Palpation of the Extensors and Flexors of the Wrist

00:10:06
https://www.youtube.com/watch?v=LfTb0MP7e-8

摘要

TLDRThe video provides a detailed guide on how to palpate the wrist's extensor and flexor muscles. First, it explains that the flexors are located on the forearm's anterior side, while the extensors are on the posterior side. To distinguish between the two, the brachioradialis muscle acts as a separator. For each muscle group, specific palpation techniques are described: for extensors like extensor carpi radialis longus, extensor digitorum, and extensor carpi ulnaris, flexion and extension motions are used, while flexors such as flexor carpi radialis, palmaris longus, and flexor carpi ulnaris require flexion and abducting movements. These exercises help locate and understand the origin, insertion, and action of these muscles, aiding in their identification during physical examination.

心得

  • 💪 Wrist flexors are located on the anterior forearm (non-hairy side).
  • 🔍 Wrist extensors reside on the posterior forearm (hairy side).
  • 🔄 Brachioradialis helps in differentiating flexors and extensors.
  • 👋 Wiggling fingers helps identify extensor digitorum.
  • ✊ Flexing the wrist highlights flexor carpi radialis.
  • 👈 Flexor carpi ulnaris aids in wrist adduction.
  • ↔️ Palpating lateral to brachioradialis denotes extensors.
  • ➕ Palmaris longus is visible when thumb touches the little finger.
  • 🧠 Knowledge of origin and insertion points is critical for muscle identification.

时间轴

  • 00:00:00 - 00:10:06

    When examining the wrist's extensor and flexor muscles, remember that the flexors are located on the anterior (non-hairy) side of the forearm and the extensors on the posterior (hairy) side. To distinguish between them, have the client contract the brachioradialis muscle by supporting the elbow, making a fist, and pushing up. Palpating lateral to this muscle targets extensors, medial targets flexors. Start by palpating the extensors: Extensor carpi radialis longus and brevis originate from the lateral aspects of the humerus, running down to the second and third metacarpals respectively. Have the client perform abduction/adduction of the wrist to feel these muscles contract.

思维导图

视频问答

  • Where are the wrist flexors located?

    The wrist flexors are located on the anterior side of the forearm, known as the non-hairy side.

  • Where are the wrist extensors located?

    The wrist extensors are located on the posterior side of the forearm, also known as the hairy side.

  • How can brachioradialis help differentiate between flexors and extensors?

    Brachioradialis acts as a divider; palpating lateral to it indicates extensors, and medial to it indicates flexors.

  • What is the origin and insertion of the extensor carpi radialis longus?

    It originates from the supracondylar ridge of the humerus and inserts into the base of the second metacarpal.

  • What movement helps identify the extensor digitorum?

    Wiggling the fingers or extending the wrist can highlight the extensor digitorum.

  • How do you identify flexor carpi radialis during palpation?

    Flex the wrist and feel the tendon closest to the thumb.

  • How can you palpate palmaris longus?

    Palmaris longus can be palpated by flexing the wrist or bringing the thumb to the fifth digit, revealing its central tendon.

  • What is the action of the flexor carpi ulnaris?

    Flexor carpi ulnaris adducts the wrist.

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  • 00:00:07
    as we palpate the extensors of the wrist
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    and the flexors of the wrist one thing
  • 00:00:12
    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
  • 00:01:16
    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
  • 00:01:36
    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
  • 00:02:04
    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
  • 00:02:59
    form it's an extensor muscle therefore
  • 00:03:01
    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
  • 00:03:22
    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
  • 00:03:31
    going to pop up on the dorsum of the
  • 00:03:33
    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
  • 00:04:03
    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
  • 00:04:12
    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
  • 00:04:22
    going to insert on the base of the fifth
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    metacarpal this muscle is one
  • 00:04:30
    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
  • 00:04:36
    between the two we will actually see the
  • 00:04:38
    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
  • 00:04:50
    going to follow
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    it down the
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    forearm and I should be able to follow
  • 00:05:00
    it right to the base of the fifth
  • 00:05:04
    metacarpal all right so again those are
  • 00:05:06
    your
  • 00:05:07
    extensors we have extensor carpy
  • 00:05:09
    radialis longus and
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    brevis going down the forearm longus
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    inserting to the base of the second
  • 00:05:17
    brevis inserting to the base of the
  • 00:05:20
    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
  • 00:05:42
    base of the fifth metacarpal so that's
  • 00:05:45
    your extensor group now we're going to
  • 00:05:47
    be palpating the flexors so you want to
  • 00:05:50
    make sure that you're palpating on the
  • 00:05:52
    anterior side of the
  • 00:05:54
    forearm all of your
  • 00:05:57
    flexors are going to originate around
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    this medial
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    epicondilite is going to be flexor carpy
  • 00:06:08
    radialis it's going to originate at the
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    medial
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    epicondyle the one thing about the
  • 00:06:22
    flexors I usually like to start
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    palpating at the wrist because the
  • 00:06:26
    tendons pop up so if you have your
  • 00:06:29
    client into flexion of the wrist you can
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    actually
  • 00:06:33
    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
  • 00:06:42
    Pal's longest the one you see closer to
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    the little finger the fifth digit or
  • 00:06:48
    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
  • 00:06:53
    client Flex the
  • 00:06:55
    wrist and I'm going to find the tendon
  • 00:06:57
    of flexor carpy radialis
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    and I'm going to follow
  • 00:07:02
    it to get this muscle to contract we can
  • 00:07:06
    have our client ab and AD duct the
  • 00:07:09
    wrist as they AB duct I will feel a
  • 00:07:15
    contraction and I'm going to follow the
  • 00:07:17
    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
  • 00:07:27
    again if we have our client Flex the
  • 00:07:28
    wrist the the tendon that pops up that's
  • 00:07:30
    more in the center is going to be pis
  • 00:07:33
    longus we can also have our client bring
  • 00:07:36
    the thumb to the in the um fifth digit
  • 00:07:40
    and that pops up the poma's longest
  • 00:07:43
    tendon pops up even more with wrist
  • 00:07:45
    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
  • 00:08:02
    follow
  • 00:08:08
    it if I'm not sure I'm on the muscle
  • 00:08:10
    again I can have my client bring the
  • 00:08:12
    thumb to the fifth digit cont
  • 00:08:16
    tracks I can follow it up to the medial
  • 00:08:21
    Epicon the last
  • 00:08:23
    flexor is going to be flexor carpy
  • 00:08:26
    NYS flexor carpy Alys again is going to
  • 00:08:29
    originate from the medial
  • 00:08:37
    epicondilite and the base of the fifth
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    metacarpal when I have my client Flex
  • 00:08:42
    the wrist I'm going to feel a
  • 00:08:45
    tendon if I can find pisor if I fall
  • 00:08:48
    right off
  • 00:08:49
    pisor proximately I feel that tendon pop
  • 00:08:52
    up of flexor carpon arys and then I'm
  • 00:08:55
    going to follow
  • 00:08:56
    it if I'm not sure I'm on the muscle
  • 00:08:59
    again I'm going to have my client move
  • 00:09:00
    into ad and ab duction alternating
  • 00:09:04
    between the two flexor carpy Alys its
  • 00:09:08
    action is AD duction of the wrist so
  • 00:09:10
    when my client ad ducts I should feel
  • 00:09:13
    the muscle pop up and then I'm going to
  • 00:09:15
    follow it to the medial
  • 00:09:20
    epicondyle or group again we have flexor
  • 00:09:24
    carpy radialis origin medial
  • 00:09:29
    down the forearm past the wrist to
  • 00:09:31
    insert at the base of the second and
  • 00:09:33
    third
  • 00:09:34
    metacarpal we have palaris longus it's
  • 00:09:37
    going to originate at the medial
  • 00:09:41
    epicondylar
  • 00:09:43
    fascia and then we have flexor carpy
  • 00:09:45
    olaris again it's originating from the
  • 00:09:48
    medial EP aond of the humoris comes down
  • 00:09:51
    the forearm crossing the wrist to insert
  • 00:09:53
    it the Pisa form hook of the hamate base
  • 00:09:55
    of the fifth F carpal
标签
  • wrist anatomy
  • muscle palpation
  • extensor muscles
  • flexor muscles
  • brachioradialis
  • forearm anatomy
  • muscle identification
  • wrist tendons