Hand Lecture Part 2
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1
how many degrees of extension is the wrist in when in its functional position?
ulnar devation?
ulnar devation?
extension: 20 degrees
ulnar deviation: 10 degrees
ulnar deviation: 10 degrees
2
how many degrees of flexion at the MCP joints in digits 2-5 if the fingers are in functional position?
PIP?
DIP?
PIP?
DIP?
MCP 45 degrees flexion
PIP 30-45 degrees flexion
DIP 10-20 degrees flexion
PIP 30-45 degrees flexion
DIP 10-20 degrees flexion
3
during functional thumb position what position is the thumb CMC in?
MP?
IP?
MP?
IP?
CMC: 1st CMC partial abduction and opposition
MP: 10 degrees flexion
IP: 5 degrees flexion
MP: 10 degrees flexion
IP: 5 degrees flexion
4
what is the cilincal significance of the functional position of the thumb
- allows best position for function after immobilization
- clinical significance; orthotic fabrication
- clinical significance; orthotic fabrication
5
what is the function of the flexor pulley system
- prevents bowstringing of tendons
- force transmission from muscle contraction into finger flexion
- force transmission from muscle contraction into finger flexion
6
what are the most important pulleys
A2 and A4
7
what muscles are present in PIP flexion for digits 2-5
flexor digitorum superficialis
flexor digitorum profundus
flexor digitorum profundus
8
what muscles are present in DIP flexion for digits 2-5
flexor digitorum profundus
9
what are the abductors for digits 2-5
dorsal interossei (DAB)
10
what are the 5th digit special muscles
abductor digiti minimi
opponens digiti minimi
flexor digiti minimi
opponens digiti minimi
flexor digiti minimi
11
what are the extensors of digits 2-5
Extensor digitorum: digits 2-5
Extensor indicis: digit 2 only
extnesor digiti minimi: digit 5 only
Extensor indicis: digit 2 only
extnesor digiti minimi: digit 5 only
12
what are the adductors for digits 2-5
palmar interossi (PAD)
13
what muscles are responsible for plate grip/holding a tray
lumbricals
14
what is the function of the lumbricals
MCP flexion
DIP and PIP extension
DIP and PIP extension
15
what are the requirements for spherical grip
arches
intrinsic and extrinsic muscles
intrinsic and extrinsic muscles
16
what happens to the arches during cylindrical grip
arches flatten
17
what is the primary muscle during hook grip
flexor digitorum profundus
18
what are the primary muscles during power grisp
flexor digitorum profundus and superficialis
19
lateral pinch is also known as
key pinch
20
what is required for two point and three point pinch
thumb opposition
21
what is the primary muscle during lateral pinch
what is the nerve innervated during lateral pinch
what is the nerve innervated during lateral pinch
adductor pollicis
ulnar nerve
ulnar nerve
22
what are some functuional ways to assess the hand
- grasping various objects: cylindrical can, sperical ball, keys
- manipulation of objects: finger to hand translation (coins)
- typing
- rubber band open/close or hair scrunchies
- spray bottles
- manipulation of objects: finger to hand translation (coins)
- typing
- rubber band open/close or hair scrunchies
- spray bottles
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