Chapter 7
The Wrist and Hand Joints
Manual of Structural Kinesiology
PE 3320
The Wrist & Hand Joints
Many sports require precise functioning of wrist & hand
Archery, bowling, golf, baseball, tennis, etc. require
combined use of wrist & hand joints
Relate functional anatomy to joint actions
flexion, extension, abduction, & adduction of wrist
& hand
____________ bones
More than 25 joints
More than 30 muscles
18 are intrinsic
Bones
________ carpal bones
Proximal row from radial to ulnar side
____________ (boat-shaped) or navicular
____________ (moon-shaped)
____________ (three-cornered)
____________(pea-shaped)
Distal row, from the radial to ulnar side
____________ (greater multangular)
____________(lesser multangular)
____________(head-shaped)
____________(hooked)
____________ most often injured
From falling on outstretched hand
Often dismissed as a sprain
Significant problem if not recognized & treated properly
Usually long period of precise immobilization or surgery
Joints
Wrist joint
____________-type joint
allows ______________________________________
motion occurs primarily between distal radius & proximal
carpal row (scaphoid, lunate, & triquetrum)
Movements
Wrist
______________
________________
______________
________________
Fingers
________ & __________
MCP joints also abduct & adduct
Flexion
____________________________________________
Movements
Extension
____________________________________________
_______________ (radial flexion)
movement of thumb side of hand toward lateral aspect or
radial side of forearm
Also, movement of fingers away from middle finger
_______________ (ulnar flexion)
movement of little finger side of hand toward medial aspect
or ulnar side of forearm
Also, movement of fingers toward middle finger
________________
movement of thumb across palmar aspect to oppose any or all
of the phalanges
Reposition
movement of thumb as it returns to anatomical position from
opposition with hand and/or fingers
Muscles
Extrinsic muscles of wrist & hand grouped according to
function & location
_______ muscles move wrist but not fingers & thumb
_______ wrist flexors
flexor carpi radialis
flexor carpi ulnaris
palmaris longus
_______wrist extensors
extensor carpi radialis longus
extensor carpi radialis brevis
extensor carpi ulnaris
Muscles
All wrist flexors generally have their origins on
anteromedial aspect of proximal forearm and medial epicondyle of humerus with
insertions on anterior aspect of wrist & hand
Median nerve & all flexor tendons except flexor carpi
ulnaris & palmaris longus pass through carpal tunnel
Muscles
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
Wrist extensors generally have their origins on
posterolateral aspect of proximal forearm & lateral humeral epicondyle with
insertions located on posterior aspect of wrist & hand
Flexor & extensor tendons immediately proximal to wrist
are held in place on palmar & dorsal aspects by transverse bands of tissue
known as flexor & extensor retinaculum to prevent the tendons from
bowstringing during flexion & extension
Muscles
Wrist abductors
Generally cross wrist joint anterolaterally &
posterolaterally to insert on radial side of hand
Flexor carpi radialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis
Wrist adductors
cross wrist joint anteromedially & posteromedially to
insert on ulnar side of hand
Flexor carpi ulnaris
Extensor carpi ulnaris
Anteromedially at elbow & forearm and anterior at hand
Primarily wrist flexion
Flexor carpi radialis
Flexor carpi
ulnaris
Palmaris longus
Anteromedially at elbow & forearm and anterior at hand
Primarily wrist & phalangeal flexion
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Posterolaterally at elbow & forearm and posterior at
hand
Primarily wrist extension
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Posterolaterally at elbow & forearm and posterior at
hand
Primarily wrist & phalangeal extension
Extensor digitorum
Extensor indicis
Extensor digiti
minimi
Extensor pollicis
longus
Extensor pollicis brevis
Abductor pollicis longus
Intrinsic Muscles of the Hand
Wrist Flexion
Agonists
Flexor carpi radialis
Flexor carpi
ulnaris
Palmaris
longus
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Wrist Flexion
Agonists
Flexor carpi radialis
Flexor carpi
ulnaris
Palmaris longus
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Wrist Extension
Agonists
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor digitorum
Extensor indicis
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis
Wrist Extension
Agonists
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor digitorum
Extensor indicis
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis
Wrist Extension
Agonists
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor digitorum
Extensor indicis
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis
Wrist Abduction
Agonists
Flexor carpi radialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis
Wrist Abduction
Agonists
Flexor carpi radialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis
Wrist Adduction
Agonists
Flexor carpi ulnaris
Extensor carpi ulnaris
Phalangeal Flexion
Agonists
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Phalangeal Extension
Agonists
Extensor digitorum
Extensor indicis
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis
Phalangeal Extension
Agonists
Extensor digitorum
Extensor indicis
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis