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Lecture 14 Text figures from: MD: Moore and Dalley, Clinically Oriented Anatomy 5th EdiBon 2006 LippincoG Williams and Wilkins G: Drake, Vogl and Mitchell, Gray's Anatomy for Medical Students 2005 Elsevier NP: Netter, Atlas of Human Anatomy 5 Edition, Elsevier, 2011 RM: White, USMLE Road Map Gross Anatomy 2nd Ed. McGraw-Hill MD6.8 Distal interphalangeal (IP) joint- hinge Proximal IP joint- hinge Metacarpophalangeal Joint- condyloid (biaxial) Flex/extend Abduct/adduct To reach MP and IP joints Tendons must pass through Carpal tunnel G7.8A,B Abduction/ adduction occur at MP joints (intrinsic hand muscles) Flexion/ extension occur at all three joints (anterior forearm muscles) MD6.38C MOVEMENTS OF THE FINGERS Abbreviations CM- carpometacarpal joints MP- metacarpophalangeal joints PIP- proximal interphalangeal joints DIP- distal interphalangeal joints Action Muscles involved Innervation Flexion, all fingers All joints & DIP Flexor digitorum profundus Major Segments of innervation MP and PIP, all Flexor digitorum superficialis Lumbricals MP only, all CM and MP little CM little Interossei Flexor digiti minimi Opponens digiti minimi to index and middle Median (ant. interosseous n.) to ring and little Ulnar (deep br.) Median Median - index and middle Ulnar (deep br.)ring and little Ulnar (deep br.) Ulnar (deep br.) Ulnar (deep br.) index, middle, ring index only Iittle finger only Extensor digitorum Extensor indicis Extensor digiti minimi Radial (deep br.) Radial (deep br.) Radial (deep br.) C6,7,8 C7,8 C7,8 Extension-IP joints Lumbricals through extensor expansion Interossei Median - index and middle Ulnar (deep br.)ring and little Ulnar (deep br.) C8,T1 C8,T1 C8,T1 Abduction-MP joints all fingers except little finger Dorsal Interossei Abductor digiti minimi Ulnar (deep br.) Ulnar (deep br.) C8,T1 C8,T1 Palmar Interossei Ulnar (deep br.) C8,T1 Opponens digiti minimi Ulnar (deep br.) C8,T1 C8 T1 C7,8,T1 C8,T1 C8,T1 C8,T1 C8,T1 C8,T1 Extension-MP joints Adduction-MP joints all fingers except middle Opposition at CM of little finger only MDT6.7 Anterior forearm 4 superficial muscles FCU innervated by ulnar n. MDT6.7 One intermediate Muscle Flexes middle phalanx At proximal interphalangeal joint MDT6.7 3 deep muscles Flexes distal Phalanges at Distal Interphalangeal (IP) Joints Flexes distal IP joint of thumb Brachioradialis: ExceptionFlexes forearm At elbow Anterior view Posterior forearm G7.87 Superficial Extensors: Extend wrist and digits at MP joints Posterior view Ext carpi radialis Longus and brevis, Ext. digitorum, Ext digiti minimi Ext carpi ulnaris, Anconeus
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