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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
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WRIST & HAND PTA 106 Unit 3 presentation by: Lisa, Bobbi, Deanna, Chris
Wrist Bones Some Lovers Try Positions That They Can’t Handle
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 Formed by dense irregular connective tissue attached to the periosteum surface of joints. Allows for movement. Provides stability • 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
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 Joints- articular 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 Planar Joints- 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: 90degrees
Motions of the Fingers PIPJ flexion: 110-120 degrees, 0 degrees extension DIPJ flexion: 80-90 degrees, 0 degrees extension Abduction: 20-25 degrees MCPJ flexion: 85-105 degrees MCPJ extension: 20-30 degrees
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.
Central Nervous System Aka “The Boss”
Capo # 1 • The median nerve: - Is responsible for the innervations of the following soldiers. • 1. Flexor carpi radialis • 2 .Flexor digitorumsuperficialis • 3. Flexor digitorumprofundus • 4. Flexor pollicislongus • 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 carpiradialis 2. Flexor digitorumprofundus
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 branchWinfield
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
The Five Burrows • Arteries: • 1. Deep palmar arch • 2. Superficial palmar arch • 3. Common palmar digital arteries
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
ReccurentInterosseous Artery • -supplies: • -Extensor digitorum • -Extensor digiti minimi
Posterior Interosseous Artery • -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)
Ganglion cyst Clinical Concerns Carpal tunnel • The transverse carpal ligament in the wrist puts pressure on the medial nerve • - possible cause: overuse, hormonal • http://www.youtube.com/watch?v=SGyKQchSEJ4 • Is a fluid filled cyst that develops out of a joint. • - possible cause: joint trauma • http://www.youtube.com/watch?v=mJ6oj3lkqm8
De Quervain’sTenosynovitis • -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