Kines Chap 7

7/25/2019 Kines Chap 7

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2007 McGraw-HillHigher Education. Allrights reserved. 7-1

Chapter 7

The Wrist and Hand Joints

Manual of Structural KinesiologyR.T. Floyd, EdD, ATC, CSCS


The Wrist & Hand Joints

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Bones

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Bones

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Bones

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Joints

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Movements

Wrist

Flexion & extension Abduction & adduction

Fingers

Flex & extend

MCP joints also abduct & adduct


Movements

Middle phalange is reference point to

differentiate abduction & adduction Thumb, index & middle fingers abduct when

they move laterally toward radial side of hand

Ring & little fingers adduction when they movemedially toward ulnar side of hand

Medial movement of thumb, index & middlefingers toward ulnar side of hand is adduction

Lateral movement of ring & little finger towardradial side of hand is abduction


Movements

Flexion

movement of palm ofhand and/or phalangestoward anterior or volaraspect of forearm


Movements

Extension

movement of back of handand/or phalanges towardposterior or dorsal aspectof forearm


Movements

Abduction (radial

flexion)

movement of thumb

side of hand towardlateral aspect orradial side of forearm

Also, movement offingers away frommiddle finger


Movements

Adduction (ulnar flexion)

movement of little fingerside of hand toward

medial aspect or ulnarside of forearm

Also, movement offingers toward middlefinger


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Movements

Opposition

movement of thumbacross palmar aspect tooppose any or all of thephalanges

Reposition movement of thumb as it

returns to anatomicalposition from oppositionwith hand and/or fingers


Muscles

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particularly common with repetitive use of thehand and wrist in manual labor and clerical worksuch as typing and keyboarding

Often, slight modifications in work habits and hand& wrist positions during these activities can bepreventative

Flexibility exercises for the wrist & finger flexorsmay be helpful


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Muscles

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Muscles

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Muscles

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Nerves

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Nerves

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Nerves

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Nerves

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Nerves

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Flexor Carpi Radialis Muscle

Weak pronationof forearm

Weak flexion ofelbow

Abduction of wrist

Flexion of wrist


Palmaris Longus Muscle

Flexion of wrist

Weak flexionof elbow


Flexor Carpi Ulnaris Muscle


Adduction of wrist,together withextensor carpiulnaris muscle

Flexion of wrist


Extensor Carpi Ulnaris Muscle

Adduction of wristtogether with flexorcarpi ulnaris muscle

Extension ofwrist

Weak extensionof elbow


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Extensor Carpi Radialis Brevis Muscle

Abduction of wrist

Extension ofwrist



Extensor Carpi Radialis Longus Muscle

Abduction ofwrist

Extension ofwrist


Weak pronationto neutralfrom a fullysupinatedposition


Flexor Digitorum Superficialis Muscle

Flexion of wrist

Weak flexionof elbow

Flexion of fingers atmetacarpophalangeal& proximalinterphalangeal joints


Flexor Digitorum Profundus Muscle

Flexion of wrist

Flexion of 4 fingers atmetacarpophalangeal,proximalinterphalangeal, &distal interphalangealjoints


Flexor Pollicis Longus Muscle

Flexion of wrist

Abduction ofwrist

Flexion of thumbcarpometacarpal,metacarpophalangeal,& interphalangealjoints


Extensor Digitorum Muscle

Extension of wrist

Extension of 2nd, 3rd, 4th,& 5th phalanges atmetacarpophalangealjoints

Weak extensionof elbow


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Extensor Indicis MuscleExtension of index finger at

metacarpophalangealjoint

Weak wrist extension

Weak supination offorearm from apronated position


Extensor Digiti Minimi Muscle

Extension of little fingeratmetacarpophalangealjoint


Weak elbow extension


Extensor Pollicis Longus Muscle

Extension of thumb atcarpometacarpal,metacarpophalangeal, &interphalangeal joint

Extension of wrist


Abduction of wrist


Extensor Pollicis Brevis Muscle

Wrist abduction


Extension of thumb atcarpometacarpal &metacarpophalangealjoints


Abductor Pollicis Longus Muscle

Abduction of wrist

Abduction ofthumb atcarpometacarpaljoint


Extension of thumb atcarpometacarpaljoint

Weak flexion of wrist


Intrinsic Muscles of the Hand

Modified from Van De GraaffKM:Humananatomy, ed 4, New York, 1995, McGraw-Hill.


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Thenar eminence - muscular pad on

palmar surface of 1st metacarpal

abductor pollicis brevis

opponens pollicis

flexor pollicis brevis

adductor pollicis



Hypothenar eminence - muscular pad

that forms ulnar border on palmar surface

abductor digiti minimi

flexor digiti minimi brevis

opponens digiti minimi

Intermediate muscles

three palmar interossei

four dorsal interossei

four lumbrical muscles



Four muscles act on CMC of thumb

opponens pollicis - opposition in thumbmetacarpal

abductor pollicis brevis & flexor pollicis brevisabduct thumb metacarpal

flexor pollicis brevis flexes thumb metacarpal

adductor pollicis adducts thumb metacarpal

flexor pollicis brevis & adductor pollicis flexproximal phalanx of thumb



Three palmar interossei

adduct the 2nd, 4th, & 5th phalanges

Four dorsal interossei

flex & abduct index, middle, & ring proximalphalanxes

assist with extension of middle & distalphalanxes of index, middle, & ring f ingers

Third dorsal interossei

adducts middle finger



Four lumbricales flex index, middle, ring, & little proximal

phalanxes

extend middle & distal phalanxes of index,middle, ring, & little fingers.

Three muscles act on little finger opponens digiti minimi causes opposition of

little finger metacarpal

abductor digiti minimi abducts 5th metacarpal

flexor digiti minimi brevis flexes 5th

metacarpal 2007 McGraw-HillHigher Education. Allrights reserved. 7-66

Wrist Flexion

Agonists


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Wrist Flexion

Agonists


Wrist Extension

Agonists


Wrist Extension

Agonists


Wrist Extension

Agonists


Wrist Abduction

Agonists


Wrist Abduction

Agonists


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Wrist Adduction

Agonists


Phalangeal Flexion

Agonists


Phalangeal Extension

Agonists


Phalangeal Extension

Agonists


Web SitesRadiologic Anatomy Browser

http://radlinux1.usuf1.usuhs.mil/rad/iong/index.html

This site has numerous radiological views of themusculoskeletal system.

University of Arkansas Medical School Gross Anatomy forMedical Students

http://anatomy.uams.edu/anatomyhtml/grossresources.html Dissections, anatomy tables, atlas images, links, etc.Loyola University Medical Center: Structure of the Human Body

www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/GA.html An excellent site with many slides, dissections, tutorials, etc.,

for the study of human anatomyWheeless Textbook of Orthopaedics

www.wheelessonline.com/

This site has an extensive index of links to the fractures,joints, muscles, nerves, trauma, medications, medical topics,lab tests, and links to orthopedic journals and other orthopedicand medical news.


Web SitesArthroscopy.Com

www.arthroscopy.com/sports.htm

Patient information on various musculoskeletal problems ofthe upper and lower extremity

Premiere Medical Search Engine

http://www.medsite.com/Default.asp?bhcp=1

This site allows the reader to enter any medical condition andit will search the net to find relevant articles.Virtual Hospital

www.vh.org Numerous slides, patient information, etc.

Medical Multimedia Group

www.healthpages.org/AHP/LIBRARY/HLTHTOP/CTD/ A Patient's Guide to Cumulative Trauma Disorder(CTD)


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Web SitesMedical Multimedia Group

www.healthpages.org/AHP/LIBRARY/HLTHTOP/CTS/ctsndx.htm

A Patient's Guide to Carpal Tunnel Syndrome

Physioroom.comwww.physioroom.com/injuries/arm/index.shtml

Articles on hand and wrist injuriesDartmouth Medical School

www.dartmouth.edu/~anatomy/wrist-hand/muscles/

Muscles of the wrist and handAmerican Academy of Orthopaedic Surgeons

http://orthoinfo.aaos.org/category.cfm?topcategory=Arm Patient Education Library on the Hand

MayoClinic.com

www.mayoclinic.com/invoke.cfm?id=AR00030 Hand exercises for people with arthritis


Web SitesAmerican Society for Surgery of the Hand

http://www.assh.org/Content/NavigationMenu/PatientsPublic/HandConditions/ExtensorTendonInjuries/Extensor_Tendon_In

j.htm

Extensor Tendon Injuries

Documents

Kines Chap 7