Biomwchanics of wrist and hand
- Kinematics and Kinetics of joints including flexion and extension mechanism
-Pathomechanics
- Prehension
-Functional position of wrist
This document discusses the structure and biomechanics of the hip joint. It describes the anatomy of the acetabulum and femoral head that form the ball and socket joint. It details the angles of the acetabulum, including the center edge angle and acetabular anteversion angle. It also describes the acetabular labrum and angles of the femur relative to the shaft. The primary function of the hip joint is to support weight and enable mobility through walking, running, and other activities.
The hip joint is a ball-and-socket joint that allows flexion, extension, abduction, adduction, and rotation. It is formed by the acetabulum of the pelvis articulating with the femoral head. The primary function is to support the weight of the upper body. Key biomechanical aspects include the angles of inclination and torsion of the femur, congruence of the joint surfaces, and forces transmitted during weight bearing that are balanced by the joint capsule and trabecular bone structure. Motion occurs through tilting and rotation of the pelvis on a fixed femur. Surrounding muscles provide dynamic stability and control movement.
The document discusses the anatomy and biomechanics of the hip joint. It describes the ball and socket structure of the hip joint formed by the acetabulum and femoral head. It details the angles of the hip joint including the central edge angle and angle of anteversion. It discusses the muscles, ligaments, biomechanics including ranges of motion, and forces across the hip joint during activities like standing, walking, and squatting. Pathomechanics of conditions like hip fractures and dislocations are also mentioned.
Connective tissues exhibit viscoelastic properties that make their mechanical behavior dependent on time, rate, and loading history. When a constant strain is applied, stress will decrease over time as the tissue relaxes. Conversely, under constant stress, strain will increase over time as the tissue creeps. This viscoelastic behavior, along with the tissue's adaptive responses, allow connective tissues to absorb loads while maintaining structural integrity.
The document discusses static and dynamic stability of the glenohumeral joint. Statically, the joint is stabilized by the humeral head resting in the glenoid fossa, creating negative pressure. The rotator cuff muscles and deltoid provide a vertical force to counteract gravity. Dynamically, the deltoid, rotator cuff, biceps and scapulohumeral rhythm work together to precisely guide humeral movement and stabilize the joint throughout its range of motion. Scapulohumeral rhythm involves greater scapular movement in the first 90 degrees of arm elevation compared to humeral movement.
This document provides an overview of biomechanics of posture. It defines static and dynamic posture and describes the major goals and elements of postural control, including maintaining the body's center of gravity over its base of support. It discusses perturbations that can disrupt posture and the compensatory muscle synergies and strategies used to regain equilibrium, such as ankle and hip synergies. The document also covers kinetics of posture involving forces like inertia, gravity and ground reaction forces. It analyzes optimal posture and deviations, and describes various postural abnormalities.
This document discusses strategies to reduce force on the hip joint for individuals with hip osteoarthritis or weak hip abductor muscles. It analyzes using a lateral lean, cane on the same side, or cane on the opposite side. A lateral lean reduces gravitational torque but increases energy expenditure. A cane on the same side provides some relief but a cane on the opposite side may offset gravity's torque, reducing the need for abductor muscle force and joint compression to just body weight. However, the full distance between hand and hip may overestimate the cane's effectiveness.
Here are potential answers to your questions:
If you fall down to the ground with wrist hyperextension, you could injure the ligaments and bones in your wrist. The most common injuries are:
- Ligament sprains of the dorsal radiocarpal ligaments which stabilize the wrist in extension. A sprain means the ligament is stretched or torn.
- Fractures of the distal radius bone. Since the wrist bone is forcefully hyperextended, it can fracture at the end of the radius bone near the wrist joint.
Instability generally refers to a lack of stability in a joint. In the wrist, instability means the bones and ligaments can no longer properly control and
The document discusses gait and the gait cycle. It defines gait as a person's pattern of walking and notes walking patterns can differ between individuals. The gait cycle is defined as the period from one heel strike to the next heel strike of the same limb. The gait cycle consists of the stance phase, when the foot is on the ground, and the swing phase, when the foot is off the ground. Temporal and distance variables are used to analyze gait, including single limb support time, stride length, and degree of toe out. The document also reviews the kinematics and kinetics of normal gait.
The lumbar spine supports great compressive loads from body weight and ground reaction forces. The lumbar vertebrae have large, thick bodies and intervertebral disks to withstand these loads. Flexion and extension occur primarily in the sagittal plane due to facet orientation, while rotation is most limited at L5-S1. The ligaments and fascia, including the thoracolumbar fascia, provide stability and transmit forces between the spine and pelvis. Lumbar-pelvic rhythm increases the range of motion of bending by coordinating pelvic and spinal motion. Compressive loads are shared between the intervertebral disks and facet joints.
This document discusses forces on the hip joint during bilateral and unilateral stance. In bilateral stance, each hip experiences approximately one-third of body weight compression from gravity. Additional compression may come from hip muscles. In unilateral stance, the supporting hip experiences compression of approximately five-sixths of body weight from gravity. Additional compression comes from hip abductor muscle contraction needed to counter the adduction torque from the weight of the body. Together these forces can result in a total hip joint compression of around 2-3 times body weight in unilateral stance.
This document summarizes the biomechanics of the hip joint. It describes the bony anatomy including the femoral head, acetabulum, and labrum. It also discusses the capsule, ligaments including the iliofemoral, pubofemoral, and ischiofemoral ligaments. Muscles that act on the hip joint and the ranges of motion are outlined. Factors affecting hip joint stability and weight transmission through the joint are summarized. Pathomechanics related to variations in the neck shaft angle and angle of torsion are covered.
The knee is a complex joint composed of the tibiofemoral and patellofemoral joints. It functions to provide mobility and support body weight during both static and dynamic activities. The knee joint contains menisci that increase joint congruence and distribute weight forces. It also contains cruciate and collateral ligaments that restrict motion and provide stability. During flexion and extension, the tibia glides and rotates on the femur through rolling and sliding motions controlled by the ligaments and menisci.
Anatomical pulleys in the hand redirect the pulling force of flexor tendons to provide precise control of finger movement. There are two types - annular pulleys, which are rings of connective tissue at the finger joints, and cruciate pulleys, which are smaller cross-shaped pulleys in between. Damage to the annular pulleys, especially the major A2 and A4 pulleys, can cause the tendon to be pulled away from the finger bone during movement, weakening grip. The pulley system enhances tendon power and allows normal range of motion in the fingers.
The shoulder complex is composed of three bones - the clavicle, scapula, and humerus - joined by three joints. It provides a wide range of motion to the arm. The glenohumeral joint between the humerus and scapula has the greatest mobility of any joint. The sternoclavicular and acromioclavicular joints link the clavicle, scapula, and upper extremity to the axial skeleton. These joints contain articular surfaces, discs, capsules, and ligaments that allow motion while providing stability to the shoulder complex.
The document summarizes the kinematics and biomechanics of the wrist. It describes:
1. The wrist has 2 degrees of freedom - flexion-extension and ulnar-radial deviation. Wrist circumduction is a combination of these movements.
2. Movements typically combine elements of both frontal and sagittal planes. Extension occurs with radial deviation and flexion with ulnar deviation.
3. The axis of rotation passes through the head of the capitate bone. Axes migrate slightly throughout range of motion.
4. Flexion-extension and ulnar-radial deviation occur through synchronous rotations at the radiocarpal and midcarpal joints.
This document summarizes recent advances in understanding the structure and function of the wrist. It describes the anatomy of carpal bones and ligaments. The proximal row includes the scaphoid, lunate, and triquetrum bones connected by strong interosseous ligaments. The distal row includes the trapezium, trapezoid, capitate, and hamate bones. Motion occurs at both the mid-carpal joint between rows and the radiocarpal joint. The row theory, not column theory, best explains wrist kinematics. Ligament strength testing showed interosseous ligaments are stronger than capsular ligaments.
The document provides information on the biomechanics of the wrist joint. It discusses the basic anatomy including the ligaments and muscles. It describes the two joints of the wrist complex - the radiocarpal and midcarpal joints. It details the range of motion of the wrist in flexion, extension, ulnar deviation, and radial deviation. It explains the osteokinematics and arthrokinematics of wrist movement including the convex-concave rule and how the bones roll and slide during flexion, extension, ulnar deviation, and radial deviation.
The document provides an overview of the anatomy and biomechanics of the wrist complex. It describes the wrist as comprising two joints - the radiocarpal and midcarpal joints. Key points include descriptions of the carpal bones and ligaments, biomechanics of flexion/extension and other motions, and clinical examination techniques for evaluating common wrist injuries such as scaphoid fractures and carpal tunnel syndrome.
This document provides information about the anatomy and biomechanics of the wrist joint. It discusses the following key points:
1. The wrist joint is made up of the radiocarpal and midcarpal joints, which allow for fine adjustment of grip. It has ligaments and muscles that provide stability and control rather than maximize torque.
2. The wrist joint involves the lower end of the radius articulating with three carpal bones. It is stabilized by various intrinsic and extrinsic ligaments. Flexion and extension occurs in the sagittal plane while ulnar and radial deviation occurs in the coronal plane.
3. During flexion and extension, the convex lunate bone rolls and slides on the
Hand anatomy and biomechanics wrist examination.pptx
The document provides an overview of hand biomechanics and examination. It discusses the components of hand movement including muscles, tendons, joints, and spatial movement. It describes the 27 degrees of freedom of the hand and details the stabilizing structures like ligaments. The document reviews biomechanics concepts including arthrokinematics, osteokinematics, and degrees of freedom. It examines the biomechanics of different grips and pinches. The joints, muscles, tendons, and stabilizing ligaments of the hand are described.
This document provides an overview of the anatomy and biomechanics of the forearm, wrist, and hand. It describes the bones and joints in these regions, including the radioulnar joint, radiocarpal joint, intercarpal joints, and joints within the hand. It discusses the range of motion, ligaments, muscles, vascular supply, and common injuries or conditions that can affect these structures. Key points include that the wrist is a biaxial joint that connects the forearm and hand, while the joints of the hand allow for intricate finger movement and grasping abilities.
This document provides information about the anatomy and kinesiology of the wrist joint. It discusses the following key points:
1. The wrist joint is made up of the radiocarpal joint between the radius and carpal bones, and the midcarpal joint between carpal bones.
2. Ligaments connecting the radius, ulna, carpals and metacarpals provide stability to the joint. Muscles crossing the volar and dorsal aspects of the wrist allow for flexion, extension, ulnar and radial deviation motions.
3. Kinesiologically, flexion and extension occur in the sagittal plane around a coronal axis. Ulnar and radial deviation occur in the cor
The document provides an overview of elbow joint anatomy, including bones, ligaments, muscles, and range of motion. It describes the compound synovial joint formed by the distal humerus, proximal radius, and proximal ulna. Common fractures are also classified, such as supracondylar fractures in children and radial head fractures in adults. X-ray projections of the elbow joint are outlined to properly evaluate fractures and dislocations.
1) The wrist joint complex includes the radiocarpal joint between the radius and proximal carpal row, midcarpal joints between the proximal and distal carpal rows, and carpometacarpal joints of the thumb and fingers.
2) Key structures include the triangular fibrocartilage complex between the ulna and triquetrum bone, ligaments such as the radiocarpal and intercarpal ligaments, joint capsules, and muscles that cross the wrist including flexors and extensors.
3) The document describes the bones, joints, ligaments, muscles, movements, blood supply and common injuries of the wrist complex in detail.
The elbow is a complex joint that allows flexion-extension and pronation-supination movements. It has multiple bony structures that articulate including the distal humerus, ulna, and radius. The elbow is stabilized by ligaments like the medial and lateral collateral ligaments as well as surrounding muscles. During motion, the elbow experiences changing axes of rotation and joint forces that can reach up to 3 times body weight during activities. The biomechanics of the elbow are crucial for understanding normal function and injury mechanisms.
The wrist joint, also known as the radiocarpal joint, is a complex synovial joint that involves the distal end of the radius, articular disc, and three carpal bones. It allows for flexion, extension, abduction, and adduction movements and is supplied by branches of the median, radial, and ulnar nerves. Common injuries to the wrist joint include fractures of the scaphoid bone and Colles' fracture of the radius.
Biomechanics of Wrist and Hand Complex- Dr Gurjant Singh (PT)
The document summarizes the anatomy and biomechanics of the wrist and hand complex. It describes:
1) The wrist complex consists of the radiocarpal and midcarpal joints, providing a large range of motion with protection of articular surfaces.
2) The radiocarpal joint involves the radius, triangular fibrocartilage complex, scaphoid, lunate and triquetrum bones. The midcarpal joint connects these proximal carpals to the distal carpal row.
3) The hand complex includes 19 bones and joints distal to the carpals forming the fingers and thumb. Each finger has carpometacarpal, metacarpophalangeal and interphalange
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
This document provides information on the biomechanics of the wrist and hand complex. It describes the bones, joints, ligaments, muscles, and range of motion of the wrist, hand, fingers, and thumb. Key points include that the wrist is a complex of two joints (radiocarpal and midcarpal) that allow flexion/extension and radial/ulnar deviation. The hand has 19 bones and joints distal to the carpals that form transverse and longitudinal arches to enhance grip. Each finger has carpometacarpal, metacarpophalangeal, and interphalangeal joints while the thumb only has one interphalangeal joint. Ligaments and muscles work together to provide stability and
The wrist joint, or radiocarpal joint, connects the forearm to the hand. It is formed by the distal end of the radius articulating with the proximal row of carpal bones. The ulna does not directly articulate with the wrist joint. The wrist joint allows for flexion, extension, adduction and abduction through movement along two axes. Common injuries to the wrist joint include fractures of the scaphoid, anterior dislocation of the lunate, and Colles' fractures of the radius.
Assessent and radiology of distal end radius fracture
distal end radius is a common fracture in elderly groups and also in young by high velocity trauma its assessment and radiology should know for its management
Retinal artery occlusion is a blockage in one or more of the arteries that carry blood to the retina.
Central Retinal Artery Occlusion (CRAO) is an ophthalmic emergency which is analogous to a cerebral stroke. It is caused by sudden, painless monocular vision loss.
Branch Retinal Artery Occlusion ( BRAO )
Cilio-retinal Artery Occlusion ( CLRAO )
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Seminal vesiculitis can cause jelly-like sperm. Fortunately, herbal medicine Diuretic and Anti-inflammatory Pill can eliminate symptoms and cure the disease.
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Not all women with hydrosalpinx should choose laparoscopy. Natural medicine Fuyan Pill can also be a nice option for patients, especially when they have fertility needs.
Giant Breast Lipoma Masquerading as Breast Enlargement ورم شحمي عملاق للثدي م...
Case presentation of a 14-year-old female presenting as unilateral breast enlargement and found to have a giant breast lipoma. The tumour was successfully excised with the result that the presumed unilateral breast enlargement reverting back to normal. A review of management including a photo of the removed Giant Lipoma is presented.
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/pCU7Plqbo-E
- Video recording of this lecture in Arabic language: https://youtu.be/kbDs1uaeyyo
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Chemical kinetics is the study of the rates at which chemical reactions occur and the factors that influence these rates.
Importance in Pharmaceuticals: Understanding chemical kinetics is essential for predicting the shelf life of drugs, optimizing storage conditions, and ensuring consistent drug performance.
Rate of Reaction: The speed at which reactants are converted to products.
Factors Influencing Reaction Rates:
Concentration of Reactants: Higher concentrations generally increase the rate of reaction.
Temperature: Increasing temperature typically increases reaction rates.
Catalysts: Substances that increase the reaction rate without being consumed in the process.
Physical State of Reactants: The surface area and physical state (solid, liquid, gas) of reactants can affect the reaction rate.
Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide ...
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
In healthcare, every day, millions of conversations fail. They fail to cover what’s really important, fail to resolve key issues, miss the point and lead to misunderstandings and disagreements.
Clean Language is one approach that can improve things. It’s a set of precise questions – and a way of asking them – which help us all get clear on what matters, what we’d like to have happen, and what’s needed.
Around 1000 people working in healthcare have trained in Clean Language skills over the past 20+ years. People are using what they’ve learnt, in their own spheres, and share anecdotes of significant successes. But the various local initiatives have not scaled, nor connected with each other, and learning has not been widely shared.
This project, which emerged from work done by the NHS England South-West End-Of-Life Network, with help from the Q Community and especially Hesham Abdalla, aims to fix that.
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 2 - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/FHV_jNJUt3Y
- Video recording of this lecture in Arabic language: https://youtu.be/D5kYfTMFA8E
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Coronary Circulation and Ischemic Heart Disease_AntiCopy.pdf
In this lecture, we delve into the intricate anatomy and physiology of the coronary blood supply, a crucial aspect of cardiac function. We begin by examining the physiological anatomy of the coronary arteries, which lie on the heart's surface and penetrate the cardiac muscle mass to supply essential nutrients. Notably, only the innermost layer of the endocardial surface receives direct nourishment from the blood within the cardiac chambers.
We then explore the specifics of coronary circulation, including the dynamics of blood flow at rest and during strenuous activity. The impact of cardiac muscle compression on coronary blood flow, particularly during systole and diastole, is discussed, highlighting why this phenomenon is more pronounced in the left ventricle than the right.
Regulation of coronary circulation is a complex process influenced by autonomic and local metabolic factors. We discuss the roles of sympathetic and parasympathetic nerves, emphasizing the dominance of local metabolic factors such as hypoxia and adenosine in coronary vasodilation. Concepts like autoregulation, active hyperemia, and reactive hyperemia are explained to illustrate how the heart adjusts blood flow to meet varying oxygen demands.
Ischemic heart disease is a major focus, with an exploration of acute coronary artery occlusion, myocardial infarction, and subsequent physiological changes. The lecture covers the progression from acute occlusion to infarction, the body's compensatory mechanisms, and the potential complications leading to death, such as cardiac failure, pulmonary edema, fibrillation, and cardiac rupture.
We also examine coronary steal syndrome, a condition where increased cardiac activity diverts blood flow away from ischemic areas, exacerbating the condition. The long-term impact of myocardial infarction on cardiac reserve is discussed, showing how the heart's capacity to handle increased workloads is significantly reduced.
Angina pectoris, a common manifestation of ischemic heart disease, is analyzed in terms of its causes, presentation, and referred pain patterns. We identify factors that exacerbate anginal pain and discuss both medical and surgical treatment options.
Finally, the lecture includes a case study to apply theoretical knowledge to a practical scenario, helping students understand the real-world implications of coronary circulation and ischemic heart disease. The role of biochemical factors in cardiac pain and the interpretation of ECG changes in myocardial infarction are also covered.
A comparative study on uroculturome antimicrobial susceptibility in apparentl...
The uroculturome indicates the profile of culturable microbes inhabiting the urinary tract, and it is often required to do a urine culture to find an effective antimicrobial to treat UTIs. This study targeted to understand the profile of culturable pathogens in the urine of apparently healthy (128) and humans with clinical UTIs (161). In urine samples from UTI cases, microbial counts were 1.2×104 ± 6.02×103 colony-forming units (cfu)/ mL, while in urine samples from apparently healthy humans, the average count was 3.33± 1.34×103 cfu/ mL. In eight samples (six from UTI cases and two from apparently healthy people) of urine, Candida (C. albicans 3, C. catenulata 1, C. krusei 1, C. tropicalis 1, C. parapsiplosis 1, C. gulliermondii 1) and Rhizopus species (1) were detected. Candida krusei was detected only in a single urine sample from a healthy person and C. albicans was detected both in urine of healthy and clinical UTI cases. Fungal strains were always detected with one or more types of bacteria. Gram-positive bacteria were more commonly (OR, 1.98; CI99, 1.01-3.87) detected in urine samples of apparently healthy humans, and Gram -ve bacteria (OR, 2.74; CI99, 1.44-5.23) in urines of UTI cases. From urine samples of 161 UTI cases, a total of 90 different types of microbes were detected and, 73 samples had only a single type of bacteria. In contrast, 49, 29, 3, 4, 1, and 2 samples had 2, 3, 4, 5, 6 and 7 types of bacteria, respectively. The most common bacteria detected in urine of UTI cases was Escherichia coli detected in 52 samples, in 20 cases as the single type of bacteria, other 34 types of bacteria were detected in pure form in 53 cases. From 128 urine samples of apparently healthy people, 88 types of microbes were detected either singly or in association with others, from 64 urine samples only a single type of bacteria was detected while 34, 13, 3, 11, 2 and 1 samples yielded 2, 3, 4, 5, 6 and seven types of microbes, respectively. In the urine of apparently healthy humans too, E. coli was the most common bacteria, detected in pure culture from 10 samples followed by Staphylococcus haemolyticus (9), S. intermedius (5), and S. aureus (5), and similar types of bacteria also dominated in cases of mixed occurrence, E. coli was detected in 26, S. aureus in 22 and S. haemolyticus in 19 urine samples, respectively. Gram +ve bacteria isolated from urine samples' irrespective of health status were more often (p, <0.01) resistant than Gram -ve bacteria to ajowan oil, holy basil oil, cinnamaldehyde, and cinnamon oil, but more susceptible to sandalwood oil (p, <0.01). However, for antibiotics, Gram +ve were more often susceptible than Gram -ve bacteria to cephalosporins, doxycycline, and nitrofurantoin. The study concludes that to understand the role of good and bad bacteria in the urinary tract microbiome more targeted studies are needed to discern the isolates at the pathotype level.
The document discusses the scapulohumeral rhythm, which is the coordinated movement between the glenohumeral joint and scapulothoracic joint during shoulder movement. Specifically, it notes that for every 2 degrees of shoulder abduction or flexion, the scapula upwardly rotates approximately 1 degree. This ratio maintains proper shoulder range of motion and prevents impingement. Clinical issues like frozen shoulder and scapular winging can result from impairments affecting the scapulothoracic joint.
The document summarizes the anatomy and biomechanics of the shoulder joint. It describes the three joints that make up the shoulder complex - the sternoclavicular joint, acromioclavicular joint, and glenohumeral joint. For each joint, it outlines the bony structures, ligaments, range of motion, and stabilizing muscles involved. It then discusses the kinetics of the glenohumeral joint, including the static stabilization of the humeral head both with the arm unloaded and loaded at the side through the resultant force of surrounding structures.
The document discusses the biomechanics of the hip joint, including its structure, motions, stability mechanisms, and common injuries. The hip is a ball-and-socket joint between the pelvis and femur that allows for flexion/extension, abduction/adduction, and internal/external rotation. Stability is provided by bony configuration, cartilage, ligaments like the iliofemoral and ischiofemoral, and large muscles like the gluteals. Common injuries include fractures from direct impacts or degenerative joint disease from repeated stresses.
This document discusses the structure and biomechanics of the hip joint. It describes the anatomy of the acetabulum and femoral head that form the ball and socket joint. It details the angles of the acetabulum, including the center edge angle and acetabular anteversion angle. It also describes the acetabular labrum and angles of the femur relative to the shaft. The primary function of the hip joint is to support weight and enable mobility through walking, running, and other activities.
BIOMECHANICS OF HIP JOINT BY Dr. VIKRAMVicky Vikram
The hip joint is a ball-and-socket joint that allows flexion, extension, abduction, adduction, and rotation. It is formed by the acetabulum of the pelvis articulating with the femoral head. The primary function is to support the weight of the upper body. Key biomechanical aspects include the angles of inclination and torsion of the femur, congruence of the joint surfaces, and forces transmitted during weight bearing that are balanced by the joint capsule and trabecular bone structure. Motion occurs through tilting and rotation of the pelvis on a fixed femur. Surrounding muscles provide dynamic stability and control movement.
The document discusses the anatomy and biomechanics of the hip joint. It describes the ball and socket structure of the hip joint formed by the acetabulum and femoral head. It details the angles of the hip joint including the central edge angle and angle of anteversion. It discusses the muscles, ligaments, biomechanics including ranges of motion, and forces across the hip joint during activities like standing, walking, and squatting. Pathomechanics of conditions like hip fractures and dislocations are also mentioned.
General properties of connective tissues.pptxAnand Patel
Connective tissues exhibit viscoelastic properties that make their mechanical behavior dependent on time, rate, and loading history. When a constant strain is applied, stress will decrease over time as the tissue relaxes. Conversely, under constant stress, strain will increase over time as the tissue creeps. This viscoelastic behavior, along with the tissue's adaptive responses, allow connective tissues to absorb loads while maintaining structural integrity.
The document discusses static and dynamic stability of the glenohumeral joint. Statically, the joint is stabilized by the humeral head resting in the glenoid fossa, creating negative pressure. The rotator cuff muscles and deltoid provide a vertical force to counteract gravity. Dynamically, the deltoid, rotator cuff, biceps and scapulohumeral rhythm work together to precisely guide humeral movement and stabilize the joint throughout its range of motion. Scapulohumeral rhythm involves greater scapular movement in the first 90 degrees of arm elevation compared to humeral movement.
This document provides an overview of biomechanics of posture. It defines static and dynamic posture and describes the major goals and elements of postural control, including maintaining the body's center of gravity over its base of support. It discusses perturbations that can disrupt posture and the compensatory muscle synergies and strategies used to regain equilibrium, such as ankle and hip synergies. The document also covers kinetics of posture involving forces like inertia, gravity and ground reaction forces. It analyzes optimal posture and deviations, and describes various postural abnormalities.
This document discusses strategies to reduce force on the hip joint for individuals with hip osteoarthritis or weak hip abductor muscles. It analyzes using a lateral lean, cane on the same side, or cane on the opposite side. A lateral lean reduces gravitational torque but increases energy expenditure. A cane on the same side provides some relief but a cane on the opposite side may offset gravity's torque, reducing the need for abductor muscle force and joint compression to just body weight. However, the full distance between hand and hip may overestimate the cane's effectiveness.
Here are potential answers to your questions:
If you fall down to the ground with wrist hyperextension, you could injure the ligaments and bones in your wrist. The most common injuries are:
- Ligament sprains of the dorsal radiocarpal ligaments which stabilize the wrist in extension. A sprain means the ligament is stretched or torn.
- Fractures of the distal radius bone. Since the wrist bone is forcefully hyperextended, it can fracture at the end of the radius bone near the wrist joint.
Instability generally refers to a lack of stability in a joint. In the wrist, instability means the bones and ligaments can no longer properly control and
The document discusses gait and the gait cycle. It defines gait as a person's pattern of walking and notes walking patterns can differ between individuals. The gait cycle is defined as the period from one heel strike to the next heel strike of the same limb. The gait cycle consists of the stance phase, when the foot is on the ground, and the swing phase, when the foot is off the ground. Temporal and distance variables are used to analyze gait, including single limb support time, stride length, and degree of toe out. The document also reviews the kinematics and kinetics of normal gait.
The lumbar spine supports great compressive loads from body weight and ground reaction forces. The lumbar vertebrae have large, thick bodies and intervertebral disks to withstand these loads. Flexion and extension occur primarily in the sagittal plane due to facet orientation, while rotation is most limited at L5-S1. The ligaments and fascia, including the thoracolumbar fascia, provide stability and transmit forces between the spine and pelvis. Lumbar-pelvic rhythm increases the range of motion of bending by coordinating pelvic and spinal motion. Compressive loads are shared between the intervertebral disks and facet joints.
This document discusses forces on the hip joint during bilateral and unilateral stance. In bilateral stance, each hip experiences approximately one-third of body weight compression from gravity. Additional compression may come from hip muscles. In unilateral stance, the supporting hip experiences compression of approximately five-sixths of body weight from gravity. Additional compression comes from hip abductor muscle contraction needed to counter the adduction torque from the weight of the body. Together these forces can result in a total hip joint compression of around 2-3 times body weight in unilateral stance.
This document summarizes the biomechanics of the hip joint. It describes the bony anatomy including the femoral head, acetabulum, and labrum. It also discusses the capsule, ligaments including the iliofemoral, pubofemoral, and ischiofemoral ligaments. Muscles that act on the hip joint and the ranges of motion are outlined. Factors affecting hip joint stability and weight transmission through the joint are summarized. Pathomechanics related to variations in the neck shaft angle and angle of torsion are covered.
The knee is a complex joint composed of the tibiofemoral and patellofemoral joints. It functions to provide mobility and support body weight during both static and dynamic activities. The knee joint contains menisci that increase joint congruence and distribute weight forces. It also contains cruciate and collateral ligaments that restrict motion and provide stability. During flexion and extension, the tibia glides and rotates on the femur through rolling and sliding motions controlled by the ligaments and menisci.
Anatomical pulleys in the hand redirect the pulling force of flexor tendons to provide precise control of finger movement. There are two types - annular pulleys, which are rings of connective tissue at the finger joints, and cruciate pulleys, which are smaller cross-shaped pulleys in between. Damage to the annular pulleys, especially the major A2 and A4 pulleys, can cause the tendon to be pulled away from the finger bone during movement, weakening grip. The pulley system enhances tendon power and allows normal range of motion in the fingers.
The shoulder complex is composed of three bones - the clavicle, scapula, and humerus - joined by three joints. It provides a wide range of motion to the arm. The glenohumeral joint between the humerus and scapula has the greatest mobility of any joint. The sternoclavicular and acromioclavicular joints link the clavicle, scapula, and upper extremity to the axial skeleton. These joints contain articular surfaces, discs, capsules, and ligaments that allow motion while providing stability to the shoulder complex.
The document summarizes the kinematics and biomechanics of the wrist. It describes:
1. The wrist has 2 degrees of freedom - flexion-extension and ulnar-radial deviation. Wrist circumduction is a combination of these movements.
2. Movements typically combine elements of both frontal and sagittal planes. Extension occurs with radial deviation and flexion with ulnar deviation.
3. The axis of rotation passes through the head of the capitate bone. Axes migrate slightly throughout range of motion.
4. Flexion-extension and ulnar-radial deviation occur through synchronous rotations at the radiocarpal and midcarpal joints.
This document summarizes recent advances in understanding the structure and function of the wrist. It describes the anatomy of carpal bones and ligaments. The proximal row includes the scaphoid, lunate, and triquetrum bones connected by strong interosseous ligaments. The distal row includes the trapezium, trapezoid, capitate, and hamate bones. Motion occurs at both the mid-carpal joint between rows and the radiocarpal joint. The row theory, not column theory, best explains wrist kinematics. Ligament strength testing showed interosseous ligaments are stronger than capsular ligaments.
The document provides information on the biomechanics of the wrist joint. It discusses the basic anatomy including the ligaments and muscles. It describes the two joints of the wrist complex - the radiocarpal and midcarpal joints. It details the range of motion of the wrist in flexion, extension, ulnar deviation, and radial deviation. It explains the osteokinematics and arthrokinematics of wrist movement including the convex-concave rule and how the bones roll and slide during flexion, extension, ulnar deviation, and radial deviation.
The document provides an overview of the anatomy and biomechanics of the wrist complex. It describes the wrist as comprising two joints - the radiocarpal and midcarpal joints. Key points include descriptions of the carpal bones and ligaments, biomechanics of flexion/extension and other motions, and clinical examination techniques for evaluating common wrist injuries such as scaphoid fractures and carpal tunnel syndrome.
This document provides information about the anatomy and biomechanics of the wrist joint. It discusses the following key points:
1. The wrist joint is made up of the radiocarpal and midcarpal joints, which allow for fine adjustment of grip. It has ligaments and muscles that provide stability and control rather than maximize torque.
2. The wrist joint involves the lower end of the radius articulating with three carpal bones. It is stabilized by various intrinsic and extrinsic ligaments. Flexion and extension occurs in the sagittal plane while ulnar and radial deviation occurs in the coronal plane.
3. During flexion and extension, the convex lunate bone rolls and slides on the
Hand anatomy and biomechanics wrist examination.pptxIbnSaad1
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forearm, Wrist, hand joint anatomy & examinationSagarGajra1
This document provides an overview of the anatomy and biomechanics of the forearm, wrist, and hand. It describes the bones and joints in these regions, including the radioulnar joint, radiocarpal joint, intercarpal joints, and joints within the hand. It discusses the range of motion, ligaments, muscles, vascular supply, and common injuries or conditions that can affect these structures. Key points include that the wrist is a biaxial joint that connects the forearm and hand, while the joints of the hand allow for intricate finger movement and grasping abilities.
This document provides information about the anatomy and kinesiology of the wrist joint. It discusses the following key points:
1. The wrist joint is made up of the radiocarpal joint between the radius and carpal bones, and the midcarpal joint between carpal bones.
2. Ligaments connecting the radius, ulna, carpals and metacarpals provide stability to the joint. Muscles crossing the volar and dorsal aspects of the wrist allow for flexion, extension, ulnar and radial deviation motions.
3. Kinesiologically, flexion and extension occur in the sagittal plane around a coronal axis. Ulnar and radial deviation occur in the cor
The document provides an overview of elbow joint anatomy, including bones, ligaments, muscles, and range of motion. It describes the compound synovial joint formed by the distal humerus, proximal radius, and proximal ulna. Common fractures are also classified, such as supracondylar fractures in children and radial head fractures in adults. X-ray projections of the elbow joint are outlined to properly evaluate fractures and dislocations.
1) The wrist joint complex includes the radiocarpal joint between the radius and proximal carpal row, midcarpal joints between the proximal and distal carpal rows, and carpometacarpal joints of the thumb and fingers.
2) Key structures include the triangular fibrocartilage complex between the ulna and triquetrum bone, ligaments such as the radiocarpal and intercarpal ligaments, joint capsules, and muscles that cross the wrist including flexors and extensors.
3) The document describes the bones, joints, ligaments, muscles, movements, blood supply and common injuries of the wrist complex in detail.
The elbow is a complex joint that allows flexion-extension and pronation-supination movements. It has multiple bony structures that articulate including the distal humerus, ulna, and radius. The elbow is stabilized by ligaments like the medial and lateral collateral ligaments as well as surrounding muscles. During motion, the elbow experiences changing axes of rotation and joint forces that can reach up to 3 times body weight during activities. The biomechanics of the elbow are crucial for understanding normal function and injury mechanisms.
The wrist joint, also known as the radiocarpal joint, is a complex synovial joint that involves the distal end of the radius, articular disc, and three carpal bones. It allows for flexion, extension, abduction, and adduction movements and is supplied by branches of the median, radial, and ulnar nerves. Common injuries to the wrist joint include fractures of the scaphoid bone and Colles' fracture of the radius.
Biomechanics of Wrist and Hand Complex- Dr Gurjant Singh (PT)Dr. Gurjant Singh
The document summarizes the anatomy and biomechanics of the wrist and hand complex. It describes:
1) The wrist complex consists of the radiocarpal and midcarpal joints, providing a large range of motion with protection of articular surfaces.
2) The radiocarpal joint involves the radius, triangular fibrocartilage complex, scaphoid, lunate and triquetrum bones. The midcarpal joint connects these proximal carpals to the distal carpal row.
3) The hand complex includes 19 bones and joints distal to the carpals forming the fingers and thumb. Each finger has carpometacarpal, metacarpophalangeal and interphalange
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
This document provides information on the biomechanics of the wrist and hand complex. It describes the bones, joints, ligaments, muscles, and range of motion of the wrist, hand, fingers, and thumb. Key points include that the wrist is a complex of two joints (radiocarpal and midcarpal) that allow flexion/extension and radial/ulnar deviation. The hand has 19 bones and joints distal to the carpals that form transverse and longitudinal arches to enhance grip. Each finger has carpometacarpal, metacarpophalangeal, and interphalangeal joints while the thumb only has one interphalangeal joint. Ligaments and muscles work together to provide stability and
The wrist joint, or radiocarpal joint, connects the forearm to the hand. It is formed by the distal end of the radius articulating with the proximal row of carpal bones. The ulna does not directly articulate with the wrist joint. The wrist joint allows for flexion, extension, adduction and abduction through movement along two axes. Common injuries to the wrist joint include fractures of the scaphoid, anterior dislocation of the lunate, and Colles' fractures of the radius.
Assessent and radiology of distal end radius fractureSusanta85
distal end radius is a common fracture in elderly groups and also in young by high velocity trauma its assessment and radiology should know for its management
Retinal artery occlusion is a blockage in one or more of the arteries that carry blood to the retina.
Central Retinal Artery Occlusion (CRAO) is an ophthalmic emergency which is analogous to a cerebral stroke. It is caused by sudden, painless monocular vision loss.
Branch Retinal Artery Occlusion ( BRAO )
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Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptxAmandaChou9
Seminal vesiculitis can cause jelly-like sperm. Fortunately, herbal medicine Diuretic and Anti-inflammatory Pill can eliminate symptoms and cure the disease.
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Case presentation of a 14-year-old female presenting as unilateral breast enlargement and found to have a giant breast lipoma. The tumour was successfully excised with the result that the presumed unilateral breast enlargement reverting back to normal. A review of management including a photo of the removed Giant Lipoma is presented.
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.GawadNephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/pCU7Plqbo-E
- Video recording of this lecture in Arabic language: https://youtu.be/kbDs1uaeyyo
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Chemical kinetics is the study of the rates at which chemical reactions occur and the factors that influence these rates.
Importance in Pharmaceuticals: Understanding chemical kinetics is essential for predicting the shelf life of drugs, optimizing storage conditions, and ensuring consistent drug performance.
Rate of Reaction: The speed at which reactants are converted to products.
Factors Influencing Reaction Rates:
Concentration of Reactants: Higher concentrations generally increase the rate of reaction.
Temperature: Increasing temperature typically increases reaction rates.
Catalysts: Substances that increase the reaction rate without being consumed in the process.
Physical State of Reactants: The surface area and physical state (solid, liquid, gas) of reactants can affect the reaction rate.
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
Mainstreaming #CleanLanguage in healthcare.pptxJudy Rees
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Around 1000 people working in healthcare have trained in Clean Language skills over the past 20+ years. People are using what they’ve learnt, in their own spheres, and share anecdotes of significant successes. But the various local initiatives have not scaled, nor connected with each other, and learning has not been widely shared.
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Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 2 - Dr.GawadNephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/FHV_jNJUt3Y
- Video recording of this lecture in Arabic language: https://youtu.be/D5kYfTMFA8E
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Coronary Circulation and Ischemic Heart Disease_AntiCopy.pdfMedicoseAcademics
In this lecture, we delve into the intricate anatomy and physiology of the coronary blood supply, a crucial aspect of cardiac function. We begin by examining the physiological anatomy of the coronary arteries, which lie on the heart's surface and penetrate the cardiac muscle mass to supply essential nutrients. Notably, only the innermost layer of the endocardial surface receives direct nourishment from the blood within the cardiac chambers.
We then explore the specifics of coronary circulation, including the dynamics of blood flow at rest and during strenuous activity. The impact of cardiac muscle compression on coronary blood flow, particularly during systole and diastole, is discussed, highlighting why this phenomenon is more pronounced in the left ventricle than the right.
Regulation of coronary circulation is a complex process influenced by autonomic and local metabolic factors. We discuss the roles of sympathetic and parasympathetic nerves, emphasizing the dominance of local metabolic factors such as hypoxia and adenosine in coronary vasodilation. Concepts like autoregulation, active hyperemia, and reactive hyperemia are explained to illustrate how the heart adjusts blood flow to meet varying oxygen demands.
Ischemic heart disease is a major focus, with an exploration of acute coronary artery occlusion, myocardial infarction, and subsequent physiological changes. The lecture covers the progression from acute occlusion to infarction, the body's compensatory mechanisms, and the potential complications leading to death, such as cardiac failure, pulmonary edema, fibrillation, and cardiac rupture.
We also examine coronary steal syndrome, a condition where increased cardiac activity diverts blood flow away from ischemic areas, exacerbating the condition. The long-term impact of myocardial infarction on cardiac reserve is discussed, showing how the heart's capacity to handle increased workloads is significantly reduced.
Angina pectoris, a common manifestation of ischemic heart disease, is analyzed in terms of its causes, presentation, and referred pain patterns. We identify factors that exacerbate anginal pain and discuss both medical and surgical treatment options.
Finally, the lecture includes a case study to apply theoretical knowledge to a practical scenario, helping students understand the real-world implications of coronary circulation and ischemic heart disease. The role of biochemical factors in cardiac pain and the interpretation of ECG changes in myocardial infarction are also covered.
A comparative study on uroculturome antimicrobial susceptibility in apparentl...Bhoj Raj Singh
The uroculturome indicates the profile of culturable microbes inhabiting the urinary tract, and it is often required to do a urine culture to find an effective antimicrobial to treat UTIs. This study targeted to understand the profile of culturable pathogens in the urine of apparently healthy (128) and humans with clinical UTIs (161). In urine samples from UTI cases, microbial counts were 1.2×104 ± 6.02×103 colony-forming units (cfu)/ mL, while in urine samples from apparently healthy humans, the average count was 3.33± 1.34×103 cfu/ mL. In eight samples (six from UTI cases and two from apparently healthy people) of urine, Candida (C. albicans 3, C. catenulata 1, C. krusei 1, C. tropicalis 1, C. parapsiplosis 1, C. gulliermondii 1) and Rhizopus species (1) were detected. Candida krusei was detected only in a single urine sample from a healthy person and C. albicans was detected both in urine of healthy and clinical UTI cases. Fungal strains were always detected with one or more types of bacteria. Gram-positive bacteria were more commonly (OR, 1.98; CI99, 1.01-3.87) detected in urine samples of apparently healthy humans, and Gram -ve bacteria (OR, 2.74; CI99, 1.44-5.23) in urines of UTI cases. From urine samples of 161 UTI cases, a total of 90 different types of microbes were detected and, 73 samples had only a single type of bacteria. In contrast, 49, 29, 3, 4, 1, and 2 samples had 2, 3, 4, 5, 6 and 7 types of bacteria, respectively. The most common bacteria detected in urine of UTI cases was Escherichia coli detected in 52 samples, in 20 cases as the single type of bacteria, other 34 types of bacteria were detected in pure form in 53 cases. From 128 urine samples of apparently healthy people, 88 types of microbes were detected either singly or in association with others, from 64 urine samples only a single type of bacteria was detected while 34, 13, 3, 11, 2 and 1 samples yielded 2, 3, 4, 5, 6 and seven types of microbes, respectively. In the urine of apparently healthy humans too, E. coli was the most common bacteria, detected in pure culture from 10 samples followed by Staphylococcus haemolyticus (9), S. intermedius (5), and S. aureus (5), and similar types of bacteria also dominated in cases of mixed occurrence, E. coli was detected in 26, S. aureus in 22 and S. haemolyticus in 19 urine samples, respectively. Gram +ve bacteria isolated from urine samples' irrespective of health status were more often (p, <0.01) resistant than Gram -ve bacteria to ajowan oil, holy basil oil, cinnamaldehyde, and cinnamon oil, but more susceptible to sandalwood oil (p, <0.01). However, for antibiotics, Gram +ve were more often susceptible than Gram -ve bacteria to cephalosporins, doxycycline, and nitrofurantoin. The study concludes that to understand the role of good and bad bacteria in the urinary tract microbiome more targeted studies are needed to discern the isolates at the pathotype level.
2. The wrist is the distal joint of the upper limb
and allows the hand to assume the optimal
position for prehension.
DR NEETI CHRISTIAN (PT) 2
3. The articular complex of the wrist contain
two joints:
The radio-carpal joint between the distal
radius and the proximal row of carpal bones.
The mid-carpal joint between the proximal
and distal rows of carpal bones.
DR NEETI CHRISTIAN (PT) 3
5. Type of Joint
Proximal and Distal articulating surfaces
Basic Anatomy: Capsule
Ligaments
Muscles
Kinematics: Axis of Motion
Osteo and Arthrokinematics
Normal ROM
End feel
Synergistic and stabilizing action
DR NEETI CHRISTIAN (PT) 5
6. Radio-carpal joint is an ellipsoidal joint and
the carpal aspect presents two convexities
transverse convexity and antero-posterior
convexity.
DR NEETI CHRISTIAN (PT) 6
7. The distal radius has a
single continuous,
biconcave curvature that
is long and shallow side to
side (frontal plane) and
shorter and sharper
anteroposteriorly (sagittal
plane).
DR NEETI CHRISTIAN (PT) 7
8. DR NEETI CHRISTIAN (PT) 8
The proximal joint surface is composed of
(1) the lateral radial facet, which
articulates with the scaphoid;
(2) the medial radial facet, which
articulates with the lunate; and
(3) the TFCC, which articulates with the
triquetrum, also with the lunate in the
neutral wrist.
9. DR NEETI CHRISTIAN (PT) 9
•The radiocarpal joint is formed by the radius and radioulnar
disk as part of the triangular fibrocartilage complex (TFCC)
proximally and by the scaphoid, lunate,and triquetrum
distally.
The TFCC consists of the radioulnar disk and the various fibrous
attachments that provide the primary support for the distal
radioulnar joint.
10. The radiocarpal joint is enclosed by a strong
but somewhat loose capsule and is reinforced
by capsular and intracapsular ligaments.
DR NEETI CHRISTIAN (PT) 10
11. The ligaments of the radio-carpal joint are,,,,
1. collateral ligaments (lateral and medial)
2. The anterior ligaments [attached to the
anterior edge of the distal surface of the radius and
neck of the capitates]
3. Posterior ligament [forms a strap posteriorly].
DR NEETI CHRISTIAN (PT) 11
12. DR NEETI CHRISTIAN (PT) 12
Action of the ligaments:
During adduction-abduction the medial and
lateral ligaments are active. Starting from
the rest position .
Adduction lateral ligament is stretched,
medial slackened
Abduction vice versa
During flexion-extension the anterior and
posterior ligaments are most active.
Flexion posterior ligament stretched
Extension anterior ligament stretched
15. The articular complex of the wrist has
basically two degree of freedom.
DR NEETI CHRISTIAN (PT) 15
16. Transverse axis takes place in the sagittal
plane with movement:
Flexion the anterior palmar surface of the
hand moves towards the anterior aspect of
the forearm
Extension the posterior dorsal surface of
the hand moves towards the posterior aspect
of the forearm.
DR NEETI CHRISTIAN (PT) 16
19. Antero-posterior axis takes place in the
frontal plane with movements:
Adduction or ulnar deviation: the hand
moves toward the body and its medial (ulnar)
border forms an angle with the medial
border of the forearm.
Abduction or radial deviation: the hand
moves away from the body and its lateral
(radial) border forms an angle with the
lateral border of the forearm.
DR NEETI CHRISTIAN (PT) 19
20. Range of movement of the wrist, range of
abduction does not exceed 15 , of adduction
is 45, of flexion is 85, and range of
extension is also 85.
Movement of circumduction [combination of
the movement of flexion, extension,
adduction and abduction] takes place in two
axes of the wrist.
End feel : Flexion ;Ext. ;UD: Firm
RD : Hard
DR NEETI CHRISTIAN (PT) 20
21. DR NEETI CHRISTIAN (PT) 21
OSTEOKINEMATICS ARTHROKINEMATICS
(Sliding Motion
of Proximal
Row of
Carpals)
(Rolling Motion of
Proximal Row of
Carpals)
Flexion Dorsal Volar
Extension Volar Dorsal
Ulnar Deviation Radial Ulnar
Radial Deviation Ulnar Radial
22. Close packed Position: Full extension
Loose packed Position: Neutral with slight
Ulnar deviation
DR NEETI CHRISTIAN (PT) 22
23. Extensor muscles of the wrist act
synergistically with the flexors of the fingers.
E.g. during extension of the wrist the fingers
are automatically flexes and, to extend the
fingers in this position, a voluntary
movement is required.
Flexor muscles of the wrist act
synergistically with the extensors of the
fingers. When the wrist is flexed, extension
of the proximal phalanx follows
automatically.
DR NEETI CHRISTIAN (PT) 23
24. DR NEETI CHRISTIAN (PT) 24
•The compound proximal radiocarpal
joint surface is oblique, angled
slightly volarly and ulnarly.
• The average inclination of the distal
radius is 23 degrees.
•This inclination occurs because the
radial length (height) is greater
(approx.12 mm ) on the radial side
than on the ulnar side.
•The distal radius is also tilted volarly
with the posterior radius slightly
longer than the anterior (volar)
radius.
25. The curvature of the distal radiocarpal joint
surface is sharper than the proximal joint
surface, which makes the joint somewhat
incongruent.
Joint incongruence and the angulation of the
proximal joint surface result in a greater range
of flexion than extension and in greater ulnar
deviation than radial deviation for the
radiocarpal joint.
DR NEETI CHRISTIAN (PT) 25
26. The length of the ulna in relation to the
radius is also a factor which affects the
functions of wrist joint.
Ulnar negative variance is described as a
short ulna in comparison with the radius at
their distal ends,
ulnar positive variance, the distal ulna is
long in relation to the distal radius.
DR NEETI CHRISTIAN (PT) 26
28. The midcarpal joint is a functional rather
than anatomic unit because it does not form
a single uninterrupted articular surface.
DR NEETI CHRISTIAN (PT) 28
29. The extrinsic ligaments are those that
connect the carpals to the radius or ulna
proximally or to the metacarpals distally.
The intrinsic ligaments are those that
interconnect the carpals themselves and are
also known as intercarpal or interosseous
ligaments.
DR NEETI CHRISTIAN (PT) 29
30. Volar Ligament includes Three bands:
1) The radioscaphocapitate (radiocapitate),
2) Radiolunate (radiolunotriquetral), and
3) Radioscapholunate
The radial collateral ligament may be
considered an extension of the volar
radiocarpal ligament and capsule.
The two intrinsic ligaments (scapholunate and
lunotriquetral) are maintains the scaphoid
stability.
DR NEETI CHRISTIAN (PT) 30
32. DR NEETI CHRISTIAN (PT) 32
•Dorsal Radiocarpal ligaments
•Dorsal Intercarpal Ligaments
•These ligaments forms a horizontal V
shape , adding to radiocarpal
stability.
33. It is a unique combination of active muscular
and passive ligamentous and joint reaction
forces.
1. Flexion/Extension of the Wrist
2. Radial/Ulnar Deviation of the Wrist
DR NEETI CHRISTIAN (PT) 33
34. During flexion/extension of the wrist, the
scaphoid seems to show the greatest motion
of the three proximal carpal bones, whereas
the lunate moves least.
As wrist extension is initiated from full
flexion,
(1) the distal carpal row moves on the
proximal carpal row;
(2) the scaphoid and distal row move on
the lunate/triquetrum;
(3) the carpals move as a unit on the
radius and TFCC to achieve.
DR NEETI CHRISTIAN (PT) 34
35. Wrist motion from full extension to full
flexion occurs in the reverse sequence.
In the context of this conceptual framework,
the scaphoid participates at different times
in scaphoid-capitate, scaphoid-lunate, or
radioscaphoid motion.
DR NEETI CHRISTIAN (PT) 35
36. More Complex.
The proximal carpal row displays a unique
“reciprocal” motion with radial and ulnar
deviation.
In radial deviation, the carpals slide medially on
the radius, The carpal motion not only produces
deviation of the proximal and distal carpals
radially, but simultaneous flexion of the proximal
carpals and extension of the distal carpals.
The Opposite motion occurs at Ulnar deviation.
DR NEETI CHRISTIAN (PT) 36
37. In full radial deviation, both the radiocarpal
and midcarpal joints are in close-packed
position.
The ranges of wrist radial and ulnar deviation
are greatest when the wrist is in neutral.
DR NEETI CHRISTIAN (PT) 37
38. Carpometacarpal Joints of the Fingers
Meta carpophalangeal joints
Interphalangeal joints
DR NEETI CHRISTIAN (PT) 38
39. They have articulations between the distal
carpal row and the bases of the second
through fifth metacarpal joints.
2nd metacarpal articulates primarily with the
trapezoid and secondarily with the trapezium
and capitate.
3rd metacarpal articulates primarily with the
capitate,
4th metacarpal articulates with the capitate
and hamate.
5th metacarpal articulates with the hamate.
DR NEETI CHRISTIAN (PT) 39
40. All finger CMC joints are supported by strong
transverse and weaker longitudinal ligaments
volarly and dorsally.
The ligamentous structure is primarily
responsible for controlling the total ROM
available at each CMC joint.
DR NEETI CHRISTIAN (PT) 40
41. DR NEETI CHRISTIAN (PT) 41
TCL
Intercarpal ligaments
•The proximal transverse arch, or carpal
arch,
forms the tunnel through which the
median nerve and long finger flexors
travel.
•The transverse carpal ligament and
intercarpal ligaments assist in maintaining
this concavity.
42. The second through fourth CMC joints are
plane synovial joints with one degree of
freedom: flexion/extension.
2nd and 3rd CMC joints are not mobile and
sometimes they have zero degrees of
freedom, but 3rd and 4th CMC joints are most
mobile.
DR NEETI CHRISTIAN (PT) 42
43. DR NEETI CHRISTIAN (PT) 43
•Three arches balance stability and mobility in
the hand.
1. Proximal transverse arch
2. Distal transverse arch
3. Longitudinal arch
•The proximal transverse arch is rigid, but the
other two arches are flexible, and are
maintained by activity in the hand's intrinsic
muscles.
44. PROXIMAL TRANSVERSE ARCH
A stable bony arch that forms the posterior
border of the carpal tunnel.
The arch's integrity is maintained by a soft
tissue "strut" formed by the flexor retinaculum
or transverse carpal ligament (also called the
volar carpal ligament).
This ligamentous strut connects the scaphoid
and trapezium on the arch's radial side with
the hamate on its ulnar side, and forms the
anterior border of the carpal tunnel.
DR NEETI CHRISTIAN (PT) 44
45. 2) DISTAL TRANSVERSE ARCH
Hertling and Kessler (p. 257) call this the
metacarpal arch, because it is formed by the
metacarpal heads; metacarpals 2 and 3 are stable
while 4 and 5 are relatively mobile.
You can observe the arch's combination of "radial"
stability and "ulnar" mobility by loosely closing your
fist, then squeezing more tightly, when you will
observe movement in the more mobile fourth and
fifth metacarpals.
3) LONGITUDINAL ARCH
Observe this arch's behavior as you loosely close
your fist. Tighten the fist and watch the fourth and
fifth metacarpals.
DR NEETI CHRISTIAN (PT) 45
46. The arches provide a balance between
stability and mobility for grasping.
For instance, we produce the so-called
"chuck grasp" by using the more stable
second and third metacarpals, instead of
the more mobile fourth and fifth
metacarpals.
Therapeutic splints must support these
three arches.
DR NEETI CHRISTIAN (PT) 46
47. The convex metacarpal head proximally and
the concave base of the first phalanx distally.
The MP joint is condyloid with two degrees of
freedom: 1)flexion/extension
2)abduction/adduction.
DR NEETI CHRISTIAN (PT) 47
48. Metacarpophalangeal (MP)
condyloid, biaxial joints
joint's palmar aspect is palpable at level of distal palmar
crease
proximal joint surface is convex and distal surface is concave
roll and glide occur in same direction
anterior with flexion
posterior with extension.
large metacarpal joint surface
a fibrocartilaginous volar plate is lined with hyaline cartilage
so that it augments or enlarges the proximal phalanx' relatively
small articular surface.
superficial to volar plate is the transverse metacarpal ligament
joint capsule supported by two collateral ligaments
close-packed position:
MP joints of digits 2 through 5: close-packed in flexion; you cannot
abduct or adduct these joints when they are flexed.
MP joint of thumb: close-packed in extension
DR NEETI CHRISTIAN (PT) 48
49. The MP joint is surrounded by a capsule that is generally
considered to be lax in extension.
Given the incongruent articular surfaces, capsular laxity in
extension allows some passive axial rotation of the
proximal phalanx.
Two collateral ligaments at the volarly located transverse
metacarpal ligament enhance joint stability.
DR NEETI CHRISTIAN (PT) 49
51. It is a unique structure at MCP joint.
It improves joint congruency.
It also provides stability to the MP joint by
limiting hyperextension.
It also provides indirect support to the
longitudinal arch.
The volar plate is composed of
fibrocartilage.
DR NEETI CHRISTIAN (PT) 51
52. DR NEETI CHRISTIAN (PT) 52
Volar
plateMC
P1
•The volar plate attaches to the base of
the proximal phalanx.
•The plate lies deep to the MP joint
capsule and the deep transverse
metacarpal ligament volarly.
In MP joint flexion, the flexible
attachments of the plate allow the
plate to slide proximally on the
metacarpal head without preventing
motion.
The collateral ligament proper is
loose in MP joint extension, The
reverse occurs in MP joint flexion.
53. The four volar plates and their respective
capsules of the MP joints of the fingers also
interconnected superficially by the deep
transverse metacarpal ligament.
DR NEETI CHRISTIAN (PT) 53
54. DR NEETI CHRISTIAN (PT) 54
•Dorsal to the deep transverse metacarpal ligament are sagittal
bands on each side of the metacarpal head that connect each
volar plate (via the capsule and deep transverse metacarpal
ligament) to the ED tendon and extensor expansion.
• The sagittal bands help stabilize the volar plates over the four
metacarpal heads.
56. DR NEETI CHRISTIAN (PT) 56
Annular pullies
Deep transverse
metacarpal
ligament
57. Each IP joint is a true synovial hinge joint
with one degree of freedom
(flexion/extension), a joint capsule, a volar
plate, and two collateral ligament.
DR NEETI CHRISTIAN (PT) 57
58. uniaxial hinge joints
supported by two collateral ligaments, and by
smaller versions of a volar plate.
Like MP joint, proximal joint surface is convex
and distal surface is concave
roll and glide occur in same direction
anterior with flexion
posterior with extension
close-packed in extension
DR NEETI CHRISTIAN (PT) 58
59. The muscles of the fingers and thumb that
have proximal attachments above the wrist
(radiocarpal joint) are known as extrinsic
muscles.
whereas those with all attachments distal to
the radiocarpal joint are known as intrinsic
muscles.
DR NEETI CHRISTIAN (PT) 59
60. Two muscles:
FDS- primarily flexes the PIP joint, but it also
contributes to MP joint flexion.
FDP- flex the MP, PIP, and the DIP joints and
is considered to be the more active of the
two muscles.
DR NEETI CHRISTIAN (PT) 60
61. Optimal function of the FDS and FDP muscles
depends not only on stabilization by the wrist
musculature but also on intact flexor gliding
mechanisms.
The gliding mechanisms consist of the flexor
retinaculae, bursae, and digital tendon
sheaths.
DR NEETI CHRISTIAN (PT) 61
62. As the tendons of the FDS and FDP muscles
cross the wrist to enter the hand, they first
pass beneath the proximal flexor
retinaculum and through the carpal tunnel.
The radial and ulnar bursae contain a
synovial-like fluid that minimizes frictional
forces.
The FDS and FDP tendons of each finger pass
through a fibro-osseous tunnel that
comprises five transversely oriented annular
pulleys as well as three obliquely oriented
cruciate pulleys.
DR NEETI CHRISTIAN (PT) 62
63. DR NEETI CHRISTIAN (PT) 63
Ulnar
bursa
Radial bursaFlexor retinaculum
and TCL
Digital tendon
sheath
64. DR NEETI CHRISTIAN (PT) 64
Flexor pulley system consists of following
• Palmar Aponeurosis Pulley
• 5 Annular Pulleys
• 3 Cruciform Culleys.
Together, these form a fibro-osseous tunnel on the palmar aspect of
the hand through which passes the deep and superficial
flexor tendons.
65. We can extend the PIP and DIP joints without
also extending the MP joints.
But we can't extend the PIP joint without
extending the DIP joint at the same time.
Flexing only the DIP joint without also flexing
the PIP joint is difficult.
Full (active or passive) flexion of the PIP
joint prevents active extension of the DIP
joint.
DR NEETI CHRISTIAN (PT) 65
66. The extensor mechanism is an elaboration of
the extensor digitorum (ED) tendon on the
dorsum of each phalanx.
The extensor indicis (EI) and the extensor
digiti minimi (EDM) insert into the extensor
mechanisms of the second and fifth digits,
respectively.
DR NEETI CHRISTIAN (PT) 66
67. DR NEETI CHRISTIAN (PT) 67
The ED tendon attaches by a tendinous slip to the
proximal phalanx, through which it extends the MP joint.
The central tendon (or "slip") proceeds dorsally to
attach to base of middle phalanx, where tension can
extend the PIP joint.
68. DR NEETI CHRISTIAN (PT) 68
• Two lateral bands proceed on either side of dorsal
midline and rejoin before attaching to the distal
phalanx. Tension in the lateral bands extends the DIP
joint.
• The extensor hood surrounds the MP joint laterally,
medially, and dorsally, and receives tendinous fibers
from the lumbricales and interossei.
69. Dorsal interossei (DI)
The dorsal interossei attach proximally
between adjacent metacarpals.
Abduction is stronger at the second MP
joint because the most of the first DI's
muscle fibers attach directly to the
second proximal phalanx.
Abduction of the fourth MP joint is
relatively weak because the fourth DI
attaches largely to the extensor
mechanism itself.
• The dorsal interossei produce MP
abduction and, in certain instances, MP
flexion.
DR NEETI CHRISTIAN (PT) 69
70. Palmar interossei (PI):
palmar interossei attach
proximally to a
metacarpal, and distally to
the same digit's proximal
phalanx and/or its extensor
mechanism.
They produce MP adduction
and, in certain instances,
MP flexion.
They also produce PIP and
DIP extension when they
introduce tension into the
extensor mechanism.
DR NEETI CHRISTIAN (PT) 70
71. Lumbricales:
The four lumbricales attach proximally to the
tendons of the flexor digitorum profundus, and
distally to the extensor mechanism on its radial
side at the level of the lateral bands.
If they act alone, they produce MP flexion. They
also produce PIP and DIP extension when they
introduce tension into the extensor mechanism.
They permit a dynamic interaction between
flexors and extensors.
Their attachments transmit their force to both
the Flexor and the extensor mechanism.
Specifically, lumbrical activity:
increases passive tension in the extensor mechanism.
decreases passive tension in FDP tendon's distal
portion.
DR NEETI CHRISTIAN (PT) 71
73. Prehension activities of the hand involve the
grasping or taking hold of an object between
any two surfaces in the hand; the thumb
participates in most but not all prehension
tasks.
DR NEETI CHRISTIAN (PT) 73
74. Two types of grasp are differentiated according
to the position and mobility of the thumb's CMC
and MP joints. (Smith, Weiss, & Lehmkuhl, 1995, pp.
216-219; Hertling & Kessler, 1996,pp.259-260)
1. Power grip
2. Precision grip
DR NEETI CHRISTIAN (PT) 74
76. The fingers in power grip usually function in
concert to clamp on and hold an object into
the palm.
The palm is likely to contour to the object as
the palmar arches form around it. The thumb
may serve as an additional surface to the
finger-palm vise by adducting against the
object, or it may be removed from the
object.
In this, the hand's position is static.
DR NEETI CHRISTIAN (PT) 76
77. A. Cylindrical grip
It may orient the finger tips toward the
thumb. This is accomplished by ulnarly
deviating the MP joints using the interossei
muscles.
eg: Holding a glass or any object.
DR NEETI CHRISTIAN (PT) 77
78. B. spherical grip (Hand curves to hold a round or
sphere shaped object)
eg: Holding a ball, Grasping a jar when twisting
the lid open.
DR NEETI CHRISTIAN (PT) 78
79. C. Hook grip (MP extended with flattening of
transverse arch; the person may or may include
the thumb in this grasp)
eg: Holding a bag, barbell
DR NEETI CHRISTIAN (PT) 79
80. D. Lateral prehension is a rather unique form of
grasp. Contact occurs between two adjacent
fingers.The MP and IP joints are usually
maintained in extension.
DR NEETI CHRISTIAN (PT) 80
81. Muscles are active that abduct or oppose the
thumb; the hand's position is dynamic.
The three varieties of precision grasp:
pad-to-pad prehension, tip-to-tip
prehension, and pad-to-side prehension.
Each tends to be a dynamic function with
relatively little static holding.
DR NEETI CHRISTIAN (PT) 81
83. Wrist
extended 20 degrees
ulnarly deviated 10 degrees
Digits 2 through 5
MP joints flexed 45degrees
PIP joints flexed 30-45 degrees
DIP joints flexed 10-20 degrees
Thumb
first CMC joint partially abducted and opposed
MP joint flexed 10 degrees
IP joint flexed 5 degrees
DR NEETI CHRISTIAN (PT) 83
84. When therapists immobilize a patient's hand,
they often position it this way.
During a period of immobilization, the resting
lengths of the hand's ligaments and muscles
change.
This hand position provides the best balance of
resting length and force production so the hand
can function when the patient mobilizes it again.
In making splints for the hand, a normal
transverse arch is maintained and the thumb is
in abduction and aligned with pads of all four
fingers.
DR NEETI CHRISTIAN (PT) 84
86. Median:
Often due to carpal tunnel sd.
Wasting of thenar eminence
Decreased thumb function, especially opposition.
DR NEETI CHRISTIAN (PT) 86
87. Ulnar:
Damage to ulnar nerve can occur with trauma to
elbow region. Ulnar neuropathy is a frequent
complication of diabetes mellitus
Wasting of web space and interosseous spaces.
Affects strength of intrinsic muscles of hand, so
person can't hold a piece of paper between
extended but adducted fingers
DR NEETI CHRISTIAN (PT) 87
88. Radial:
Associated with gunshot or stab wounds, fracture
of humerus, "Saturday night palsy."
person demonstrates a "dropped wrist," and
cannot reposition thumb.
lack of wrist extension may cause hand grip to be
weak.
DR NEETI CHRISTIAN (PT) 88
89. Carpal tunnel syndrome (CTS) is an entrapment
neuropathy caused by compression of
the median nerve as it travels through the wrist's
carpal tunnel.
It is the most common nerve
entrapment neuropathy, accounting for 90% of
all neuropathies.
Early symptoms of carpal tunnel syndrome
include pain, numbness, and paresthesias.
Pain also can radiate up the affected arm. With
further progression, hand weakness, decreased
fine motor coordination, clumsiness, and thenar
atrophy can occur.
DR NEETI CHRISTIAN (PT) 89
90. De Quervain's Tenosynovitis is a painful inflammation
of tendons on the side of the wrist at the base of the
thumb.
These tendons include the extensor pollicis brevis
(EPB) and the abductor pollicis longus (APL).
The pain, which is the main complaint, gets worse
with abduction of the thumb, grasping action of the
hand and an ulnar deviation of the wrist. Thickening
and swelling can also be present.
DR NEETI CHRISTIAN (PT) 90
91. A wrist sprain is an injury to the ligaments of the
wrist region.
There are three grades:
1. A mild overstretching of the ligaments, without
joint instability.
2. A partial rupture of the ligaments, with no or
mild joint instability.
3. A complete rupture of a ligament with severe
joint instability.
DR NEETI CHRISTIAN (PT) 91
92. HAND AND WRIST OSTEOARTHRITIS:
Hand osteoarthritis(OA) is a common chronic
condition involving one or more joints of the thumb
and fingers. It is associated with pain, reduced grip
strength, loss of range of motion (ROM), and joint
stiffness, leading to impaired hand function and
difficulty with daily activities.
Estimates of the prevalence of symptomatic hand OA
range from 13% to 26% and are greater in women.
DR NEETI CHRISTIAN (PT) 92
93. Rheumatoid arthritis (RA) :
It is a systemic autoimmune disease characterized by
inflammatory arthritis and extra-articular involvement.
C/F : Polyarthritis of small joints of hands: proximal
interphalangeal (PIP), metacarpophalangeal (MCP) joints
and wrist.
Stiffness in the joints in the morning may last up to several
hours, usually greater than an hour. The patient may have
a "trigger finger" due to flexor tenosynovitis.
DR NEETI CHRISTIAN (PT) 93
94. Complex regional pain syndrome (CRPS) is a
term for a variety of clinical conditions
characterized by chronic persistent pain and
are subdivided into Type I and Type II CRPS.
It is a condition that can develop after a limb
trauma and appears mostly in one or more
limbs.
DR NEETI CHRISTIAN (PT) 94
95. Colles fracture
Smith s fracture
Scaphoid fracture
Lunate Instability
Hamate frcture
Metacarpal fracture
DR NEETI CHRISTIAN (PT) 95
96. Ape thumb :Paralysis of thenar muscles due
to Median nerve injury or polio or leprosy.
Claw hand : Inability to extend fingers from
IP joints due to ulnar nerve injury.
Deformities of RA
DR NEETI CHRISTIAN (PT) 96
97. Dupuytren contracture is a progressive disease of the palmar
fascia which results in shortening, thickening and fibrosis of
the fascia and aponeurosis of the palm.
The most commonly affected digits are the third and fourth
digits.
The disease begins in the palm as painless nodules that form
along longitudinal lines of tension.
The nodules form cords that produce contracture deformities
within fascial bands and tissues of the hand.
DR NEETI CHRISTIAN (PT) 97
98. A crush injury is defined as compression of the
extremities causing muscular and neurological
disturbance and in the upper limb is sustained
when the fingers, hand or wrist are caught
between two surfaces (sharp, blunt, smooth or
irregular) forcibly producing damage to the skin.
DR NEETI CHRISTIAN (PT) 98