KINE 3200- CHAPTER 7 (HAND AND WRIST) Flashcards
Wrist and hand include 29 bones including radius and ulna
CARPALS
proximal row- scaphoid, lunate, triquetrum, and pisiform
distal row- trapezium, trapezoid, capitate, hamate
5 METACARPALS
I, II, III, IV, V
14 PHALANGES
we have proximal, middle and distal phalanges in our digits besides our thumb. Our thumb only has proximal and distal phalange
UPPER LIMB-HAND IS DIVIDED INTO 3 REGIONS
-CARPALS (8)-wrist
-METACARPALS (5) - palm of the hand
-PHALANGES (14)
what type of joint is our wrist
condyloid joint
allows for these actions: flexion, extension, radial and ulnar deviation
how many joints does each finger have?
(SLIDE 7 IN POWERPOINT HAS A PICTURE OFK WHERE THESE JOINTS ARE)
each finger has 3 joints EXCEPT thumb
-metacarpalphalangeal joint (MCP)-condyloid
-proximal interphalangeal joint(PIP)-ginglymus
-distal interphalangeal joint (DIP)-ginglymus
THUMB only has 2 joints
-metacarpalphalangeal joint (MCP)-condyloid
- interphalangeal joint
the carpometacarpal (CMC) joint of the thumb is what kind of joint?
Saddle
Movements of hand and wrist
(pictures of these starting on slide 9)
-wrist flexion
-wrist extension
-wrist abduction
-wrist adduction
-extension of fingers and thumb, abduction of metacarpophalangeal joints
-flexion of fingers and thumb, adduction of metacarpophalangeal joints, opposition of thumb
-MCP abduction
-MCP adduction
how many muscles move the wrist but don’t cross the hand to move fingers or thumb
6
how many muscles primarily move phalanges? (these also involve wrist action because they are biarticular)
9
MUSCLES
(ANTEROMEDIAL AT ELBOW AND FOREARM, ANTERIOR AT THE HAND)
*PRIMARILY WRIST FLEXION
-flexor carpi radialis
-flexor carpi ulnaris
-palmaris longus
(^these msucles are the superficial layer and originate on common tendon on the anteromedial aspect of proximal forearm and medial humeral epicondyle)
*PRIMARILY WRIST AND PHALANGEAL FLEXION
-flexor digitorum superficialis (flexes digits)-intermnediate layer
-flexor digitorum profundus (flexes digits)-deep layer
-flexor pollicis longus (flexes thumb)-deep layer
MUSCLES
(POSTEROLATERAL AT ELBOW AND FOREARM, POSTERIOR AT THE HAND)
*PRIMARILY WRIST EXTENSION
-extensor carpi radialis longus
-extensor carpi radialis brevis
-extensor carpi ulnaris
(^these muscles are on superficial layer and originate on common tendon on the posterolateral aspect of proximal forearm and lateral humoral epicondyle
*PRIMARILY WRIST AND PHALANGEAL EXTENSION
-extensor digitorum-superficial layer
-extensor indicis-deep layer
-extensor digiti minimi-superficial layer
-extensor pollicis longus-deep layer
-extensor pollicis brevis-deep layer
-abductor pollicis longus-deep layer
FLEXOR CARPI RADIALIS
anterior side
ORIGIN: medial epicondyle of humerus
INSERTION: base of second and third metacarpal, palmar side
ACTIONS: flexion of wrist, abduction of wrist, weak flexion of elbow, weak pronation of forearm
MEDIAN NERVE (C6,C7)
STRENGTHEN BY wrist curls against a handheld resistance
STRECTH BY having elbow fully extended with forearm supinated while a partner passively extends and adducts the wrist
PALMARIS LONGUS
anterior side
ORIGIN: medial epicondyle of humerus
INSERTION: palmaris aponeurosis of second, third, fourth, and fifth matacarpals
ACTIONS: flexion of wrist ad weak flexion at elbow
MEDIAN NERVE (C6,C7)
STRENGTHEN BY wrist curling activities
STRETCH BY maximal elbow and wrist extension
FLEXOR CARPI ULNARIS
anterior side
ORIGIN: medial epicondyle of humerus, posterior aspect of proximal ulna
INSERTION: pisiform, hamate, and base of fifth metacarpal
ACTIONS: flexion of wrist, adduction of wrist, and weak flexion of elbow
ULNAR NERVE (C8,T1)
STRENGTHEN BY wrist curls against resistance
STRETCH BY having elbow fully extended with forearm supinated while partner passively extends and abducts wrist
EXTENSOR CARPI ULNARIS
ORIGIN: lateral epicondyle of humerus and middle two-fourths of the posterior border of ulna
INSERTION: base of fifth metacarpal (dorsal side)
ACTIONS: extension of wrist, adduction of wrist, and weak extension of elbow
RADIAL NERVE
STRENGTHEN BY wrist extension against resistance
STRETCH BY elbow extended with forearm pronated while wrist is passively flexed and sightly abducted
EXTENSOR CARPI RADIALIS BREVIS
ORIGIN: lateral epicondyle of humerus
INSERTION: base of third metacarpal
ACTIONS: extension of wrist, abduction of wrist and weak flexion of elbow
RADIAL NERVE C6,C7
STRENGTHEN BY wrist extension activities
STRETCH BY elbow extended with forearm pronated while wrist is passively flexed and slightly adducted
EXTENSOR CARPI RADIALIS LONGUS
ORIGIN: lower one-third of the lateral supracondylar ridge of the humerus and lateral epicondyle of humerus
INSERTION: base of second metacarpal, dorsal side
ACTIONS: extension of wrist, abduction of wrist, weak flexion of elbow, and weak pronation to neutral from a fully supinated position
RADIAL NERVE C6,C7
STRENGTHEN BY wrist extension activities
STRETCH BY elbow extended with forearm pronated while wrist is passively flexed and slightly adducted
FLEXOR DIGITORUM SUPERFICIALIS
ORIGIN: medial epicondyle of humerus.
Ulnar head: medial coronoid process
Radial head: upper two-thirds of anterior border of radius
INSERTION: split tendons attach to sides of middle phalanx of four fingers (palmar side)
ACTIONS: flexion of wrist and flexion of fingers at metacarpophalangeal and proximal interphalangeal joints and weak flexion of elbow
CROSSES wrist joint, metacarpal phalangeal joint and interphalangeal joint
MEDIAN NERVE C7,C8,T1
STRENGTHEN BY squeezing a sponge rubber ball in palm of hand/gripping activities
STRETCH BY passively extending elbow, wrist and metacarpophalangeal and proximal interphalangeal joints while maintaining the forearm in full supination
FLEXOR DIGITORUM PROFUNDUS
ORIGIN: proximal three-fourths of anterior and medial ulna
INSERTION: base of distal phalanxes of the four fingers
ACTIONS: flexion of four fingers and flexion of wrist
CROSSES wrist, metacarpal phalangeal joint, proximal and distal interphalangeal joint
STRETCHED BY extending digits and extending wrist
FLEXOR POLLICIS LONGUS
ORIGIN: middle anterior surface of radius and from the anterior medial border of ulna just distal to coronoid process
INSERTION: base of distal phalanx of thumb (palmar surface)
ACTIONS: flexes thumb, flexes wrist, abduction of wrist
MEDIAN NERVE
STRENGTHEN BY pressing a sponge rubber ball into hand with thumb and by other squeezing activities, finger push ups
STRETCH BY passively extending the entire thumb while simultaneously maintaining maximal wrist extension
EXTENSOR CARPI RADIALIS BREVIS
ORIGIN: Lateral epicondyle of humerus
INSERTION: base of third metacarpal
ACTIONS: extension of wrist and abduction of wrist and weak flexion of elbow
RADIAL NERVE
STRENGTHEN BY wrist extension exercises
STRETCH BY elbow to be extended with forearm pronated while wrist is passively flexed and slightly adducted
EXTENSOR DIGITORUM
ORIGIN: lateral epicondyle of humerus
INSERTION: four tendons to bases of middle and distal phalanges of four fingers (dorsal surface)
ACTIONS: extension of fingers, extension of wrist, weak extension of elbow
RADIAL NERVE
STRENGTHEN BY applying manual resistance to dorsal aspect of flexed fingers and then extending fingers fully
STRETCH BY having fingers maximally flexed at metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints while the wrist is fully flexed
EXTENSOR INDICIS
ORIGIN: middle and distal one third of posterior ulna
INSERTION: base of middle and distal phalanxes of second phalange (dorsal surface)
ACTIONS: extension of index finger (pointer finger), weak wrist extension, and weak supination of forearm from pronated position
RADIAL NERVE
STRENGTHEN BY applying manual resistance to dorsal aspect of flexed fingers and then extending fingers fully
STRETCH BY passively taking index finger into maximal flexion while fully flexing the wrist with forearm in pronation
EXTENSOR DIGITI MINIMI
ORIGIN: lateral epicondyle of humerus
INSERTION: base of the middle and distal phalanxes of the fifth phalange (dorsal surface)
ACTIONS: extension of little finger (pinky) at metacarpophalangeal joint, weak wrist extension and weak elbow extension
RADIAL NERVE
STRENGTHEN BY applying manual resistance to dorsal aspect of flexed fingers and then extending fingers fully
STRETCH BY passively taking the little finger into maximal flexion at its metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints while fully flexing the wrist and elbow
EXTENSOR POLLICIS BREVIS
ORIGIN: posterior surface of lower middle radius
INSERTION: base of proximal phalanx of thumb (dorsal side)
ACTIONS: extension of thumb, wrist abduction, and weak wrist extension
RADIAL NERVE
STRENGTHEN BY extending the flexed thumb against a manual resistance
STRECTH BY passively taking the first carpometacarpal joint and the metacarpophalangeal joint of the thumb into maximal flexion while fully flexing and adducting the wrist
