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as we palpate the extensors of the wrist
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and the flexors of the wrist one thing
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we want to keep in
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mind all of the flexors are found on the
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anterior forearm when we're in correct
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anatomical position we say that this is
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the non-hairy side of the forearm the
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extensors are going to be found on the
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posterior forearm or the hairy side of
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the
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forearm another important tool that you
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can use to find extensors versus flexors
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is to have your client contract a muscle
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called bracho radialis we sometimes call
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this did the divider muscle so we
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support our client's elbow have them
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make a fist and push up into our hand
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and you'll see this muscle here pop up
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it runs all the way down to the styloid
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process of the radius that's called
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bracho radialis if we're palpating
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lateral to bracho radialis we are now on
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the extensor muscle group if we're
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palpating medial to bracho radialis
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we're then on the flexor muscle group so
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let's begin by palpating the extensors
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first so the first extensor muscle we're
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going to palpate it's really two muscles
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we're going to palpate it as one it's
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extensor Carpe radialis longus and
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extensor carpy radialis Revis longus is
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going to originate from the super ular
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Ridge on the lateral side of the
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humorus extensor Carpe radialis brevis
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is going to originate from the lateral
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epicondyles are going to run down the
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forearm they're going to cross the wrist
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longus is going to insert into the base
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of the second metacarpal brevis inserts
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into the base of the
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third so to palpate these two
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muscles you can take your client's hand
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we're going to start around the lateral
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humoris and we're going to have our
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client ab and AD docked when they do
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this it causes the extensor carpi
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radialis longest and brevis to pop up
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and you can feel the muscle to
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Contracting so we're going to find
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it and then we're going to follow it
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down the
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forearm if you feel like you're losing
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the muscle you're not sure you're on it
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again have your client go into ab and AD
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duction as the ab duct we're going to
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feel the muscle
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contract we're going to follow that
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muscle
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down and you can differentiate between
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longus going to the base of the
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second and then brevis is going to the
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base of the third
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metacarpal the next muscle we're going
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to look at and we're going to find is
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extensor digitorum extensor digitorum
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form it's an extensor muscle therefore
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it's going to originate from the lateral
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epicondyle then comes down the forearm
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crossing the wrist and it's going to
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insert into the middle and distal fanges
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of digits 2 3 four and
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five one thing you can have your client
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do to contract the muscle is to wiggle
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their fingers as if they're playing the
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piano and you actually see this muscle
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contract which makes it very easy to
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palpate also if they extend the wrist
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and extend their digits the tendons are
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going to pop up on the dorsum of the
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hand all right so I'm going to start at
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the lateral
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and again the tendon's branch
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here you'll get a branch of each tendon
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going into digits 2 3 4 and
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five last extensor is going to be
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extensor Carpe
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nerys it originates from the lateral EP
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aond of the humoris it then will go down
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the forearm crossing the wrist and it's
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going to insert on the base of the fifth
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metacarpal this muscle is one
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that will ad deduct the wrist so again
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if we have our client go into ad
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deduction and abduction alternating
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between the two we will actually see the
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muscle pop up so I'm going to start at
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the lateral
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epicondyle as it's Contracting and I'm
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going to follow
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it down the
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forearm and I should be able to follow
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it right to the base of the fifth
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metacarpal all right so again those are
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your
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extensors we have extensor carpy
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radialis longus and
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brevis going down the forearm longus
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inserting to the base of the second
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brevis inserting to the base of the
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third extensor digitorum originating at
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the lateral epic of the humoris goes
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down the forearm crossing the wrist and
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goes to digits 2 3 four and
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five lastly we have extensor carpy Olas
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originating at the lateral epic cond of
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the
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humoris heads down the
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forearm P the wrist to insert at the
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base of the fifth metacarpal so that's
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your extensor group now we're going to
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be palpating the flexors so you want to
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make sure that you're palpating on the
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anterior side of the
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forearm all of your
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flexors are going to originate around
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this medial
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epicondilite is going to be flexor carpy
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radialis it's going to originate at the
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medial
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epicondyle the one thing about the
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flexors I usually like to start
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palpating at the wrist because the
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tendons pop up so if you have your
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client into flexion of the wrist you can
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actually
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see the tendon of flexor carpy radialis
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it's going to be the one closest to the
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thumb the one you see in the middle is
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Pal's longest the one you see closer to
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the little finger the fifth digit or
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closer to the Ona is going to be flexor
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carpy
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Olas so again I'm going to have my
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client Flex the
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wrist and I'm going to find the tendon
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of flexor carpy radialis
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and I'm going to follow
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it to get this muscle to contract we can
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have our client ab and AD duct the
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wrist as they AB duct I will feel a
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contraction and I'm going to follow the
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muscle up to where it's
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originating at the medial
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epicondyle is going to be pis longus so
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again if we have our client Flex the
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wrist the the tendon that pops up that's
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more in the center is going to be pis
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longus we can also have our client bring
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the thumb to the in the um fifth digit
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and that pops up the poma's longest
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tendon pops up even more with wrist
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flexion all right pus longus originates
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at the medial
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epicondylar
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aerosis so I'm going to start here
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finding the tendon and then I'm going to
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follow
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it if I'm not sure I'm on the muscle
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again I can have my client bring the
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thumb to the fifth digit cont
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tracks I can follow it up to the medial
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Epicon the last
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flexor is going to be flexor carpy
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NYS flexor carpy Alys again is going to
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originate from the medial
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epicondilite and the base of the fifth
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metacarpal when I have my client Flex
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the wrist I'm going to feel a
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tendon if I can find pisor if I fall
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right off
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pisor proximately I feel that tendon pop
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up of flexor carpon arys and then I'm
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going to follow
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it if I'm not sure I'm on the muscle
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again I'm going to have my client move
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into ad and ab duction alternating
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between the two flexor carpy Alys its
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action is AD duction of the wrist so
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when my client ad ducts I should feel
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the muscle pop up and then I'm going to
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follow it to the medial
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epicondyle or group again we have flexor
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carpy radialis origin medial
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down the forearm past the wrist to
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insert at the base of the second and
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third
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metacarpal we have palaris longus it's
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going to originate at the medial
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epicondylar
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fascia and then we have flexor carpy
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olaris again it's originating from the
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medial EP aond of the humoris comes down
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the forearm crossing the wrist to insert
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it the Pisa form hook of the hamate base
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of the fifth F carpal