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Joint Detail
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Metacarpophalangeal joints Specifically known as Condyloid joints
Joint type
Ginglymoid joint (hinge joint)
Close packed position
Thumb,full opposition-fingers full flexion
Loose packed position
Slight flexion
Degrees of freedom
90*of flexion and 10*of extension in joints 2-5; 20*in add, abd and circumduction
in joint 1 (thumb)
Bones & specific bony
wrist
Radius, ulna
landmarks
hand
Hamate, capitates, pisiform, triquetrum, lunate, scaphoid, trapezoid,
trapezium
fingers Distal phalanx, proximal phalanx, metacarpal
Specific articulating bony
Styloid process, MCP, IP, PIP, DIP, CMC
surfaces
Movement
Motion:
flexion
Range:
70-90
degrees
Plane:
Sagittal
Axis:
Frontal
Agonists
Flexor Carpi
Radialis
Flexor carpi
ulnaris
Flexor digitorum
superficialis
Flexor digitorum
profundus
Motion:
extention
Range:
65-85
degreea
Plane:
Frontal
Axis:
sagittal
Agonists
Extensor carpi
ulnaris
Extensor carpi
radialis
Extensor
digitorum
Muscles
Proximal
Distal Attachment
Attachment
Anterior distal forearm and Medial epicondyle Base of 2nd and 3rd
wrist surface slightly lateral of humerus
metacarpals
in line with 2nd and 3rd
metacrapals
Anteriomedial surface of the Medial epicondyle Base of 5th
forearm a few inches below of humerus and
metacarpal pisiform
the medial epicondyle of the posterior aspect of and hamate
humerus just proximal to the proximal ulna
wrist
Depressed area of Palmaris Medial epicondyle f Middle phalanx
longus and flexor carpi
humerus ulnar head
ulnaris tendon
radial head 2/3 of
radius
Proximal ¾ of
Base of distal
Anterior mid forearm
anterior and medial phalanges of our
ulna
four fingers
Palpation
Palpation
Proximal
Attachment
Just lateral to the ulnar
Lateral epicondyle
styloid process and crossing of the humerusand
the posteromedial wrist,
½ of the posterior
particularly with wrist
border of the ulna
extension/ adduction
Lateral epicondyle
of humerus, lower
Proximal to the dorsal aspect third of lateral
of the wrist and medial to the supracondylar ridge
radial styloid
of humerus and
lateral epicondyle
of the humerus
Posterior surface of the distal Lateral
forearm medial to extensor epicondyleof
carpi ulnaris
humerus
4/30/2017
3:27:57 PM
Name:
Date:
Joint Stability
Static (ligaments)
Dynamic (muscles)
carpometacarpal ligaments, dorsal Extensor Carpi Radialis Brevis
Anterior
Posterior
Medial
Lateral
metacarpal ligaments, dorsal
intercarpal ligaments, Ulnar
collateral ligament, Radial
collateral ligament, dorsal
radiocarpal ligament
palmar ulnocarpal ligament,
palmer ligament, intercarpal
ligaments, carpometacarpal
ligament
ulnar collateral ligament
pisometacarpal ligament, radial
collateral ligament
Extensor Carpi Radialis Longus
Extensor Carpi Ulnaris
Flexor Carpi Radialis
Flexor Carpi Ulnaris
Abductor Pollicis Longus
Goniometry
Manual Muscle Testing
Recommended Sitting, forearm in 00 supinationMotion or
Muscle specific, list ↓
pronation, wrist in 00 flexion,
Testing
Muscle(s) Flexor Carpi Radialis, Flexor carpi
extension, radial & ulnar flexion.
Position
Median nerve c6 c7
ulnaris, Flexor digitorum
Forearm & hand rest on
superficialis, Flexor digitorum
supporting surface. MCP in 00
profundus
abd & add. Avoid extreme flex
Recommended The patient is sitting or
of PIP & DIP
Ulnar nerve c8 t1
Testing
supine with forearm in
Stabilization Stabilize metacarpal to prevent
Position
supination. The wrist is in
wrist motion. Do not hold MCP
neutral with the MCP joints
of other fingers in extension
fully extended.
Over dorsal aspect of MCP
Center
Resistance The therapist stabilizes the
Proximal Arm Dorsal midline of metacarpal
Median nerve c7 c8
Hand
metacarpals just proximal
Distal Arm Dorsal midline of proximal
t1
Placement to the MCP joint, and
phalanx
applies resistance on the
palmer surface of the
proximal row of phalanges
Median nerve ulnar
in the direction of MCP
nerve c8 t1
extension
Patient
Flex at the mcp joint
Instruction
Special notes Stabilize the other
phalanges while testing the
others
Distal Attachment
Innervation
Recommended Sitting, forearm in 00 supinationMotion or
Muscle specific, list ↓
pronation, wrist in 00 flexion,
Testing
Muscle(s) Extensor carpi ulnaris, Extensor
extension, radial & ulnar flexion.
Position
Base of 5th
Radial nerve c6 c7
carpi radialis, Extensor digitorum
Forearm & hand rest on
metacarpal on
c8
Recommended The patient's forearm is in
0
supporting surface. MCP in 0
dorsal surface
Testing
pronation with the wrist in
abd & add. Avoid extension or
Position
neutral. MP joints and IP
extreme flex of PIP & DIP
joints are in relaxed flexion
Stabilize
metacarpal
to
prevent
Stabilization
Base of 3rd
Radial nerve c6 c7
posture.
wrist motion. Do not hold MCP
metacarpal on
c8
Resistance
Therapist stabilizes the
of other fingers in full flexion
dorsal surface. Base
Hand
wrist and places the index
Over
dorsal
aspect
of
MCP
Center
of 2nd metacarpal on
Placement finger of the resistance
Proximal Arm Dorsal midline of metacarpal
dorsal surface
hand across the dorsum of
Distal Arm Dorsal midline of proximal
all proximal phalanges just
phalanx
distal to the MCP joints.
Four tendon to base Radial nerve c6 c7
Give resistance in the
of middle and distal c8
direction of flexion.
phalanxes of four
Patient
Lay with your hand in
1
Innervation
Joint Detail
Motion:
abduction
Range:
15-20
degrees
Plane:
transverse
Axis:
vertical
Last saved by Valued Acer Customer
4/30/2017
fingers on dorsal
surface
Extensor indicis
Middle to distal 1/3 Base of middle and Radial nerve c6 c7
Posterior aspect of the
of posterior ulna
distal phalanxes of c8
forearm and dorsal surface of
the 2nd phalange
the hand
dorsal surface
Agonists
Palpation
Proximal
Distal Attachment
Innervation
Recommended
Attachment
Testing
Position
Abductor pollicis Lateral aspect of the wrist
Posterior aspect of Base of 1st
Radial nerve c6 c7
joint just proximal to the 1st radius and midshaft metacarpal on
metacrapal
of the ulna
dorsal lateral
Stabilization
surface
3:27:57 PM
Instruction pronation flexed slightly
Special notes Patient should not let wrist
leave the surface of the
table or examination
surface.
Sitting, forearm in full pronation,
Motion or
Muscle specific, list ↓
wrist in 00 flexion, extension,
Muscle(s) Abductor pollicis
radial & ulnar flexion. Forearm Recommended The patient's forearm is
& hand rest on supporting
Testing
pronated with the wrist in
surface. MCP in 00 flex & ext
Position
neutral. Fingers start in
Stabilize metacarpal to prevent
extension and adduction.
wrist motion.
MCP joints are in neutral
Over dorsal aspect of MCP
Center
while avoiding
Proximal Arm Dorsal midline of metacarpal
hyperextension.
Distal Arm Dorsal midline of proximal
Resistance Therapist supports wrist in
phalanx
Hand
Placement
neutral. The fingers of the
other hand are used to give
resistance on the distal
phalanx, on the radial side
of one finger and the ulnar
side of the adjacent finger.
The direction of resistance
is toward adduction while
patient actively abducts.
Patient
Lay with your hand in
Instruction pronation, extended and
adducted and do not
hyperextend your digits
Special notes Do not let wrist swag, keep
fully supported.
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