wrist/ hand Flashcards
wrist joint (4)
- compound/ complex (radial/ ulnar disc)
2 components: - radiocarpal- distal end of R/RU disc articulating with proximal row of carpals (except pisiform)
- midcarpal
- biaxial: flext/extend (x) 80-90’/ 70-80’ radial/ ulnar deviation (z) 25’/35’
movement analysis: fully flexed -> extension (3)
- midcarpal- full flexed -> neutral
- distal carpals (plus scaphoid):neutral -> 45’ they are moving on proximal row and distal radius
- radiocarpal- 45’ -> full extension
ulnar deviation analysis of movement (and plane) (3)
1. scaphoid movement (saggital plane) extends carpals movement (frontal): 2. distal row -> ulnarly 3. proximal row -> radialy
wrist ligaments (8)
dorsal:
1. radiolunate
2. radiotriquietrium
these two only stabilize RC joint
palmar:
3. radiotriquietrium
4. radiocapitate
5. ulnocapitate
these three stabilize Mid carpal and RC joint
6. ulnolunatecollateral
7. radiocollateral (to scaphoid)
8. ulnarcollateral (triquetrium, pisiform, 5th MC)
primary wrist flexors (7)
- FCR
- FCU
- plamaris longus
(all are shunt muscles for elbow) - FDP
- FDS
- FPL
- AbPL
these 4 are extrinsic finger flexors
primary wrist extensors (7)
- ECRL
- ECRB
- ECU
shunt muscles for elbow - ED
- EI (extensor indicies)
- EDM
- EPL
these 4 are extrinsic finger extensors
primary radial deviators (7)
- EPL
- EPB
- AbPL
- FPL
- FCR
- ECRB
- ECRL
primary ulnar deviators (3)
- FCU
- ECU
- EDM
CMC joints and functional movement(4)
- distal carpals with MC- all work on corresponding MC #
- function of MC is to orientate hand around object (cupping and uncupping)
- function of MC 1 is opposition
- 1st (thumb) is most mobile, then #5, 4 and 2/3 are not very mobile
CMC 2nd -> 5th cupping muscles (4)
cupping = flexion
- FCU
- FCR
- FDP
- FDS
CMC 2nd -> 5th uncupping muscles (4)
uncupping = extension
- ECU
- ECRB
- ED
- ECRL
MCP joint (type of movement and ROM) (6)
- knuckles
- proximal phalanges (concave) move on 3. convex heads of MC ==> translatory and rotary movement is in the same direction
- 2nd -> 5th MCP joint- biaxial
flexion/ ab/duction with third finger as reference point for ab/duction
normal ROM - flex/ extend 90-110’/ 45-60’
- ab/duction 20’
- 1st MCP = hinge (uniaxial)
PIP and DIPs (type of movement and ROM) (5)
1. uniaxial (hinge) ROM - PIP 2. 100-130' (digit 5 moves less than digit 2) 3. concave moving on convex ROM - DIP 4. flex/extend 80-90'/ 10' 5. thumb: flex/ extend 80/10'
hand flexor muscles (digits 2-5) (4)
extrinsic- forearm flexors
1. FDP- MCP flexor/ IP extensor (inn ulnar and median nerve)
intrinsic:
2. 4 lumbricals (don’t attach to bone)
3. 4 dorsal interossei (abduct in neutral wrist)
4. 3 palmar interossei (adduct in neutral wrist)
hand extensor muscles (digits 2-5) (3)
extrinsic: 1. extensor digitorum (codependent with lumbricals and interossei intrinsic: 2. lumbricals 3. interossei (flexors and extensors)
thumb movements at CMC joint(7)
(Types of joint, movement and axis)
- CMC biaxial (+) joint
- saddle joint
movements: - in anatomical position flexion = bringing thumb into palm (z axis)
- this is concave 1st MC moving on convex trapezium
- ab/duction is movement around x axis
- this is convex 1st MC moving on concave trapezium
- axial rotation- movement into and out of palm
thumb MCP joint (type and ROM) (2)
- hinge
normal ROM - flex/ extend 70’/45’
thumb IP normal ROM
- flex/ extend 80’/10’
intrinsic thumb muscles (4)
- flexor pollicis brevis
- abductor policis brevis
- adductor policis
- opponens
hypothenar muscles (3)
- AbDM
- FDM
- OppDM
prehension
grasp
power grasp (5)
- stabilizing something with hand or stabilized into palm
- this uses extrinsic finger muscles
- cylindrical- drinking- thumb adducted (addp) and extrinsic muscles
- spherical (holding round object ie ball) - abduction at CMC => FDP, FDS
- hook/ snap (carry suit case)- FDP, FDS (thumb not used)
precision handling (5)
- holding objects between tips or pads of fingers
- intrinsic finger muscles
- tip- most amt of DIP/PIP precision
- pad to side/ lateral using a key
- 2 (or 3) jaw chuck- holding a pen
synergies of extensor digitorium and lumbricals (2 synergies)
- prevent MCP flexion when using long finger flexors
2. IP extension
synergies of snuff box and hypothenar muscles
FCU and ECU coutneract radial deviation of extrinsic thumb muscles
Synergies of wrist extensors and long finger flexors
Wrist extensors stabilize wrist during finger flexion