Wrist & Hand

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Health

University/Undergrad

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39 Terms

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The ____ fine-tunes hand position
wrist
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Radius (landmarks)
\-Body

\-Styloid Process

\-Ulnar Notch
\-Body \-Styloid Process \-Ulnar Notch
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Ulna (landmarks)
\-Body

\-Styloid Process

\-Ulnar Head
\-Body \-Styloid Process \-Ulnar Head
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How many carpal bones are there?
8 (4 in proximal row, 4 in distal row)
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What are the proximal row? (carpal bones)
\-Scaphoid

\-Lunate

\-Triquetrum

\-Pisiform
\-Scaphoid \-Lunate \-Triquetrum \-Pisiform
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What are the distal row? (carpal bones)
\-Trapezium

\-Trapezoid

\-Capitate

\-Hamate
\-Trapezium \-Trapezoid \-Capitate \-Hamate
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How many metacarpal bones are there?
5 (long bones of the hand, # 1-5)
5 (long bones of the hand, # 1-5)
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How many phalangeal bones are there?
\-14

\-Thumb (Proximal, Distal)

\-Fingers 2-5 (Proximal, Middle, Distal)

\-Landmarks (Base, Body, Head)
\-14 \-Thumb (Proximal, Distal) \-Fingers 2-5 (Proximal, Middle, Distal) \-Landmarks (Base, Body, Head)
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Sesamoid Bones
Sesamoid Bones
\-Maybe 1 or 2 sesamoid bones (free floats) on the palmar aspect of 1st MCP joint

\-Typically lie in the opponens pollicus muscle
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Distal Radioulnar Joint
Distal Radioulnar Joint
\-Head of the ulna articulates with the ulnar notch of the radius

\-Interosseous membrane holds these bones together in the forearm

\-Motions: Pronation/Supination
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Radiocarpal Joint
\-Distal radius articulates with proximal carpals (Scaphoid, Lunate, Triquetrum{slight})

\-Motions: Flexion/extension, Radial/ulnar deviation

\-Joint capsule and ligaments stabilize
\-Distal radius articulates with proximal carpals (Scaphoid, Lunate, Triquetrum{slight}) \-Motions: Flexion/extension, Radial/ulnar deviation \-Joint capsule and ligaments stabilize
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Triangular Fibrocartilage
\-Ulna is separated from the proximal row of carpals by fibrocartilaginous disc

green part
\-Ulna is separated from the proximal row of carpals by fibrocartilaginous disc green part
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Midcarpal Joints
\-Joints between adjacent carpal bones

\-Functional joint exists between proximal and distal rows of carpals

\-Gliding motions

\-Dozens of individual ligaments
\-Joints between adjacent carpal bones \-Functional joint exists between proximal and distal rows of carpals \-Gliding motions \-Dozens of individual ligaments
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Carpometacarpal Joints
\-1st MC & Trapezium (Separate joint cavity)

\-2nd MC & Trapezoid

\-3rd MC & Capitate

\-4th MC & Hamate

\-5th MC & Hamate
\-1st MC & Trapezium (Separate joint cavity) \-2nd MC & Trapezoid \-3rd MC & Capitate \-4th MC & Hamate \-5th MC & Hamate
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1st Metacarpophalangeal Joint
\-Extreme Mobility

\-Saddle Joint

\-Flexion/extension

\-Abduction/Adduction

\-Opposition/Reposition
\-Extreme Mobility \-Saddle Joint \-Flexion/extension \-Abduction/Adduction \-Opposition/Reposition
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2-5 Metacarpophalangeal Joints
\-Condyloid Joint

\-Flexion/extension

\-Abduction/adduction
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Interphalangeal Joints
\-Hinge Joints: Thumb has one IP joint; Fingers each have PIP and DIP joints

\-Flexion/extension
\-Hinge Joints: Thumb has one IP joint; Fingers each have PIP and DIP joints \-Flexion/extension
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Thenar Eminence
\-Muscle mass on radial side of palm (squishy muscles on palm, thumb side)

* Abductor pollicis brevis
* Flexor pollicis brevis
* Opponens pollicis
* (Pollicis → related to thumb)
\-Muscle mass on radial side of palm (squishy muscles on palm, thumb side) * Abductor pollicis brevis * Flexor pollicis brevis * Opponens pollicis * (Pollicis → related to thumb)
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Hypothenar Eminence
\-Muscle mass on ulnar side of palm (fat pad on pinky side)

\-Abductor digiti minimi

\-Flexor digiti minimi brevis

\-Opponens digiti minimi
\-Muscle mass on ulnar side of palm (fat pad on pinky side) \-Abductor digiti minimi \-Flexor digiti minimi brevis \-Opponens digiti minimi
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Anatomical Snuffbox
\-Contents → Scaphoid Bone

\-Radial Border → EPB tendon & Abd. PB tendon

\-Ulnar Border → EPL tendon

(PIC: Bottom → EPB tendon, Middle → Abd. PB tendon, Top → EPL tendon
\-Contents → Scaphoid Bone \-Radial Border → EPB tendon & Abd. PB tendon \-Ulnar Border → EPL tendon (PIC: Bottom → EPB tendon, Middle → Abd. PB tendon, Top → EPL tendon
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Carpal Tunnel
\-Contents: Median nerve, FPL tendon, 4 tendons of FDS, 5 tendons of FDP

\-Floor: Carpal Bones

\-Roof: Transverse carpal ligament (aka flexor retinaculum)

(PIC: supinated view)
\-Contents: Median nerve, FPL tendon, 4 tendons of FDS, 5 tendons of FDP \-Floor: Carpal Bones \-Roof: Transverse carpal ligament (aka flexor retinaculum) (PIC: supinated view)
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Tunnel of Guyon
\-Contents: Ulnar nerve

\-Borders: Hook of hamate & Pisiform bone

\-Lies superficial to transverse carpal ligament
\-Contents: Ulnar nerve \-Borders: Hook of hamate & Pisiform bone \-Lies superficial to transverse carpal ligament
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Muscle which spinate
\-Supinator : O → L. epicondyle; I → Anterior Radius

\-Bicep brachii
\-Supinator : O → L. epicondyle; I → Anterior Radius \-Bicep brachii
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Muscles which Pronate
\-Pronator Teres: O → M. epicondyle, I → lateral radius

\-Pronator quadratus
\-Pronator Teres: O → M. epicondyle, I → lateral radius \-Pronator quadratus
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Wrist Extensor Muscles
\-All originate off L. epicondyle via common extensor tendon

* ECRB
* EDC
* ECU
* EDM
* ECRL: O → Humerus, I → 2nd MC
\-All originate off L. epicondyle via common extensor tendon * ECRB * EDC * ECU * EDM * ECRL: O → Humerus, I → 2nd MC
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Wrist Flexor Muscles
\-Originate off M. epicondyle via common flexor tendon

* FCR
* Flexor Digitorum Superficialis
* Palmaris Longus
* FCU
* Flexor Digitorum profundus: O → Proximal ulna, I → distal phalanges of 4 fingers
\-Originate off M. epicondyle via common flexor tendon * FCR * Flexor Digitorum Superficialis * Palmaris Longus * FCU * Flexor Digitorum profundus: O → Proximal ulna, I → distal phalanges of 4 fingers
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Radial Deviation Muscles (moving toward thumb)
\-FCR

\-ECRB

\-ECRL

\-Abductor pollicus longus

\-Extensor pollicus longus

\-Extensor pollicus brevis
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Ulnar Deviation Muscles
\-FCU

\-ECU
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Finger (2-5) Extensor Muscles
\-EDC → all

\-Extensor indices → 2nd only

\-Extensor digiti minimi → 5th only

\-Lumbricals → IP joints only, place writing position
\-EDC → all \-Extensor indices → 2nd only \-Extensor digiti minimi → 5th only \-Lumbricals → IP joints only, place writing position
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Finger (2-5) Flexor Muscles
\-MCP joints: Lumbricals, FDS

\-PIP joints: FDS

DIP joints: FDP
\-MCP joints: Lumbricals, FDS \-PIP joints: FDS DIP joints: FDP
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Finger (2-5) Abduction & Adduction Muscles
\-MCP joints

* Dorsal interossei
* ABD
* Palmar interossei
* ADD
\-MCP joints * Dorsal interossei * ABD * Palmar interossei * ADD
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Thumb Extensor Muscles
\-EPL

\-EPB
\-EPL \-EPB
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Thumb Flexor Muscles
\-FPL

\-FPB
\-FPL \-FPB
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Thumb Abductor Muscles
\-APL

\-APB
\-APL \-APB
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Thumb Adductor Muscles
\-Adductor Pollicus
\-Adductor Pollicus
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Thumb Opposition Muscles
\-Opponens Pollicus
\-Opponens Pollicus
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Thumb Reposition Muscles
\-EPL

\-EFB

\-APL

\-APB
\-EPL \-EFB \-APL \-APB
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Nerve Supply
\-Ulnar Nerve

\-Median Nerve

\-Radial Nerve
\-Ulnar Nerve \-Median Nerve \-Radial Nerve
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Functional Movements of Wrist & Hand
\-Strength of Grip

* Males grip strength on average 2× greater than females of similar age.
* Studies vary, but overall, \~6% stronger grip on dominant side.

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