week 10- Wrist Flashcards
How many phalanges are there
14
Proximal
Middle
Distal
How many metacarpals are there
5
How many carpals are there
4- distal caprals
4- proximal carpals
How many sesamoids are there
2
List the joints of the hand
Radio-carpal joint
Inter-carpal joint
Mid-carpal joint
Carpalmetacarpal joint
List nerves of wrist and hand
Ulna nerve
Median nerve
Radial nerve
Blood supply
Ulna and radial artery form superficial and deep palmar arches
Scaphoid location
Most lateral and inferior bone of the hand
Lunate bone location
Located between scaphoid and pisiform
Centrally and inferior of the hand
Pisiform bone location
Medially and infeiorly on hand
Small bone
Next to triquetrum( inferior and medial to)
Next to lunate
Triquetrum bone location
Laterally and superior to pisiform
Trapezium bone location
Trapezius shaped
Distal yo scaphoid
Trapezoid bone location
Lateral to trapezium
Distal to scaphoid
Capitate bone location
Larger bone
Central, distal to lunate and some of scaphoid
Medially is trapezoid
Laterally is hamate
Hamate bone location
Distal to triquetrum
Most Lateral and distal bone
Distal transverse crease location
Inferior to metacarpals, the line that is transverse across the hand
Proximal transverse crease location
Inferior to distal transverse crease, line that curves proximally
Middle crease location
Inferior to proximal transverse crease
Medial to thenar crease
Radio carpal joint type
Synovial
Condyloid
Wrist Flexors
- Pronator teres
- Flexor carpi radialis
- Palmaris longus
- Flexor carpi ulnaris
- Flexor digitorum superficialis
- Flexor digitorum profundus
- Flexor pollicis longus
- Pronator quadratus
how do you find the palamaris longus tendon
extend your hand in front of you, anterior and palmar aspect facing up
flex your hand, examine your wrist
the raised ridge that runs centrally on the wrist is the PALAMARIS LONGUS TENDON
superficial wrist extensors
- Brachioradialis
- Extensor carpi radialis longus
- Extensor carpi radialis brevis* Extensor digitorum
- Extensor digiti minimi
- Extensor carpi ulnaris
- Anconeus
deep wrist extensors
- Supinator
- Abductor pollicis longus
- Extensor pollicis brevis
- Extensor pollicis longus
- Extensor indicis
proximal articulating surfaces of the radiocarpal (wrist) joiunt
distal end of the radius,the articular disk
distal articulating surfaces of the radiocarpal (wrist) joint
Distally: Scaphoid, Lunate and Triquetrum (except Pisiform)
- The Ulna is NOT a part of the wrist joint
ligaments of radiocarpal joint
Palmar radiocarpal ligament
* Dorsal radiocarpal ligament
* Ulnar Collateral ligaments
Radial Collateral ligaments
which ligament of the wrist is most medial
ulnar collateral ligamnent
which ligament of the wrist is most lateral
radial collateral ligament
movements of radiocarpal joint
Flexion
* Extension
* Abduction / Radial Deviation
* Adduction / Ulnar deviation
why can the hand be adducted to a greater degree
Because the radial styloid process extends further distally than does theulnar styloid process, the hand can be adducted to a greater degree than itcan be abducted
ulnar nerve location
most mefial
descends on the medial aspect of the forearm, over the flexor digitorum profundus muscle
deep to the flexor carpi ulnaris muscle.
median nerve location
derived from the medial and lateral cords of the brachial plexus
Innervates the flexor and pronator muscles in the anterior compartment of the forearm
Also supplies innervation to the thenar muscles and lateral two lumbricals in the hand.
(tip of thumb, index, third and half ring finger dorsl view
thumb, index, third and half ring finger palmar view)
radial nerve location
most lateral
(palmar view from proximal phalange to metacarpal body
dorsal view, thumb, first and second middle phalange)
origin: axillary region. descends posterior surface of humorous. passes through cubital fossa and terminates in posterior compartment of forearm
Where do wrist flexors originate
Medial epicondyles
Name phrase to learn hand bones
Some
Lovers
Try
Positions
That
They
Can’t
Handle
Using a phrase, list carpals
Some- scaphoid
Lovers- lunate
Try- triquetreum
Positions- pisiform
That- trapezium
They- trapezoid
Can’t- capitate
Handle- hamate
Which side are flexor muscles located
Palm up
Which side are extensor muscles located
Palm down
Where do pollicis muscles go to
Thumb
Where do indicis go to
Index finger
Where do minimi muscles go
Little finger
Movements of digits of hand
Flexion
Extension
Adduction
Abduction
Thumb flexion
Thumb extension
Palmer adduction
Palmer abduction of thumb
Opposition of thumb and fingers
What does the first metacarsal articulate with
Trapezium
What is scaphoid between
Trapezium and radius
What does the capitate articulate with
Third metacarpal
Origin of flexor carpi radialis
Medial epicondyle of the humerous
Insertion of flexor carpi radialis
Trapezium
2nd and 3rd metacarpal bone
Action of flexor carpi radialis
Flexion
Origin of palamaris longus
Medial epicondyle of the humerous
Palamaris longus insertion
Flexor rectinaculum
Action of palamaris longus
Flexion
Flexor carpi ulnaris origin
Medial epicondyle of the humerous
Flexor carpi ulnaris insertion
Pisiform
Hook of hamate
Base of 5th metacarpal
Flexor carpi ulnaris action
Flexion
Adduction
Extensor carpi ulnaris origin
Lateral epicondyle of the humerous
Olecranon
Extensor carpi ulnaris insertion
Crosses forearm
Base of 5th metacarpal
Extensor carpi ulnaris action
Extension
Extensor carpi radialis longus origin
Lateral epicondyle of the humerous
Lateral supracondylar ridge of humerous
Extensor carpi radialis longus insertion
Base of 2nd metacarpal
Extensor carpi radialis longus action
Supination
Pronation
Radial/ulnar deviation
Elbow flexion / extension
Wrist flexion / extension
extensor carpi radialis brevis origin
Lateral epicondyle of humerous
extensor carpi radialis brevis insertion
Base of 3rd metacarpal
extensor carpi radialis brevis action
Extend and abduct hand at wrist joint
Flexor digitorum suoerficialis origin
Medial epicondyle
Coronoid process of ulna
Flexor digitorum suoerficialis insertion
Sides of middle phalanges 2-3
Flexor digitorum suoerficialis action
Finger flexion
Flexor digitorum profundus origin
Proximal 1/2 anterior surface of ulna
Interaseous membrane
Flexor digitorum profundus insertion
Palmar surfaces of distal phalanges 2-5
Flexor digitorum profundus action
2-5 finger flexiom
What does the ulna articulate with
Lunate
extensor carpi radialis longus and brevis origin
he ECRL originates from the lateral supracondylar ridge of the humerus, while the ECRB originates from the lateral epicondyle.
extensor carpi radialis longus and brevis insertion
he ECRL originates from the lateral supracondylar ridge of the humerus, while the ECRB originates from the lateral epicondyle.
extensor carpi radialis longus and brevis action
extend and abducts the wrist
extensor carpi radialis longus and brevis innervatio
radial nerve
extensor digitorum origin
Originates from the lateral epicondyle.
extensor digitorum insertion
The tendon continues into in the distal part of the forearm, where it splits into four, and inserts into the extensor hood of each finger.
extensor digitorum action
Extension of the digits at the interphalangeal and metacarpophalangeal joints.
extensor digitorum innervation
radial nerve
extensor digit mini
Originates from the lateral epicondyle of the humerus.
extensor digit mini insertion
It attaches, with the extensor digitorum tendon, into the extensor hood of the little finger.
extensor digit mini action
Extends the little finger, and contributes to extension at the wrist.
extensor digit mini innervation
Radial nerve (deep branch).
extensor carpi ulnaris origin
lateral epicondyle of the humerus,
extensor carpi ulnaris insertion
attaches to the base of metacarpal V.
extensor carpi ulnaris action
Extension and adduction of wrist.
extensor carpi ulnaris innervation
Radial nerve (deep branch).
aconeus origin
lateral epicondyle
aconeus insertion
posterior and lateral part of the olecranon.
aconeus action
Extends and stabilises the elbow joint. Abducts the ulna during pronation of the forearm.
aconeus innervation
Radial nerve (very small muscle)
brachioradialis origin
proximal aspect of the lateral supracondylar ridge of humerus,
brachioradialis insertion
and attaches to the distal end of the radius, just before the radial styloid process.
brachioradialis actions
: Flexes at the elbow.
brachioradialis innervation
radial nerve
flexor carpi ulnaris
Flexor Carpi Ulnaris
Attachments:
The humeral head originates from the medial epicondyle of the humerus with the other superficial flexors,
the ulnar head originates from the olecranon of the ulna.
insertion: The muscle tendon passes into the wrist and attaches to the pisiform bone, hook of hamate, and base of the 5th metacarpal
Actions: Flexion and adduction at the wrist.
Innervation: Ulnar nerve.
palmaris longus
Palmaris Longus
This muscle is absent in about 15% of the population.
Attachments: Originates from the medial epicondyle, attaches to the flexor retinaculum of the wrist.
Actions: Flexion at the wrist.
Innervation: Median nerve.
flexor carpi radialis
Flexor Carpi Radialis
Attachments: Originates from the medial epicondyle, attaches to the base of metacarpals II and III.
Actions: Flexion and abduction at the wrist.
Innervation: Median nerve.
pronator teres
Pronator Teres
The lateral border of the pronator teres forms the medial border of the cubital fossa, an anatomical triangle located over the elbow.
Attachments: It has two origins, one from the medial epicondyle, and the other from the coronoid process of the ulna. It attaches laterally to the mid-shaft of the radius.
Actions: Pronation of the forearm.
Innervation: Median nerve.
flexor digitorum superficialis
INTERMEDIATE COMPARTMENT
Attachments: It has two heads – one originates from the medial epicondyle of the humerus, the other from the radius. The muscle splits into four tendons at the wrist, which travel through the carpal tunnel, and attach to the base of the middle phalanx of the four digits.
Actions: Flexes the metacarpophalangeal joints and proximal interphalangeal joints at the 4 fingers, and flexes at the wrist.
Innervation: Median nerve.
Flexor digitorum profundus DEEP
Flexor Digitorum Profundus
Attachments: Originates from the ulna and associated interosseous membrane. At the wrist, it splits into four tendons, that pass through the carpal tunnel and attach to the distal phalanges of the four fingers.
Actions: It is the only muscle that can flex the distal interphalangeal joints of the fingers. It also flexes at metacarpophalangeal joints and at the wrist.
Innervation: The medial half (acts on the little and ring fingers) is innervated by the ulnar nerve. The lateral half (acts on the middle and index fingers) is innervated by the anterior interosseous branch of the median nerve.
Flexor pollicis longus DEEP
Flexor Pollicis Longus
This muscle lies laterally to the flexor digitorum profundus
Attachments: Originates from the anterior surface of the radius and surrounding interosseous membrane. Attaches to the base of the distal phalanx of the thumb.
Actions: Flexes the interphalangeal joint and metacarpophalangeal joint of the thumb.
Innervation: Median nerve (anterior interosseous branch).
pronator quadratus
Pronator Quadratus
A square shaped muscle found deep to the tendons of the flexor digitorum profundus and flexor pollicis longus.
Attachments: Originates from the anterior surface of the ulna and attaches to the anterior surface of the radius.
Actions: Pronates the forearm.
Innervation: Median nerve (anterior interosseous branch).
name superficial muscles of aterior forearm
flexor carpi ulnaris, palmaris longus, flexor carpi radialis, pronator teres.
name intermediate muscles of aterior forearm
: flexor digitorum superficialis
name deep muscles of aterior forearm
flexor pollicis longus, flexor digitorum profundus and pronator quadratus
what movements does the radiocarpal joint allow
includes flexion, extension, adduction, and abduction of the wrist
NMe muscles of wrist using pass fail pass fail
Pronator teres
Flexor carpi radialis
Palmar is longus
Flexor carpi ulnaris
