Chapter 010 the Wrist and Hand Joints

Chapter 010 The Wrist and Hand Joints

True / False Questions

1. The wrist and hand contain 27 bones including the radius and ulna.
True False

2. The flexor retinaculum is a tissue bridge that covers the carpal tunnel.
True False

3. The wrist is classified as a hinge or ginglymus joint.
True False

4. Movement of the thumb across the palmar aspect of the hand is called opposition.
True False

5. The palmaris longus originates on the lateral epicondyle of the humerus.
True False

6. The wrist flexors and extensors contribute to abduction and adduction of the wrist.
True False

7. Both the flexor digitorum superficialis and flexor digitorum profundus tendons go through the carpal tunnel.
True False

8. The extensor digiti minimi originates on the medial epicondyle of the humerus.
True False

9. The flexor carpi ulnaris is innervated by the ulnar nerve.
True False

10. The flexor digitorum superficialis muscle has 4 sites of origin.
True False

Multiple Choice Questions

11. The nerve that travels through the carpal tunnel is the ___________.
A. ulnar nerve
B. radial nerve
C. median nerve
D. musculocutaneous nerve

12. The carpal bone located most centrally inferior to the 3rd phalange is called the _________.
A. capitate
B. hamate
C. lunate
D. pisiform

13. There are _________ carpal bones that form the wrist.
A. 6
B. 7
C. 10
D. 8

14. The _________________ is a carpal bone that if it is depressed can shrink the size of the carpal tunnel.
A. hamate
B. capitate
C. lunate
D. trapezium

15. The distal interphalangeal joints are classified as _____________ joints.
A. condyloid
B. saddle-type
C. ginglymus or hinge
D. pivot

16. The metacarpophalangeal joints or knuckles are classified as _________________ joints.
A. pivot
B. condyloid
C. ginglymus
D. saddle-type

17. The carpometacarpal joint of the thumb is classified as a(n) ______________ joint and can perform _______________.
A. saddle-type; opposition
B. ginglymus; flexion and extension
C. pivot; rotation
D. condyloid; flexion, extension, abduction, adduction

18. The muscle that inserts into the palmar aponeurosis of the hand, but does not go through the carpal tunnel, is the ________________ muscle.
A. flexor carpi radialis
B. flexor carpi ulnaris
C. flexor digitorum superficialis
D. palmaris longus

19. The palmaris longus, flexor carpi radialis, and flexor carpi ulnaris all originate from the ____________________.
A. lateral epicondyle
B. medial epicondyle
C. radial tuberosity
D. coronoid process of the ulna

20. The proximal interphalangeal joints are classified as _____________ joints.
A. ball-and-socket
B. pivot
C. ginglymus or hinge
D. condyloid

21. Pollicis in the words extensor pollicis longus or flexor pollicis longus is defined as the ____________.
A. digit
B. phalange
C. great toe
D. thumb

22. The extensor radialis longus, extensor radialis brevis, and extensor ulnaris all originate from the ______________.
A. lateral epicondyle of the humerus
B. medial epicondyle of the humerus
C. syloid process of the radius
D. coronoid process of the ulna

23. Flexor carpi radialis flexes the wrist and _____________.
A. adducts the hand at the wrist
B. extends the wrist
C. abducts the hand at the wrist
D. rotates the hand

24. The muscle that inserts at the base of the distal phalanges of four fingers is the ______________________ muscle.
A. flexor digitorum superficialis
B. flexor carpi ulnaris
C. flexor digitorum profundus
D. flexor pollicis longus

25. The extensor pollicis brevis inserts on the ___________________.
A. base of the distal phalanx of the thumb (dorsal)
B. base of the proximal phalanx of the thumb (dorsal)
C. base of the 1st metacarpal (dorsal)
D. pisiform and hamate

26. The muscle that performs abduction of the thumb is _________________.
A. adductor pollicis
B. flexor pollicis longus
C. abductor pollicis longus
D. extensor pollicis brevis

27. Extensor indicis literally means extending the ___________________.
A. little finger
B. wrist
C. middle finger
D. index finger

28. The extensor digitorum originates on the __________________.
A. medial epicondyle of the humerus
B. radial tuberosity of the radius
C. lateral epicondyle of the humerus
D. coronoid process of the ulna

29. The flexor digitorum superficialis is above the _____________ muscle.
A. flexor digitorum profundus
B. flexor carpi radialis
C. flexor carpi ulnaris
D. brachioradialis

30. To demonstrate flexion of the wrist the therapist would move the
A. back of the hand toward the posterior aspect of the forearm.
B. palm of the hand toward the anterior aspect of the forearm.
C. little finger toward the ulna.
D. thumb toward the radius.

31. Movement of the thumb across the palm is called _____________.
A. abduction of the thumb
B. adduction of the thumb
C. opposition of the thumb
D. flexion of the thumb

32. The structure that spans the top of the carpal tunnel is called the ____________.
A. flexor retinaculum
B. palmaris longus
C. capitate
D. extensor retinaculum

33. The flexors and extensors of the wrist are considered to be __________ for the actions of flexion and extension.
A. synergists
B. neutralizers
C. abductors
D. antagonists

34. The flexor carpi radialis inserts on the ___________________.
A. base of the 3rd metacarpal, dorsal surface
B. base of the 4th metacarpal, palmar surface
C. base of the 2nd and 3rd metacarpal, palmar surface
D. pisiform

35. The flexor carpi ulnaris inserts on the ___________________.
A. sides of the shafts of the four fingers (palmar surface)
B. base of the 5th metacarpal, pisiform and hamate (palmar surface)
C. base of the 3rd metacarpal, pisiform and hamate (palmar surface)
D. pisiform and hamate only (palmar surface)

36. A powerful way to strengthen the extensor and flexors of the wrist is by using a
A. squeeze putty.
B. pulley.
C. dumbbell.
D. wrist roller.

37. This muscle is important in any sports activity that requires powerful wrist extension, such as golf or tennis.
A. Supinator
B. Extensor carpi radialis brevis
C. Palmaris longus
D. Flexor carpi radialis

38. These are the most powerful of the wrist flexors.
A. Biceps brachii and brachialis
B. Supinator and pronator teres
C. Palmaris longus and brachialis
D. Flexor carpi radialis and flexor carpi ulnaris

39. This muscle is often used for tendon repair in surgery.
A. Flexor digitorum profundus
B. Palmaris longus
C. Flexor pollicis longus
D. Extensor carpi radialis longus

40. Strengthening the wrist and forearm is helpful to what condition?
A. Carpal tunnel
B. Lymphitis
C. Arthritis
D. Bursitis

41. What forearm muscle is often absent?
A. Flexor carpi ulnaris
B. Extensor carpi radialis longus
C. Palmaris longus
D. Extensor carpi radialis longus

42. Using a resistance ball on the 4th finger will challenge what muscle at the medial epicondyle?
A. Extensor digitorum
B. Flexor digitorum
C. Abductor pollicis longus
D. Extensor digiti minimi

43. The primary function of the abductor pollicis longus muscle is
A. adduction of the thumb.
B. abduction of the thumb.
C. flexion of the wrist.
D. abduction of the wrist.

44. The primary function of the flexor pollicis longus muscle is
A. flex the little finger.
B. grip objects.
C. abduction of the thumb.
D. flexion of the thumb.

45. This often overused muscle, because of its insertion, is used in any type of gripping, squeezing, or hand-clenching activity.
A. Anatomical leverage system
B. Flexor digitorum superficialis
C. Flexor digitorum profundus
D. Extensor carpi radialis brevis

46. The __________ muscles of the wrist and hand can be grouped according to function and location.
A. extrinsic
B. intrinsic
C. lateral
D. medial

47. The wrist extensors have their origin on the _________.
A. medial epicondyle
B. radius
C. lateral epicondyle
D. ulna

48. Stretching of the abductor pollicis longus is accomplished by fully flexing and adducting the entire thumb across the _________ with the wrist fully adducted.
A. dorsal hand
B. palm
C. ulna
D. carpal tunnel

49. de Quervain's tenosynovitis involves this muscle.
A. Abductor pollicis longus
B. Flexor digiti minimi brevis
C. Opponens digiti minimi
D. Flexor pollicis brevis

50. The metacarpal of the thumb is adducted by the
A. opponens digiti minimi.
B. abductor digiti minimi.
C. flexor digiti minimi brevis.
D. adductor pollicis.

Fill in the Blank Questions

51. Another name for abduction of the wrist is ______________.
________________________________________

52. Another name for adduction of the wrist is ________________.
________________________________________

53. The proximal carpal bones consist of ____________, ____________, ____________ and _____________.
________________________________________

54. The distal carpal bones consist of _____________, _____________, ______________, and _______________.
________________________________________

55. The flexor retinaculum spans the top of the carpal tunnel from the _____________ to the ________________.
________________________________________

56. There are _________ metacarpal bones in the wrist.
________________________________________

57. There are _________ phalanxes in the fingers.
________________________________________

58. The phalanxes are divided into __________, _____________, and ___________ from the metacarpals.
________________________________________

59. The palmaris longus only _____________ in weak wrist flexion.
________________________________________

60. Flexor carpi ulnaris and extensor carpi ulnaris are considered to be ________ for the action of adduction of the wrist.
________________________________________

61. The muscles that extend the pinky finger are ___________ and _____________.
________________________________________

62. The muscle that does not originate at the medial epicondyle that assists in flexion the fingers is the _________________.
________________________________________

63. The flexor pollicis longus not only flexes the thumb but it assists in ___________ and _____________.
________________________________________

64. Extensor carpi radialis longus and brevis and the flexor carpi radialis assist in __________ of the wrist.
________________________________________

65. The extensor digitorum inserts into the _____________________.
________________________________________

66. The flexor digitorum superficial and flexor digitorum profundus are ___________
flexors.
________________________________________

67. The flexor carpi ulnaris and the flexor carpi radialis are the most powerful wrist ________.
________________________________________

68. Flexor carpi ulnaris is innervated by the ___________ nerve.
________________________________________

69. The ulna attachment of the flexor digitorum superficialis is the ________________.
________________________________________

70. The flexor digitorum profundus is in part responsible for the ability of the hand to have gross _____________.
________________________________________

71. Palpate the tendons of extensor pollicis longus and brevis on the __________ side of the wrist.
________________________________________

72. The thumb muscle that is present in the carpal tunnel is the ____________.
________________________________________

73. The strong wrist flexor that goes through the carpal tunnel is the ____________.
________________________________________

74. The eight tendons that are finger flexors that go through the carpal tunnel are the _________________ and _______________.
________________________________________

75. The extensor carpi radialis longus is located ___________ and ___________ just medial to the bulk of the brachioradialis.
________________________________________

10-1

Chapter 010 The Wrist and Hand Joints Key

True / False Questions

1. The wrist and hand contain 27 bones including the radius and ulna.
FALSE

There are actually 29 bones in the wrist and hand including the radius and ulna.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 10-1
Learning Outcome: 10-2
Learning Outcome: 10-3
Learning Outcome: 10-6

2. The flexor retinaculum is a tissue bridge that covers the carpal tunnel.
TRUE

Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 10-2
Learning Outcome: 10-3
Learning Outcome: 10-4
Learning Outcome: 10-6

3. The wrist is classified as a hinge or ginglymus joint.
FALSE

The wrist is classified as a condyloid joint and has actions of flexion, extension, abduction, and adduction.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 10-2
Learning Outcome: 10-3
Learning Outcome: 10-4
Learning Outcome: 10-6
Learning Outcome: 10-8

4. Movement of the thumb across the palmar aspect of the hand is called opposition.
TRUE

Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 10-2
Learning Outcome: 10-3
Learning Outcome: 10-4
Learning Outcome: 10-6
Learning Outcome: 10-8

5. The palmaris longus originates on the lateral epicondyle of the humerus.
FALSE

The palmaris longus originates on the medial epicondyle of the humerus.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-5
Learning Outcome: 10-6
Learning Outcome: 10-7

6. The wrist flexors and extensors contribute to abduction and adduction of the wrist.
TRUE

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-10
Learning Outcome: 10-8
Learning Outcome: 10-9

7. Both the flexor digitorum superficialis and flexor digitorum profundus tendons go through the carpal tunnel.
TRUE

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-11

8. The extensor digiti minimi originates on the medial epicondyle of the humerus.
FALSE

The extensor digiti minimi originates on the lateral epicondyle of the humerus.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-5
Learning Outcome: 10-6
Learning Outcome: 10-7

9. The flexor carpi ulnaris is innervated by the ulnar nerve.
TRUE

Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 10-1

10. The flexor digitorum superficialis muscle has 4 sites of origin.
FALSE

The flexor digitorum superficialis has 3 sites of origin at the medial epicondyle of the humerus, on the ulna, and on the radius.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-5
Learning Outcome: 10-6
Learning Outcome: 10-7

Multiple Choice Questions

11. The nerve that travels through the carpal tunnel is the ___________.
A. ulnar nerve
B. radial nerve
C. median nerve
D. musculocutaneous nerve

Only the median nerve traverses through the carpal tunnel.

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-11

12. The carpal bone located most centrally inferior to the 3rd phalange is called the _________.
A. capitate
B. hamate
C. lunate
D. pisiform

The capitate is the carpal bone that is described as located inferior to the 3rd phalange.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-3
Learning Outcome: 10-4
Learning Outcome: 10-6

13. There are _________ carpal bones that form the wrist.
A. 6
B. 7
C. 10
D. 8

There are 8 carpal bones in the wrist.

Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 10-1
Learning Outcome: 10-2
Learning Outcome: 10-3
Learning Outcome: 10-6

14. The _________________ is a carpal bone that if it is depressed can shrink the size of the carpal tunnel.
A. hamate
B. capitate
C. lunate
D. trapezium

The capitate is centrally positioned and if depressed can shrink the size of the carpal tunnel.

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-3
Learning Outcome: 10-4

15. The distal interphalangeal joints are classified as _____________ joints.
A. condyloid
B. saddle-type
C. ginglymus or hinge
D. pivot

The only action of the DIP joints is flexion and extension, hence they are hinge joints.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 10-1
Learning Outcome: 10-8

16. The metacarpophalangeal joints or knuckles are classified as _________________ joints.
A. pivot
B. condyloid
C. ginglymus
D. saddle-type

The metacarpophalangeal joints are capable of performing flexion, extension, abduction, and adduction and are classified therefore as condyloid joints.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-1
Learning Outcome: 10-8

The carpometacarpal joint of the thumb is capable of opposition because of its unique saddle-type shape.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-1
Learning Outcome: 10-8

The palmaris longus is superficial to the carpal tunnel and inserts into the palmar aponeurosis of the hand.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-1
Learning Outcome: 10-5
Learning Outcome: 10-6
Learning Outcome: 10-7

The flexor carpi radialis, flexor carpi ulnaris, and palmaris longus all originate from the medial epicondyle.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 10-1
Learning Outcome: 10-5
Learning Outcome: 10-6
Learning Outcome: 10-7