FA: wrist and hand joints

what is the O/I of the flexor carpi radialis?

O: Medial epicondyle of humerus

I: base of 2nd and 3rd metacarpals, anterior (palmar surface)

what is the O/I of the palmaris longus?

O: Medial epicondyle of humerus

I: palmaris aponeurosis of 2nd, 3rd, 4th, and 5th metacarpals

what is the O/I of the flexor carpi ulnaris?

O: Medial epicondyle of humerus, posterior aspect of proximal ulna

I: pisiform, hamate, and base of 5th metacarpal (palmar surface)

what is the O/I of the extensor carpi ulnaris?

O: lateral epicondyle of humerus + middle 2/4ths of the posterior border of the ulna

I: base of 5th metacarpal (dorsal surface)

what is the O/I of the extensor carpi radialis brevis?

O: lateral epicondyle of humerus

I: base of third metacarpal (dorsal surface)

what is the O/I of the extensor carpi radialis longus?

O: distal 1/3rd of lateral supracondylar ridge of humerus and lateral epicondyle of humerus

I: base of second metacarpal (dorsal surface)

what is the O/I of the flexor digitorum superficialis?

O: Medial epicondyle of humerus

ulnar head: Medial coronoid process

radial head: upper 2/3rds of anterior border of radius

I: split tendons attach to sides of middle phalanx of 4 fingers (palmar surface)

what is the O/I of the flexor digitorum profundus?

O: proximal 3/4ths of anterior and medial ulna

I: base of distal phalanxes of the 4 fingers

what is the O/I of the flexor pollicis longus?

O: middle anterior surface of radius and from the anterior medial border of ulna just distal to coronoid process

I: base of distal phalanx of thumb (palmar surface)

what is the O/I of the extensor digitorum?

O: lateral epicondyle of humerus

I: 4 tendons to bases of middle and distal phalanxes of 4 fingers (dorsal surface)

what is the O/I of the extensor indicis?

O: b/w middle and distal 1/3rd of posterior ulna

I: base of middle and distal phalanxes of 2nd phalange (dorsal surface)

what is the O/I of the extensor digiti minimi?

O: lateral epicondyle of the humerus

I: Base of middle and distal phalanxes of 5th phalange (dorsal surface)

what is the O/I of the extensor pollicis longus?

O: posterior lateral surface of lower middle ulna

I: Base of distal phalanx of thumb (dorsal surface)

What is the O/I of the extensor pollicis brevis?

O: posterior surface of lower middle radius

I: base of proximal phalanx of thumb (dorsal surface)

what is the O/I of the abductor pollicis longus?

O: posterior aspect of the radius and midshaft of ulna

I: base of 1st metacarpal (dorsal lateral surface)

What are the 2 categories of wrist and hand muscles? and what is the origin and insertion for each category?

Extrinsic —> O: in the forearm, I: in the hand

Intrinsic —> O/I: both in the hand

how many bones are in the wrist and hand? what is the breakdown?

29

• radius and ulna

• 8 wrist (carpal) bones

• 5 metacarpal bones connect wrist to fingers

• 14 phalanges

  • 3 for each finger (proximal, middle, distal)

  • 2 for thumb (proximal and distal)

What kind of joint is the wrist joint?

condyloid joint

where does wrist joint movement occur?

it occurs mostly b/w the radius and the proximal row of carpal bones

What are the 2 finger joints and what type are they?

MCP joints (metacarpophalangeal): condyloid

PIP (proximal interphalangeal) and DIP (distal interphalangeal) joints: ginglymus

What are the 3 thumb joints? and what type are they?

Carpometacarpal joint (thumb): saddle

MCP joint: ginglymus

IP joint: ginglymus

The forearm muscles are divided into anterior and posterior compartments. The anterior compartments contains what muscles? the posterior compartment contains what muscles?

anterior compartment: flexor muscles

posterior compartment: extensor muscles

all pure wrist flexors and extensors attach somewhere on the ___nd and ___th metacarpals.

• 2nd and 5th

What are the 2 important forearm muscle tendons?

• common flexor tendon

• common extensor tendon

The common flexor tendon attaches where? what 5 muscles attach to the common flexor tendon?

• attaches to the Medial epicondyle of the humerus

• Flexor carpi radialis, palmaris longus, flexor carpi ulnaris, pronator teres, flexor digitorum superficialis

The common extensor tendon attaches where? what 4 muscles attach to the common extensor tendon?

• attaches to lateral epicondyle of the humerus

• Extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris

Where do finger muscles insert? these muscles can also move what joints?

• insert at the base of the proximal, middle, and distal phalanges

• because these muscles also cross the wrist or elbow joints, they can also move these joints

All muscles that move the wrist are (intrinsic or extrinsic)? Muscles of the hand can be (intrinsic, extrinsic, or both)? Extrinsic movements are more (gross/fine) movements? Intrinsic movements are more (gross/fine) movements?

• extrinsic

• both

• gross

• fine

There are 8 gross movements of the wrist and hand. What are they?

Wrist flexion

Wrist extension

Wrist abduction (radial deviation)

Wrist adduction (ulnar deviation)

Finger and thumb flexion (opposition)

Finger and thumb extension (reposition)

Adduction of metacarpophalangeal (MCP) joint and thumb

Abduction of MCP joint and thumb

most impairments of the wrist and hand are related to…..?

overuse

what syndrome is this?

• The _____ ________ is a passageway on the palmar side of the wrist through which the median nerve and several tendons travel 

  • Of particular interest are the tendons associated with the flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus  

• Overuse of these muscles can cause swelling pressing on the median nerve

• Often causes pain in the hand and tingling of the thumb and index fingers

• carpal tunnel (carpal tunnel syndrome)

what syndrome is this?

• The _____ _______ refers to the space between the two heads of the flexor carpi ulnaris through which the ulnar nerve passes

• The ulnar nerve can become compressed between these two heads

• Usually identified by tingling in the little and ring fingers (as opposed to the thumb and index fingers felt with carpal tunnel syndrome)

• cubital tunnel (cubital tunnel syndrome)

What impairment of the thumb is this?

• Overuse/irritation of the flexor pollicis longus

texting thumb

What impairment of the thumb is this?

• Arthritis of the saddle joint of the thumb

Basilar arthritis

What impairment of the thumb is this?

• Inflammation of the synovial sheath covering the abductor pollicis longus and extensor pollicis brevis

• De Quervain’s disease

what are the 5 muscles involved in wrist flexion?

• flexor carpi radialis

• flexor carpi ulnaris

• palmaris longus

• flexor digitorum profundus

• flexor digitorum superficialis

What 4 muscles are involved in wrist extension?

• extensor carpi ulnaris

• extensor carpi radialis brevis

• extensor carpi radialis longus

• extensor digitorum

What 4 muscles are involved in wrist abduction?

• flexor carpi radialis

• extensor carpi radialis brevis

• extensor carpi radialis longus

• abductor pollicis longus

What 2 muscles are involved in wrist adduction?

• extensor carpi ulnaris

• flexor carpi ulnaris

What 2 muscles are involved in finger flexion?

• flexor digitorum superficialis

• flexor digitorum profundus

What 3 muscles are involved in finger extension?

• extensor digitorum

• extensor indicis

• extensor digiti minimi

What muscle is involved in thumb flexion?

• flexor pollicis longus

What 2 muscles are involved in thumb extension?

• extensor pollicis longus

• extensor pollicis brevis

What muscle is involved in finger/thumb abduction?

• abductor pollicis longus

How many muscles are in finger/thumb adduction?

NONE

What 5 muscles are innervated by the median nerve?

• flexor carpi radialis

• palmaris longus

• flexor digitorum superficialis

• flexor digitorum profundus

• flexor pollicis longus

What muscle is innervated by the ulnar nerve?

flexor carpi ulnaris

What 9 muscles are innervated by the radial nerve?

• extensor carpi ulnaris

• extensor carpi radialis brevis

• extensor carpi radialis longus

• extensor digitorum

• extensor indicis

• extensor digiti minimi

• extensor pollicis longus

• extensor pollicis brevis

• abductor pollicis longus