Hand & Wrist Skeletal Anatomy

1. Hand & Wrist Skeletal Anatomy Sports Medicine Property of CTE Joint Venture

2. Bellwork • Complete only the B portion of the BLT chart writing what you know about the hand and wrist. Then put BLT chart aside until the end of the lesson. • Write-Pair-Share a list of all the anatomical structures of the hand that you can recall from previous lessons. Record list on paper and share with partner. Property of CTE Joint Venture

3. Objectives • Recognize skeletal anatomy for the hand & wrist • Recognize ligaments of the hand & wrist Property of CTE Joint Venture

4. Terminology • Carpals: small bones of the hand • Metacarpals: long bones of the hand, between the carpal bones and the phalanges • Phalanges: bones of the fingers Property of CTE Joint Venture

5. Bones of the Hand & Wrist • Ulna • Radius • Carpals (8) • Metacarpals (5) • Phalanges (14) • Distal • Intermediate • Proximal http://www.sports-injury-info.com/hand-anatomy.html Property of CTE Joint Venture

6. Property of CTE Joint Venture

7. Bones of the Wrist • Ulna • Styloid Process • Radius • Styloid Process https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjJs8nWmKzUAhVp0FQKHY2nBKMQjhwIBQ&url=https%3A%2F%2Fplasticsurgerykey.com%2Fmanagement-of-wrist-fractures%2F&psig=AFQjCNE55xqAwlryP3FxyKP_UJQsgKC7BQ&ust=1496940591745748 Property of CTE Joint Venture

8. Carpal Bones • (Starting with distal row, lateral to medial) • 1. Trapezium • 2. Trapezoid • 3. Capitate • 4. Hamate • 5. Pisiform • 6. Scaphoid • 7. Lunate • 8. Triquetrum 2 3 4 1 5 6 8 7 Property of CTE Joint Venture

9. Metacarpals • Numbered from 1 to 5, starting with the thumb • 1 – thumb • 2 – pointer finger • 3 – middle finger • 4 – ring finger • 5 – pinkie finger 3 2 4 5 1 Property of CTE Joint Venture

10. Phalanges (14) • Proximal phalynx • Intermediate phalynx (except thumb) • Distal Phalynx Property of CTE Joint Venture

11. Identify the bones of the hand Property of CTE Joint Venture http://www.yalemedicalgroup.org/stw/Page.asp?PageID=STW023547

12. Ligaments of the Wrist • Wrist: • Ulnar collateral ligament • Radial collateral ligament • Transverse carpal ligament Property of CTE Joint Venture

13. Ligaments of the Hand • Fingers: • Collateral ligaments Property of CTE Joint Venture

14. Articulations of the wrist • Radiocarpal joints • Intercarpal joints • Carpometacarpal joints

15. Joints of the Hand & Wrist • Radiocarpal joint (wrist joint) • Carpal joints • Metacarpophalangeal joints • Phalangeal joints • Proximal interphalangeal (PIP) joint • Distal interphalangeal (DIP) joint

16. Radiocarpal Joint • The articulation between the radius and the carpal bones • Type of joint: condyloid • Allows flexion, extension, ulnar and radial deviation, and circumduction

17. Carpal Joints • Type of joint: gliding • Stabilized by various ligaments • Allow limited movement

18. Metacarpophalangeal Joints • Articulation between the metacarpals and the phalanges • 1st MCP (thumb) is a saddle joint • Allows flexion, extension, abduction, adduction and rotation

19. Metacarpophalangeal Joints • 2nd through 5th MCP joints are condyloid joints • Allow flexion, extension, abduction, adduction and circumduction

20. Interphalangeal Joints • Type of joint: hinge • Allow flexion and extension • Two categories of phalangeal joints: • proximal • distal

21. Interphalangeal Joints • Proximal interphalangeal (PIP) joint is the articulation between the proximal & intermediate phalanges • Distal interphalangeal (DIP) joint is the articulation between the intermediate and distal phalanges • Exception: The thumb only has an interphalangeal joint (IP) joint because it has just 2 phalanges

22. Carpal Ligaments • Wrist is stabilized by anterior, posterior, and interosseous ligaments. • Play important role in stabilization of the wrist complex. • Identification of specific ligament difficult if not impossible.

23. Bone structure allows 6 different motions Flexion Extension Adduction (Ulnar deviation) Abduction (Radial deviation) Pronation Supination Wrist Motion

24. Muscles of the Wrist • Wrist flexors: • group of muscles located on the anterior part of the wrist • perform flexion of the wrist

25. Wrist Flexors • Pronator Teres: strongest wrist & forearm pronator; works with the pronator quadratus • Flexor carpi radialis: flexes & abducts the wrist toward the radial side (radial deviation) • Flexor carpi ulnaris: flexes & adducts the wrist toward the ulnar side (ulnar deviation) • Palmaris longus: a secondary muscle active during wrist flexion • 14% OF PEOPLE DON’T HAVE ONE! DO YOU? • Oppose your pinkie & thumb, then slightly flex your wrist. Are two tendons popping up or just one? If just one, then you’re unique! • Supinator: performs wrist & forearm supination *Carpus is Latin for wrist!

27. Wrist Extensors • Wrist extensors: • group of muscles located on the posterior part of the wrist • perform extension of the wrist • Extensor carpi ulnaris: extends & adducts the wrist • Extensor carpi radialis longus & brevis: extend & abduct the wrist

28. Muscles of the Fingers • Finger flexors: • muscles on the anterior part of the hand • perform flexion of the fingers • Finger extensors: • muscles on the posterior part of the hand • perform extension of the fingers

30. Finger Flexors • Flexor digitorum superficialis: Flexes the digits at the proximal interphalangeal joints • Flexor digitorum profundus: Flexes the digits at the distal interphalangeal joints • Flexor pollicis longus: Flexes the thumb at the IP joint • Flexor pollicis brevis: Flexes the thumb at the MCP joint

31. Finger Extensors • Extensor digitiminimi • Extends the pinkie finger • Extensor indicis • Extends the index finger • Extensor digitorum • Extends the fingers as a group • Extensor pollicis brevis • Extends the thumb at the MCP joint • Extensor pollicis longus • Extends the thumb at the IP joint • Abductor pollicis • Abducts the thumb

32. Flexor Retinaculum • Strong fibrous band that restrains or holds in place tissue, muscles or organs • Restraining structure for the flexor tendons

33. Extensor retinaculum • Strong fibrous band • Restraining structure for the extensor tendons

34. Review Property of CTE Joint Venture

35. NumberedHeads 4 Students Number 1-4 Identify the skeletal structure that the teacher is pointing to on the model of the hand and wrist. Property of CTE Joint Venture PROPERTY OF PIMA COUNTY JTED, 2010

36. Closure • Write down the anatomical names on a piece of paper that your teacher points to • Share your answers with a partner until you are sure you agree on the anatomy • Finish your “L” and “T” columns on your BLT sheet Property of CTE Joint Venture