3.  Key bony landmarks
for wrist & hand
muscles
 medial epicondyle
 lateral epicondyle
 lateral supracondylar
ridge
6-3

4.  Ginglymus or hinge-type joint
 Allows only flexion & extension
 2 interrelated joints
 humeroulnar joint
 radiohumeral joints
Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-4

5.  Radioulnar joint
 Trochoid or pivot-type joint
 Radial head rotates around
at proximal ulna
 Distal radius rotates around
distal ulna
 Annular ligament maintains
radial head in its joint
Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-5

6.  Key distal bony
landmarks
for muscles involved in
wrist motion
 base of 2nd, 3rd, & 5th
metacarpals, pisiform, &
hamate
Manual of
Structural Kinesiology The Wrist and Hand Joints 7-6

7. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-7
 Wrist joint
 condyloid-type joint
 allows
flexion, extension, abducti
on, & adduction
 motion occurs primarily
between distal radius &
proximal carpal row
(scaphoid, lunate, &
triquetrum)

8.  Wrist joint
 70 to 90 degrees of flexion
 65 to 85 degrees of
extension
 15 to 25 degrees of
abduction
 25 to 40 degrees of
adduction
Manual of
Structural Kinesiology The Wrist and Hand Joints 7-9

9.  Pronation
 internal rotary movement
of radius on ulna that
results in hand moving
from palm-up to palm-
down position
 Supination
 external rotary
movement of radius on
ulna that results in hand
moving from palm-down
to palm-up position
Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-11

10.  Radioulnar pronators
 Pronator teres
 Pronator quadratus
 Brachioradialis
 Radioulnar supinators
 Biceps brachii
 Supinator muscle
 Brachioradialis
Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-12

11.  “Tennis elbow" - common problem usually
involving extensor digitorum muscle near its
origin on lateral epicondyle
 known lateral epicondylitis
 associated with gripping & lifting activities
 Medial epicondylitis
 somewhat less common
 known as golfer's elbow
 associated with medial wrist flexor & pronator group
near their origin on medial epicondyle
 Both conditions involve muscles which cross elbow
but act primarily on wrist & hand
Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-13

12.  Anterior
 Primarily elbow
flexion & pronation
 Biceps brachii
 Brachialis
 Brachioradialis
 Pronator teres
 Pronator quadratus
Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-14

13. Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-15
Elbow flexion when pronated or
Neutral.
Pronation and supination

14. Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-16
Actions: Pronation
and elbow flexion

15. Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-17
Action: Pronation

16. Manual of
Structural Kinesiology The Elbow and Radioulnar Joints 6-18
Action: Supination

17.  All wrist flexors generally have
their origins on anteromedial
aspect of proximal forearm
and medial epicondyle of
humerus with insertions on
anterior aspect of wrist & hand
 Median nerve & all flexor
tendons except flexor carpi
ulnaris & palmaris longus
pass through carpal tunnel
Manual of
Structural Kinesiology The Wrist and Hand Joints 7-19

18. Extrinsic muscles of wrist & hand grouped
according to function & location
 muscles move wrist
 6 wrist flexors (Anterior)
 flexor carpi radialis
 flexor carpi ulnaris Superficial
 palmaris longus
 flexor digit. superficialis Middle
 flexor digit. profundus Deep
 Flexor pollicis longus
Manual of
Structural Kinesiology The Wrist and Hand Joints 7-20

19. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-21
 Primarily wrist flexion
 Flexor carpi radialis
 Flexor carpi ulnaris
 Palmaris longus

20. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-22
 Anteromedially at elbow
& forearm and anterior
at hand
 Primarily wrist &
phalangeal flexion
 Flexor digitorum
superficialis
 O: medial epi and
coronoid process
 I: base of middle phalanx

21. Flexor digitorum
profundus
O: Profundus – prox.
Two-thirds of ulna
I: distal phalanx of 2-
5
Flexor pollicis longus
 O: middle half of radius

26. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-28
Wrist flexion
Wrist abduction
Weak elbow flexion and
pronation
Origin: Medial epicondyle
Insertion: Base of 2nd – 3rd
metacarpal

27. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-29
Wrist flexion
Wrist adduction in
Concert with ext.
Carpi ulnaris
Origin: medial epicondyle
Upper two-thirds of dorsal
border of ulna
Insertion: pisiform, hamate
and 5th metacarpal

28. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-30
Wrist flexion
Weak elbow
flexion
Origin: Medial epicondyle
Insertion: palmarar
Aponeurosis of palm
metacarpals

29. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-31
 Agonists
Flexor carpi
radialis
Flexor carpi
ulnaris
Palmaris longus

30. wrist extensors (Posterior)
extensor carpi radialis longus O: Supracondylar ridge
I: Base of 2nd metacarpal
extensor carpi radialis brevis
I: Base of 3rd metacarpal
extensor carpi ulnaris
I: Base of 5th metacarpal
Extensor digitorum
I: Middle and distal phalanx
Ext. digiti minimi (not covered)

31. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-33
 Wrist extensors generally have their origins on
posterolateral aspect of proximal forearm &
lateral humeral epicondyle with insertions
located on posterior aspect of wrist & hand
 Flexor & extensor tendons immediately
proximal to wrist are held in place on palmar &
dorsal aspects by transverse bands of tissue
known as flexor & extensor retinaculum to
prevent the tendons from bowstringing during
flexion & extension

32.  Extensors
 Extensor digitorum
 Extensor indicis
 Extensor digiti minimi
 Extensor pollicis longus
(thumb extensor)
 Extensor pollicis brevis
(thumb extensor)
 Abductor of thumb & wrist
 Abductor pollicis longus
Manual of
Structural Kinesiology The Wrist and Hand Joints 7-34

33. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-35
 Extensor carpi radialis
longus
 Extensor carpi radialis
brevis
 Extensor carpi ulnaris
 Extensor digitorum
 Brachioradialis

34. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-36
Wrist extension
Abduction of wrist
Weak elbow flexion
Origin: Lower third of
Supracondylar ridge
And lateral epicondyle
Insertion: Dorsal surface
of 1st metacarpal

35. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-37
Wrist extension
Wrist abduction
Origin: Lateral epicondyle
Insertion: Base of third
metacarpal

36. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-38
Wrist extension
Wrist adduction in concert
with flexor carpi ulnaris
Origin: lateral epicondyle
Insertion: base of 5th
metacarpal

37. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-39

38. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-40
 Agonists
 Extensor carpi
radialis longus
 Extensor carpi
radialis brevis
 Extensor carpi
ulnaris

39. Ext. pollicus longus
O: Post. Surface of middle third of ulna
I: Distal phalanx
Ext. pollicus brevis
O: Post surface of radius and Interosseus
mem.
I: Proximal phalanx
Abductor pollicus longus
O: Post. Surface of radius and ulna
I: Base of first metacarpal

40. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-42
 Agonists
 Extensor pollicis
longus
 Extensor pollicis
brevis

42. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-44
 Wrist abductors
 Generally cross wrist joint anterolaterally &
posterolaterally to insert on radial side of hand
 Flexor carpi radialis
 Extensor carpi radialis longus
 Extensor carpi radialis brevis
 Abductor pollicis longus
 Extensor pollicis longus
 Extensor pollicis brevis

43. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-45
 Agonists
 Flexor carpi radialis
 Extensor carpi
radialis longus
 Extensor carpi
radialis brevis

44. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-46
 Agonists
 Abductor pollicis
longus
 Extensor pollicis
longus
 Extensor pollicis
brevis

45. Manual of
Structural Kinesiology The Wrist and Hand Joints 7-47
 Agonists
 Flexor carpi
ulnaris
 Extensor carpi
ulnaris