1. Chapter 13 Hand

2. Joints and Motions of the Thumb
Carpometacarpal (CMC)
Flexion and extension
Abduction and adduction
Opposition and reposition
Metacarpophalangeal (MCP)
Interphalangeal (IP)
CMC – trapezium & base of 1st metacarpal; saddle joint; rotation is a passive accessory motion of thumb
Modified biaxial joint
MCP – uniaxial
IP - uniaxial

3. Joints and Motions of the Fingers
Carpometacarpal (CMC)
Accessory motion, minimal opposition
Metacarpophalangeal (MCP)
Flexion/extension/hyperextension
Abduction/adduction
Proximal interphalangeal (PIP) and distal interphalangeal (DIP)
Flexion/extension
CMC – nonaxial; plane joints

4. Bones and Landmarks
Metacarpals (5)
Base
Head
Phalanges (14)

5. Ligaments and Other Structures
Flexor retinaculum
Palmar carpal ligament
Transverse carpal ligament
Extensor retinaculum
Extensor expansion ligament (extensor hood)

6. Ligaments and Other Structures
Palmar arches
Proximal carpal arch
Distal carpal arch
Longitudinal arch

7. Extrinsic Muscles of the Thumb and Fingers
Anterior
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
FDS – middle phalanx
FDP – distal phalanx (not a muscle card)

8. Extrinsic Muscles of the Thumb and Fingers
Posterior
Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis
Extensor digitorum
Extensor indicis
Extensor digiti minimi

9. Intrinsic Muscles of the Thumb and Fingers
Thenar (thenar eminence)
Flexor pollicis brevis
Abductor pollicis brevis
Opponens pollicis

10. Intrinsic Muscles of the Thumb and Fingers
Deep palm
Adductor pollicis
Dorsal and palmar interossei
Lumbricales
No muscle cards on these

11. Intrinsic Muscles of the Thumb and Fingers
Hypothenar (hypothenar eminence)
Flexor digiti minimi
Abductor digiti minimi
Opponens digiti minimi

12. Hand Description of anatomical relationships Summary of muscle actions
Summary of muscle innervation
Summary of muscle actions – Table 13.4 page 187
Summary of Muscle Innervations – Table 13.5 & 13.6 page 188

13. Common Wrist and Hand Pathologies
Wrist fracture
de Quervain’s disease
Dupuytren’s contracture
Wrist Fractures
- Colles – transverse fracture of distal radius with posterior displacement of distal fragment
- Smith’s – distal fragment displaces anteriorly
- greenstick fracture

14. Hand Function Functional position Grasps Power grip Precision grip
Functional Position – wrist slightly extended; MCP & PIP slightly flexed; thumb in opposition
Power Grip – holds forcibly while being moved;
Precision Grip – aka precision prehension grip; manipulating objects with finer type movement
Power Grips
Cylindrical – holding a hammer
Spherical – doorknobs
Hook – holding a handle
Precision Grips
Pad to Pad
Pinch grip
Three Jaw chuck – holding a pen
Tip to Tip – pincer grip
Pad to side – lateral prehension – key
Side to side - cigarette