The Wrist and Hand

Question 1

Origin, insertion and action of Flexor carpi ulnaris

Answer 1

Origin- Medial epicondyle of humerus, olecranon and posterior border of ulna

Insertion- Pisiform bone, hamate bone, base of metacarpal bone 5

Action- Wrist joint: Wrist flexion, wrist adduction

Question 2

Origin, insertion and action of Flexor carpi radialis

Answer 2

Origin- Medial epicondyle of humerus

Insertion-Bases of metacarpal bones 2-3

Action- Wrist joint: Wrist flexion, wrist abduction

Question 3

Origin, insertion and action of Palmar Interossei

Answer 3

Origin- Ulnar side of metacarpal bone 2, Radial side of metacarpal bones 4 and 5

Insertion- 1: Ulnar base of proximal phalanx/extensor expansion of digit 2

-2 & 3: Radial base of proximal phalanges/extensor expansions of digits 4 and 5

Action- Metacarpophalangeal joints 2,4 & 5: Finger adduction, Finger flexion; Interphalangeal joints 2,4 & 5: Finger extension

Mnemonic: PAD DAB (‘Use your hand to dab with a pad’) - Palmar interossei ADduct, Dorsal interossei ABduct

Question 4

Origin, insertion and action of Extensor carpi radialis brevis

Answer 4

Origin- Lateral epicondyle of humerus (common extensor tendon)

Insertion- Posterior aspect of base of metacarpal bone 3

Action- Wrist joints: Hand extension, hand abduction (radial deviation)

Question 5

Origin, insertion and action of Flexor digitorum superficialis

Answer 5

Origin- Humeroulnar head: Medial epicondyle of humerus, coronoid process of ulna

• Radial head: Proximal half of anterior border of radius

Insertion- Sides of middle phalanges of digits 2-5

Action- Metacarpophalangeal and proximal interphalangeal joints 2-5: Finger flexion

Question 6

Origin, insertion and action of Extensor carpi radialis longus

Answer 6

Origin- Lateral supracondylar ridge of humerus, lateral intermuscular septum of arm

Insertion- Posterior aspect of base of metacarpal bone 2

Actions- Wrist joints: Hand extension, hand abduction (radial deviation)

Question 7

Origin, insertion and action of Palmaris longus

Answer 7

Origin- Medial epicondyle of humerus (common flexor origin)

Insertion- Flexor retinaculum, palmar aponeurosis

Action- Wrist joint: Wrist flexion;
Tenses palmar aponeurosis

Question 8

Origin, insertion and action of Extensor carpi ulnaris

Answer 8

Origin- Lateral epicondyle of humerus, posterior border of ulna (common extensor origin)

Insertion- Base of metacarpal bone 5

Action- Wrist joint: Hand extension and adduction

Question 9

Origin, insertion and action of Flexor digitorum profundus

Answer 9

Origin- Proximal half of anterior surface of ulna, interosseous membrane

Insertion- Palmar surfaces of distal phalanges of digits 2-5

Action- Metacarpophalangeal and interphalangeal joints 2-5: Finger flexion

Question 10

Origin, insertion and action of Flexor Digiti Minimi Brevis

Question 11

Origin, insertion and action of Extensor digitorum

Question 12

Origin, insertion and action of Extensor digiti minimi

Question 13

Origin, insertion and action of Extensor indicis

Question 14

Origin, insertion and action of Flexor pollicis longus

Question 15

Origin, insertion and action of Flexor pollicis longus

Question 16

Origin, insertion and action of Flexor pollicis brevis

Question 17

Origin, insertion and action of Extensor pollicis longus

Question 18

Origin, insertion and action of Extensor pollicis brevis

Question 19

Origin, insertion and action of Abductor pollicis longus

Question 20

Origin, insertion and action of Thenar eminence

Question 21

Origin, insertion and action of Hypothenar eminence

Question 22

Origin, insertion and action of Dorsal Interossei

Question 23

Origin, insertion and action of Lumbricals

Question 24

What are the Stabilising features of the wrist?

Question 25

What is a retinaculum?

Question 26

What is the Close packed position of the wrist?

Answer 26

Extension with radial deviation

Question 27

Identify and explain the end feel for radial deviation and how this can contribute to your clinical reasoning.

Question 28

State the range of movement for ulnar deviation and state which muscles are involved in this movement.

Question 29

Identify and explain the attachments of extensor digitorum.

Question 30

Identify and explain findings of testing the ligaments of the wrist and how they will influence your clinical reasoning.

Question 30

Identify and explain which structures limit movement of wrist flexion.

Question 31

When testing the flexor digitorum superficialis in longitudinal stretch which other structures re also under stretch?

Question 32

Identify and explain which structures lie in close proximity to the carpal tunnel

Question 33

Why is the longitudinal stretch for Extensor pollicis longus?

Question 34

Identify and explain which other structures may be under stretch when doing thumb

Question 35

Identify and explain the end feel for MCP flexion for all digits 2-5 and how this can contribute to your clinical reasoning.

Question 36

Identify and explain which structures limit movement of finger extension.

Question 37

State the range of movement for finger abduction and state which muscles are involved in this movement.

Question 38

Identify and explain the attachments of Opponens Pollicis.

Question 39

Identify and explain findings of the longitudinal stretch for the lumbricals and how this can contribute to your clinical reasoning

Question 40

Identify and explain which structures lie in close proximity to the pisiform.

Question 41

Identify and explain the different types of grips that are available in the hand.

Question 42

Identify and explain the stabilising features of the wrist joint

Question 43

Identify and explain the end feel concept for radial deviation of the wrist and how this can contribute to your reasoning

Question 44

Identify and explain the attachments of flexor digitorum profundus in detail

Question 45

Identify and explain the other structures that insert around the lateral collateral ligament of the wrist

Question 46

Identify and explain how shortness of flexor digitorum superficialis could affect active and passive movements at both the wrist and fingers.

Question 47

Identify and explain normal and abnormal findings of the lateral collateral ligament of the wrist testing and how this can contribute to your reasoning

Question 48

Identify and explain the muscles involved in finger flexion.

Question 49

Identify and explain how shortness of flexor digitorum profundus could affect active and passive movements at the fingers.

Question 50

Identify and explain the other structures that insert around the lateral collateral ligament of the wrist

Question 51

Identify and explain the role of the flexor pollicis longus in thumb flexion.

Question 52

What is the close packed position for the wrist joint

Question 53

Identify and explain which structures limit normal movement of finger extension.