Transcript WRIST & HAND

WRIST & HAND
PTA 106
Unit 3 presentation by:
Lisa, Bobbi, Deanna, Chris
Surface Anatomy
Surface Anatomy
Anatomical Snuff Box
Compartments & Spaces
Wrist Bones
Wrist Bones
Some
Lovers
Try
Positions
That
They
Can’t
Handle
Hand Bones
Cartilage
Articular Cartilage
Is smooth shiny material that covers the
bones of the hand and wrist. It absorbs
forces of impact and provides for low
friction motion.
Articular Capsule
Synovial Membrane
Fibrous Layer
• Is the inner membrane of a
joint made up of loose
connective tissue.
• Secretes synovial fluid
which services to lubricate
the joint and reduce the
friction between bones in
joints.
• Supplies nutrients to the
joint
• Formed by dense irregular
connective tissue attached
to the periosteum surface of
joints.
• Allows for movement.
• Provides stability
Joints
• Metacarpo-phalangeal Joint
Joints
Proximal Interphalangeal Joint
Distal Interphalangeal Joint
Types of Joints
Hinge Joints- Convex surface of one bone fits
into the concave surface of the adjoining bone
Example: interphalangeal joints
Condyloid Joints- Convex oval-shape
projection of one bone fits into the oval-shaped
depression of another bone
Example: MCPJ and radio-scapho-lunate joint
Types
of
Joints
Saddle JointsPlanar Jointsarticular surface of one bone is
the saddle-shaped, and the articular surface of the other
bone fits into the “saddle” as a sitting rider would sit.
Example: CMCJ between the trapezium and the thumb
Flat or slightly curved bones
joined together that allow back and forth and side to side
movements.
Example: Intercarpal joints
Ligaments
Palmar Aponeurosis
It gives firm attachment to the skin of
the palm to improve the grip, and it
protects the underlying tendons
Flexor Retinaculum
Is a strong band that is attached on
the radial side to the tubercle of the
scaphoid ridge of the trapezium and
on the ulnar side to the pisiform and
hook of the hamate. Serves as the top
sheath of the carpal tunnel for which
the flexor tendons and median nerve
pass through.
Ligaments
Common Flexor Sheath
Surrounds the eight tendons of the superficial and deep
flexors of the digits of the hand as they pass through the
carpal canal.
Extensor Retinaculum
Consists of a group of heavy connective fibers in the
tissues of the wrist. It connects the lateral margin of the
radius with the inside border of the ulna.
Motions of the Wrist
Flexion: 80-90 degrees
 Extension: 75-85 degrees
Radial deviation: 20 degrees
Ulnar deviation: 35 degrees
 Supination: 90 degrees
 Pronation: 90 degrees
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
Motions of the Fingers
Abduction: 20-25 degrees
MCPJ flexion: 85-105 degrees
MCPJ extension: 20-30 degrees
PIPJ flexion: 110-120 degrees, 0 degrees
extension
DIPJ flexion: 80-90 degrees, 0 degrees
extension
Range of Motion of the Thumb
Thumb:
CMCJ flexion: 60-70 degrees
Flexion at MCPJ: 85-105 degrees
Abduction: 70-80 degrees
Opposition- combined motion of abduction, flexion,
and rotation of the thumb.

Posterior Muscles of Wrist and Hand
Anterior Muscles of Wrist and Hand
Nerve, Artery/ Veins of the
Hand and Wrist Debrief:
The Sinistra Nervous Family
Central Nervous System
Aka “The Boss”
The “Under Boss”
Capo # 1
•
The median nerve:
- Is responsible for the innervations of the following
soldiers.
1. Flexor carpi radialis
2 .Flexor digitorum superficialis
3. Flexor digitorum profundus
4. Flexor pollicis longus
5. Palmaris longus
Gives humans the ability to oppose the thumb
joint
Capo # 2
- Is responsible for the
innervations of the following
soldiers.
- 1. Flexor carpi radialis
- 2. Flexor digitorum
profundus
Capo # 3
• The Radial Nerve:
- Is responsible for the
innervations of the following
muscles
- 1. Extensor carpi radialis
longus
- 2. Extensor carpi radialis brevis
-
3. extensor digitorum
4. extensor carpi ulnaris
5. Abductor pollicis longus
6. Extensor digiti minimi
7. extensor pollicis brevis
8. Extensor pollicis longus
Other known associates
Dorsal cutaneous branch Vaga and
Palmer cutaneous branch Winfield
Median Associate #1
• - The Palmer
cutaneous branch:
• - splits off the median
nerve before crease of
the wrist
Ulnar Associate #1
• The dorsal cutaneous branch:
• Known for famous debilitating
wrist lock
There Will Be Blood
The Five Burrows
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Arteries:
1. Deep palmar arch
2. Superficial palmar arch
3. Common palmar digital arteries
•
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The Radial artery supplies blood to:
1. Flexor carpi radialis
2. Extensor carpi radialis longus
3. Extensor carpi radialis brevis
4. Flexor pollicis longus
The Ulnar artery supplies blood to:
1. Flexor carpi radialis
2. Flexor carpi ulnaris
3. Extensor carpi ulnaris
4. Flexor digitorum superficialis
5. Flexor digitorum profundus
6. Palmaris longus
Reccurent Interosseous Artery
•
•
•
-supplies:
-Extensor digitorum
-Extensor digiti minimi
Posterior Interosseous Artery
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-supplies:
- Abductor pollicis longus
-Extensor pollicis brevis
-Extensor pollicis longus
Waste Management
- 1. Cephalic vein
- 2. Basillic vein
- 3. Superficial dorsal
venous arch (network)
- 4. Deep dorsal venous
arch (network)
Clinical Concerns
Carpal tunnel
Ganglion cyst
- The transverse carpal ligament in the wrist
puts pressure on the medial nerve
- - possible cause: overuse, hormonal
- http://www.youtube.com/watch?v=SGyKQc
hSEJ4
- Is a fluid filled cyst that develops
out of a joint.
- - possible cause: joint trauma
- http://www.youtube.com/watch?v=
mJ6oj3lkqm8
De Quervain’s Tenosynovitis
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-irritation of the sheath around the tendon
- affects the tendons on the thumb side of the wrist
- possibly caused by repetitive actions, over use
- http://www.youtube.com/watch?v=q87zSRYHa1o
Spoiler Alert