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"Take your life in your own hands, and what happens? A terrible thing: no one to blame"

—Erika Jong, Author and educator

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LEARNING OUTCOMES

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LEARNING OUTCOMES

This chapter investigates the wrist and hand. By the end of this chapter, you should be able to:

  • Identify the bones, joints, soft tissue, and muscles of the wrist and hand;

  • List muscles that are prime movers in wrist flexion, extension, radial, and ulnar deviation and intricate hand movements;

  • Name muscle groups that function to position and move the wrist and hand in specific functional motions;

  • Identify the nerves that innervate the main muscles of the wrist and hand;

  • Describe commonly encountered movement disorders of the wrist/hand and their functional consequences;

  • Identify normal grasping patterns of the hand and their importance in functional activities.

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CLINICAL SCENARIO

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CLINICAL SCENARIO

Lori is a hairdresser who has been trying to build her business and clientele. She has noticed most recently that she is experiencing numbness in her hands, and she is frequently dropping the combs and brushes she uses. At night, she experiences pain and tingling which radiate up to her fingertips, and the pain often wakes her up at night. Lori loves her work and is proud of her new shop. She is concerned that if she goes to her physician, she will need surgery and will be forced to take time off from work.

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INTRODUCTION

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Several bones, joints, muscles, tendons, nerves, and blood vessels make up the hand. The hand is a predominant part of the body, serving many purposes. As such, it is a very versatile body segment, adapting to the many demands placed upon it. As with the shoulder and elbow, the wrist positions the hand and provides a stable platform from which the hand functions, but unlike the shoulder and elbow, the wrist is responsible for finely tuned hand positioning as well as more global positioning. The hand contains the palm and fingers. These structures are both sturdy and mobile. The fingers are sometimes referred to as digits and are named for either their position or their purpose:

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  • Thumb comes from the Latin word pollex, which is the medical term for the thumb: pollicis. It is our first digit or number one (#1) digit.

  • The second digit, sometimes referred to as the "first finger" is also called the index finger, pointer finger, or forefinger. "Index finger" was perhaps attached to this #2 digit because it is often used to point, and pointing is a method of making things clearer; making things clearer is the purpose of an index.

  • The third digit is also the middle finger or second finger. It is usually the longest finger of the hand.

  • The fourth digit is commonly referred to as the ring finger or third finger. Sometime around the fifth century, it was believed that this finger contained a "vein ...

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