints (articular surfaces)

back 9

  • A. surfaces of 2nd-> 5th carpometacarpal joints (ligaments = cut)

front 10

Arthrology: CMC joints and ligaments

back 10

front 11

Arthrology: The 1st carpometacarpal

back 11

  • exposed to show saddle-shaped appearance
  • right thumb

front 12

Arthrology: The 1st carpometacarpal (ABD/ADD)

back 12

  • stretched: intermetacarpal ligamet (IML), radial collateral ligament (RCL), and adductor pollicis muscle
  • CONCAVE+CONVAX = ROL + SLide in same direction

front 13

Arthrokinematics of the 1st CMC: Flex/Ext

back 13

  • flexion: slight medial roation + RCL elongation + slack oblique anterior ligament
  • extension: slight lateral rotation + oblique anterior ligament elongation

front 14

Arthrokinematics of the 1st CMC: Opposition

back 14

  • 2 Phases of opposition
    • abduction and flexion with medial rotation
    • tight posterior oblique ligament + contraction opponents pollicis

front 15

Metacarpophalangeal joints: radial

back 15

  • radial collateral ligament and connective tissues
    • (metacarpophalangeal, proximal interphalangeal, distal interphalangeal points)

front 16

Metacarpophalangeal joints: periarticular connective tissues

back 16

  • periarticular connective tissues at metacarpophalangeal joints

front 17

Arthrokinematics: MCPs (FLEX/EXTEN)

back 17

  • flexion: activation of flexor digitorum profundus muscle
    • tendon at A1 and A2 pulleys
    • tight=> dorsal capsule and R.ColLig.
    • ROLL SLIDE = SAME DIRE
  • Extension: extensor digitorum+ intrinsic muscle activate
    • tight= palmar plate
    • slack= RCL cord

front 18

Arthrokinematics: MCPs (ABDUCTION)

back 18

  • first dorsal interosseus muscle (DI1)
    • tight= U.Col.Lig
    • slack= R.Col.Lig
  • ANTERIOR POSTERIOR DIRECTION

front 19

General features of proximal interphalangeal ligaments (IPs)

back 19

front 20

IPs: Arthrokinematics

back 20

  • active flexion
    • metacarpophalangeal and interphalangeal joints (thumb)
    • Powered by flexor pollicis longus +PLong. brevis
  • CONCAVE+CONCAVE = same direction

front 21

Muscular Function of the hand: intrinsic

back 21

  • all attachments within the hand
  • themear eminence // hypothenar eminence // other

front 22

Muscular Function of the hand: Extrinsic muscles

back 22

  • proximal attachments outside of the hand
  • flexor of the digits
  • extensors of fingers
  • exntensors of thumb

front 23

Extrinsic flexors of the digits: muscles

back 23

  • Flexor digitorum superficialis
  • FDP
  • Flexor pollicis longus

front 24

Palmar view of the hand (sheath/ligaments/muscles/bones)

back 24

front 25

Muscle activation for proximal interphalangeal joint flexion (pulling finger down/in)

back 25

  • force by the flexor digitorum superficialis = flexion torque on all joint it crosses
    • flexor torques progressively increase in the proximal direction
  • Isoloate only flexion => extensor digitorum+ extensor carpi radialis brevis RESIST flexion effect (on wrist and metacarpal joints)

front 26

Tenodesis

back 26

  • wriust extends/moves back (palm up) => thumb and fingers automatically flex (b/c extrinsic digital flexors stretch)

front 27

Extrinsic extensors of the digits Muscles

back 27

  1. Extensor digitorum (communis)
  2. Extensor indicis
  3. Extensor digit minimi

front 28

Extrinsic extensors of the digits Muscles (with arm)

back 28

front 29

Extrinsic extensors of the thumb (muscles)

back 29

  1. Extensor pollicis longus
  2. Extensor pollicis brevis
  3. Abductor pollicis longus

front 30

Intrinsic muscles of the hand

back 30

front 31

Thenar eminence (muscles)

back 31

  1. Abductor pollicis brevis
  2. Flexor pollicis breview
  3. Opponens pollicis

front 32

Hypothenar eminence (muscles)

back 32

  1. Flexor digiti minimi
  2. Abductor digiti minimi
  3. Opponens digiti minimi
  4. Palmaris brevis

front 33

Thenar & Hypothenar

back 33

  • used during the opposition of thumb and small finger

front 34

Adductor Pollicis

back 34

  • combo of flexion and adduction torque at the base of the thumb
  • oblique and transverse head

front 35

Lumbricals & Interossei

back 35

front 36

Lumbricals

back 36

  • innervated: median nerve (laterally) + ulnar nerve (medially)
  • distal attachments: oblique fibers of dorsal hood (externsor mechanism on lateral band)
  • Contractile: generate small force over long distance
  • primary actions: MCP joint flexion and PIP and DIP joint extension

front 37

Dorsal Interossei

back 37

  • innervated: ulnar nerve
  • distal attachments: oblique fibers of dorsal hood (side base of proximal phalanx)
  • Contractile: small force over shortdistance
  • primary actions: Abduction of MCP joint flexion and PIP and DIP joint extension

front 38

Palmar Interossei

back 38

  • innervated: ulnar nerve
  • distal attachments: oblique fibers of dorsal hood (side base of proximal phalanx)
  • Contractile: nondistnct
  • primary actions: Adduction of MCP joint flexion and PIP and DIP joint extension

front 39

Adduction and Abduction of hand

back 39

front 40

Combined actions of lumbricals and interossei

back 40

  • shown as flexors at the metacarpophalangeal joint + extensors at the interphalangeal joints

front 41

Extensor Mechanism & Interaction
between extrinsics and intrinsics

back 41

  • Intrinsic plus: fingers flat across
    • MCP joint flexion and IP joint extension
  • Extrinsic plus: fingers curled back
    • extrinsic muscles => MCP joint hyperextension and IP joint flexion
  • Opening and closing the hand

front 42

Full extension of finger

back 42

  1. Early phase: extensor digitorum extends metacarpophalangeal joint
  2. Middle phase: intrinsic muscles+ extensors dig. to extend proximal+distal interphalangeal joints
    1. flexor torque prevents E.dig from hyperextending the metacarpal joint
  3. Late Phase: muscle activation continues thru full finger extension

front 43

Full flexion of finger

back 43

  1. Early phase: flexor dig. superficial and interosseus muscles flex joints
    1. inactive lumbrical
  2. Late Phase: muscle action = unchanged, lumbricals stretched across both ends,

front 44

hand grips

back 44

  1. power grip
  2. precision grip (egg)
  3. precision grip (baseball)
  4. Precision grip (with alternating concavity of distal transverse arch)
  5. power key pinch
  6. tip-to-tip prehension pinch
  7. pad-to-pad prehension pinch
  8. hook grip