Lecture 12: Wrist complex Flashcards
Flexion percentages at each joint
40% and radiocarpal joint
60% at midcarpal joint
Radiocarpal arteries
Arise from dorsal and palmar carpal arches
Pisiform
Sesamoid bone
Forms in tendon of the flexor carpi ulnaris
Scaphoid
Forms floor of anatomical snuff box
Most commonly fractured, fractures may compromise radial artery in snuff box
Articulates with radius
______ runs in the floor of the snuff box over the scaphoid
Radial artery
Palmar structure sequence (radial to ulnar)
Radius Radial artery Flexor carpi radialis tendon Median nerve (under palmaris longus tendon) Flexor digitorum superficialis tendons Ulnar artery Ulnar nerve Flexor carpi ulnaris tendon
Branches of the __________ are in the roof of the snuff box
Superficial radial nerve
Radiocarpal joint ligaments
Lateral collateral ligament
Medial collateral ligament
Dorsal radiocarpal ligament
Palmar radiocarpal ligament
Metacarpal bones #
5 bones
Proximal bones of wrist
Scaphoid
Lunate
Triquetral
Pisiform
Radiocarpal movements
Some flexion/extension
Ulnar deviation
Collateral ligaments of wrist/hand/digits
Radial
Ulnar
Phalangeal
Extensor pollicis longus proximal attachment
Posterior surface of middle 1/3 of ulna and interosseous membrane
Extensor pollicis longus distal attachment
Dorsal aspect of base of distal phalanx of thumb
Lunate
Articulates with radius
Radiocarpal joint articulates with
Scaphoid
Lunate
Distal radius
Triquetral (only during extreme ulnar deviation)
Extensor pollicis brevis distal attachment
Dorsum of proximal phalanx of thumb
Phalanges bone #
14 bones
Extensor pollicis longus innervation
Posterior interosseous artery
Extensor pollicis brevis proximal attachment
Posterior surface of distal 1/3 of radius and interosseous membrane
Radiocarpal joint injuries
Colles fracture Scaphoid fracture (compromises radial artery)
Extension percentages at each joint
33% at midcarpal joint
67% and radiocarpal joint
Abductor pollicis longus blood supply
Posterior interosseous artery
Extensor pollicis brevis function and blood/nerve supply
Extends proximal phalanx of thumb at its metacarpophalangeal joint, also extends carpometacarpal joint
Posterior interosseous nerve/artery
Radiocarpal joint
Condyloid synovial
2 degrees of freedom
Carpal bones #
8 bones
Radiocarpal nerve supply
Anterior interosseous branch from median
Posterior interosseous branch from radial
Dorsal and deep branches of ulnar nerve
Extensor pollicis longus blood supply
Posterior interosseous artery
Perforating branch of anterior interosseous arteries
Abductor pollicis longus actions
Abducts thumb and extends it at the carpometacarpal joint
Abductor pollicis longus distal attachment
Base of first metacarpal
Midcarpal joint ligaments
Dorsal ligaments
Palmar ligaments
Interosseous ligaments
Midcarpal joint arteries
Arise from dorsal and palmar carpal arches
Extensor pollicis longus actions
Extends distal phalanx of thumb and extends metacarpophalangeal and carpometacarpal joints
Tendons that define the anatomical snuff box
Extensor pollicis longus- dorsal and more medial
Extensor pollicis brevis- palmar border
Abductor pollicis longus- runs with extensor pollicis brevis
Abductor pollicis longus nerve supply
Posterior interosseous nerve
Movements of midcarpal joint
Some flexion/extension
Radial deviation (abduction)
-Especially due to movement of head of capitate in its socket
Abductor pollicis longus proximal attachment
Posterior surface of proximal half of ulna, radius and interosseous membrane
Other ligaments of wrist/hand/digits
Carpal ligaments Metacarpal ligaments Carpometacarpal ligaments Palmar ligaments Intermetacarpal ligaments
Midcarpal joint nerves
Anterior interosseous branch from median
Posterior interosseous branch from radial
Dorsal and deep branches of ulnar nerve
Triquetral
Articulates with ulna via ulnar disc during extreme ulnar deviation