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Chapter 7 Wrist & Hand Joints. Hand Distal Middle Base Metacarpals Hamate Capitate Trapezoid Pisiform Triquetrum Lunate Scaphoid Proximal Phalanges Head.

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Presentation on theme: "Chapter 7 Wrist & Hand Joints. Hand Distal Middle Base Metacarpals Hamate Capitate Trapezoid Pisiform Triquetrum Lunate Scaphoid Proximal Phalanges Head."— Presentation transcript:

1 Chapter 7 Wrist & Hand Joints

2 Hand Distal Middle Base Metacarpals Hamate Capitate Trapezoid Pisiform Triquetrum Lunate Scaphoid Proximal Phalanges Head Shaft Carpals Trapezum Label

3 Joints Radioulnar (Pivot) –Supination and pronationSupination and pronation Radiocarpal (Condylodial) –Primarily articulates with scaphoid, lunate, and triquetrum –Movement and Range of Motion Flexion: 80°-90° Extension: 70°-90° Abduction: 15°-25° Adduction: 25°-40°

4 Joints Intercarpal (Arthrodial) Intermetacarpal (Arthrodial) Metacarpophalangeal (Condylodial) –Movement and ROM Flexion: 90° Extension: 0-40° –Metacarpophalangeal of the thumb: 40º to 90º from full extension

5 Joints Carpometacarpal of the thumb: (seller) –Movement and ROM Flexion: 15º to 45º Extension: 0º to 20º Abduction: 50º to 70º Opposition:Opposition –movement of thumb across palmer aspect to oppose any or all of the phalanges Reposition: –movement of thumb back to anatomical position Proximal Interphalangeal (ginglymus) –ROM: Flexion: 90º to 120º from full extension Distal Interphalangeal (ginglymus) –ROM: Flexion: 80º to 90º from full extension

6 Cutaneous Distribution

7 Wrist Flexors –Flexor Carpi Radialis –Palmaris Longus –Flexor Carpi Ulnaris –Flexor Digitorum Superficialis –Flexor Digitorum Profundus –Flexor Pollicis Longus Muscles Label

8 Muscles Wrist Extensors –Extensor Carpi Radialis Longus –Extensor Carpi Ulnaris –Extensor Carpi Radialis Brevis –Extensor Digitorum –Extensor Indicis –Extensor Digiti Minimi –Abductor Pollicis Longus –Extensor Pollicis Brevis –Extensor Pollicis Longus Not Shown? Label

9 Muscles Flexor Carpi Radialis Strengthening Stretching

10 Muscles Palmaris Longus Strengthening Stretching

11 Muscles Flexor Carpi Ulnaris Strengthening Stretching

12 Muscles Extensor Carpi Ulnaris Strengthening Stretching

13 Muscles Extensor Carpi Radialis Brevis Strengthening Stretching

14 Muscles Extensor Carpi Radialis Longus Strengthening Stretching

15 Muscles Flexor Digitorum Superficialis Strengthening Stretching

16 Muscles Flexor Digitorum Profundus Strengthening Stretching

17 Muscles Extensor Indicis Strengthening Stretching

18 Muscles Extensor Digiti MinimiStrengthening Stretching

19 Muscles Extensor Pollicus Longus Strengthening Stretching

20 Muscles Extensor Pollicus Brevis Strengthening Stretching

21 Muscles Abductor Pollicus Longus Strengthening Stretching

22 Thenar Muscles Opponens Pollicis

23 Thenar Muscles Abductor Pollicis Brevis

24 Thenar Muscles Flexor Pollicis Brevis

25 Intermediate Muscles Adductor Pollicis

26 Intermediate Muscles Palmar Interossei Drawn illustration

27 Intermediate Muscles Dorsal Interossei Drawn illustration

28 Intermediate Muscles Lumbricals

29 Hypothenar Muscles Opponens Digiti Minimi

30 Hypothenar Muscles Abductor Digiti Minimi

31 Hypothenar Muscles Flexor Digiti Minimi Brevis

32 Injuries of the Wrist Scaphoid Fracture Carpel Tunnel Claw Hand Ape Hand

33 Carpal Tunnel Syndrome 1.Anatomy a.Bounds b.Muscles/Tendons c.Nerve d.Other

34 Carpel Tunnel Syndrome Common Causes: –Pregnancy –Rheumatoid Arthritis –Diabetes –Wrist Trauma –Occupational (typing)

35 Symptoms Tests: Carpel Tunnel Syndrome TINEL’S SIGN STRIKE THE PATIENT’S WRIST AS SHOWN. A TINGLING SENSATION RADIATING DOWN THE WRIST TO THE HAND IN THE DISTIBUTION OF THE MEDIAN NERVE IS A POSITIVE SIGN. Tinel’s Sign Phalen Test Thumb Abduction Test PHALEN TEST HAVE THE PATIENT HOLD THEIR WRISTS AS SHOWN FOR ONE MINUTE. NUMBNESS AND PARAESTHESIA IN THE DISTRIBUTION OF THE MEDIAN NERVE IS A POSITIVE TEST. THUMB ABDUCTION TEST TESTS THE STRENGTH OF THE ABDUCTOR POLLICIS BREVIS WHICH IS INERVATED BY THE MEDIAN NERVE. HAVE THE PATIENT PLACE THEIR PALM UP WITH THEIR THUMB PERPENDICULAR TO IT. APPLY DOWNWARD PRESSURE ON THE THUMB. WEAKNESS IS ASSOCIATED WITH CARPAL TUNNEL SYNDROME. JAMA 2000;283: MOSBY’S GUIDE TO THE PHYSICAL EXAMINATION 5TH ED.

36 Claw Hand 1.Description: Hyperextension at the MCP joint, and flexion at the IP joint 2.Etiology?

37 Ape Hand 1.Description: atrophy of the thenar eminence 2.What nerves and muscles are involved and how?


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