Post on 01-Jan-2016
Hand and Hand and WristWrist
Mrs. MarrMrs. Marr
Anterior View
Clavicle
HumerusSc apula
UlnaRadius
MedialEpic ondy le ofHumerus
LateralEpic ondy le of
Humerus
Metac arpalsCarpals
Proximal Phalanges
Middle PhalangesD istal Phalanges
Ac romionProc ess
Corac oidProc ess
AC J t.
SC J t.GH J t.
Upper Extremity
•Shoulder
•Gleniod Humeral joint
•Humerus
•Gleniod Fossa
•Scapula (Shoulder Blade)
•Clavicle (Collarbone)
•Upper Arm
•Humerus
•Forearm
•Radius (Thumb side)
•Ulna (Pinky side)
•Wrist
•Carpals!
•Hand and Fingers
Thumb Side vs. 5Thumb Side vs. 5thth PhalangePhalange
RADIUSRADIUS
UULNALNA
Anterior V iew
Bic epsBrac hii
ThenarMusc les
Hy pothenarMusc les
Brac hioradialis
PronatorTeres
Flex. CarpiRadialis
PalmarisLongus
Flexor CarpiUlnaris
Extensors
Retinac ulum/Aponeurosis
Corac obrac hialis
Tric eps
Brac hialis
Tric eps
Poster ior V iew
Medial:Flex ors
W rist~ F lex. C a rp i R ad ia lis
Pa lmaris Longus F lex. C a rp i U lna r is
D ig its~ F lex. D ig ito rum
S uperf ic ia lis & P rodundusT hum b ~
F lex. P ollic is Longus
Lateral:Ex tens ors
W rist~Ext.C a rp i R ad ia lis
Longus & Brevis Ext. C a rp i U lna r is D ig its~ Ext. D ig ito r ium Ext. D ig iti M in imi Ext. Ind ic isT humb~ Ext. Po llic is Longus&
BrevisAbd . Po llic is Longus
Olec ranon
Anc oneus
Anatomic alSnuffbox
Brac hioradialis
Articular cartilageArticular cartilage
RadiusUlna
8 Carpal Bones: Scaphoid (Navicular), Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate5 Metacarpal Bones14 Phalanges
Navicular
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate Hamate
Head(Knuckles)
ProximalPhalanx
MiddlePhalanx
DistalPhalanx
Metacarpo-phalangeal
(MP)Jt
Radialcarpal(wrist) Jt
Metacarpals
Phalanges
Interphalangeal(IP) joint
Base
• 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 FractureBoxer’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 FractureA Bennett's
Fracture is a fracture + dislocation of the Metacarpal bone at the base of the thumb.
UlnarNerve
RadialNerve
MedianNerve
Nerve Root Scheme
Carpal Tunnel
DE QUERVAINS SYNDROME
• A common condition of inflammation around the tendons on the thumb side of the wrist.
Ligamentous Laxity Ligamentous Laxity
Now for the
Injuries....
Forearm (Radius) Forearm (Radius) fracturefracture
Ulnar Ulnar FractureFracture
Colles FractureColles Fracture
Colles fracture
Metacarpal Fracture
Metacarpal Fractures
Scaphoid (Navicular) Fracture
Hook of the Hook of the Hamate FractureHamate Fracture
Finger Amputation(Complete avulsion)
Re- attachmentRe- attachment
Finger Avulsion (Justin)
Hand Laceration (Rachel's)
The Test may look like this....
33 32
30
29
36
37
2728
25
39
40
21
38
34
______26______
_________24_____
22
23
35
31
Anterior View
C
K
F
HI
GJ
A
E
B
DL
___
bone
sid
e
An te rio r Vie w Po ste r io r Vie w
_ __
_ __
_ __
_ __
_ ___ __
_ __
___
bone
sid
e
__B ones_ _Bon e s
_ _
_ _
_ _ _ _
_ _Jt
_ _Jt_ _Jt
_ _ _ _
_ _
_ _
__
_ _
_ __ _
__
_ _
_ _
_ ___ _
_ _
_ __
_ __
1. Scapula2. Humerus3. Clavicle4. Acromion5. Coracoid6. Radius7. Ulna8. Carpals9. Metacarpals10. Phalanges11. Spine of Scapula12. SC Joint13. AC Joint14. GH Joint15. MP Joint16. PIP Joint17. DIP Joint18. Medial Epicondyle19. Lateral Epicondyle20. Olecranon21. Radial Head22. Biceps Brachii23. Triceps Brachii24. Brachialis25. Brachioradialis26. Coracobrachialis27. Extensor Muscle Mass
25. Ext. Carpi Radialis26. Ext. Digitorim27. Ext. Pollicis
Longus/Brevis28. Flexor Muscle Mass
29. Flex. Carpi Ulnaris30. Flex. Carpi Radialis31. Palmaris
32. Ulnar Collateral Lig.33. Radial Collateral Lig.34. Anatomical Snuff Box35. Thenar Muscles36. Hypothenar Muscles
Anterior V iewA
ED
F
B
C
G
N
Posterior V iewH
K
I
J
L
QUESTIONS / COMMENTS?QUESTIONS / COMMENTS?
Done....Done....Now study Now study