Structural Kinesiology

scaphoid

Lunate

Triquetrium

Pisiform

Trapezium

capitate

trapezoid

hamate

Distal: Trapezium, trapezoid, capitate, hamate

Proximal: scaphoid, lunate, triquetrium, pisiform

What are all the carpal bones? Which ones are distal and which ones are proximal?

Base Shaft Head

What are the three parts of a metacarpal?

The 4th and 5th are mobile and the 2nd and 3rd are immobile. The ability to grasp objects of varying shapes and sizes is because of the mobility of the 4th and 5th metacarpal. The gripping and pinching motions are stable due to the 2nd and 3rd metacarpal.

Which metacarpals are mobile and which are immobile? Why is this important and how does it show the design of the Creator?

synoival pivot

What is the joint classification of the distal radioulnar joint?

Head of the ulna

ulnar notch of radius

What are the articulating surfaces of the distal radioulnar joint?

TFCC- Triangular Fibrocartilage complex

interosseous membrane

Movements: forearm pronation and supination

What are the stabilizing ligaments/structures of the distal radioulnar joint and what are this joints movements?

Synovial condyloid joint

Surfaces: distal radius and TFCC and proximal row of carpal bones

What is the joint classification of the radiocarpal (wrist) joint and what are the articulating surfaces?

Palmer radiocarpal ligament

Dorsal radiocarpal ligament

Radial collateral ligament

Ulnar collateral ligament

Movements:flexion, extension, radial and ulnar deviation, circumduction

What are the stabilizing ligaments and movements of the radiocarpal joint?

synovial condyloid

Head of metacarpals with the bases of proximal phalanges

what are the articulating surfaces and joint classification of the metcarpophalangeal joint?

collateral ligaments

Volar plates (prevent hyperextension)

Flexion and extension

Adduction and abduction

what are the movements and stabilizing ligaments of the metacarpophalangeal MCP joints

synovial hinge joints

Head and bases of phalanges (of adjacent phalanges)

What type of joint are the DIP and PIP joints and what are the articulating surfaces?

collateral ligaments

Volar palmer plates

Flexion and extension

What are the movements and stabilizing ligaments of the DIP and PIP ligaments?

synovial saddle joint

Movements occur around oblique axis

Flexion and extension

Adduction and abduction

Opposition and reposition

what is the joint classification and movements of the 1st carpometacarpal CMC joint

Radial

What nerve innervates all the muscles that extend the wrist and fingers?

Median Nerve

What nerve innervates most of the muscles that flex the wrist and fingers?

O- medial epicondyle of the humerus

I- slips from base of 2nd and 3rd metacarpal (palmer side)

A- flexion, radial deviation (abduction)

N-median nerve

Flexor carpi radialis OIAN

O: medial epicondyle of humerus

I: palmar aponeurosis

A: tenses aponeurosis and weakly assist with wrist flexion

This muscle may be absent from one or both arms in around 15% of the population

Palmaris Longus OIA

O: Medial epicondyle of the humerus and proximal ulna

I: base of 5th metacarpal; hamate and pisiform

A: flexion and ulnar deviation (cutting with a knife or hammering)

N: ulnar nerve

Flexor carpi Ulnaris OIAN

Flexor carpi radialis and flexor carpi ulnaris

What muscles would need to be working to act PURE WRIST FLEXION (with no deviation)?

O: medial epicondyle of the humerus

I: sides of the middle phalanges, digits 2-5

N: median nerve

Flexor digitorum superficialis (FDS) OIN

O: proximal ulna

I: Base of distal phalanges of digits 2-5

N: Lateral part (digits 2 and 3)- median nerve

medial part (digits 4 and 5)- ulnar nerve

Flexor digitorum profundus (FDP) OIN

MCP and PIP joint flexion (digits 2-5)

wrist flexion

(DIP joint flexion is an additional action of FDP)

What are the actions of both the FDS and FDP?

1) Synovial sheaths- surround the flexor tendons of each finger

2) Fibrous sheaths- surround the synovial sheaths and consist of multiple pulleys

Job: reduce friction and hold the long finger flexor tendons close to prevent bowstringing

What are the two types of sheaths found in the hand and what is their job?

Floor and sides: carpal bones and ligaments

Roof: flexor retinaculum (transverse carpal ligament)

What structures form the floor and sides of the carpal tunnel and what structure form the roof?

wrist and finger flexor tendond (FDS and FDP)

median nerve

What are the contents of the tunnel?

Radial: scaphoid and trapezium

Ulnar: pisiform and hook of hamate

continuous with the palmar aponeurosis

What are the attachments of the flexor retinaculum? Radial and Ulnar side? what is this retinaculum continuous with?

O: lateral supracondylar ridge of the humerus

I: base of 2nd metacarpal, dorsal surface

Extensor carpi radialis longus OI

O: lateral epicondyle of the humerus

I: Base of 3rd metacarpal, dorsal surface

Extensor carpi radialis brevis OI

wrist extension

radial deviation

What are the actions of the extensor carpi radialis longus and brevis?

O: lateral epicondyle of the humerus and posterior border of the ulna

I: base of the 5th metacarpal, dorsal surface

A: wrist extension and ulnar deviation

Extensor carpi ulnaris OIA

O: lateral epicondyle of the humerus

I: Central slip- base of middle phalanges

lateral bands- distal phalanges (digits 2-5)

A: extension of MCP, DID, PIP jpints and wrist extension

Extensor digitorum OIA

help to stablize the tendons and they reduce friction

What are intertendinous connections?

Extensor retinaculum and it helps to hold the tendons in place and prevent bow stringing

Extensor tendons pass under what? and what does this structure do?