9 - Hand 1

9 - Hand 1 - Foundations of Occupation: Kinesiology The...

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Foundations of Occupation: Kinesiology The Hand: Part I Lecture 9 Summer 2010
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PARTY!
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Overview: Wrist Review and Directional Terms Hand Anatomy: Bones, Joints and Accessory Structures Arches of the Hand Motions of the Thumb Muscles: Finger Extrinsics Muscles: Thumb Extrinsics Muscles: Thumb Intrinsics Activation: Thumb Opposition & Reposition
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WRIST REVIEW
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Review: Carpal Kinematics Vary by individual Axes of motion are not constant Firmly attached metacarpals (hand) move with distal carpal row In general… Axis for flexion (from extension) begins proximally and moves distally Axis for extension (from flexion) begins distally and moves proximally
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Review: Ulnar and Radial Deviation
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Review: Wrist Muscles 3 flexors (with PL) 3 extensors Finger and thumb muscles also cross (and may act on) the wrist FCU able to exert greatest tension ECRB is smaller than ECRL, but more centrally located -> active during most grasp-and-release activities; stabilizes wrist during grasp ECRL increases activity when forceful finger flexion motions required
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Directional Terms Anterior (palmar/volar) Posterior (dorsal) Ulnar Deviation (Wrist ADduction) Radial Deviation (Wrist ABduction) Ulnar   (medial) Radial (Lateral)
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3) Triquetrum 4) Pisiform 7) Capitate 8) Hamate Review: The Carpal Bones ?    View  of the   ?  Hand
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HAND ANATOMY: BONES, JOINTS & ACCESSORY STRUCTURES
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1 2 3 4 5 1 5 4 3 2 1 Bones of the Hand Phalanges Distal Phalynx Middle Phalynx Proximal Phalynx Metacarpals Dorsal View of the  Right Hand
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The Joints of the Hand Carpometacarpal Joint (CMC) articulation between distal carpal row and bases of metacarpal bones Metacarpophalangeal Joint (MCP or MP) articulation between the metacarpal and its phalanx Interphalangeal Joint (IP) articulations between the phalanges of the digits identified as either proximal (PIP) or distal (DIP) Consideration of the intrinsic/extrinsic musculature
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DIP PIP MP / MCP CMC Joints of the Hand
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Carpometacarpal Joints (CMC) Articulate with one another and the carpal bones digits 2 -4: flexion/extension (plane, synovial) digit 5: flexion/extension, slight AB /AD (saddle) Thumb Carpometacarpal (CMC) - articulation between the trapezium and base of 1st metacarpal. True saddle joint – CMC stability: Supported by Strong transverse ligaments Weaker longitudinal ligaments volarly and dorsally
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Metacarpophalangeal Joints (MP or MCP) Articulation between: convex head of metacarpal bones concave base of proximal phalange MP/MCPs in 2-5 Condyloid joints Two degrees of freedom Flex/ Ext ABduction / ADduction MCP of thumb (operates more like IP) Somewhat of a condyloid joint Due to limited aBduction/aDduction, it functions more like a hinge joint with one degree of freedom Thumb CMC functions like a freer version of MCP of other digits
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MCP Stability Provided by 1 plate and 3 ligaments Volar Plate
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9 - Hand 1 - Foundations of Occupation: Kinesiology The...

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