Kinesiological Concepts of the Elbow, Wrist and Hand

1
Kinesiological Concepts of the Elbow, Wrist and
Hand
2
Anatomical Landmarks to Review

• Humerus
• Medial and lateral epicondyles, medial and
  lateral supracondylar ridge, trochlea, capitulum,
  coronoid fossa, radial fossa and olecranon fossa
• Radius
• Radial head and radial tuberosity
• Ulna
• Olecranon process, coronoid process and trochlear
  notch

3
Elbow Articulations

• Humeroulnar Joint
• True elbow joint
• Strong bony configuration
• Hinge joint
• Humeroradial Joint
• Slides along capitulum
• Modified ball and socket joint
• Provides no ABD or ADD
• Proximal Radioulnar Joint
• Annular ligament
• Movements
• Interosseous membrane

4
Elbow Articulations

• Humeroulnar Joint
• True elbow joint
• Strong bony configuration
• Hinge joint
• Humeroradial Joint
• Slides along capitulum
• Modified ball and socket joint
• Provides no ABD or ADD
• Proximal Radioulnar Joint
• Annular ligament
• Movements
• Interosseous membrane

5
Ligaments of the Elbow

• Capsular Ligament
• Annular Ligament
• Lateral Collateral (Radial)
• Medial Collateral (Ulnar)

6
Ligaments of the Elbow

• Capsular Ligament
• Annular Ligament
• Lateral Collateral (Radial)
• Medial Collateral (Ulnar)

7
Ligaments of the Elbow

• Capsular Ligament
• Annular Ligament
• Lateral Collateral (Radial)
• Medial Collateral (Ulnar)

8
Overall Appearance of the Elbow

• Carrying Angle
• Forearm is ABD in relation to the humerus
• Caused by articulation between the ulna and
  humerus

9
Muscles of the Humeroulnar Joint as Stabilizers

• Anterior
• Biceps brachii

10
Muscles of the Humeroulnar Joint as Stabilizers

• Anterior
• Biceps brachii
• Brachialis

11
Muscles of the Humeroulnar Joint as Stabilizers

• Anterior
• Biceps brachii
• Brachialis
• Brachioradialis

12
Muscles of the Humeroulnar Joint as Stabilizers

• Anterior
• Biceps brachii
• Brachialis
• Brachioradialis
• Wrist flexors
• Flexor Carpi Radialis
• Flexor Carpi Ulnaris
• Pronator Teres
• Palmaris Longus

13
Muscles of the Humeroulnar Joint as Stabilizers

• Posterior
• Triceps

14
Muscles of the Humeroulnar Joint as Stabilizers

• Posterior
• Triceps
• Wrist Extensors
• Extensor Carpi Radialis Longus
• Extensor Carpi Ulnaris

15
Muscles at the Elbow as Movers

• Biceps Brachii

16
Muscles at the Elbow as Movers

• Biceps Brachii
• Elbow flexion
• Supination

17
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis

18
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis
• Primary flexor of the elbow

19
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis
• Brachioradialis

20
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis
• Brachioradialis
• Contributes to elbow flexion
• Assist with pronation and supination of forearm

21
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis
• Brachioradialis
• Triceps brachii

22
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis
• Brachioradialis
• Triceps brachii
• Elbow extension
• Medial head principle extensor when no resistance
• 100 effort rotary

23
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis
• Brachioradialis
• Triceps brachii
• Anconeus

24
Muscles at the Elbow as Movers

• Biceps Brachii
• Brachialis
• Brachioradialis
• Triceps brachii
• Anconeus
• Locks out the elbow in extension

25
Muscle of the Proximal Radioulnar Joint

• Pronation
• Pronator Teres
• Pronator Quadratus

26
Muscle of the Proximal Radioulnar Joint

• Pronation
• Pronator Teres
• Pronator Quadratus
• Supination
• Supinator
• Biceps Brachii
• Brachioradialis

27
Kinesiological Concepts of the Wrist and Hand
28
Wrist and Hand Bones

• Wrist
• Scaphoid
• Lunate
• Triquetrium
• Pisiform
• Trapezium
• Trapezoid
• Capitate
• Hamate

29
Wrist and Hand Bones

• Hand
• Metacarpals
• Phalanges 2-5
• Proximal
• Middle
• Distal
• Phalange 1 (Thumb)
• Proximal
• Distal

30
Wrist Musculature

• Primary Wrist Flexors
• Flexor Carpi Radialis
• Flaxor Carpi Ulnaris
• Secondary Wrist Flexors
• Palmaris Longus
• Flexor Digitorum Profundus
• Flexor Digitorum Profundus
• Flexor Pollicus Longus

31
Wrist Musculature

• Primary Wrist Extensors
• Extensor Carpi Radialis Longus/Brevis
• Extensor Carpi Ulnaris
• Secondary Wrist Extensors
• Extensor Digitorum
• Extensor Indicis
• Extensor Digit Minimi

32
Hand Musculature

• Hand Flexors
• Flexor Digitorum Profundus
• Flexor Digitorum Superficialis
• Flexor Pollicis Longus/Brevis
• Flexor Digit Minimi Brevis
• Lumbricales

33
Hand Muscles

• Hand Extensors
• Extensor Pollicis Longus/Brevis
• Extensor Indicis
• Lumbricales

34
Closer Look at the Carpal Tunnel

• Structures within Tunnel
• FDS
• FDP
• FPL
• Median Nerve