Wrist and Hand Bones,Joints and Movements Flashcards
Features of distal radius and ulna
Radial and ulna styloid process
Dorsal tubercle of radius
Head of ulna
Triangular fibro cartilage complex
What are the bones in the carpus proximal/distal row
Proximal row (lateral-medial-thumb to 5th finger) - Scaphoid - Lunate - Triquetral - Pisiform Distal row (lateral-medial) - Trapezium - Trapezoid - Capitate - Hamate
Describe the scaphoid
Scaphoid tubercle (palpable)
Tubercle - responsible for blood supply
Avascular necrosis is a common problem for post fracture
Describe the lunate
Articulates with the scaphoid and triquetral in the proximal carpal row
Describe the triquetral/pisiform
Palpable - medial aspect proximal carpal row
Pisiform is a sesamoid bone in the tendon of flexor carpi ulnaris lying on the palmar surface of triquetral
Describe the trapezium
Palpable tubercle
Forms the first carpometacarpal joint with the base of the first metacarpal
It’s important for the mobility of the thumb
Describe the trapezoid
Base of index finger metacarpal
Describe the capitate
Largest of the carpal bones
Articulates distally with the base of MC3 (middle finger)
Describe the hamate
Large hook palpable in the muscles on the medial side of the proximal palm (the hypothenar eminence) - hook of hamate.
It articulates distally with the bases of MCs 4 and 5 (ring and little fingers)
What are the joints in the wrist region
The radiocarpal joint - the wrist joint The carpal joints - mid carpal and inter carpal joints CMC MCP PIP DIP
Describe the radiocarpal joint/wrist joint
Synovial ellipsoid joint - flexion/extension - ABD/ADD close pack - full extension - radial deviation
What are the ligaments, articular surfaces and movements in the radiocarpal joint
Articular surfaces - distal radius, triangular fibrocartilaginous disc, scaphoid, lunate and triquetral
Synovial ellipsoid joint
Capsule
Ligaments - dorsal/palmar radio carpal, radial/ulnar collateral
Movements - flexion/extension, ulnar/radial deviation
Describe the mid carpal joint
Synovial complex saddle
Between the proximal and distal rows of carpal bones
Capsule
Ligaments - intercarpal-Palmer/dorsal, collateral
Movements - flexion/extension and ABD/ADD
Movements of the R/C and mid carpal joints
Flexion - 85degrees
Extension - 85degrees
Radial deviation - 15degrees
Ulnar deviation - 45degrees
What stabilises the wrist
The many tendons crossing the joints (plus pronator quadratus).
Ligaments anteriorly,posteriorly, medially and laterally.
Tendons bound by extensor and flexor retinaculum.
Radiocarpal, inter carpal ligaments
Close pack position: extension with radial deviation
Active movements of the wrist and hand
Flexion occurs and mid carpal joint > radial carpal joint
Extension occurs at radio carpal joint > mid carpal joint
Radial and ulnar deviation occur mainly at radio carpal joint
What accessory movements at the radio and mid carpal joint
A-P and P-A
Ulna glide
Radial glide
Longitudinal caudad
Describe the carpometacarpal (CMC) joint
Articulate surfaces - trapezium and base of the 1st metacarpal.
Ligaments - radial CMC, anterior/posterior oblique
Movements - flexion/extension, ABD/ADD, opposition
Classify the 1st carpometacarpal joint
Synovial saddle - biaxial
Loose capsule - supported by ligaments
Classify the inter carpal joint
Synovial plane joints
Between individual carpal bones
Ligaments - dorsal and Palmer inter carpal and interosseous
Movements (slight) - small glides, only significantly capitate
Classify the metacarpophalangeal MCP joints
Synovial ellipsoid joint
Articular surfaces - round metacarpal head with the base of phalanx
Ligaments - palmar, collateral, transverse metacarpal (4 fingers), deep transverse.
Movements - flexion/extension,ABD/ADD
Classify the inter-phalangeal (IP) Joints
Synovial hinge joints
Proximal/distal
Ligaments - collateral and palmar
Movements - flexion/extension
Function of hand
Communication Manipulation Sensation Protection Stability
