Carpal tunnel syndrome Swelling & inflammation can cause increased pressure in carpal tunnel resulting in decreased function of median nerve leading to reduced motor & sensation function in its distribution particularly common with repetitive use of the hand and wrist in manual labor and clerical work such as typing and keyboarding Often, slight modifications in work habits and hand & wrist positions during these activities can be preventative Flexibility exercises for the wrist & finger flexors may be helpful
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Wrist Flexion 0 to ± 80 degrees Wrist Extension 0 to ± 70 degrees Ulnar Deviation 0 to 30 degrees Radial Deviation 0 to 20 degrees
MuscleOriginInsertionActionInnervation Flexor Carpi Radialis Medial epicondyle of humerus Base of 2 nd and 3 rd metacarpals on palmar surface -Flexion of wrist -Abduction of wrist -Weak flexion of elbow -weak pronation of forearm Median nerve (C6 and C7) Palmaris Longus Medial epicondyle of humerus Palmar aponeurosis of the 2 nd, 3 rd, 4 th, and 5 th metacarpals -Flexion of wrist -Weak flexion of elbow Median nerve (C6 and C7) Flexor Carpi Ulnaris Medial epicondyle of humerus and posterior aspect of proximal ulna Base of 5 th metacarpal (palmar surface), pisiform, and hamate -Flexion of wrist -Adduction of wrist -Weak flexion of elbow Ulnar nerve (C8 and T1)
MuscleOriginInsertionActionInner- vation Flexor Digitorum Profundus Proximal ¾ of anterior and medial ulna Base of distal phalanges of four fingers Flexion of the four fingers at the metacarpo- phalangeal, proximal inter- phalangeal, and distal inter- phalangeal joints Median nerve (C8, T1) to 2 nd and 3 rd fingers; ulnar nerve (C8, T1) to 4 th and 5 th fingers Flexor Digitorum Superficialis -Medial epicondyle of humerus -Ulnar head: medial coronoid process -Radial head: upper 2/3 of anterior border of the radius just distal to the radial tuberosity Each tendon splits and attaches to the sides of middle phalanx of four fingers on palmar surface -Flexion of the fingers at the metacarpo- phalangeal and proximal inter- phalangeal joints -Flexion of wrist -Weak flexion of elbow Median nerve (C7, C8, and T1)
MuscleOriginInsertionActionInnervation Extensor Carpi Ulnaris Lateral epicondyle of humerus and middle ½ of the posterior border of the ulnaq Base of 5 th metacarpal on dorsal surface -Extension of wrist -Adduction of wrist -Weak extension of elbow Radial nerve (C6, C7, and C8) Extensor Carpi Radialis Brevis Lateral epicondyle of humerus Base of 3 rd metacarpal on dorsal surface -Extension of wrist -Abduction of wrist -Weak flexion of elbow Radial nerve (C6 and C7)
The flexor carpi ulnaris is important in wrist flexion or curling activities. It is one of only two muscles involved in wrist adduction or ulnar flexion. It may be strengthened with any type of wrist-curling activity against resistance.
The ulnar nerve assists the flexor carpi ulnaris in Flexion of the wrist Adduction of the wrist Weak flexion of the elbow therefore these movements would be most affected if the ulnar nerve gets injured.
Opposition will not take place in its full range of motion.