Wrist

1. Name the primary wrist flexors and extensors. flexor carpi radialis flexor carpi ulnaris palmaris longus 3 wrist extensors extensor carpi radialis longus extensor carpi radialis brevis extensor carpi ulnaris

2. What type of joint is the wrist? Condyloid-type joint

3. What is the degree of freedom for the wrist joint? Flexion – 70-90 degrees Extension – 65-85 degrees Abduction – 15-20 degrees Adduction – 25-40 degrees

4. Articulation of which bones makes the wrist joint? Articulation primarily occurs between the distal radius and the proximal carpal row (scaphoid, lunate, triquetrum)

5. Draw a diagram representing all the movement of the wrist joint and name the plane and axis of each movement. Movement Plane Axis Flexion (palmar flexion) Sagittal Lateral Extension (dorsiflexion) Abduction (radial deviation, radial flexion) Frontal Anteroposterior Adduction (ulnar deviation, ulnar flexion)

6. Label the bones Metacarpals Hamate Trapezium Triquetrum Trapezoid Scaphoid Pisiform Lunate Capitate

7. Name the ligaments of the metacarpophalangeal and interplalangeal joint. Interphalangeal Joint Collateral Ligament Palmar Ligament Metacarpophalangeal Joint Collatoral Ligament Deep Transverse Metacarpal Ligament

8. Name the movement demonstrated in the figure. Palmar Flexion

9. What is Carpal Tunnel Syndrome? Swelling & inflammation can cause increased pressure in carpal tunnel resulting in decreased function of median nerve leading to reduced motor & sensation function in its distribution particularly common with repetitive use of the hand and wrist in manual labor and clerical work such as typing and keyboarding Often, slight modifications in work habits and hand & wrist positions during these activities can be preventative Flexibility exercises for the wrist & finger flexors may be helpful

10. Name the ligaments of the wrist joint. The book said there were too numerous to mention in this discussion.

11. What is the normal range of? Wrist Flexion 0 to ± 80 degrees Wrist Extension 0 to ± 70 degrees Ulnar Deviation 0 to 30 degrees Radial Deviation 0 to 20 degrees

12. Name the ligament to be injured in hyperextension of the Proximal Interphalengreal Joint. Collateral Ligament

Muscle Origin Insertion Action Innervation Flexor Carpi Radialis Medial epicondyle of humerus Base of 2nd and 3rd metacarpals on palmar surface -Flexion of wrist -Abduction of wrist -Weak flexion of elbow -weak pronation of forearm Median nerve (C6 and C7) Palmaris Longus Palmar aponeurosis of the 2nd, 3rd, 4th, and 5th metacarpals Flexor Carpi Ulnaris Medial epicondyle of humerus and posterior aspect of proximal ulna Base of 5th metacarpal (palmar surface), pisiform, and hamate -Adduction of wrist Ulnar nerve (C8 and T1)

Muscle Origin Insertion Action Inner-vation Flexor Digitorum Profundus Proximal ¾ of anterior and medial ulna Base of distal phalanges of four fingers Flexion of the four fingers at the metacarpo- phalangeal, proximal inter-phalangeal, and distal inter-phalangeal joints Median nerve (C8, T1) to 2nd and 3rd fingers; ulnar nerve (C8, T1) to 4th and 5th fingers Flexor Digitorum Superficialis -Medial epicondyle of humerus -Ulnar head: medial coronoid process -Radial head: upper 2/3 of anterior border of the radius just distal to the radial tuberosity Each tendon splits and attaches to the sides of middle phalanx of four fingers on palmar surface -Flexion of the fingers at the metacarpo- phalangeal and proximal inter- phalangeal joints -Flexion of wrist -Weak flexion of elbow Median nerve (C7, C8, and T1)

Muscle Origin Insertion Action Innervation Extensor Carpi Ulnaris Lateral epicondyle of humerus and middle ½ of the posterior border of the ulnaq Base of 5th metacarpal on dorsal surface -Extension of wrist -Adduction of wrist -Weak extension of elbow Radial nerve (C6, C7, and C8) Extensor Carpi Radialis Brevis Lateral epicondyle of humerus Base of 3rd metacarpal on dorsal surface -Abduction of wrist -Weak flexion of elbow (C6 and C7)

14. How can you strengthen the flexor carpi ulnaris muscle? The flexor carpi ulnaris is important in wrist flexion or curling activities. It is one of only two muscles involved in wrist adduction or ulnar flexion. It may be strengthened with any type of wrist-curling activity against resistance.

15. If ulnar nerve gets injured the which movement is likely to be affected? The ulnar nerve assists the flexor carpi ulnaris in Flexion of the wrist Adduction of the wrist Weak flexion of the elbow therefore these movements would be most affected if the ulnar nerve gets injured.

16. If there is contracture of wrist flexors then which movement will not take place in its full range? Opposition will not take place in its full range of motion.

17. During the concentric contraction of wrist flexors, which type of contraction will take place in wrist extensors? Eccentric Contraction

18. If you hold a cup tightly then which type of contraction occurs? Isometric Contraction

19. Which movement is demonstrated in the figure? A – wrist flexion B – wrist extension