Wrist and Hand Flashcards
what is the purpose of the wrist and hand?
dexterity, precision, and interaction with environment
what are the hand bones?
- metacarpals 1-5
- phalanges: proximal, middle, and distal
what are the wrist bones?
- 8 carpal bones (some lovers try positions that they cannot handle)
- proximal row:
Scaphoid
Lunate
Triquetrum
Pisiform - distal row:
Trapezium
Trapezoid
Capitate
Hamate
what is the wrist joint?
Radiocarpal joint
- condyloid (allows movement in 2 planes)
- bones: distal radius, proximal carpal row
- wrist movement: flexion, extension, radial and ulnar deviation
what are the 3 finger joints?
Metacarpophalangeal (MCP)
- condyloid (allows movement in 2 planes)
Proximal interphalangeal (PIP)
- ginglymus (hinge/movement in one plane only)
Distal interphalangeal (DIP)
- ginglymus (hinge/movement in one plane only)
what are the 3 thumb joints?
Metacarpophalangeal (MCP)
- ginglymus (hinge/movement in one plane only)
Interphalangeal (IP)
- ginglymus (hinge/movement in one plane only)
Carpometacarpal (CMC)
- saddle (wide ROM in all directions)
what are the landmarks of the radius?
- head
- radial tuberosity
what are the landmarks of the ulna?
- olecranon
- coronoid process
- ulnar tuberosity
- trochlear notch
- radial notch
what are the landmarks of the humerus?
- medial and lateral epicondyles
- medial and lateral supracondylar ridges
what are the 3 wrist flexors?
- Flexor carpi radialis
- Flexor carpi ulnaris
- Palmaris longus
what are the 3 wrist extensors?
- Extensor carpi radialis longus
- Extensor carpi radialis brevis
- Extensor carpi ulnaris
what are the 4 muscles involved in wrist radial deviation
- Flexor carpi radialis
- Extensor carpi radialis longus and brevis
- Abductor pollicis longus
- Extensor pollicis longus and brevis
what are the 2 muscles involved in wrist ulnar deviation?
- Flexor carpi ulnaris
- Extensor carpi ulnaris
flexor carpi radialis origin, insertion, movement, and innervation
- Origin: medial epicondyle
- Insertion: base of 2nd and 3rd metacarpals, anterior palmar surface
- Wrist movement: flexion and radial deviation
- Innervation:
C6-T1
Median nerve
palmaris longus origin, insertion, movement, and innervation
- Origin: medial epicondyle
- Insertion: palmar aponeurosis of the 2nd-5th metacarpals
- Wrist movement: flexion
- Invervation:
C6-T1
Median nerve
flexor carpi ulnaris origin, insertion, movement, and innervation
- Origin:
Medial epicondyle
Posterior proximal ulna - Insertion:
Pisiform
Hamate
Base of 5th metacarpal (palmar) - Wrist movement
Flexion
Ulnar deviation - Innervation:
C8-T1
Ulnar nerve
extensor carpi ulnaris origin, insertion, movement, and innervation
- Origin:
Lateral epicondyle
Posterior middle ulna - Insertion: Base of 5th metacarpal (dorsal)
- Wrist movement:
Extension
Ulnar deviation - Innervation: posterior interosseous nerve (branch of radial nerve)
extensor carpi radialis brevis origin, insertion, movement, and innervation
- Origin:
Lateral epicondyle
Lateral supracondylar ridge - Insertion: base of 2nd metacarpal (dorsal)
- Wrist movement: extension and radial deviation
- Innervation:
C6-C8
Radial nerve
what are the 3 finger flexors?
- Finger digitorum superficialis
- Finger digitorum profundus
- Flexor pollicis longus
what are the 5 finger extensors?
- Extensor digitorum
- Extensor indicis
- Extensor digiti minimi
- Extensor pollicis longus
- Extensor pollicis brevis
what is the thumb abductor?
Abductor pollicis longus
what 4 muscles are involved in the thenar eminence?
- Abductor pollicis brevis
- Opponens pollicis
- Flexor pollicis brevis
- Adductor pollicis
what 3 muscles are involved in the hypothenar eminence
- opponens digiti minimi
- flexor digiti minimi brevis
- abductor digiti minimi
wrist flexion
palm toward forearm - 70-90 degrees
wrist extension
dorsum of hand toward forearm - 65-85 degrees
wrist ABD
move laterally - 15-25 degrees from neutral
wrist ADD
move medially - 25-40 degrees from neutral
finger MCP movement
- Flexion: toward palm - 85-
100 degrees - Extension: toward dorsum
of hand - 0-40 degrees - ABD: away from 3rd finger
- 20-30 degrees
finger IP movement
- Flexion: move toward
palm - 90-120 degrees - Extension: move toward
dorsum - 0-10 degrees
finger DIP movement
- Flexion: move toward
palm - 80-90 degrees - Extension: move toward
dorsum of hand - 0-10
degrees
wrist flexion agonists and exercises
A:
- Flexor carpi radialis and ulnaris
- Palmaris longus
- Flexor digitorum superficialis and profundus
- Flexor pollicis longus
E:
- Wrist curl: TB or weight
wrist extension agonists and exercises
A:
- Extensor carpi radialis longus and brevis
- Extensor carpi ulnaris
- Extensor digitorum
- Extensor indicis
- Extensor digiti minimi
- Extensor pollicis longus and brevis
E:
- Wrist extension: TB or weight
wrist ABD/radial deviation agonists and exercises
A:
- Flexor carpi radialis
- Extensor carpi radialis
longus and brevis
- Abductor pollicis longus
- Extensor pollicis longus
and brevis
E:
- Wrist radial deviation: TB
or weight
wrist ADD/ulnar deviation agonists and exercises
A:
- Flexor carpi ulnaris
- Extensor carpi ulnaris
E:
- Wrist ulnar deviation: TB
or weight
what is the injury associated with FOOSH?
scaphoid fracture
what are some symptoms of a scaphoid fracture from a FOOSH?
- pain at base of thumb
- resisted wrist supination
- ulnar deviation
what is the cause of Carpal Tunnel Syndrome?
compression of the median nerve in the wrist
what are some symptoms of Carpal Tunnel Syndrome?
- Numbness and tingling in median nerve distribution
- Weakness in hand
what is the cause of ulnar nerve compression?
- acute injury (hit the “funny bone”)
- repetitive injury/pressure (subluxing ulnar nerve)
what are some symptoms of ulnar nerve compression?
numbness and tingling in 4th and 5th fingers
what is the cause of a UCL sprain aka “gatekeepers or skier’s thumb” ?
hyperabduction trama of the thumb
what are some symptoms of a UCL sprain aka “gatekeepers or skier’s thumb” ?
- Pain at the base of the
thumb (web space) - Swelling and bruising
- Weakness in thumb
