Wrist and Hand Flashcards
Wrist is a synovial joint between:
The distal end of the radius
The carpal bones
Scaphoid
Lunate
Triquetum
The pronation and the supination of the forearm results from …
The rotation of the radio over the ulna
Wrist Joint ligaments
Palmar radiocarpal ligaments
Dorsal radiocarpal ligaments
Ulnar Collateral ligament
Radial Collateral ligament
Palmar radiocarpal ligaments
Pass from the radius to the rows of carpals
They are arranged so that the hand follows the radius during supination of the forearm
Composed of a radiocapitate part and radioscapholunate part
Dorsal radiocarpal ligaments
They are arranged so that the hand follows the radius during pronation of the forearm
Ulnar Collateral ligament
Strength the joint capsule medially
Attached to the ulnar styloid process triquetum
Radial Collateral ligament
Strength the joint capsule laterally
Attached to the radial styloid process scaphoid
The hand is composed by:
8 carpal bones line in two rows
5 metacarpal bones
14 phalanges
Proximal line of carpal bones
Pisiform Triquetum Lunate Scaphoid
Distal line of carpal bones
Hamate Capitate Trapezoid Trapezium
Scaphoid
Articulates directly with the distal end of the radius
Lunate
It has a semilunar shape and articulates directly with the radius
Triquetum
Articulates with the distal part of the radio-ulnar joint
Pisiform
Is found in the palmar surface of the triquetum
Trapezium
It has 4 sides, articula con el metacarpo del prime digito
Trapezoid
It has a wedge shape
Capitate
It has a round shape
Hamate
It has a bone process described as the hook of the hamate
Metacarpals
Are numbered from I-V
Its proximal end is also known as the base of the bone and have a concave shape to articulate with the carpal bones
Its distal end is also known as the head and have a convex shoe to articulate with phalanges
Phalanges
Every digit has 3 phalanges with the exception of the thumb
Parts of the phalanges
Base (proximal)
Body
Head (distal)
Carpometacarpal joint
Saddle (Biaxial)
Metacarpophalangeal joint
Condyloid (Biaxial)
Every phalange has the joints… Except the thumb
Metacarpophalangeal joint
Proximal interphalangeal joint
Distal interphalangeal joint
The thumb contains the joints…
Metacarpophalangeal joint
Proximal interphalangeal joint
Clinical correlation:
Rheumatoid Arthritis
Clasified as and autoimmune disease , characterized that produced chronic inflammation at the joints
Retinaculum ligament is composed of:
Flexor retinaculum
Extensor retinaculum
Flexor retinaculum (Transverse carpal ligament)
Is found distal to the radio-carpal joint and o palmar aspect of the hand
It forms the carpal tunnel
Extensor retinaculum
Cross the wrist joint and the radio-ulnar joint
Its found in the dorsal aspect of the hand
Carpal tunnel
It is a canal that is found on the wrist
Anteriorly is formed by flexor retinaculum
Posteriorly is form by the carpal bones
Across the carpal tunnel the following structures are seen
The tendon of the flexor pollicis longus
Tendons of the flexor digitorum superficial and profundus
Median nerve
Clinical correlation:
Carpal tunnel syndrome
A lesion that significantly reduces the size of the carpal tunnel or, more commonly, increases the size of some of the nine structures or their coverings that pass through it (Inflammation of synovial sheaths).
– Pressure to the median nerve is the cause of the following symptoms:
* Paresthesia (tingling), hypoesthesia (diminished sensation),
or anesthesia (absence of sensation) may occur in the lateral three-and-a-half digits.
* Sensation in the central palm remains unaffected
*: The median nerve also has terminal motor branches: the recurrent branch, which serves the three thenar muscles, and branches to lumbricals 1 and 2
Movements of the wrist
Flexors of the wrist
Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus
Movements of the wrist
Extensors of the wrist
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Muscles of the hand subdivides in
Thenar Region
Hypothenar Region
Lumbricals
Dorsal interossei
Palmar interossei
Thenar Region
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Adductor pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Adductor pollicis
Hypothenar Region
Palmaris brevis
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
Lumbricals 1st and 2nd
Innervated by Median Nerve
Function: Flex metacarpophalangeal joint: extend interpalangeal joints of 2nd-5th digits
Lumbricals 3rd and 4th
Innervated by Deep branch of ulnar nerve
Function: Flex metacarpophalangeal joint: extend interpalangeal joints of 2nd-5th digits
Dorsal interossei 1st-4th
Innervated by Deep branch of ulnar nerve
Function: Abduct 2nd-4th digits from the axial line; act with lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints
Palmar interossei 1st-3rd
Innervated by Deep branch of ulnar nerve
Function: Adduct 2nd, 4th and 5th digits from the axial line; act with lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joint
