the joy of hands

Sally Poole is the kinesiology instructor this semester. It's a fun, hands-on class that puts anatomy into action. Because I'm very much interested in hands, I'll go through a run-down as to what we've done so far. We started off with the wrist, it's bones, ligaments, and significance. The ligaments look complicated, but if you have a good atlas and common sense, following the patterns isn't difficult.

There are 5 extrinsic ligaments:

1. Dorsal radio-carpal ligament
2. Volar radio-carpal ligament (the strongest) - radiocapitate, radiotriquetral, and radioscaphoid
3. Volar ulnar-carpal ligament - ulnolunate, ulnotriquetral, and capitotriquetral
4. Radio collateral ligament
5. Ulnar collateral ligament

The intrinsic (intercarpal) ligaments have not been named, however I found a hand kinesiology site that really helps with the visuals. Hand Kinesiology

Muscles that act on the wrist: FCU, FCR, PL, ECRL, ECRB, and ECU.

Professor Poole challenged the entire class to search for the Triangular Fibrocartilage Complex (TFCC) in anatomy. I was amazed at the amount of lubrication at the joints, especially between the carpal joints. Then I cracked the wrist open, scraped away tissue and located the TFCC just distal to the ulna.

We briefly touched on the arthokinematics at the distal radius, radio-carpal joint and mid-carpal joint. And ended with wrist positions:

Position of rest:

1. 10-15 degrees extension
2. 5-10 degrees ulnar deviation

Position of function:

1. 40-45 degrees extension
2. 15 dgrees ulnar deviation

NEXT TIME: THE HAND!

what the torque?!

Brunnstrom's Clinical Kinesiology Chapter 2 is in alien language. Thankfully, I don't need to understand every mathematical concept (trigonometry, algebra).

At equilibrium when no motion or acceleration of the body is occurring, the torque of the resistance force equals the torque of the holding force: force times the force arm equals resistance times the resistance arm. F x a = W x b for each type of lever.

Brunnstrom, page 37

Torque = force times perpendicular distance
static equilibrium for torque = 0
static equilibrium for force = 0

My question: what the hell?!
Okay, I'm not THAT clueless. But I am having some difficulty knowing when to plug in certain numbers. My professor laid it out in an obvious fashion, but I didn't get it.

The forearm was the example. The elbow joint is the axis. The forearm is at 90 degrees flexion and paralell to the floor. The hand is holding a 10 pound weight. The perpendicular distance of the resistance arm is 12 inches (axis to weight), the perpendicular distance of the force arm (axis to muscle pull) is 2 inches. We do not know the force of the muscle is exerting (X), but we are looking for how much it has to exert to hold up the 10 lbs.

10 lbs x 12 in = 120 lbs in
2X = 120
X=60

I'm getting it, but I'm not.

test update

Quick Kinesiology Practical Exam update. I got a 95.5! I made a mistake when measuring radial deviation of the wrist. I let the stationary arm move a bit. Be careful with wrist radial and ulnar deviations! Keep the stationary arm stationary!

Kinesiology Lab

What's more fun that running around in tank tops grabbing fellow classmates and leaving fingerprints on their body? It's a bit weird at first. Do I have enough deodorant on? Am I sweating? T-shirt sweat stains? Enough perfume? Did I remember to shave? lol

We're venturing toward the axillary area tomorrow, palpating muscles in the shoulder region. Thankfully, I was assigned serratus anterior and supraspinatus to teach the class. Unfortunately, I don't know whether I'm palpating the trapezius or the supraspinatus. I'm following the instructions in Brunnstrom's Clinical Kinesiology. Still having some difficulty.

goniometry

My first practical exam for kinesiology is Wednesday. I will be tested on 3 bony palpations, 3 active ROM goniometry, 1 passive ROM goniometry, and 1 documentation.



This is a list of bony structures we learned to palpate:

1. clavicle
2. spine of scapula
3. medial and lateral border of scapula
4. superior and inferior angle of scapula
5. acromion
6. acromioclavicular joint
7. corocoid process
8. greater and lesser tuberosity of humerus
9. bicipital groove of humerus
10. sternal notch
11. manubrium
12. medial and lateral epicondyle of humerus
13. olecranon fossa
14. ulnar ridge
15. ulnar styloid process
16. radial head
17. radial styloid
18. capitate

Testing shoulder range of motion (ROM) at the glenohumeral joint:

1. flexion
2. extension
3. abduction
4. abduction with external rotation
5. external rotation
6. internal rotation

Testing elbow ROM at elbow joint:

1. extension to flexion

Testing forearm ROM:

1. supination
2. pronation

Testing wrist ROM:

1. flexion
2. extension
3. radial deviation
4. ulnar deviation

The biggest problem I'm having with using a goniometer is when I'm measuring passive ROM (patient's limb is moved by therapist). Actually, I feel the entire science of goniometry is looking for a ballpark range. I measure the same person twice and can get two different measurements. It doesn't seem to be an exact science, which makes me a bit nervous concerning the test.