- Movement (motor skills): grasping, holding, moving
- Feeling (sensitivity): surface quality (rough, smooth, soft, hard, sharp, dull, cold, warm)
- Gestures: greeting, instructions, defensiveness, emotional expressions
The importance of the human hand is expressed in numerous words and expressions containing the word "Hand" (examples of proverbs and sayings are given in various places on this site).
Possible causes of aches in the shoulders and forearms
The causes of aches in the shoulders and forearms include degenerative and inflammatory processes:
- Arthrosis . A degenerative-dystrophic process that destroys cartilage. Can lead to absolute immobility.
- Arthritis . Inflammation of the joint capsule, leading to intense pain and destruction of the joint without treatment.
- Bursitis . It often develops in the elbow area and affects the connective tissue. Accompanied by severe swelling and aching pain, worse at night.
- Neuritis . Inflammation of peripheral nerves. May occur with paralysis and loss of sensitivity.
- Lesion of the shoulder cuff . Pathology is caused by excessive stress on the joint.
- Shoulder impingement syndrome . A disease caused by the deposition of calcium salts. The pain is sudden, sharp, and often occurs when the shoulder is pulled back.
- Tendobursitis . Inflammatory process of the joint capsule due to the deposition of salts.
- Humeroscapular periarthrosis . Pain occurs with severe muscle stiffness due to joint diseases.
- Cervical osteochondrosis . Leads to compression of nerves and blood vessels, which can affect the structures below - the nerves of the arms and hands.
These are the most common causes of discomfort that can occur even in young people and develop over the years.
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In some cases, pain in the left forearm can be a consequence of cardiovascular pathologies. Also, reflected symptoms develop with tumors and some diseases of other organs.
Muscle pathologies caused by inflammation
Hematoma due to a bruise of the forearm
A separate category of factors includes soft tissue pathologies in which the forearms are pulled:
- bruises and sprains – accompanied by bruises, pain, limited mobility and muscle inflammation;
- chronic muscle hypertonicity - caused by overexertion, muscle tissue dystrophy;
- myofascial syndrome – typical for women, the exact cause has not been established, there are no visible injuries or diseases;
- neurovascular and other syndromes, as well as plexopathies leading to shoulder dysfunction after injuries and tumors;
- neuropathy of the radial nerve - occurs when playing sports with a load on the hands, during prolonged work at the computer;
- myositis - against the background of hypothermia, infection and excessive stress, various muscles of the forearm can become inflamed and cause acute pain.
Less common are diseases such as pectoral or anterior scalene syndrome, Volkmann's ischemic contracture . The latter pathology develops when wearing a bandage or plaster for a long time.
If a person has constant pain in the shoulder or forearm, this becomes a reason for diagnosis. Many small tendons, muscle fibers and bones are vulnerable to external and internal factors. But timely detection of the cause of the pathological condition will help find effective treatment.
Subsurface muscles
Flexor digitorum superficialis
This muscle is covered by the palmaris muscle and the flexor digitorum. It has two heads:
- Shoulder. It is a long and narrow head that originates from the medial epicondyle of the humerus. And also, from the external process of the ulna
- Radial. This head is short, but at the same time very wide. Attached to the inner part of the radius bone.
Both heads unite into a common muscle and form a large abdomen. Which ends in a tendon. And it is attached to the base of the middle phalanges except the large one.
Function: Helps to bend the hand. Bends the middle phalanges of the fingers from the 2nd to the 5th, and with them the fingers themselves.
Spine
The lateral corticospinal tract is responsible for the motor pathway of the pronator quadratus muscle. This tract begins in the precentral gyrus of the motor cortex, where the signal is transmitted from the upper motor nerve through the tracts of the internal capsule and through the cerebral peduncles of the midbrain. It decussates at the medulla oblongata and moves down the lateral corticospinal tract in the lateral column of the spinal cord. It then decussates at the spinal cord and synapses in the anterior horn with lower motor neurons of skeletal muscle. The cuneate tract of the fasciculus is responsible for sensing the position and movement of the pronator quadratus muscle, deep touch, visceral pain, and vibration. This tract begins at the spinal nerve root, where the signal is transmitted through the dorsal horn and up the dorsal column of the spinal cord. It synapses with an interneuron in the gracile nucleus. It then decussates at the medial lemniscus of the medulla oblongata, passes through the cuneate nucleus and through the medial lemniscus of the midbrain to synapse in the thalamus. It synapses with a third-order neuron and transmits a signal to the postcentral gyrus of the somesthetic cortex, which can apply to any muscle of the upper limb, and is not specific to this muscle.
Hand bones
The hand consists of the bones of the wrist, as well as the bones of the fingers (phalanx) and metacarpus (tubular bones running from the wrist to the fingers). The wrist itself has eight spongy bones. They are short in size and arranged in 2 rows:
- Upper. It includes such bones as: scaphoid, triquetrum, pisiform and lunate.
- Lower. Consists of: trapezoid, capitate, trapezoid and hamate.
The bottom row connects to the top and the carpal bones. And also among themselves. And they form a low-moving joint.
After the carpus come the metacarpal bones. There are only five of them, one for each finger. Next they connect to the phalanges of the fingers. They have a short tubular shape. Each finger has three phalanges: main (proximal or lower), middle and upper (distal or terminal). The exception is the thumb; it consists of only two phalanges - lower and upper.
Clinical significance
Pronator teres syndrome is one of the causes of wrist pain. This is a type of neurogenic pain.
- Patients with pronator teres syndrome have numbness in the distribution of the median nerve with repetitive pronation/supination of the forearm rather than flexion and extension of the elbow.
- Early fatigue of the forearm muscles manifests itself with repetitive stressful movements, especially during pronation.
- EMG may show only slightly reduced conduction velocities.
- Despite the anatomical proximity, patients with pronator teres syndrome do not have a higher incidence of AIN syndrome
- Other compression sites: Struthers Bundle
- Lakerthus fibrosis
- Proximal arc FDS
- Rare causes, such as subsequent tendon transfers of radial palsy
- Positive Tinel's sign in the forearm rather than the wrist
In patients with C5 tetraplegia or radial nerve palsy, the pronator teres tendon may be redirected, called a tendon transfer, to the extensor carpi radialis brevis tendon to restore wrist extension.[3]
Recommendations
This article incorporates public domain text from page 446 of the 20th edition
Gray's Anatomy
(1918)
- "Descending Paths" TeachMeAnatomy
. Retrieved December 3, 2015. - Brachial Plexus Anatomy
at eMedicine - Summer, Douglas M.; Chang, Kevin S. (2009). "Tendon Transfer, Part I: Principles of Transfer and Transfer in Radial Nerve Palsy." Plastic and reconstructive surgery
.
123
(5): 169e–177e. doi:10.1097/PRS.0b013e3181a20526. PMC 4414253. PMID 19407608. - Muscolino, Joseph E. (2013-12-19). Know Your Body: The Basics of Muscle, Bones, and Palpation - eBook
. Elsevier Health Sciences. ISBN 9780323291439. - Surgical anatomy of the hand and upper limb
, paragraph 110, on Google Books
