Transcript Hand and Wrist

Hand and Wrist
Mrs. Dobbins
Upper Extremity
•Shoulder
•Gleniod Humeral joint
•Humerus
•Gleniod Fossa
•Scapula (Shoulder Blade)
•Clavicle (Collarbone)
•Upper Arm
Anterior View
Acromion
AC Jt.
icle
Process
v
Cla
GH Jt.
SC Jt.
Coracoid
Process
Scapula
Humerus
Lateral
Epicondyle of
Humerus
Medial
Epicondyle of
Humerus
•Humerus
•Forearm
Radius
Ulna
•Radius (Thumb side)
•Ulna (Pinky side)
•Wrist
•Carpals!
•Hand and Fingers
Carpals
Metacarpals
Proximal Phalanges
Middle Phalanges
Distal Phalanges
Thumb Side vs.
Phalange
th
5
RADIUS
ULNA
Biceps
Brachii
Coracobrachialis
Brachialis
Triceps
Brachioradialis
Pronator
Teres
Flex. Carpi
Radialis
Extensors
Palmaris
Longus
Flexor Carpi
Ulnaris
Retinaculum/
Aponeurosis
Thenar
Muscles
Hypothenar
Muscles
Anterior View
Triceps
Olecranon
Anconeus
Medial:
Flexors
Wrist~
Flex. Carpi Radialis
Palmaris Longus
Flex. Carpi Ulnaris
Digits~
Flex. Digitorum
Brachioradialis
Lateral:
Extensors
Wrist~
Ext.Carpi Radialis
Longus & Brevis
Ext. Carpi Ulnaris
Digits~
Ext. Digitorium
Ext. Digiti Minimi
Ext. Indicis
Thumb~
Ext. Pollicis Longus&
Brevis
Abd. Pollicis Longus
Anatomical
Snuffbox
Superficialis & Produndus
Thumb~
Flex. Pollicis Longus
Posterior View
Articular cartilage
8 Carpal Bones: Scaphoid (Navicular), Lunate, Triquetrum, Pisiform,
Trapezium, Trapezoid, Capitate, Hamate
5 Metacarpal Bones
Distal
14 Phalanges
Phalanx
Interphalangeal
(IP) joint
Middle
Phalanx
Phalanges
Base
Head
(Knuckles)
Proximal
Phalanx
Metacarpophalangeal
(MP)Jt
Metacarpals
Trapezoid
Capitate
Hamate
Pisiform
Triquetrum
Trapezium
Lunate
Navicular
Radialcarpal
(wrist) Jt
Radius
Ulna
•
•
•
•
Navicular Never Scaphoid
Lunate Lower
Triquetrum Tilley's
Pisiform Pants
•
•
•
•
Trapezium Trouble
Trapezoid Times
Capitate Can
Hamate Happen
Muscular Hand Anatomy
Finger Mechanism
EXTENSOR (FINGER)
TENDON INJURY
Wrist
Motion
MOTIONS
Boxer’s Fracture
Skier’s Thumb (Gamekeeper’s)
• Acute instability of the
Ulnar collateral
ligament (UCL)
• The most common soft
tissue injury of the
thumb
Metacarpophalangeal
(MP) joint is UCL
sprain
Mallet Finger (Dropped Finger)
•
Mallet finger refers to a condition in which
the end joint of a finger bends but will not
straighten by itself.
– Caused by sudden flexion of the distal
interphalangeal (DIP) joint while the finger is
in an extended position
– Often occurs from a blow to the tip of an
extended finger
•
In this situation, the joint can be pushed
straight but will not hold that position on its
own.
– Traumatic avulsion of the DIP extensor
tendon of the finger
– Most common extensor tendon injury
•
Sometimes called baseball finger or drop
finger
– Tendon may be stretched, completely torn, or
associated with a bony avulsion
Boutonniere Deformity (Buttonhole)
• The boutonniere deformity
refers to a finger which is
bent in a particular way: bent
down at the middle joint and
bent back at the end joint
• When the finger is hit or bent
forcefully in just the wrong
way, the sheet on the top of
the finger (the central slip of
tendon) tears away from its
attachment to the top of the
middle finger bone.
Jersey Finger (FDP TENDON AVULSION)
• Traumatic avulsion of the
flexor Digitorum
profundis (FDP) tendon
• The ring finger is most
commonly affected
– DIP hyperextension
(i.e. “jammed finger”)
• Similar to Mallet finger
injury – outcome
dependant on whether
flexion or hyperextension
injury occurred
• Most commonly occurs in
football when grabbing
the jersey of an opponent
who is pulling away
Bennett's Fracture
A Bennett's Fracture is
a fracture +
dislocation of the
Metacarpal bone at
the base of the
thumb.
Nerve Root Scheme
Radial
Nerve
Ulnar
Nerve
Median
Nerve
Carpal
Tunnel
DE QUERVAINS SYNDROME
• A common condition of inflammation around the
tendons on the thumb side of the wrist.
Ligamentous Laxity 
Now for the
Injuries....
Forearm (Radius) fracture
Ulnar
Fracture
Colles Fracture
Colles fracture
Metacarpal Fracture
Metacarpal
Fractures
Scaphoid
(Navicular)
Fracture
Hook of the
Hamate Fracture
Finger Amputation
(Complete avulsion)
Re- attachment
Finger Avulsion (Justin)
Hand Laceration (Rachel's)
The Test may look
like this....
Anterior View
21
A
22
40
C
D
F
L
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B
25
E
K
39
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27
_2 6_
38
28
G
29
37
30
36
31
35
34
J
33
32
I
H
Anterior View
Posterior View
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id e
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__B o
ne s
__Bones
__Jt
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id e
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bo _
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bo _
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Scapula
Humerus
Clavicle
Acromion
Coracoid
Radius
Ulna
Carpals
Metacarpals
Phalanges
Spine of Scapula
SC Joint
AC Joint
GH Joint
MP Joint
PIP Joint
DIP Joint
Medial Epicondyle
Lateral Epicondyle
Olecranon
Radial Head
Biceps Brachii
Triceps Brachii
Brachialis
Brachioradialis
Coracobrachialis
Extensor Muscle Mass
25. Ext. Carpi Radialis
26. Ext. Digitorim
27. Ext. Pollicis
Longus/Brevis
Flexor Muscle Mass
29. Flex. Carpi Ulnaris
30. Flex. Carpi Radialis
31. Palmaris
Ulnar Collateral Lig.
Radial Collateral Lig.
Anatomical Snuff Box
Thenar Muscles
Hypothenar Muscles
A
Anterior View
Posterior View
H
G
I
F
J
B
L
C
E
D
K
N
QUESTIONS / COMMENTS?
Done....Now study 