Chapter 7 Wrist & Hand Joints
Hand Distal Middle Phalanges Proximal Head Shaft Metacarpals Hamate Base Trapezoid Pisiform Carpals Trapezum Triquetrum Scaphoid Label Capitate Lunate
Joints Radioulnar (Pivot) Radiocarpal (Condylodial) Supination and pronation Radiocarpal (Condylodial) Primarily articulates with scaphoid, lunate, and triquetrum Movement and Range of Motion Flexion: 80°-90° Extension: 70°-90° Abduction: 15°-25° Adduction: 25°-40°
Joints Intercarpal (Arthrodial) Intermetacarpal (Arthrodial) Metacarpophalangeal (Condylodial) Movement and ROM Flexion: 90° Extension: 0-40° Metacarpophalangeal of the thumb: 40º to 90º from full extension
Joints Carpometacarpal of the thumb: (seller) Movement and ROM Flexion: 15º to 45º Extension: 0º to 20º Abduction: 50º to 70º Opposition: movement of thumb across palmer aspect to oppose any or all of the phalanges Reposition: movement of thumb back to anatomical position Proximal Interphalangeal (ginglymus) ROM: Flexion: 90º to 120º from full extension Distal Interphalangeal (ginglymus) Flexion: 80º to 90º from full extension
Cutaneous Distribution
Muscles Wrist Flexors Flexor Carpi Radialis Palmaris Longus Flexor Carpi Ulnaris Flexor Digitorum Superficialis Flexor Digitorum Profundus Flexor Pollicis Longus Label
Muscles Wrist Extensors Extensor Carpi Radialis Longus Extensor Carpi Ulnaris Extensor Carpi Radialis Brevis Extensor Digitorum Extensor Indicis Extensor Digiti Minimi Abductor Pollicis Longus Extensor Pollicis Brevis Extensor Pollicis Longus Not Shown? Label
Muscles Flexor Carpi Radialis Strengthening Stretching
Muscles Palmaris Longus Strengthening Stretching
Muscles Flexor Carpi Ulnaris Strengthening Stretching
Muscles Extensor Carpi Ulnaris Strengthening Stretching
Muscles Strengthening Stretching Extensor Carpi Radialis Brevis
Muscles Strengthening Stretching Extensor Carpi Radialis Longus
Muscles Strengthening Stretching Flexor Digitorum Superficialis
Muscles Flexor Digitorum Profundus Strengthening Stretching
Muscles Extensor Indicis Strengthening Stretching
Muscles Extensor Digiti Minimi Strengthening Stretching
Muscles Strengthening Stretching Extensor Pollicus Longus
Muscles Strengthening Stretching Extensor Pollicus Brevis
Muscles Abductor Pollicus Longus Strengthening Stretching
Thenar Muscles Opponens Pollicis
Thenar Muscles Abductor Pollicis Brevis
Thenar Muscles Flexor Pollicis Brevis
Intermediate Muscles Adductor Pollicis
Intermediate Muscles Palmar Interossei Drawn illustration
Intermediate Muscles Dorsal Interossei Drawn illustration
Intermediate Muscles Lumbricals
Hypothenar Muscles Opponens Digiti Minimi
Hypothenar Muscles Abductor Digiti Minimi
Hypothenar Muscles Flexor Digiti Minimi Brevis
Injuries of the Wrist Scaphoid Fracture Carpel Tunnel Claw Hand Ape Hand
Carpal Tunnel Syndrome Anatomy Bounds Muscles/Tendons Nerve Other
Carpel Tunnel Syndrome Common Causes: Pregnancy Rheumatoid Arthritis Diabetes Wrist Trauma Occupational (typing)
Carpel Tunnel Syndrome THUMB ABDUCTION TEST Carpel Tunnel Syndrome Symptoms Tests: TINEL’S SIGN STRIKE THE PATIENT’S WRIST AS SHOWN. A TINGLING SENSATION RADIATING DOWN THE WRIST TO THE HAND IN THE DISTIBUTION OF THE MEDIAN NERVE IS A POSITIVE SIGN. PHALEN TEST HAVE THE PATIENT HOLD THEIR WRISTS AS SHOWN FOR ONE MINUTE. NUMBNESS AND PARAESTHESIA IN THE DISTRIBUTION OF THE MEDIAN NERVE IS A POSITIVE TEST. Tinel’s Sign Phalen Test TESTS THE STRENGTH OF THE ABDUCTOR POLLICIS BREVIS WHICH IS INERVATED BY THE MEDIAN NERVE. HAVE THE PATIENT PLACE THEIR PALM UP WITH THEIR THUMB PERPENDICULAR TO IT. APPLY DOWNWARD PRESSURE ON THE THUMB. WEAKNESS IS ASSOCIATED WITH CARPAL TUNNEL SYNDROME. JAMA 2000;283:3110-3117 MOSBY’S GUIDE TO THE PHYSICAL EXAMINATION 5TH ED. Thumb Abduction Test
Claw Hand Description: Hyperextension at the MCP joint, and flexion at the IP joint Etiology?
Ape Hand Description: atrophy of the thenar eminence What nerves and muscles are involved and how?