the wrist and hand

IN THE NAME OF JESUS CHRIST AND MY FAMILY'S PRAYERS I will do even BETTER on this exam and get the highest grade in the class because ive applied myself and committed to learning the information amen! Manifesting that A.

distal radio ulnar joint

uniaxial pivot// pronation supination

radoiocarpal joint (wrist joint)

connecting carpal bones to radius// flexion extension, and radial and ulnar deviation

biaxial

TFCC (triangular fibrocartilage complex)

provides stability of ulnar side of wrist // cushion between distal ulna and carpals // volar radiocarpal ligaments + dorsal radio ulnar ligament

carpometacarpal joints of fingers

connect wrist bones to metacarpals // dorsal and volar gliding //

no physiological active movement

metacarpophalangeal joints (these are your knuckles)

structural: ellipsoid (NOT hinge, because they can also AB/adcuct)

functional: biaxial

flexion (volar gliding) /extension (dorsal gliding) + abduction/adduction

interphalangeal joints (2nd and third knuckles)

hinge, uniaxial, flexion and extension

POWER GRIP at proximal interphalangeal joints

carpometacarpal joint of thumb

structural saddle, biaxial functional // flex extend and ab/adduct in weird planes

extrinsic muscles

originate proximal to wrist and generate more force

intrinsic muscles

contained ENTIRELY within hand and have precise control

extrinsic FLEXOR muscles

flexor carpi radialis, flexor carpi ulnaris, palmaris longus, flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus

flexor carpi radialis and flexor carpi ulnaris

original at MEDIAL epicondyle// needed for self feeding, writing, hammering

palmaris longus

object grasp

flexor digitorum superficialis

flexes MCP and PIP (not DIP)

functional grasp and pinch // brushing teeth and combing hair (this less intense activity)

flexor digitorum PROFUNDUS

DEEP to superficialis// flexes MCP, PIP AND DIP also fucnional grasp and pinch // playing racket ball and drawing (think more intense activity)

pulleys

hold flexor digitorum tendons in place// 5 annular and 3 cruciate

trigger finger?

stenosing tendinitis// inflammation of A1 pulley causes finger to be stuck in flexion// like ur pulling the trigger of a rifle

flexor pollicis longus

flexes the thumb// needed for texting on discord, pinching and sewing

extrinsic extensor muscles

extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digititorum, extensor indicis, extensor digit minimi, abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis

anatomical snuff box

the pollicis muscles on the back of the hand// abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis

extensor carpi radialis longus and brevis

originate from LATERAL epicondyle like supinators// needed for playing pickleball, painting a wall

longus: attaches to SECOND metacarpal

brevis: attaches to THIRD metacarpal

extensor carpi ulnaris

originate from lateral epicondyle, needed to play violin and hammer?

extensor digitorum

O: lateral epicondyles

I: bases and middle and distal phalanges of 2-5th fingers

boutonniere and swan neck deformities

buton: DIP extension, PIP flexion

swan neck: PIP hyperextension, DIP flexion, lax PIP volar plate and terminal tendon damage

extensor indicis and extensor digiti minimi

point of a mf

abductor pollicis longus

texting or picking up a baby

extensor pollicis brevis and longus

give a thumbs up or flip a coin

INTRINSIC HAND MUSCLES

thenar// pollicis - thumb

hypothenar// digiti minimi - pinky

palmar interossei// adduct fingers

dorsal interossei// abduct fingers

lumbricals// flex MCP but not DIP or PIP to eat sandwich

thenar

abductor pollicis longus, flexor pollicis brevis, opponens pollicis

hypothenar muscles

adductor digit minimi: stretch from pisiform to base of 5th finger

opponent digitmini: touch thumb and pinky together

palmar interossiei

bring digits towards middle finger // hold book or sandwich

dorsal interossei

spread fingers apart, typing or cutting with scissors

adductor pollicis

lateral pinch, hold a key, swipe my card, brush my hair

lumbricals

balance flexion and extension// originate from tendon of extensor digitorum profundus, only muscle in body to originates and terminates in soft tissu

ulnar nerve injury

sensory and motor deficits, can’t pinch, loss in interossei, adductor pollisus, ring and pinky

duputren contracture

thickening of palmar aponeurosis, contracture of ring and pinky fingers

dequervains tenosynovitis

inflammation of pollicis tendons and synovial sheath, texting thumb, coming with new mothers// trauma disorder of tendons of 1st dorsal compartment

opposition (policies brevises)

opponens pollicis, flexor pollicis brevis, abductor pollicis brevis to touch

radial aspect of hand

fine motor control// thumb, index, middle finger

ulnar aspect of hand

forceful grasp// ring and pinky fingers

tenodesis

passive finger flexion from wrist extension// function grip for paralysis of finger flexors // spinal cord injury c6

composite grasp

my fingers around my neck after this fucking exam// all fingers forcefully contract at once

grip types

cylindrical// midrange flexion, tube shaped object, holding water bottle

spherical// varied flexion, holding a round object like a bowling ball

hook// MCP extended, DIP and PIP flexed// carrying an owala

pinch patterns

tip// precise movement, threading needle

lateral (key)// pad of thumb against radial side of index finger, holding a key

three jaw chuck// tripod pinch, tip of thumb touch tips and index and middle fingers, writing with a pencil

distal radius fractures

smiths// volar (inward) displacement of distal bone

colles// dorsal (outward) displacement of distal bones

radial nerve injury

wrist drop// radial nerve motor impairment// loss of wrist, thumb, digit extension

ulnar nerve injury

claw hand// motor nerve impairment// hyperextension of MCPs, loss of IP extension in knuckle and ring ringers

median nerve injury (hand of benediction)

can’t flex thumb, point of middle finger, loss of web space of thumb