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The Wrist and Hand

The Wrist and Hand. Great Mobility = Many Joints. Joints. You know the bones…. The Wrist. Radiocarpal wrist joint condyloid joint Carpals two rows of four bones carpal joints gliding joints. The Hand. Metacarpals carpometacarpal joint intermetacarpal joints

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The Wrist and Hand

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  1. The Wrist and Hand Great Mobility = Many Joints

  2. Joints You know the bones…

  3. The Wrist • Radiocarpal • wrist joint • condyloidjoint • Carpals • two rows of four bones • carpal joints • gliding joints

  4. The Hand Metacarpals carpometacarpal joint intermetacarpal joints metacarpal-phalangeal joints interphalangeal joints

  5. Ligaments of the wrist(radiocarpal joint) • volar (palmar) radiocarpal • volar (palmar) ulnarcarpal • ulnar collateral • dorsal radiocarpal • dorsal ulnarcarpal • radial collateral

  6. Movements of theHand at the Wrist Joint • Flexion • Extension • Hyperextension • Radial flexion (abduction) • Ulnarflexion (adduction) • Circumduction

  7. Carpal Tunnel • finger flexors and median nerve pass through it • overuse my result in pain caused by nerve compression and numbing of the fingers caused by blood vessel involvement.

  8. Movements of the Thumb(saddle joint) • Abduction • Adduction • Flexion • Extension • Circumduction • Opposition

  9. Movements of the Fingers(Hinge joints) • Flexion • Extension • Abduction • Adduction • Circumduction

  10. Muscles Of the wrist and hand

  11. Muscles of theHand • Of the 19 muscles that move the fingers and thumb • 10 are located entirely in the hand – called intrinsics • Those located outside the hand on the forearm but with tendon attachments on the thumb or fingers are extrinsic muscles

  12. Naming muscles • Digitorium • fingers • Superficialis • Superficial or outermost • Pollicis • thumb • Palmus • palm • Digit minimi • Little finger • Indicis • Index finger • Brevis • short • Longus • long

  13. Intrinsic Muscles • Opponenspollicis- flexion • Abductor pollicisbrevis- abduction • Flexor pollicisbrevis- flexion • Oponens digit minimi- opposition • Abductor digit minimi- abduction • Flexor digit minimibrevis- circumduction of thumb • Adductor pollicis- adduction • Palmarinterosseus- adduction • Dorsal interosseus- abduction • Lumbrical Thenareminance: Move thumb; circumduction Hypothenar eminance grasping

  14. Muscles of the Wrist • Wrist Flexors (proximal attachment) – medial epicondyle

  15. Muscles of the Wrist and Hand • Wrist Extensors (proximal attachment) – lateral epicondyle • These attachments allow these muscles to remain effective across the wrist joint regardless of the position of the forearm – they also contribute to the stabilization of the elbow • Disadvantage is the limiting ROM when there is simultaneous movement across all joints

  16. Flexors/Extensors of Wrist and Hand* flexors extensors • Flex. Digitoriumprofundus* • Flex. Pollicislongus* • Flex. Digitoriumsuperficialis* • Flex. Carpi ulnaris • Palmaris longus • Flex. Carpi radialis • Ext. indicis* • Ext. pollicislongus* • Ext. pollicisbrevis* • Ext. carpiulnaris • Ext. digitiminimi* • Ext. digitorum* • Ext. carpiradialislongus • Ext. carpiradialisbrevis

  17. Other cool stuff How it all works

  18. Cooperative Action of theWrist and Digits • The length of the long finger muscles is relative to the ROM in the wrist and fingers • Long finger muscles do not have sufficient length to permit the full range of motion in the joints of the fingers and wrist at the same time. • Try and flex the wrist and fingers at the same time • Try and extend the wrist and fingers at the same time

  19. Using the Hands for Grasping (Prehension) • Power grip • flexion of all fingers • thumb being primarily a stabilizer • palm is not involved • depends on size and shape of object • uses more extrinsic muscles

  20. Precision handling – involves the use of the thumb and one or two fingers in various positions in order to accommodate a variety of grasping functions • great variability in pressure and fine motor control • more intrinsic muscles being used

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