Understanding the Anatomy of the Hand and Wrist
Explore the bones, articulations, and structures of the hand and wrist, including carpal bones, flexor and extensor retinaculum, and carpal tunnel. Learn about the anatomical snuff box, wrist retinacula, nervous and arterial distribution, and the resting and anatomical position of the hand. Detailed descriptions and images provide a comprehensive overview.
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The Hand The Hand pp. pp. 782 782 Objectives: 1. Identify the bones & articulations of the hand 2. Study the anatomical snuff box & wrist retinacula with arrangement of structures around them 3. Study the nervous & arterial distribution of the hand And understand its resting & anatomical position
General overview General overview - 1. Wrist = Carpus 2. Palm= Metacarpus 3. Digit = Phalanges Parts: Parts: - - Palmar & Dorsal surfaces Palmar & Dorsal surfaces Palmar skin Palmar skin= hairless thick with creases Dorsal skin Dorsal skin= thin hairy with prominent superficial veins Resting fingers Resting fingers= semiflexed in an arc Anatomical position Anatomical position= all extended - - -
Carpal bones Carpal bones - 1. Scaphoid 2. Lunate 3. Triquetrum 4. Pisiform - Distal row: Distal row: 1. Trapezium 2. Trapezoid 3. Capitate 4. Hamate Proximal row: Proximal row:
Carpal bones Carpal bones - 1. Scaphoid: boat-shaped with ant. tubercle 2. Lunate: crescent-shaped 3. Triquetrum: 3-sided 4. Pisiform: Seasamoid Pea-like on top of triquetrum - Distal row: Distal row: 1. Trapezium: Irregular 4-sided with ant. tubercle 2. Trapezoid: regular 4 sided 3. Capitate: largest one 4. Hamate: has ant. hook Proximal row: Proximal row:
Carpal arch Carpal arch - 1. Laterally: Tubercles of scaphoid & trapezium 2. Medially: Pisiform & hook of hamate Anterior projections: Anterior projections:
The Flexor retinaculum & Carpal Tunnel
Flexor retinaculum of the wrist
Extensor retinaculum of the wrist
Flexor retinaculum & Carpal tunnel structure arrangement: A. Superficial (Anterior): 1. Ulnar n. 3. Palmar cut. br. of ulnar nerve 4. Palmaris longus tendon 5. Palmar cut. br. of median n. 2. Ulnar a. Thank you Thank you B. Deep (posterior): 1. FDS 4 tendons 2. FDP 4 tendons 3. FPL tendon 4. FCR tendon (isolated) 5. Median nerve Thanks to your commitment and strong work ethic, we know next year will be even better than the last. We look forward to working together. Contoso Contoso sales@contoso.com
Extensor retinaculum structure arrangement: A. Superficial (Posterior): 1. Dorsal cut. br. of ulnar nerve 2. Basilic vein 3. Cephalic vein 4. Superficial br. Of radial nerve Thank you Thank you B. Deep (posterior): 1. ECU tendon 2. EDM tendon 3. ED (4)+EI (1) 4. EPL tendon 5. ECRL & ECRB 6. APL+EPB+RA Thanks to your commitment and strong work ethic, we know next year will be even better than the last. We look forward to working together. Contoso Contoso sales@contoso.com
The Anatomical snuff The Anatomical snuff- -box * * Boundaries Boundaries: EPL (medially) : EPL (medially) , EPB & APL (laterally) *Floor: Scaphoid & trapezium *Floor: Scaphoid & trapezium * *Contents Contents: Radial a., Superficial branch of radial nerve, Cephalic v. : Radial a., Superficial branch of radial nerve, Cephalic v. box , EPB & APL (laterally)
The Anatomical snuff The Anatomical snuff- -box * * Boundaries Boundaries: EPL (medially) : EPL (medially) , EPB & APL (laterally) *Floor: Scaphoid & trapezium *Floor: Scaphoid & trapezium * *Contents Contents: Radial a., Superficial branch of radial nerve, Cephalic v. : Radial a., Superficial branch of radial nerve, Cephalic v. box , EPB & APL (laterally)
Joints Joints 1. Radiocarpal (wrist)= radial styloid process Scaphoid & Lunate (Ellipsoid) 1. Intercarpal (Plane) (Plane) (Ellipsoid) 2. Carpometacarpal (Plane EXCEPT thumb: Saddle) (Plane EXCEPT thumb: Saddle) 3. Intermetacarpal (Plane) (Plane) 4. Metacarpophalangeal (Condylar) (Condylar) 5. Proximal & distal interphalangeal (Hinge) (Hinge)
The wrist articulation The wrist articulation & Ligaments & Ligaments
Wrist movements Wrist movements - FCR, PL, FCU, FDS, FDP, FPL Flexion: Flexion: - - Extension: Extension: ECRL, ECRB, ED, EI, EDM, ECU, EPL, EPB - - Abduction: Abduction: FCR, ECRL, ECRB, FPL, APL - - Adduction: Adduction: FCU, ECU
Carpometacarpal joint of the Carpometacarpal joint of the thumb thumb
Carpometacarpal joint of the Carpometacarpal joint of the thumb thumb Adductor pollicis+ Adductor pollicis+ 1 1st st Palmar Palmar interosseous interosseous APL + APB APL + APB EPL + EPB EPL + EPB FPL + FPB FPL + FPB Opponens Opponens pollicis + pollicis + Opponens Opponens digiti minimi minimi digiti
Metacarpophalangeal Joints Metacarpophalangeal Joints - Flexion, extension, abduction, adduction, limited (passive) rotation Condylar joints allowing: Condylar joints allowing: - Fibrous capsule thickened on the Fibrous capsule thickened on the sides as collateral ligaments sides as collateral ligaments - - Palmar ligaments Palmar ligaments - - 3 3 Deep transverse metacarpal Deep transverse metacarpal ligaments (between medial ligaments (between medial 4 4 fingers) fingers)
Interphalangeal Joints Interphalangeal Joints - Flexion / Extension Hinge joints allowing: Hinge joints allowing: - Fibrous capsule thickened on the Fibrous capsule thickened on the sides as collateral ligaments sides as collateral ligaments - - Palmar plates Palmar plates
