Wrist and hand bones Flashcards
what part does the thumb doesnt have and what is its number
no metacarpals
labeled 1 metacarpals
where are the middle phalanges seen
2,3,4,5 digits
what is the largest joint in the body
forearm
these bones are cartilaginous at birth but start to ossify 1st to 12 year
bones of the hand
this part is beside the radial fossa
Radial styloid
Tendonds that form the anatomical snuffbox
- Abductor longus muscle
- extensor pollicis brevis
- extensor pollicis longus
Radial styloid and the tendons that form the
anatomical snuffbox form some kind of friction
around the area as the thumb is moving
De Quervain’s Tenosynovitis
this is more prominent when in prone position
- insertion of strong ligaments connected to the wrists
Ulnar Styloid
this is a circular structure
- like radial head
- allow pronation and supination
Ulnar Head
for supination and pronation
- if injured difficult to do movement
radioulnar joint
Dorsal and Volar radiocarpal ligaments are
supporting ligament structures that give
stability to the wrist.
Volar Radiocarpal Ligaments
Extrinsic ligaments: bridges carpal bones to radius
or metacarpals
Intrinsic ligaments:
Wrist Ligaments
wrist ligaments
Extrinsic ligaments:
Intrinsic ligaments:
originate and insert on carpal
bones
Intrinsic ligaments:
2 types of Intrinsic ligaments:
Scapholunate interosseous ligament
• Lunotriquetral interosseous ligament
2 types of Extrinsic ligaments:
- Dorsal Radiocarpal Ligaments
* Volar Radiocarpal Ligaments
what are the stronger ligaments of the hand
Triangular Fibrocartilage complex TFCC
if the the radial styloid is fractured
parts of tfcc may detach and float around
decreasing wrist stability
where is the common side where wrist is sprained
Ulnar side
also more motion
has more affinity to bones of carpus
Distal radius
put our palms on the table
and push it on either the ulnar or radial side.
↑ range of motion, ↓ stability
what are the flexors that pas thru the pulley system
Flexor digitorum profundus
- flexor digitorum superficialis
serves as tunnels
- assists in holding finger flexor down to bone
prevents tendons from bow stringing out
Pulley system of the hand
site for most common diseases
- on metacarpophalangeal joint
- proximal pulley
- tendons freely ove
Annular Pulley
A1
what is the position of the hand when in rest
flexion
this is the mechenica locking of A1 pulley
Trigger finger
area that serves as the roof of the carpal tunnel
- above the carpus
- holds the long flexor tendons
- Stretches across the front of the wrist that converts
concave anterior surface
-
Flexor Retinaculum
what pass thru flexor retinaculum
- median nerve
- flexor tendon of the thumb
- flexor tendons of fingers
where does flexor reticulum attach
medially to pisiform
laterally to tubercule
origin of flexor reticulum
opponens pollicis and opponens digiti
minimi (digiti minimi = small finger/5th digit)
Muscles of the Hand
Thenar Eminence
Hypothenar Eminence
Interossei Muscles
this muscle of the hand - major under the thumb muscles: -opponens pollicis -flexor pollicis brevis - abductor pollicis brevis
Thenar Eminence
flexes the carpometacarpal
and the metacarpophalangeal joints of the thumb, not
the thumb itself
Flexor pollicis brevis
this muscle of the hand
- brings out the pinky
- palmaris brevis
- abductor digi minimi
- flexor digiti minimi brevis
HYPOTHENAR EMINENCE
what does the palmaris brevis help with
grip
this muscle of the hand
- muscles between the metacarpals and bones
- originate from metacarpals
- insert to phalanges
- Dorsal Interossei
- Palmar interrossei
Interrossei muscles
intrinsic muscles of the hand
dorsal interossei
palmar interossei
- abducts the fingers from the
middle finger
dorsal interossei
flexes fingers the metacarpal phalangeal joint
• Adducts fingers together
Palmar Interossei
PAD DAB
(Palmar -
Adduction; Dorsal - Abduction)
wrist motions
● Wrist Extension
● Wrist Flexion
● Radial Deviation
● Ulnar Deviation
what has more motion ulnar or radial
ulnar deviation
we tend to have our sprains on the
ulnar side of the hand because that is where all of
the motion goes
Blood supply
Brachial artery
The brachial artery exits the cubital fossa and
divides itself into two:
- Ulnar artery (Larger)
2. Radial artery (Smaller)
main blood supplyy of the hand and deep in the flexor digitorum profundus
Ulnar Artery
artery at the pinky finger
Common Palmar Digital Arteries
artery at the 2 middle fingers
proper palmar digital arteries
pointing finger artery
radial artery
thumb artery
proceps polices artery
- helps to tighten the skin & fascia
around the palm
Palmaris brevis
superficial; It is most likely to be hit when there is-
> Laceration on the hand
> Transection around the palmar space
Superficial Palmar Arch
rise to proper palmar digital arteries
Common Palmar Digital Arteries
Blood flow of arteries in the hand
Superficial palmar arch»>Common palmar digital
arteries»>Proper palmar digital arteries
to trauma to the upper extremity
DISCONTINUATION OF BLOOD FLOW IN HAND
How to determine discontinuity of blood flow in the
radial or ulnar artery.
Release radial artery and blood flow continues to
the fingers (visible on the nails)
• Means radial artery has patent blood flow
• Release the ulnar artery and blood flow returns
• Means both radial and ulnar arteries have patent
blood flow.
- rest of the blood supply that goes into
the hand
Axillary Artery
the terminal branches of the brachial plexus
● Goes posteriorly around the surgical
AXILLARY NERVE
Part of the lateral chord
● Passes through the coracobrachialis anteriorly
MUSCULOCUTANEOUS NERVE
Anterior to the medial epicondyle
MEDIAN NERVE
function of median nerve
motor innervation to the following Deep Anterior
Muscles:
> Flexor Digitorum Profundus that flexes wrist and all
of the digits of the hand (MCP).
> Flexor Pollicis Longus that flexes the thumb
> Pronator Quadratus
It passes posteriorly or under the medial epicondyle
(funny bone)
● Hitting the elbow against a hard surface results in a
tingling sensation on the small digit or on the ulnar
ULNAR NERVE
is the most commonly injured when
there is mid-shaft humeral fracture
Radial nerve
Innervates all of the heads of triceps brachii and
the mobile wad which are brachioradialis, ERCL,
and ERCB
> Injury at this level, wrist drop
High Radial Nerve
Radial nerve that passes through supinator muscle
and starts at the level of EDC
> At the level of EDC, radial nerve is now named
posterior interosseous nerve
> Injury at this level, only digital extension
Low Radial Nerve
Common Nerve Affected
Axillary
Radial
Median
Proximal
Midshaft
Distal
Takes up most of the thumb and half of the palm
● The whole palmar surface of the 2nd digit and middle
Palmar Surface
