wrist extensor muscles nerve supply

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Several techniques are available for the surgical management of mallet finger injuries. Radiology case reports. The average age is 38.2 years old, with only 62.50% of the people owning property. STRENGTHENING EXERCISE OF WRIST EXTENSORS : 1. An injury of this kind is going to be proximal to the wrist extensors, thus wrist drop is a . RTS is typically unilateral, with the dominant arm more likely affected. The radial nerve is a nerve in the human body that supplies the posterior portion of the upper limb. [4]The radial artery then continues laterally in the forearm, eventuallycontributing to the superficial and deep palmar arches in the palmar aspect of the hand. [4]The radial artery then continues laterally in the forearm, eventuallycontributing to the superficial and deep palmar arches in the palmar aspect of the hand. Extends and abducts hand at wrist joint Extensor carpi radialis brevis: Insertion: The posterior surface of the base of the third metacarpal bone Nerve supply: Deep branch of the radial nerve Action: Extends and abducts hand at wrist joint Extensor digitorum: Insertion: Bases of middle phalanges of the 2nd-5th digits Nerve supply: It then innervates the APL, EPB, EPL, and EIP muscles. The posterior interosseous nerve (PIN, also known as the dorsal branch of the radial nerve) innervates and then courses between the two heads of the supinator muscle before entering the posterior compartment of the forearm. [1]For these reasons, the necessity of imaging is rare in diagnosing this condition.[13]. Stretches & Myofascial Release Techniques: Vitruve Encoder Review: Is This VBT Device Worth It? It inserts on the extensor expansion located at the base of the proximal phalanx of digit V on the dorsal side. [15], Pain can be elicited by performing Finkelstein's test. Injuries to zone I (i.e., mallet finger injuries) classically result from forced flexion of an extended DIP joint. It originates from the posterior distal third of ulna and interosseous membrane. The superficial branch of the radial nerve (SBRN) provides sensation to the distal forearm and hand. My goal is to help you learn proper weight training and nutrition principles so that you can get strong and build the physique of your dreams! [15], Intersection Syndrome(extensor compartment 2), Distal intersection syndrome isclassically experienced by skiers and kickboxers, who present with dorsal wrist pain complaints. Im happy to hear you enjoyed the article. Actions: Flexion of the forearm. Nerve supply: Median nerve. fred. DIP joint rigidity on an exam is indicative of lateral band activation, an involuntary compensatory finding consistent with a central slip injury. [1][2], To achieve neutral wrist extension movements, theextensor carpi radialis brevis (ECRB), extensor carpi radialis longus (ECRL), and the extensor carpi ulnaris (ECU) musclesact synergistically based on each muscle's insertion and dynamic function. Below a summary of the general origin and insertion points can be found. Youll also have to practice taping your wrists to get the right amount of pain reduction/flexibility. [4]A high origin of the radial artery has also been observed, with branch points occurring as high as the axillary artery. I started this website back in late 2009 during college, and it has been my pet project ever since. Meraj S, Gyftopoulos S, Nellans K, Walz D, Brown MS. MRI of the Extensor Tendons of the Wrist. My goal is to help you learn proper weight training and nutrition principles so that you can get strong and build the physique of your dreams! 2012 [PubMed PMID: 22431949], Wysiadecki G,Polguj M,Haadaj R,Topol M, Low origin of the radial artery: a case study including a review of literature and proposal of an embryological explanation. You arent so good that will youre so good at the moment. Repeat 10 times. Their fiberstravel distally,down the back of the forearm, and insert on the back of thecarpals, metacarpals and phalanges. Inagaki K. Current concepts of elbow-joint disorders and their treatment. Hey! Nonoperative management consists ofsplinting the PIP joint in full extension for 4to 6 weeks. the deep fascia is firmly bound to the skin My brother suggested I may like this blog. The deep palmar archderives its main contribution from the deep arterial branch of the radial artery. [15], EPL Tenosynovitis/Drummer's Wrist/EPL Rupture (extensor compartment 3), EPL tenosynovitis (drummer's wrist) is commonly experienced by patients with rheumatoid arthritis and also in drummers, hence the eponym drummer's wrist. [Updated 2022 Aug 30]. If you have developed lateral epicondylitis, see. Extensor digitorum is innervated by the posterior interosseous nerve, which is a branch of the radial nerve. Lumbricals : Origin : It originates from the Flexor Digitorum Profundus muscle. This book is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, a link is provided to the Creative Commons license, and any changes made are indicated. [3], Like injuries tozones I-IV, injuries to zones V, VI, VII, and VIII should be managed conservatively when possible. It originates from the anterior of the lateral epicondyl of the humerus. chiropractor Gluteal surface of ilium, under gluteus maximus. It acts as extensor of the wrist and the little finger.. These variants are the extensor carpi radialis intermedius (ECRI), extensor carpi radialis tertius (ECRT), and extensor carpi radialis accessories (ECRA). If damage occurs to an extensor tendon in zone II, treatment via immobilization and splinting is the management of choice during the acute phase. Extensor tendon zones are a helpful way to identify the region where injuries to the extensor tendons occur in the hand and wrist. Action : The capitate head sits in the space allowed by the lunate and scaphoid bones of the proximal carpal bone row. Thanks so much for the post.Much thanks again. [3]The first extensor compartment is comprised of the APL and EPB tendons. a device that restricts range of motion to allow for healing), then you probably shouldnt be doing cleans at all. A positive test (i.e., positive central slip injury) includes documentation of weak PIP extension force and compensatory DIP joint rigidity. using most hand tools: hammer, screwdriver, hand saw, chain saw, garden tools, etc.). Foot Drop Folia morphologica. These muscles generally originate on or near the lateral epicondyle and insert on the distal forearm or in the hand. I simply want to give an enormous thumbs up for the great info youve right here on this post. Accessory Slip of the Extensor Carpi Ulnaris: A Cadaveric Assessment. Hey! Haadaj R, Wysiadecki G, Dudkiewicz Z, Polguj M, Topol M. The High Origin of the Radial Artery (Brachioradial Artery): Its Anatomical Variations, Clinical Significance, and Contribution to the Blood Supply of the Hand. [7]The PIN innervates the EDC, EDM, and ECU muscles from the superficial wrist extensor compartment. Extensor tendons protected by synovial tendon sheaths. Patients will present with this deformity in part due to the lateral bands of the dorsal interossei muscles. Treatment measures should be conservative. Conservative management is typically first-line treatment, including immobilization, non-steroidal anti-inflammatories, activity modifications, and anesthetic injection directly to the compression site. The only exception is the supinator muscle that acts specifically on the proximal radioulnar joint to produce supination of the forearm. West Covina is located latitude: 34 and longitude: -118 and has a median income per household of $82,938.00 per year. These muscles generally originate on or near the lateral epicondyle and insert on the distal forearm or in the hand. He was once totally right. Learn vocabulary, terms, and more with flashcards, games, and other study tools. This patient is instructed to adduct their thumb. [9], Reports exist that anatomic variants of the EIP muscle have an incidence of 16%. As a group, the primary action of the wrist flexors is, you guessed it wrist flexion! DeQuervainTenosynovitis (extensor compartment 1), DeQuervain tenosynovitis classically affects women more often than men. Thumbextension is carried out by abductor pollicis longus (APL), extensor pollicis brevis (EPB), and extensor pollicis longus (EPL). The fifth extensor compartment contains the EDM muscle tendon. It thenbecomes the brachial artery once it passes the lower edge of the teres minor muscle. Extrinsic denotes their location outside the hand. Radiographs help to rule out bone disease, arthropathy, and the presence of loose or foreign bodies. This association is whylateral epicondylitis is commonly known as tennis elbow. Great blog post.Much thanks again. A physical exam will reveal absent or weak active PIP extension. Nerve supply: Median nerve. any deadlift, shrug, dumbbell lunge, pull up or row variations with heavy enough weight). Radial Tunnel Syndrome, Diagnostic and Treatment Dilemma. Dr. Nitesh Patel ( Physiotherapist ) : Mo No : 09898607803, Pingback: origin, insertion, innervation and blood supply - Quick Weight Loss. The wrist extensor muscles comprise a significant component of the posterior forearm musculature. European journal of medical research. [6], Muscles of the Wrist and hand, External Carpi radialis longus and brevis, Abductor pollicis longus, Flexor digitorum profundus, Flexor Carpi Ulnaris, Cupinaor. The radial nerve divides off the posterior cord of the brachial plexus. [15], Intersection Syndrome Reduce your total training volume on wrist extensor exercises. Akgun U, Bulut T, Zengin EC, Tahta M, Sener M. Extension block technique for mallet fractures: a comparison of one and two dorsal pins. I value the article post.Thanks Again. A motor nerve that branches from the radial nerve is the posterior interosseous nerve. These muscles generally originate on or near the lateral epicondyle and insert on the distal forearm or in the hand. II: extensor carpi radialis longus, extensor carpi radialis brevis. Note: Most sources I found classified the ECRB and ECU as fusiform, but at least one source contradicts that and classes them as bipennate muscles. American journal of roentgenology. Griffin M, Hindocha S, Jordan D, Saleh M, Khan W. Management of extensor tendon injuries. THE SUPERFICIAL BRANCH OF THE RADIAL NERVE: A MORPHOLOGIC STUDY. Home > Anatomy > Wrist Extensors: Functional Anatomy Guide. Collectively, their primary function is wrist extension, though they also help carry out other movements of the wrist and fingers. Origin: Originates from the posterior surface of the ulna and interosseous membrane, distal to the extensor pollicis longus. [9]At the wrist, the extensor retinaculum of the hand overlies the tendons of the extensor compartment of the wrist. There is variability in the SBRNs course in the distal forearm.[8]. Clinical pathology affecting one or multiple muscles in this group is not uncommon. If you are doing anywrist flexor training, use lightweight and higher reps. These injuries to the digits includeinjury to thecommon extensor tendon(s). wrist exercises Treatment in the acute stage of lateral epicondylitis aims to reduce inflammation mainly by rest, ice, and compression of the affected arm. West CT, Ricketts D, Brassett C. An anatomical study of additional radial wrist extensors including a unique extensor carpi radialis accessorius. As it traverses towards the upper extremity, it becomes the axillary artery at the lateral border of the first rib. Some fibers also stem from the adjacent interosseous membrane. Ulnar head : It originates from the olecranon, posterior surface of ulna, antebrachial fascia. Resistance Band Wrist Extensor Exercise : origin, insertion, innervation and blood supply - Quick Weight Loss, Tactile Defensiveness(Touch sensitivity). wrist strengthening exercises. Finger posturing in a position of PIP flexion and DIP extension or hyperextension characterize central slip injuries. physiotherapy treatment I dugg some of you post as I cerebrated they were very beneficial extremely helpful. If conservative management fails, then surgical intervention is indicated. [1][2]This condition is common in individuals who repeatedly extend their wrists, such as tennis players, as they make a backhand shot. pelvic tilt exercise for low back pain Origin: Originates from the lateral epicondyle of the humerus. Dr. Bailey graduated from the University of Michigan Medical School in 1975. In some instances, tendon repair or complete muscle release may be indicated depending on the extent of pathology appreciated. [12], After extensive conservative management has been trialed and has failed to relieve symptoms, surgical intervention is indicated to treat lateral epicondylitis. Radial nerve Nervus radialis The individual wrist extensor muscles are as follows: Extensor carpi radialis longus (ECRL) I am not sureif this is actually the best place to ask butdo you guys have any ideea where to hire some professional writers?Thx. The second extensor compartment is comprised of the ECRB and ECRL muscle tendons. Initial management of most cases utilizes DIP extension splinting and conservative management. Any way Il be subscribing to your feeds and even I achievement you access consistently fast. It provides support as well as prevents bowstringing of the tendons. Sit on a chair, take a tube resistance band in the right palm, and step on the other end with the right foot. Access free multiple choice questions on this topic. Muscle Anatomy. Thumb spica splinting can be used to immobilize the thumb. The flexor retinaculum overlying the compartment becomes thickened, and the tendon sheaths become inflamed. Physiotherapist in Samarpan Physiotherapy Clinic Surgical intervention aims at debriding angiofibroblastic tissue at the origin of the ECRB. physiotherapy centre physiotherapy clinic ahmedabad [6], Vaquero-Picado A,Barco R,Antua SA, Lateral epicondylitis of the elbow. Snapping wrist due to multiple accessory tendon of first extensor compartment. These injuries present with varying degrees of flexion deformity of the affected finger, with an inability to actively extend the DIP joint. The Upper extremity II 2 Section: Muscles and Innervation of The Forearm, Wrist and Hand Resources to use: Visible Body Human Anatomy Atlas App Visible Body Physiology and Anatomy App Visible Body Muscle Premium App Upper Limb Models in the lab Introduction: There are three main nerves that supply the muscles in the forearm and hand they are the Median, Ulnar, and Radial nerves. [1][2]This condition is common in individuals who repeatedly extend their wrists, such as tennis players, as they make a backhand shot. Im grateful for the post.Really thank you! CAUSE. I just stumbled upon your website and in accession capital to assert that I get in fact enjoyed account your blog posts. It acts as extensor and abductor of the hand at the wrist joint. [10], Three variants of superfluous wrist extensor muscles have previously been described. Treatment measures should be conservative. Nonoperative management consists ofsplinting the PIP joint in full extension for 4to 6 weeks. The superficial branch of the radial nerve (SBRN) provides sensation to the distal forearm and hand. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association. Moradi A, Ebrahimzadeh MH, Jupiter JB. Good article and straight to the point. Extensor denotes their action which is to extend, or open flat, joints in the hand. It acts as the extensor of hand, wrist and fingers. Do this 10 times and then take the resistance band in the left hand and repeat. [11], Anatomists have noted several variations in the anatomy of the radial artery. non-explosively) and are highly resistant to fatigue. Independent index finger extension can be carried out by the extensor indicis proprius (EIP) muscle. It often affects rowers, weightlifters, individuals performing secretarial work, and carpenters. Tennis Elbow Thanks , I have recently been looking for info approximately this subject for awhile and yours is the best I have came upon till now. When I originaly commented I clicked the Notify me when new comments are added checkbox andnow each time a comment is added I get sevsral e-mails with the same comment.Is thre any way yyou can remov me from that service?Thanks! I just would like to offer you a big thumbs up for your excellent info you have right here on this post.I will be coming back to your blog for more soon. Below is a description of the extensor tendon zones of the thumb: The subclavian artery branches off from the aortic arch. Surgery is indicated in refractory cases, persistent PIP joint instability despite nonoperative splinting, or in the setting of an acute displaced avulsion fracture seen at the base of the middle phalanx. If you have overactive andshort wrist flexors, do the following: If possible, cut down on any repetitive daily or work activities involving the wrist flexors or pronator teres. MRI can provide more information about the nature ofthe pathology, but this modality is expensive and generally does not correlate accurately with the severity of clinical symptoms. The SBRN branches from the radial nerve and runs deep to the brachioradialis muscle in the forearm before emerging between the brachioradialis and ECRL muscles approximately 9 cm proximal to the radial styloid. (extensor compartment 2), Distal intersection syndrome isclassically experienced by skiers and kickboxers, who present with dorsal wrist pain complaints. The FCR, PL and FCU have a parallel fiber orientation and fusiform muscle architecture. These variants are the extensor carpi radialis intermedius (ECRI), extensor carpi radialis tertius (ECRT), and extensor carpi radialis accessories (ECRA). Palmaris Iongus (The muscle may be absent) Origin: Common flexor origin. Insertion : It inserts on the Extensor expansion near the metacarpophalangeal joint. As it travels to the elbow, it innervates the triceps muscle. vastus medialis oblique [3], Lateral epicondylitis (tennis elbow) ranks as one of the most prevalent pathologies affecting the wrist extensor muscles, affecting approximately 1to 5% of the population. The wrist extensor musclescomprise a significant component of the posterior forearm musculature. Physiotherapy clinic in Amaraiwadi If you dont have any issues with your wrist extensors, but want to build them up and make them stronger, the training advice below will help: Overall, the muscle fiber type of the wrist extensors is slow-twitch dominant. Repetitive injury to the APL and EPB tendons impedes the smooth gliding of tendons in the extensor compartment. [9] Estimations are that in 30to 60% of cases, the tendons of the first compartment are partially or wholly separated by a septum. POSTERIOR INTEROSSEOUS A. RTS is typically unilateral, with the dominant arm more likely affected. This is the starting position. Compression can occur at five sites, but the Arcade of Frohse is the most common location of the compression. Hello my friend! Flexion and abduction of the wrist. To answer your question, I would first have to say that Im not a medical professional, and you should definitely get an okay from your physician or physical therapist before doing anything. The following time I learn a weblog, I hope that it doesnt disappoint me as a lot as this one. Journal of wrist surgery. Much obliged. A positive test is when this maneuver causes pain. But you also dont want them too low, since they wont really provide any support and therefore wont reduce pain. Veery nice post. Physiotherapy clinic in India colony road There are multiple surgical approaches, and there is a lack of evidence supporting one specific surgical technique.[2][13]. Muscles involved in wrist extension: Extensor Carpi Radialis Longus (ECRL) Origin: Just distal to the brachioradialis at the lateral supracondylar ridge of the humerus, the lateral intermuscular septum and by a few fibers at the lateral epicondyle of the humerus. Anatomical science international. When using these techniques, give special attention to the common trigger points shown in the image below. Injuries to zone I (i.e., mallet finger injuries) classically result from forced flexion of an extended DIP joint. Call (310)652-6060 | Text (310)256-1161 | Email [email protected] This way, you avoid fatiguing your forearms andpreventyour grip strength from giving out duringa heavy compound movementlike the deadlift or bench press. Thx! It spans between the elbow and base of the little finger. MRI can provide more information about the nature ofthe pathology, but this modality is expensive and generally does not correlate accurately with the severity of clinical symptoms. paralysis of posterior compartment of forearm: weak wrist extension, weak thumb extension and finger MCPJ extension Finger IPJ extension is still possible due to intact nerve supply to the lumbrical muscles of the hand Absent triceps and supinator reflexes Deformity: "Wrist drop" deformity at rest and on attempted wrist extension (Figure 2). Thanks a lot for sharing! Thanks-a-mundo for the blog article.Really looking forward to read more. I love all of tthe points you hazvemade. Flexor digitorumsuperficialis As it courses medially, it travels distally to Lister's tubercle. [12], After extensive conservative management has been trialed and has failed to relieve symptoms, surgical intervention is indicated to treat lateral epicondylitis. firmly bound to deep fascia in many places why are there flexion ceases on palm of hand? Below a summary of the general origin and insertion points can be found. Shoulder Pain 2016 Sep [PubMed PMID: 27165982], Meraj S,Gyftopoulos S,Nellans K,Walz D,Brown MS, MRI of the Extensor Tendons of the Wrist. [3] When referencing the dorsal aspect of the wrist, the EPB and EPL tendons create the medial and lateral borders of the anatomic snuffbox, respectively. Contents 1 Structure 1.1 Relations 1.2 Blood supply 1.3 Innervation 2 Function The muscles of the superficial compartment originate on the lateral epicondyle of the humerus. ulnar wrist pain exercises Function: Extends the index finger. Extensor tendon zones are a helpful way to identify the region where injuries to the extensor tendons occur in the hand and wrist. Sciatica Repeat 10 times. levator scapulae stretch Begin backs of hands together in front of body at hip level. If damage occurs to an extensor tendon in zone II, treatment via immobilization and splinting is the management of choice during the acute phase. This muscle belongs to the superficial forearm extensor group, along with anconeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum and extensor digiti minimi muscles. It originates from lateral supracondylar ridge of humerus. Keeping the elbows stationary, turn the wrists to the left, flex them up, turn to the right, and then flex down. exercises for vastus medialis Physiotherapy clinic in Nava naroda For example, lateral epicondylitis affects 1-5% of the general population. It provides support as well as prevents bowstringing of the tendons. However, what in regards to theconclusion? Conservative treatment is the typical course of management for this condition. I shall be coming again to your blog for extra soon. Anatomy, Shoulder and Upper Limb, Wrist Extensor Muscles, Zone I: covers the fingertip to the distal interphalangeal (DIP) joint, Zone III: locatedat the proximal interphalangeal (PIP) joint, Zone V: situatedat the metacarpal phalangeal (MP) joint, Zone I: covers the fingertip to the DIP joint, Zone II: covers the interphalangeal joint, Brachioradialis origin: proximal lateral epicondyle of the humerus, Brachioradialis insertion: lateral distal radius, ECRL origin: proximal lateral epicondyle of the humerus, ECRL insertion: dorsal surface of the second metacarpal base, ECRB origin: lateral epicondyle of the humerus, ECRB insertion: dorsal surface of the second and third metacarpal bases, EDC origin: lateral epicondyle of the humerus, EDC insertion: extensor hoods of the pointer, long, ring, and small finger, EDM origin: lateral epicondyle of the humerus, EDM insertion: extensor hood of the small finger, ECU origin: lateral epicondyle of the humerus, ECU insertion: medial base of the fifth metacarpal, Anconeus origin: lateral epicondyle of the humerus, Anconeus insertion: olecranon and proximal posterior ulna, Supinator origin: superficial lateral epicondyle of the humerus, radial collateral ligament, and annular ligament, Supinator insertion: the lateral proximal third of the radius, APL origin: the posterior proximal surface of the ulna and radius, APL insertion: lateral base of the first metacarpal, EPB origin: the posterior proximal surface of the radius (distal to abductor pollicis longus), EPB insertion: dorsal surface of the base of the thumb, EPL origin: the posterior proximal surface of the radius (distal to abductor pollicis longus), EPL insertion: dorsal surface of the base of the thumb, EIP origin: posterior surface of the proximal ulna, EIP insertion: extensor hood of the index finger. My name is Alex, and I'm the owner and author of King of the Gym. Thanks! Initial management of most cases utilizes DIP extension splinting and conservative management. Extensor carpi ulnaris (ECU) muscle is a muscle of the superficial layer of the posterior compartment of the forearm.It is separated from the extensor digitorum and the extensor digiti minimi muscles by a distinct intermuscular septum. The deep palmar archderives its main contribution from the deep arterial branch of the radial artery. This condition is considered rare and can be missed if there is no clinical suspicion of the syndrome. My name is Alex, and I'm the owner and author of King of the Gym. If you still have to be in an actual brace (i.e. Want more. In contrast, the superficial palmar arch's predominant blood supply is derived from the ulnar artery. Everything you need to know about: Forearm. Amaraiwadi As a group, the primary action of the wrist flexors is, you guessed itwrist flexion! Chronic use can create friction between the EPL tendon and Lister's tubercle resulting in inflammation. However, Im guessing you just mean any type of wrist support. I enjoy looking through a post that can make people think. Greetings I am so grateful I found your site, I really found you by accident, while I was browsing on Yahoo for something else, Regardless I am here now and would just like to say thanks a lot for a remarkable post and a all round entertaining blog (I also love the theme/design), I don have time to read through it all at the moment but I have saved it and also added in your RSS feeds, so when I have time I will be back to read a great deal more, Please do keep up the excellent work. Much obliged. Separate synovial sheaths can be present in the first compartment. In this setting, irrigation and debridement should be performed. The supinator muscle, abductor pollicis longus muscle, extensor pollicis brevis muscle, extensor pollicis longus muscle, and extensor indicis muscle comprise this deep compartment. There have been reports of fusion of the APL and EPB muscles. There are multiple surgical approaches, and there is a lack of evidence supporting one specific surgical technique.[2][13]. In idea I want to put in writing like this moreover taking time and precise effort to make a very good article however what can I say I procrastinate alot and under no circumstances appear to get something done. The sixth extensor compartment harbors the ECU muscle tendon. [2]The ECRB tendon is most commonly affected and will show angiofibroblastic hyperplasia (immature reparative tissue). Want more. [15], Proximal intersection syndrome is similar to distal intersection syndrome but occurs at the junction where the APL and EPB cross over the ECRB and ECRL. Proximally, the capitate has a rounded surface whilst the distal end has a triangular shape with a palmarly directed apex. Repair of the tendon with the aforementioned 4-6 strand techniques also applies to this region. Greetings! Im new to the blog world but Im trying to get started and set up my own.Do you need any html coding expertise to make your own blog?Any help would be greatly appreciated! The radial nerve divides off the posterior cord of the brachial plexus. The Journal of hand surgery, European volume. Independent small finger extension is accomplished by the extensordigitiminimi(EDM)muscle.[3]. If youre doing a lot of wrist extensor exercises in your weight training program, make sure youre using light weight. Structures of the Wrist Joint Articulating Surfaces It is time to . Force USA X15 Pro Review: A Compact Multi-Gym With a Half Rack & Functional Trainer, Force USA G10 Review: A Plate-Loaded All-In-One with Interchangable Pulley Ratios, Force USA X20 Pro Review: A Full Power Rack with an Integrated Selectorized Funtional Trainer, Medial epicondyle of humerus via the common flexor tendon, Distal half of flexor retinaculum and apex of palmar aponeurosis, Olecranon process and posterior border of ulna (via aponeurosis), Medial epicondyle of the humerus via the common flexor tendon and the coronoid process, Shafts of middle phalanges of medial four digits, Superior half of the anterior border of radius, Proximal three quarters of medial and anterior surfaces of ulna and interosseous membrane, Bases of distal phalanges of 4th and 5th digits, Bases of distal phalanges of 2nd and 3rd digits, Anterior interosseous branch of median nerve (C8-T1), Anterior surface of radius and adjacent interosseous membrane, Thumb flexion at interphalangeal and metacarpophalangeal and carpometacarpal joints, Flexion of the index, middle, ring and little fingers at proximal interphalangeal and metacarpophalangeal joints, Flexion of the ring and little fingers at distal interphalangeal, proximal interphalangeal and metacarpophalangeal joints, Flexion of the index and middle fingers at distal interphalangeal, proximal interphalangeal and metacarpophalangeal joints. Compression can occur at five sites, but the Arcade of Frohse is the most common location of the compression. The prime functions of these muscles are to extend the hand at the wrist joint, extend the first and second digits at the metacarpophalangeal (MCP) and interphalangeal (IP) joints and to abduct the thumb. Ahmedabad If youre training the wrist flexors directly. Physiotherapy Clinic Bapunagar Amaraiwadi Odhav Naroda Vastral. Physiotherapy clinic in Vastral foot and ankle strengthening exercises With other hand, grasp at thumb side of hand and bend wrist downward. Mobile Physiotherapy Clinic 2018 [PubMed PMID: 29253811], Hinds RM,Gottschalk MB,Melamed E,Capo JT,Yang SS, Accessory Slip of the Extensor Carpi Ulnaris: A Cadaveric Assessment. Gluteal tuberosity of the femur, iliotibial tract. BioMed research international. Amongst women, those who are recently postpartum are commonly affected. Ong C, Nallamshetty HS, Nazarian LN, Rekant MS, Mandel S. Sonographic Diagnosis Of Posterior Interosseous Nerve Entrapment Syndrome. A negative Elson test consists ofthe DIP joint remaining flexible (or "floppy") during PIP joint extension against resistance. An injury to zone III disrupts the central slipover the PIP joint. For example, lateral epicondylitis affects 1-5% . Part of this increased susceptibility to injuryis attributed to the natural anatomy, as the extensors are more superficial in location. This position is known as theboutonniere deformity. Conservative treatment is the typical course of management for this condition. Part of this increased susceptibility to injuryis attributed to the natural anatomy, as the extensors are more superficial in location. As Ill detaillater, these muscles are also responsible for other movements of the fingers and wrist. Dont neglect the rest of your forearm musculature. I know how much it sucks to not be able to lift at full capacity, but its not worth prolonging your healing time, or possibly re-injuring yourself. 1900 W GARVEY AVE S STE 166, WEST COVINA, CA 91790 2.29 miles. In: StatPearls [Internet]. For example, lateral epicondylitis affects 1-5% of the general population. Upper Extremity Muscles (Origin, Insertion, Action, and Nerve Supply) 5.0 (1 review) Term 1 / 60 Muscles connecting upper limb to vertical column (superficial muscles of the back) Click the card to flip Definition 1 / 60 Trapezius Latissimus dorsi Levator scapulae Rhomboid minor Rhomboid major Click the card to flip Flashcards Learn 2015 Jul [PubMed PMID: 26213698], Vergara-Amador E,Ramrez A, Anatomic study of the extensor carpi radialis brevis in its relation with the motor branch of the radial nerve. AJR. Lateral epicondylitis of the elbow. Additionally, or alternatively, you could look into using athletic tape on your wrists. I had surgery on my forearm for anterior interosseous nerve entrapment. physiotherapy clinic bapunagar The extensor digitorum muscle (also known as extensor digitorum communis) [2] is a muscle of the posterior forearm present in humans and other animals. In this article, we shall look at the structures of the wrist joint, the movements of the joint, and the relevant clinical syndromes. Together with the extensor carpi ulnaris and extensor digiti minimi, extensor carpi radialis longus and brevis as well as the brachioradialis, it belongs to the group of superficial extensors of the forearm. Awesome. Origin: Originates from the lateral epicondyle. 2013 Jan [PubMed PMID: 23306537], Akgun U,Bulut T,Zengin EC,Tahta M,Sener M, Extension block technique for mallet fractures: a comparison of one and two dorsal pins. 80%. In 22% of cadaveric specimens, an aberrant slip of the ECU muscle was observed inserting on the fifth metacarpal. It inserts on the posterior base of the 3rd metacarpal. Once it branches from the ulnar nerve, it travels posterolateral, eventually supplying blood to muscles in the posterior compartment. I stumbledupon it I am going to revisit once again since i have bookmarked it. To start with, trainthem twice a week for 6-8 sets of 12-20+ slow and controlled (2-3 secs) reps. The four lumbricals hand muscles in the hand, each is associated with the finger movement. Bilateral RTS is rare. [3], Like injuries tozones I-IV, injuries to zones V, VI, VII, and VIII should be managed conservatively when possible. It has 2 heads Humeral head : It originates from lateral epicondyle of the humerus. 2nd - lateral side of the tendon of the 3rd digit. The deep compartment originates in the region of the posterior radius, ulna, or both. Extend the hands forward at the shoulder level, and fold each palm into a fist. EFORT open reviews. Finger posturing in a position of PIP flexion and DIP extension or hyperextension characterize central slip injuries. This includes your brachioradialis and wrist flexors. There have been reports of fusion of the APL and EPB muscles. The fourth extensor compartment is made up of the EIP and EDC muscle tendons. A caveat includes managing zone V injuries (zone V injuries include disruption over the MCP joint of the digit or the CMC joint of the thumb. triceps workout at home with dumbbells The ulnar nerve provides the sensation of location in fingers. It is supplied by posterior interosseous nerve(C7-C8). Physiotherapy Exercise Start studying Wrist muscles (6) and nerve supply. But, what in regards to the conclusion?Are you sure in regards to the source? The wrist joint (also known as the radiocarpal joint) is a synovial joint in the upper limb, marking the area of transition between the forearm and the hand. It inserts on the extensor expansion of the middle and distal phalanges of 2nd, 3rd, 4th and 5th fingers. [9] Estimations are that in 30to 60% of cases, the tendons of the first compartment are partially or wholly separated by a septum. As the PIN enters the posterior compartment of the forearm, it passesdeep to the supinator muscle (between its two heads). As it travels to the elbow, it innervates the triceps muscle. The palmar surface is slightly convex with the other surfaces concave being the dorsal, ulnar and radial surfaces. These injuries to the digits includeinjury to thecommon extensor tendon(s). Im thankful for the article post.Much thanks again. Patients will present with this deformity in part due to the lateral bands of the dorsal interossei muscles. Reducetraining volume on wrist flexor exercises. vastus medialis exercises Clinicians must rule out "Fight Bite" injuries and carefully inspect the skin for open wounds/lacerations. These variations can lead to snapping wrist syndrome. In refractory cases, or in caseswhere a large bony fragment is appreciated on injury radiographs, consider closed reduction percutaneous pinning (CRPP) versus open reduction internal fixation (ORIF). It often affects rowers, weightlifters, individuals performing secretarial work, and carpenters. [1][2], To achieve neutral wrist extension movements, theextensor carpi radialis brevis (ECRB), extensor carpi radialis longus (ECRL), and the extensor carpi ulnaris (ECU) musclesact synergistically based on each muscle's insertion and dynamic function. Thank you extremely much. The most reliable physical examination test for diagnosing a central slip injury is an Elson test: Conservative management should be attempted before performing surgery. Again, please consult your doctor/physical therapist before doing either of these solutions. StatPearls Publishing, Treasure Island (FL). Tendon repair isindicated in caseswhere lacerations involve >50% of tendon width. [1]For these reasons, the necessity of imaging is rare in diagnosing this condition.[13]. Lumbricals muscles are very crucial to finger movement, joining the extensor tendons to the flexor tendons. It originates from the anterior portion of the lateral epicondyl of the humerus. The wrist extensor musclescomprise a significant component of the posterior forearm musculature. [15], EPL Tenosynovitis/Drummer's Wrist/EPL Rupture (extensor compartment 3), EPL tenosynovitis (drummer's wrist) is commonly experienced by patients with rheumatoid arthritis and also in drummers, hence the eponym drummer's wrist. Treatment in the acute stage of lateral epicondylitis aims to reduce inflammation mainly by rest, ice, and compression of the affected arm. Clinical pathology affecting one or multiple muscles in this group is not uncommon. Extensor indicis is a narrow muscle that originates mainly from the ulna, arising from the posterior two-thirds of its distal surface, distal to extensor pollicis longus muscle. Everything you need to know about: Forearm. Repair of the tendon with the aforementioned 4-6 strand techniques also applies to this region. Insertion: Posterior base of the 2nd metacarpal. Anatomy, Shoulder and Upper Limb, Wrist Extensor Muscles - StatPearls - NCBI Bookshelf Last Update: August 30, 2022 Zone I: covers the fingertip to the distal interphalangeal (DIP) joint Zone II: covers the middle phalanx Zone III: located at the proximal interphalangeal (PIP) joint Zone IV: covers the proximal phalanx There is definately a great deal to find outabout this issue. Stick tothe above training guidelines for. The subacute phase is managed by exercise, stretching, bracing, coordinated rehabilitation, and corticosteroid injection to the affected area. It is the only forearm extensor that lies in its own fibro-osseous tunnel at the level of the wrist with its own subsheath as it passes through the 6 th . Below is a description of the extensor tendon zones: The thumb zones are classified differently from the tip of the thumb to the carpal-metacarpal joint. Sit or stand with the spine erect, shoulders rolled back, and look forward. 2007 [PubMed PMID: 27303450], Moradi A,Ebrahimzadeh MH,Jupiter JB, Radial Tunnel Syndrome, Diagnostic and Treatment Dilemma. One of the more common methods includes the dorsal blocking pin CRPP technique.[14]. [9], Reports exist that anatomic variants of the EIP muscle have an incidence of 16%. Surgical intervention isindicated for specific injuries to these areas, but the indications and procedures are highly variable and should be individualized to the patient. [2][13], Affected patients will typically report tenderness to palpation in the region of the lateral epicondyle as well as pain with activities that require wrist extension. In order to get them to grow, you need to train with high reps/volume/frequency. Causes [15]Distal to the extensor retinaculum, the EPL crosses medially over the ECRB and ECRL. Electromyography and nerve conduction studies (EMG & NCS) are the main two components of an exam that determines the health of your nerves. Blood supply of Extensor carpi ulnaris. knee pain I started this website back in late 2009 during college, and it has been my pet project ever since. Dorsum of the Hand: A view of the Dorsal Interossei. The muscles of the superficial compartment originate on the lateral epicondyle of the humerus. You can not consider simply how much time I had spent for this information! It then innervates the APL, EPB, EPL, and EIP muscles. Blood supply of extensor pollicis longus. [3], Lateral epicondylitis (tennis elbow) ranks as one of the most prevalent pathologies affecting the wrist extensor muscles, affecting approximately 1to 5% of the population. tadalafil package insert when will generic tadalafil be available. The wrist extensors are a group of nine individual muscles on the back of the forearm that act on the wrist and fingers. The wrist extensor muscles of the hand are located in the back of the forearm and have long tendons connecting them to bones in the hand, where they exert their action. Vaquero-Picado A, Barco R, Antua SA. Estimates are that ECRA and ECRI are present in 10-20% of individuals. Extension of the second (index finger), third (long finger), fourth (ring finger), and fifth (small finger) digits occurs via the extensor digitorum communis (EDC) muscles. I wish to say that this post is amazing, nice written and include approximately all significant infos. The subacute phase is managed by exercise, stretching, bracing, coordinated rehabilitation, and corticosteroid injection to the affected area. The superficial arch also receives contributions from the superficial branch of the radial artery. Money and freedom is the best way to change, may you be rich and continue to guide others. In 22% of cadaveric specimens, an aberrant slip of the ECU muscle was observed inserting on the fifth metacarpal. Due to its position, it is able to produce adduction as well as the extension of the wrist. Extensor digitorum is a long muscle located in the posterior compartment of the forearm. what are leg raises good for It inserts on the dorsal surface of the base of the second metacarpal bone. As the PIN enters the posterior compartment of the forearm, it passesdeep to the supinator muscle (between its two heads). Distal intersection syndrome occurs when this area of crossing over becomes inflamed and causes dorsal wrist pain. Thank you, Ive recently been searching for information approximately this subject for ages and yoursis the best I have came upon so far. This condition is generally diagnosed clinically but may warrant imaging in some cases. Insertion: It splits into four, and inserts . Origin: 1st - lateral side of the tendon of 2nd digit. Lumbar Spondylolisthesis Insertion: Attaches to the extensor hood of the index finger. The archives of bone and joint surgery. Only $35.99/year wrist/hand: muscles, nerves, blood supply Flashcards Learn Test Match Flashcards Learn Test Match Created by hugsandkisses392 Terms in this set (133) the skin of the hand is firmly bound to what? If your wrist flexors are healthy and your main goal is to get them bigger, then the following advice is for you: The wrist flexors consist of a high percentage of slow-twitch muscle fibers. Treatment is via conservative management, but corticosteroid injection is not indicated in this condition due to increased local tissue pressure. Surgery is indicated in refractory cases, persistent PIP joint instability despite nonoperative splinting, or in the setting of an acute displaced avulsion fracture seen at the base of the middle phalanx. exercises for vastus medialis oblique Very useful advice in this particular article! The wrist flexors refer to six muscles in the anterior compartment of the forearm that act on the wrist and finger joints. Immediately superior to the antecubital fossa, the brachial artery branches into ulnar and radial arteries. The sixth extensor compartment harbors the ECU muscle tendon. It is common for physiologic variants to occur in the wrist extensors. 79%. In this setting, irrigation and debridement should be performed. [15]As EPL travels distally in the wrist, it travels medially towards the dorsal surface of the base of the thumb. Pretty section of content. A motor nerve that branches from the radial nerve is the posterior interosseous nerve. Actions: Flexion of the wrist, and Tension of the palmar aponeurosis. Dont change anything until your progress slows considerably or stops altogether, at which point you canincrease training volume by 2-4 more sets per workout, and/or increase training frequency from twice weekly to three times perweek. Note: The table below includes just the exercises that directly target the wrist extensor muscles. The examiner places the injured hand/digit over the edge of a table to allow 90-degree flexion at the PIP joint of interest. Corticosteroid injection into the first extensor compartment has a 75to 80% chance of alleviating symptoms. Radiographs help to rule out bone disease, arthropathy, and the presence of loose or foreign bodies. Hi Fred, thanks for reading and commenting. [15], Proximal intersection syndrome is similar to distal intersection syndrome but occurs at the junction where the APL and EPB cross over the ECRB and ECRL. Assuming thats the case, I know that a lot of guys will use wrist wraps (like these ones) to reduce pain on power cleans/front squats. The extensor tendons at the level of the wrist are divided into six extensor compartments that are designated by Roman numerals from lateral to medial 1: I: extensor pollicis brevis, abductor pollicis longus. This condition is generally diagnosed clinically but may warrant imaging in some cases. The examiner places the injured hand/digit over the edge of a table to allow 90-degree flexion at the PIP joint of interest. indicated in cases of displaced avulsion fractures or the setting of an open wound requiring irrigation and debridement, indicatedfor rheumatoid patients with chronic deformity or in patients with painful, stiff, arthritis PIP joints, Feel free to get in touch with us and send a message. Revista brasileira de ortopedia. leg press exercise at home Surgical intervention aims at debriding angiofibroblastic tissue at the origin of the ECRB. It thenbecomes the brachial artery once it passes the lower edge of the teres minor muscle. If conservative management fails, then surgical intervention is indicated. If your forearms arent burning and pumped full of blood after each set, youre doing it wrong! 2017 Mar [PubMed PMID: 27631096], Ong C,Nallamshetty HS,Nazarian LN,Rekant MS,Mandel S, Sonographic Diagnosis Of Posterior Interosseous Nerve Entrapment Syndrome. The brachial artery also supplies a small portion of the muscle via the radial collateral artery. Your email address will not be published. Nice article and review. Hinds RM, Gottschalk MB, Melamed E, Capo JT, Yang SS. [3] When referencing the dorsal aspect of the wrist, the EPB and EPL tendons create the medial and lateral borders of the anatomic snuffbox, respectively. Once it branches from the ulnar nerve, it travels posterolateral, eventually supplying blood to muscles in the posterior compartment. Various tendon repairtechniqueshave been described, and the literature supports utilizing4-6 strand repair techniques (crossing the laceration site) as these techniques allow patients to begin early active motion postoperatively. Looking forward to reading more. A completeabsence of the EPB muscle has also been observed. Against resistance, the examiner asks the patient to extend the digit. Extensor carpi radialis longus receives blood supply mainly from the radial artery. Flex the fist up toward the body. In human anatomy, the extensor pollicis longus muscle (EPL) is a skeletal muscle located dorsally on the forearm. The tendon continues into the distal part of the forearm. It is common for physiologic variants to occur in the wrist extensors. [7]The PIN innervates the EDC, EDM, and ECU muscles from the superficial wrist extensor compartment. Thumb spica splinting can be used to immobilize the thumb. A low origin of the radial artery has an incidence of 0.2% and has multiple variations within itself. The fourth extensor compartment is made up of the EIP and EDC muscle tendons. The most reliable physical examination test for diagnosing a central slip injury is an Elson test: Conservative management should be attempted before performing surgery. There is variability in the SBRNs course in the distal forearm.[8]. Dr. Ronald Oakley Bailey, MD. Conservative management is typically first-line treatment, including immobilization, non-steroidal anti-inflammatories, activity modifications, and anesthetic injection directly to the compression site. it is the site of attachment of the common extensor tendon which is the origin of several forearm extensor muscles (extensor carpi radialis brevis m., . Extensor Carpi Ulnaris: Origin, Insertion, Nerve Supply & Action Extensor Carpi Ulnaris: The extensor carpi ulnaris muscle is located on the medial aspect of the posterior forearm. Reverse the direction and repeat it 10 times. I just stumbled upon your blog and wanteed tosay that Ive tuly enjoyed surfing around your bblog posts.In any case I will bee subscribing to your feed and I holeyou write again vwry soon! This form of intersection syndrome is more common than distal intersection syndrome. Read more. This is one awesome article post.Really looking forward to read more. 47 Years Experience. 2018 [PubMed PMID: 29992133], Inagaki K, Current concepts of elbow-joint disorders and their treatment. This muscle group is comprised of the brachioradialis muscle, ECRL, ECRB, EDC, EDM, ECU, and anconeus. The third extensor compartment is comprised of the EPL muscle tendon. The posterior interosseous artery is a branch from the ulnar artery. It acts as an extensor of wirst joint and abductor of the hand at the wrist joint. The individual wrist extensor muscles are as follows: All of these muscles belong to the posterior compartment of the forearm, a classification that can be subdivided into superficial and deep layers: These muscles originate from different points on the posterior surfaces of the ulna and radius,and on the distal humerus. http://creativecommons.org/licenses/by/4.0/. Against resistance, the examiner asks the patient to extend the digit. Place the right elbow on the right thigh, with the palm facing down. That is, theyre endurance muscles, which contract slowly (i.e. This means they respond betterto high rep sets with lighter weight, high training volume and high training frequency. Hello, everything is going perfectly here and ofcourse every one is sharingfacts, thats truly excellent, keep up writing. [13]If conservative management fails to relieve symptoms, the patient might benefit from surgical correction. It is supplied by deep branch of the radial nerve(C7, C8). Seriously. wrist pain exercises with pictures I mean, I do know it was my choice to learn, but I actually thought youd have something attention-grabbing to say. Vergara-Amador E, Ramrez A. Anatomic study of the extensor carpi radialis brevis in its relation with the motor branch of the radial nerve. A low origin of the radial artery has an incidence of 0.2% and has multiple variations within itself. 2018 Sep 15 [PubMed PMID: 30219102], Griffin M,Hindocha S,Jordan D,Saleh M,Khan W, Management of extensor tendon injuries. The posterior interosseous nerve (PIN, also known as the dorsal branch of the radial nerve) innervates and then courses between the two heads of the supinator muscle before entering the posterior compartment of the forearm. Wysiadecki G, Polguj M, Haadaj R, Topol M. Low origin of the radial artery: a case study including a review of literature and proposal of an embryological explanation. Howdy! Thankfully Ive never had to deal with wrist issues, but from what Ive read, the key to wrapping them successfully is get the right position: You dont want them too high,, since that will impair your range of motion. Note: In the table below, I have only included exercises that directly target the wrist flexors. This condition is typically managed by conservative treatment, including thumb spica splinting, activity modification, non-steroidal anti-inflammatories, and steroid injection in the second extensor compartment. any variations of the reverse biceps curl, front raise, lateral raiseorrear deltoid raise). STRENGTHENING EXERCISE OF WRIST EXTENSORS : 2. DIP joint rigidity on an exam is indicative of lateral band activation, an involuntary compensatory finding consistent with a central slip injury. He works in Rancho Cucamonga, CA and 6 other locations and specializes in Neurology and Psychiatry. Variations in the extensor digitorum brevis muscle have a 9% rate of occurrence. latissimus dorsi exercises Are you certain in regards to the supply? This form of intersection syndrome is more common than distal intersection syndrome. Several techniques are available for the surgical management of mallet finger injuries. The open orthopaedics journal. Id like to see more posts like this. Your email address will not be published. In closed injuries, clinical suspicion includes ruling out sagittal band ruptures. 2016 Nov [PubMed PMID: 27777817], West CT,Ricketts D,Brassett C, An anatomical study of additional radial wrist extensors including a unique extensor carpi radialis accessorius. Thumbextension is carried out by abductor pollicis longus (APL), extensor pollicis brevis (EPB), and extensor pollicis longus (EPL). Contributed by Gray's Anatomy plates. Variations in the extensor digitorum brevis muscle have a 9% rate of occurrence. Stand at a table with the palms down, fingers flat, and elbows straight. Extensor Indicis: The extensor indicis muscle allows the index finger to be independent of the other fingers during extension. Hey! Clinicians must rule out "Fight Bite" injuries and carefully inspect the skin for open wounds/lacerations. In refractory cases, or in caseswhere a large bony fragment is appreciated on injury radiographs, consider closed reduction percutaneous pinning (CRPP) versus open reduction internal fixation (ORIF). [2]The ECRB tendon is most commonly affected and will show angiofibroblastic hyperplasia (immature reparative tissue). A positive test is when this maneuver causes pain. Whats up mates, its wonderful article concerningcultureand completely defined, keep it up all the time. This nerve branches from the radial nerve at the level of theradiocapitellar joint and are typically located immediately proximal to the supinator muscle in an area of a fibrous band known as the arcade of Frohse.[5][6]. ULNAR A. Your help woke me up. Dorsal Interossei muscles deep to the extensor tendons. The wrist flexors refer to six muscles in the anterior compartment of the forearm that act on the wrist and finger joints. Train thewrist extensors toward the end of your workout, after doinganyexercises requiring a stronggrip. That said, there many other exercises that work the wrist flexors significantly but indirectly. Fantastic blog article.Thanks Again. Clinical pathology affecting one or multiple muscles in this group is not uncommon. [2][13], Affected patients will typically report tenderness to palpation in the region of the lateral epicondyle as well as pain with activities that require wrist extension. In contrast, the superficial palmar arch's predominant blood supply is derived from the ulnar artery. EXTENSOR CARPI RADIALIS LONGUS. Recently there has been a greater occurrence of individuals who frequently send text messages. 2017 Nov [PubMed PMID: 28858545], Muscles of the Wrist and hand, External Carpi radialis longus and brevis, Abductor pollicis longus, Flexor digitorum profundus, Flexor Carpi Ulnaris, Cupinaor, Anatomy, Shoulder and Upper Limb, Wrist Extensor Muscles, Zone I: covers the fingertip to the distal interphalangeal (DIP) joint, Zone III: locatedat the proximal interphalangeal (PIP) joint, Zone V: situatedat the metacarpal phalangeal (MP) joint, Zone I: covers the fingertip to the DIP joint, Zone II: covers the interphalangeal joint, Brachioradialis origin: proximal lateral epicondyle of the humerus, Brachioradialis insertion: lateral distal radius, ECRL origin: proximal lateral epicondyle of the humerus, ECRL insertion: dorsal surface of the second metacarpal base, ECRB origin: lateral epicondyle of the humerus, ECRB insertion: dorsal surface of the second and third metacarpal bases, EDC origin: lateral epicondyle of the humerus, EDC insertion: extensor hoods of the pointer, long, ring, and small finger, EDM origin: lateral epicondyle of the humerus, EDM insertion: extensor hood of the small finger, ECU origin: lateral epicondyle of the humerus, ECU insertion: medial base of the fifth metacarpal, Anconeus origin: lateral epicondyle of the humerus, Anconeus insertion: olecranon and proximal posterior ulna, Supinator origin: superficial lateral epicondyle of the humerus, radial collateral ligament, and annular ligament, Supinator insertion: the lateral proximal third of the radius, APL origin: the posterior proximal surface of the ulna and radius, APL insertion: lateral base of the first metacarpal, EPB origin: the posterior proximal surface of the radius (distal to abductor pollicis longus), EPB insertion: dorsal surface of the base of the thumb, EPL origin: the posterior proximal surface of the radius (distal to abductor pollicis longus), EPL insertion: dorsal surface of the base of the thumb, EIP origin: posterior surface of the proximal ulna, EIP insertion: extensor hood of the index finger. inferior gluteal nerve (L5, S1, S2 nerve roots) external rotation and extension of the hip joint, supports the extended knee through the iliotibial tract, chief antigravity muscle in sitting. 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