The Wrist and Hand Joints
Abductor pollicis longus application, work out, stretch
*primary function is to abduct the thumb *worked out by abducting the thumb from the adducted position against a manually applied resistance. *stretching of the abductor pollicis longus is accomplished by fully flexing and adducting the entire thumb across the palm with the wrist fully adducted and in slight flexion.
Extensor digiti minimi application, workout, and stretch
*primary function of the extensor digiti minimi is to assist the extensor digitorum in extending the pinky *developed by applying manual resistance to the dorsal aspect of the flexed fingers and then extending the fingers fully *Stretched by passively taking the little finger into maximal flexion at is MCP , PIP, and DIP joints while fully flexing the wrist.
Flexor pollicis longus application, workout, stretch
*primary function=flexion of the thumb *Important in gripping and grasping activities *developed by squeezing a rubber ball in hand with thumb *stretched by passively extending the entire thumb while simultaneously maintaining maximal wrist extension
Posterior muscles (wrist extensors)
-Extensor carpi ulnaris -Extensor carpi radialis brevis -Extensor carpi radialis longus
Posterior muscles (wrist and phalangeal extensors)
-Extensor digitorum -Extensor indicis -Extensor digiti minimi -Extensor pollicis longus -Extensor pollicis brevis
Wrist Movements
-Flexion -Extension -Abduction (radial deviation) -Adduction (ulnar deviation)
Anterior muscles (Wrist flexors)
-Flexor carpi radialis -Palmaris longus -Flexor carpi-ulnaris
Anterior muscles (Wrist and phalangeal flexors)
-Flexor digitorum superficialis -Flexor digitorum profundus -Flexor pollicis longus
Finger Movements
-MCP flexion -MCP extension -MCP abduction -MCP adduction -PIP flexion -PIP extension -DIP flexion -DIP extension
Flexor digitorum superficialis muscle Action
Flexion of fingers at the Metacarpophalangeal and proximal interphalangeal joints flexion of the wrist weak flexion of elbow
Palmaris longus innervation
median nerve C6 and C7
Flexor pollicis longus action
Flexion of the thumb carpometacarpal, metacarpophalangeal, and interphalangeal joints flexion of the wrist abduction of the wrist (radial deviation)
Flexor carpi radialis Action
Flexion of the wrist Abduction(radial deviation) of the wrist weak flexion of elbow weak pronation of the forearm
Flexor carpi ulnaris action
Flexion of the wrist Adduction of the wrist with extensor carpi ulnaris weak flexion of elbow
Palmaris longus action
Flexion of the wrist weak flexion of the elbow
Thumb Joints
Has only two, both of which are classified as ginglymus *The MCP moves from full extension into 40-90' of flex *Interphalangeal (IP) 80-90' flex *Carpometacarpal (CMC) is a saddle type joint -50-70' abduction -15-45' flex -0-20' extention
Flexor carpi radialis Innervation
Median nerve (C6 and C7)
Flexor digitorum profundus muscle innervation
Median nerve (C8 and T1) to second and third fingers Ulnar nerve (C8 and T1) to the fourth and fifth fingers
Flexor digitorum superficialis innervation
Median nerve (c7,c8, and T1)
Flexor pollicis longus innervation
Median nerve, palmar interosseous branch (C8 and T1)
Opposition
Movement of the thumb across the palmar aspect to oppose any or all of the phalanges
Reposition
Movement of the thumb as it returns to the anatomical position from opposition with the hand/ and/ or fingers.
Extensor digiti minimi origin and insertion
O: Lateral epicondyle of humerus I:Base of middle and distal phalanxes of 5th phalange (pinky)(dorsal surface)
Extensor pollicis longus muscle origin and insertion
O: Posterior lateral surface of the lower middle ulna I: Base of the distal phalanx of the thumb (dorsal surface)
Abductor pollicis longus muscle
O: posterior aspect of the radius and midshaft of the ulna I: Base of the first metacarpal (dorsal lateral surface)
Extensor pollicis brevis O and I
O: posterior surface of the lower middle radius I: Base of the proximal phalanx of the thumb (dorsal surface)
Flexor digitorum superficialis muscle origin and insertion
Origin: medial epicondyle of the humerus ulnar head: medial coronoid process Radial head: upper two thirds of anterior border of the radius just distal to the radial tuberosity. Insertion: Each tendon splits and attaches to the sides of the middle phalanx of the four fingers (palmar surface)
Flexor pollicis longus origin and insertion
Origin: Medial anterior surface of the radius and the anterior medial border of the ulna just distal to the coronoid process ; occasionally a small head is present attaching on the medial epicondyle of the humerus. Insertion: Base of the distal phalanx of the thumb (palmar surface)
Flexor carpi ulnaris muscle origin and insertion
Origin: Medial epicondyle of the humerus Posterior aspect of proximal ulna Insertion: Pisiform, hamate, and base of the fifth metacarpal (palmar surface)
Flexor carpi radialis origin and insertion
Origin: Meidal epicondyle of the humerus Insertion: Base of the second and third metacarpals , anterior (palmar surface)
Flexor digitorum profundus muscle origin and insertion
Origin: Proximal three fourths of the anterior and medial ulna Insertion: Base of the distal phalanxes of the four fingers
Extensor digitorum muscle Origin and insertion
Origin: lateral epicondyle of the humerus Insertion:Four tendons to bases of middle and distal phalanxes of the four fingers (dorsal surface)
abductor pollicis longus innervation
Radial nerve (C6 C7)
Extensor carpi radialis brevis innervation
Radial nerve (C6 and C7)
Extensor pollicis brevis Innervation
Radial nerve (C6 and C7)
Extensor carpi ulnaris innervation
Radial nerve (C6-C8)
Extensor indicis muscle innervation
Radial nerve (C6-C8)
Extensor pollicis longus Innervation
Radial nerve (C6-C8)
Extensor digitorum muscle innervation
Radial nerve (c6-c8)
Extensor digiti minimi innervation
Radial nerve c6-c8
Carpal tunnel
The distal row, from the radial to the ulnar side, consists of the trapezium, trapezoid, capitate, and hamate bones. These bones form a three sided arch that is concave on the palmar side. This bony arch is spanned by the transverse carpal and volar carpal ligaments creating the carpal tunnel. *The scaphoid is by far the most commonly fractured.
Common points of origin
The medial epicondyle, medial condyloid ridge, and coronoid process serve as a point of origin for many of the wrist and finger flexors. The lateral epicondyle and lateral supracondylar ridge serve as the point of origin for many extensors of the wrist and fingers.
Ligaments
The wrist, hand, and fingers depend heavily on the ligaments to provide support and static stability. -collateral ligament -palmar ligament
Flexor carpi ulnaris Innervation
Ulnar nerve (C8 and T1)
Extensor pollicis brevis app, workout, and stretch
assists the extensor pollicis longus in extending thumb worked out through same exercise for extensor pollicis longus Stretched by passively taking the first carpometacarpal joint and the MCP joint of the thumb into maximal flexion while fully flexing and adducting the wrist.
Extensor indicis muscle action
extension of the index finger at the metacarpophalangeal joint weak wrist extension weak supination of the forearm from a pronated position
Extensor carpi radialis longus action
extension of the wrist Abduction of the wrist (radial deviation) Weak elbow flexion weak pronation to neutral from fully supinated position
Wrist joint (Radio-carpal joint)
*The wrist joint is classified as a condyloid type joint (permits movement in two planes), allowing flexion, extension, abduction (radial deviation), and adduction (ulnar deviation). *It is often referred to as the radio-carpal joint * 70-90' of flexion *65-85' extension *15-25' abduction *25-40'adduction
Flexor digitorum profundus App, workout, and flexibility
*assists in wrist flexion . *used in any type of gripping, squeezing, or hand clenching activity *may be worked out by squeezing a ball *stretched similarly to the flexor digitorum superficialis except that the distal interphalangeal joints must be passively extended in addition to the wrist, metacarpophalangeal, and proximal interphalangeal joints while maintaining the forearm in full supination
Bones
*8 carpals *5 metacarpals *14 phylanxes *radius *ulna
Metacarpophalangeal (MCP) Joints
*Classified as condyloid 0-40' extension 85-100' flexion
Proximal interphalangeal (PIP) Joints
*Classified as ginglymus (Hinge) *can move from full extension to approximately 90-120' of flexion
Flexor digitorum profundus muscle action
*Flexion of four fingers at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints *Flexion of the wrist
Distal interphalangeal (DIP) Joints
*Ginglymus (hinge) *can flex 80-90' from full extension.
Extensor carpi radials brevis application, work out, stretch
*Important in activity that requires powerful wrist extension, golf, tennis. *Wrist extension exercises help develop this muscle *Stretching requires the elbow to be extended with the forearm pronated while the wrist is passively flexed and slightly adducted.
Extensor carpi radialis longus app, workout, stretch
*Important in any activity that requires powerful wrist extension. *Involved in abduction of the wrist *Worked out by doing wrist extension exercises against resistance. *Stretching requires the elbow to be extended with the forearm pronated while the wrist is passively flexed and slightly adducted.
Flexor carpi ulnaris Application, workout, and flexibility
*Important in wrist flexion or curling activities *One of only 2 muscles involved in wrist adduction (Ulnar deviation) *worked out by wrist curling against resistance *To stretch, the elbow must be fully extended with the forearm supinated while a partner passively extends and abducts the wrist
Flexor digitorum superficialis app, workout, and stretch
*One of only two muscles involved in flexion of all four fingers. *Vital in any gripping activity *squeezing a rubber ball in palm of hand can be used to develop these muscles. *stretched passively extending the elbow, wrist, metacapophalangeal, and proximal interphalangeal joints while maintaining the forearm in full supination.
Extensor digitorum application, work out, and stretching
*Only muscle involved in extension of all four fingers. *developed by applying manual resistance to the dorsal aspect of the flexed fingers and then extending the fingers fully *To stretch the extensor digitorum, the fingers must be maximally flexed at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints while the wrist is fully flexed
Extensor indicis muscle application, workout, stretch
*Pointing muscle *extends index finger *developed by applying manual resistance to the dorsal aspect of the flexed fingers and then extending the fingers fully *stretched by passively taking the index finger into maximal flexion at metacarpophalangeal , PIP, DIP joints while fully flexing the wrist.
Extensor carpi ulnaris application, workout, stretch
*Powerful wrist extensor *Only muscle other than the flexor carpi ulnaris involved in adduction (ulnar deviation) *works as antagonist to wrist flexion to allow the finger flexors to function more effectively in gripping. *Seen in any activity requiring wrist extension or stabilization of the wrist against resistance. *Worked out by doing wrist extension exercises against resistance. *Stretching requires elbow to be extended with the forearm pronated while the wrist is passively flexed and slightly abducted.
Flexor carpi radialis application, workout, and stretch
*Powerful wrist flexor *Brought into play during any activity that requires wrist curling or stabilization of the wrist against resistance. *May be developed by performing wrist curls against a handheld resistance *To stretch the elbow must be fully extended with the forearm supinated while a partner passively extends and adducts the wrist.
Extensor pollicis longus Application, workout, stretch
*Primary function is extension of the thumb *worked out by extending the flexed thumb against manual resistance. *Stretched by passively taking the entire thumb into maximal flexion while fully flexing the wrist with the forearm in pronation
Innervation
*The muscles of the wrist and hand are all innervated from the radial, median, and ulnar nerves of the brachial plexus. Radial neve (C6-C8) Median nerve(C6-T1) Ulnar nerve(C8-T1)
Palmaris longus application, work out, and flexibility
*The palmaris longus is involved only in wrist flexion from the anatomical position because of its central location on the anterior forearm and wrist. *assists in abducting and adducting the wrist *Worked out with any type of wrist curling activity *Maximal elbow and wrist extension stretches the palmaris longus.
Abductor pollicis longus action
Abduction of the thumb abduction of the wrist extension of the thumb weak supination of the forearm weak extension of the wrist joint
Posterior muscles
Abductor pollicis longus
Finger Joints
Each finger has three joints -Metacarpophalangeal -Proximal interphalangeal -distal interphyalngeal
Extensor digiti minimi action
Extension of the pinky at the MCP joint Weak wrist extension Weak elbow extension
Extensor digitorum muscle action
Extension of the second, third, fourth, and fifth phalanges at the metacarpophalangeal joints Extension of the wrist Weak extension of the elbow
Extensor pollicis longus action
Extension of the thumb at the carpometacarpal , MCP, and Interphanlangeal joints Extension of the wrist Abduction of the wrist (radial deviation) Weak supination of forearm
Extensor pollicis brevis Action
Extension of the thumb at the carpometacarpal and metacarpophalangeal joints wrist abduction (radial deviation) weak wrist extension
Extensor carpi ulnaris action
Extension of the wrist adduction (ulnar deviation) with flexor carpi ulnaris weak extension of elbow
Extensor carpi radialis brevis action
Extension of the wrist abduction of the wrist (radial deviation) weak flexion of the elbow
Extensor indicis muscle origin and insertion
origin: Between middle and distal one third of the posterior ulna insertion: Base of the middle and distal phalanxes of the second phalange (dorsal surface)
Extensor carpi radialis longus muscle origin and insertion
origin: Distal one third of lateral supracondylar ridge of humerus and lateral epicondyle of humerus. Insertion: Base of the second metacarpal (dorsal surface)
Extensor carpi radialis brevis origin and insertion
origin: Lateral epicondyle of humerus Insertion: Base of the third metacarpal (Dorsal side)
Extensor carpi ulnaris muscle origin and insertion
origin: Lateral epicondyle of the humerus middle two fourths of the posterior border of ulna Insertion: Base of the fifth metacarpal (dorsal side)
Palmaris longus muscle origin and insertion
origin: Medial epicondyle of the humerus insertion: Palmar aponeurosis of the 2nd, 3rd, 4th, and 5th metacarpals.
Extensor carpi radialis longus innervation
radial nerve (C6 and C7)
Hand consists of three distinct regions
the wrist, the palm, and the finger digits
