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ThrilledCaesura6974

Uploaded by ThrilledCaesura6974

University of St. Augustine for Health Sciences

Neumann DA

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kinesiology musculoskeletal system anatomy rehabilitation

Summary

This is a chapter from a textbook that details the kinesiology of the musculoskeletal system. It includes information on the functions of the wrist and hand muscles and their innervation.

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Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd ed. Mosby; 2016. Chapter 7: Wrist pp. 218–241 1. Cite the factors that justify the greater range of ulnar deviation compared to radial deviation of the wrist. a. Radial Deviation at the ra...

Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd ed. Mosby; 2016. Chapter 7: Wrist pp. 218–241 1. Cite the factors that justify the greater range of ulnar deviation compared to radial deviation of the wrist. a. Radial Deviation at the radiocarpal joint is limited because the radial side of the carpus impinges against the styloid process of the radius. (p.230) 2. List all the muscles that have full or partial proximal attachment to the medial epicondyle of the humerus. Which nerve innervates these muscles and what is their action at the wrist? a. Pronator Teres Innervation: Median n. Action: Pronates and Flexes forearm (at the elbow) b. Flexor Digitorum Superficialis Innervation: Median n. Action: Flexes middle phalanges at proximal interphalangeal joints of middle four digits; acting more strongly, it also flexes proximal phalanges at metacarpophalangeal joints c. Common Flexor Tendon i. Palmaris Longus Innervation: Median n. Action: Flexes hand (at the wrist) and tenses palmar aponeurosis ii. Flexor Carpi Radialis Innervation: Median n. Action: Flexes and abducts hand (at the wrist) iii. Flexor Carpi Unlaris Innervation: Ulnar n. Action: Flexes and adducts hand (at the wrist) 3. Name all the muscles innervated by the deep branch of the ulnar nerve a. Adductor Compartment i. Adductor Pollicis b. Hypothenar Muscles i. Abductor Digiti Minimi ii. Flexor Digiti Minimi iii. Opponens Digiti Minimi c. Short Muscles i. Lumbricals 3 and 4 ii. Dorsal Interossei (1st - 4th) iii. Palmar Interossei (1st - 3rd) Chapter 8: Hand pp. 250–289 4. What is the primary responsibility of the muscles of the hypothenar eminence and which nerve innervates this group? a. Primary Responsibility: i. Move the little finger b. Innervation: i. Deep branch of the Ulnar n. (C8, T1) 5. Name all the responsible muscles for flexion at the carpometacarpal joint. 1. Opponens Pollicis 2. Opponens Digit Minimi 6. Which muscles are the extrinsic extensors of the thumb, and what is their nerve innervation? a. Innervation: Posterior Interosseous n. (C7,8). Continuation of deep radial n. i. Abductor Pollicis Longus (APL) *All People Love* ii. Extensor Pollicis Brevis (EPB) *Eating Peanut Butter* iii. Extensor Pollicis Longus (EPL) Moore M, Dalley AF, Agur A. Moore’s Clinically Oriented Anatomy. 9th ed. Lippincott, Williams and Wilkins; 2018. Chapter 3: Hand pp. 241–260, Wrist Joint pp. 278–283 7. Describe the different muscles used for larger/wider movements (grasping, pinching, pointing) vs. The more fine and weaker movements (typing, writing) a. Larger/Wider Movements i. Extrinsic Muscles of the Forearm: provide strong force for larger movements. 1. Flexor digitorum superficialis and flexor digitorum profundus: These muscles flex the fingers, essential for grasping and pinching. 2. Extensor digitorum: Extends the fingers, assisting with pointing and other larger motions. 3. Flexor pollicis longus: Flexes the thumb, crucial for pinching and grasping objects. ii. Intrinsic Hand Muscles (for gross movements): control the thumb and are involved in strong gripping and pinching. Thenar muscles: 1. abductor pollicis brevis, 2. flexor pollicis brevis 3. opponens pollicis Hypothenar muscles: Control the little finger, contributing to grasping larger objects. 1. abductor digiti minimi 2. flexor digiti minimi brevis 3. opponens digiti minimi iii. Dorsal interossei: Abduct the fingers, assisting in the spreading of fingers for grasping wide objects. b. Fine and Weaker Movements i. Intrinsic Hand Muscles (for fine movements): 1. Lumbricals: These small muscles flex the metacarpophalangeal joints (MCP) and extend the interphalangeal joints (IP) ★ provide precision in finger movements, essential for tasks like typing or writing. 2. Palmar interossei: Adduct the fingers and help with intricate finger movements required for fine motor tasks. Thenar and Hypothenar Muscles allow for fine adjustments in thumb and little finger positioning, essential in tasks like typing and writing. 1. opponens pollicis 2. opponens digiti minimi ★ Larger movements (grasping, pinching, pointing): Primarily involve extrinsic muscles of the forearm and some intrinsic hand muscles, generating greater force. ★ Fine movements (typing, writing): Rely heavily on intrinsic hand muscles, offering precise, controlled motion rather than strength. These movements typically require the lumbricals and interossei for dexterity. 8. Which digit has the greatest mass of intrinsic muscle and why? What are the muscles and which movements do they control? a. The thumb (1st digit) has the greatest mass of intrinsic muscles compared to the other digits. b. Muscles: 1. Adductor Pollicis 2. Opponens Pollicis 3. Flexor Pollicis Brevis 4. Abductor Pollicis Brevis 9. What are the 5 fascial compartments of the hand and which movements of the hand do they each facilitate? 1. Thenar Compartment: Controls thumb movements (abduction, flexion, opposition). 2. Hypothenar Compartment: Controls little finger movements (abduction, flexion, opposition). 3. Central Compartment: Flexion of MCP joints and extension of IP joints for fine motor tasks (controlled by lumbricals). 4. Adductor Compartment: Adduction of the thumb for pinching and gripping. 5. Interosseous Compartment: Abduction and adduction of the fingers, along with assisting in finger flexion and extension.

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