Hand Therapy Flashcards
Thenar Compartment (Thumb Movement)
- Abductor Pollicis Brevis – Abducts the thumb (moves it away from the palm).
- Flexor Pollicis Brevis – Flexes the thumb (bends it at the MCP joint).
- Opponens Pollicis – Opposes the thumb (brings it across the palm to touch other fingers).
Adductor Compartment
- Adductor Pollicis – Adducts the thumb (brings it toward the palm or index finger).
Hypothenar Compartment (Little Finger Movement)
- Abductor Digiti Minimi – Abducts the little finger (moves it away from the other fingers).
- Flexor Digiti Minimi Brevis – Flexes the little finger.
- Opponens Digiti Minimi – Opposes the little finger (brings it across the palm).
Central Compartment
- Lumbricals (4 muscles) – Flex the MCP joints while extending the PIP and DIP joints of the fingers (important for fine motor control).
Interosseous Compartment
Interosseous Compartment
- Dorsal Interossei (4 muscles) – Abduct the fingers (spread them apart).
- Palmar Interossei (3 muscles) – Adduct the fingers (bring them together).
Bones
The hand is made up of 27 bones:
Carpals (8 bones): Form the wrist and are arranged in two rows to provide flexibility and support.
Proximal Row: Scaphoid, Lunate, Triquetrum, Pisiform
Distal Row: Trapezium, Trapezoid, Capitate, Hamate
Metacarpals (5 bones): Form the palm and connect the wrist to the fingers.
Phalanges (14 bones): Form the fingers (3 per finger and 2 in the thumb). Each digit has a proximal, middle (except the thumb), and distal phalanx.
Joints
Carpometacarpal (CMC) Joints: Provide thumb movement and stability for gripping. The 1st CMC joint is particularly mobile, allowing the thumb’s opposable movement.
Metacarpophalangeal (MCP) Joints: Allow flexion, extension, abduction, and adduction in the fingers.
Proximal Interphalangeal (PIP) and Distal Interphalangeal (DIP) Joints: Critical for fine motor tasks, enabling precision grip.
Tendons & Ligaments
Tendons & Ligaments
Flexor Tendons: Control bending of the fingers and thumb (e.g., Flexor Digitorum Superficialis and Flexor Digitorum Profundus).
Extensor Tendons: Control straightening of the fingers and thumb (e.g., Extensor Digitorum, Extensor Pollicis Longus).
Collateral Ligaments: Provide lateral stability to the MCP, PIP, and DIP joints, ensuring smooth finger movement and protection against excessive sideways motion.
Nerves
Median Nerve: Provides motor control to the thenar muscles (thumb movement) and sensation in the thumb, index, middle, and half of the ring finger.
Ulnar Nerve: Controls intrinsic hand muscles, facilitating grip strength and fine motor skills; provides sensation to the little finger and half the ring finger.
Radial Nerve: Controls wrist and finger extension and provides sensation to the back of the hand.
Carpal Tunnel Syndrome
What is it?
Compression of the median nerve at the carpal tunnel in the wrist, causing pain and numbness.
Carpal Tunnel Syndrome
Causes
:Repetitive wrist movements (e.g., typing, assembly work)
Fluid retention (e.g., pregnancy, hormonal changes)
Wrist fractures or arthritis
Carpal Tunnel Syndrome
When Can it Occur?
Symptoms often worsen at night, particularly after prolonged hand use.
Common in individuals who frequently engage in repetitive hand and wrist movements.
Carpal Tunnel Syndrome
Who Does it Affect?
Common in individuals aged 30-60.
More prevalent in women and those with conditions like diabetes, obesity, or rheumatoid arthritis.
Carpal Tunnel Syndrome
Symptoms:
Numbness, tingling, or burning in the thumb, index, and middle fingers.
Weakness in grip strength and fine motor tasks.
Symptoms may radiate up the forearm in severe cases.
Carpal Tunnel Syndrome
Treatment:
Conservative:
Wrist splints to keep the wrist in a neutral position during sleep.
Activity modification to reduce repetitive stress.
Corticosteroid injections to reduce inflammation and alleviate symptoms.
Surgical:
Carpal tunnel release surgery may be necessary if symptoms persist or worsen despite conservative treatment.
Trigger Finger
What is it?
Inflammation and narrowing of the flexor tendon sheath, causing the affected finger to catch or lock when bent.
Trigger Finger
Causes:
Repetitive gripping activities such as gardening, typing, or using tools.
Conditions like diabetes, rheumatoid arthritis, or gout increase the risk.
Trigger Finger
When Can it Occur?
Can develop gradually or suddenly, often with no clear cause.
Symptoms may worsen in the morning or after periods of inactivity.
Trigger Finger
Who Does it Affect?
More common in individuals over 40.
Individuals with diabetes or other inflammatory conditions are at increased risk.
Trigger Finger
Symptoms:
Finger stiffness (especially in the morning).
Tenderness or a nodule at the base of the affected finger.
A clicking or popping sensation during movement.
The finger may become locked in a bent position and require manual straightening.
Trigger Finger
Treatment:
Conservative:
Splinting to restrict movement and reduce strain.
Anti-inflammatory medication to ease pain and swelling.
Corticosteroid injections to reduce inflammation.
Surgical:
Trigger finger release surgery may be performed in persistent cases to widen the tendon sheath.
Treatment Options for Hand Therapy
Splinting: Supports affected joints/tendons
Exercise Therapy: Improves strength, flexibility, and reduces stiffness
Soft Tissue Techniques: Massage, stretching, and mobilisation
Education: Teaching self-management strategies to reduce strain
De Quervain’s Tendonitis
What is it?
Inflammation of the tendons in the first dorsal compartment of the wrist, involving the abductor pollicis longus (APL) and extensor pollicis brevis (EPB).
De Quervain’s Tendonitis
Causes:
Repetitive thumb and wrist movements, such as lifting infants, gaming, or texting.
Common in new parents, particularly from frequent thumb and wrist use during childcare tasks.
