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Anatomy of the Hand and Wrist

Anatomy of the Hand and Wrist. Mnemonic for Learning Carpals. S he L ikes T o P lay. Lunate In the moonlight. Scaphoid A boat. Triquetrum The third T Bone. Pisiform Pea-shaped. Hamate A hambone With a hook. Trapezium: “It’s by the thumb”. Capitate. Trapezoid “Is by its side”.

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Anatomy of the Hand and Wrist

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  1. Anatomy of the Hand and Wrist

  2. MnemonicforLearningCarpals She Likes To Play Lunate In the moonlight Scaphoid A boat Triquetrum The third T Bone Pisiform Pea-shaped Hamate A hambone With a hook Trapezium: “It’s by the thumb” Capitate Trapezoid “Is by its side” Try To Catch Her Click R Button for Slideshow

  3. Bones of the Wrist (Which hand? what view?)

  4. Bones of Wrist (which hand?)

  5. Flexor Tendons • The muscles that flex your wrist are on the palmer side. • A group of the begin at the medial epicondyle of the humerus at the elbow

  6. Flexor Carpi Radialis • Origin Medial epicondyle of humerus • Insertion Base of 2nd metacarpal • Action Flexes and radial deviates the hand (at wrist) • Innervation Median nerve (C6 and C7)

  7. Flexor Digitorum Superficialis • Origin medial epicondyle of humerus, • Insertion middle phalanges of digits 2 - 5 • Action Flexes middle phalanges at proximal interphalangeal joints also flexes proximal phalanges at metacarpophalangeal joints and hand • Innervation Median nerve (C7, C8 and T1)

  8. Flexor Carpi Ulnaris • Origin medial epicondyle of humerus • Insertion Pisiform bone, hook of hamate bone, and 5th metacarpal bone • Action Flexes and ulnar deviates hand (at wrist) • Innervation Ulnar nerve (C7 and C8)

  9. Palmaris Longus • Origin Medial epicondyle of humerus • Insertion Distal half of flexor retinaculum and palmar aponeurosis • Action Flexes hand at the wrist • Innervation Median nerve (C7 and C8)

  10. Flexor Digitorum Profundus • Origin Proximal 3/4 of ulna • Insertion Base of the distal phalanx of digits 2 – 5 • Action Flexes distal phalanges at distal interphalangeal joints • Innervation • Medial part: ulnar nerveLateral part: median nerve

  11. Flexor Digiti Minimi Brevis • Origin Hook of hamate and flexor retinaculum • Insertion Medial side of base of proximal phalanx of little finger • Action Flexes proximal phalanx of little (5th) finger • Innervation ulnar nerve

  12. Flexor Pollicis Brevis • Origin Flexor retinaculum and tubercles of scaphoid and trapezium • Insertion Lateral side of base of proximal phalanx of thumb • Action Flexes thumb • Innervation Recurrent branch of median nerve (C8 and T1)

  13. Flexor Pollicis Longus • Origin Anterior surface of radius and adjacent interosseous membrane • Insertion Base of distal phalanx of thumb • Action Flexes phalanges of 1st digit (thumb) • Innervation Anterior interosseous nerve from median nerve (C8 and T1)

  14. The 2 Muscles of Pronation • Two muscles work together to turn the radius over the ulna and put the hand in a prone position • Pronator teres and pronator quadratus

  15. Pronator Quadratus • Origin Distal 1/4 of anterior surface of ulna • Insertion Distal 1/4 of anterior surface of radius • Action Pronates forearm; • Innervation median nerve

  16. Pronator Teres • Origin Medial epicondyle of humerus • Insertion Middle of lateral surface of radius • Action Pronates • Innervation Median nerve (C6 and C7)

  17. Abduction at Hand • Abduction really only occurs at the thumb and little fingers

  18. Abductor Digiti Minimi • Origin Pisiform • Insertion Medial side of base of proximal phalanx of little finger • Action Abducts little (5th) finger • Innervation ulnar nerve (C8 and T1)

  19. Abductor Pollicis Brevis • Origin scaphoid and trapezium • Insertion Lateral side of base of proximal phalanx of thumb • Action Abducts thumb • Innervation median nerve (C8 and T1)

  20. Abductor Pollicis Longus • Origin Posterior surfaces of ulna, • Insertion Base of 1st metacarpal • Action Abducts thumb • Innervation the radial nerve

  21. Adduction • Movement towards the midline of the body

  22. Adductor Pollicis • Origin 2nd and 3rd metacarpals, capitate, • Insertion Medial side of base of proximal phalanx of thumb • Action Adducts thumb • Innervation ulnar nerve

  23. Wrist Extensors • The extensors of the wrist are on the Dorsal side of the forearm • A majority of the wrist extensors begin at the lateral epicondyle

  24. Extensor Carpi Radialis Brevis • Origin Lateral epicondyle of humerus • Insertion Base of 3rd metacarpal • Action Extends and radially deviates the wrist • Innervation radial nerve (C7 and C8)

  25. Extensor Carpi Radialis Longus • Origin Lateral supracondyle ridge of humerus • Insertion Base of 2nd metacarpal • Action Extends and radially deviates at the wrist • Innervation Radial nerve (C6 and C7)

  26. Extensor Carpi Ulnaris • Origin Lateral epicondyle of humerus • Insertion Base of 5th metacarpal • Action Extends and ulnar deviates hand at wrist joint • Innervation Radial nerve

  27. Extensor Digiti Minimi Origin Lateral epicondyle of humerus Insertion 5th digit Action Extends 5th digit at metacarpophalangeal and interphalangeal joints Innervation Posterior interosseous nerve

  28. Extensor Digitorum • Origin Lateral epicondyle of humerus • Insertion Extensor expansions of medial four digits • Action Extends the four digits and the wrist • Innervation Posterior interosseous nerve

  29. Extensor Indicis • Origin Posterior sufrace of ulna and interosseous membrane • Insertion Extensor expansion of 2nd digit • Action Extends 2nd digit and helps to extend hand • Innervation Posterior interosseous nerve

  30. Extensor Pollicis Brevis • Origin Posterior sufraces of radius and interosseous membrane • Insertion Base of proximal phalanx of thumb • Action Extends proximal phalanx of thumb at carpometacarpal joint • Innervation Posterior interosseous nerve

  31. Extensor Pollicis Longus • Origin Posterior surface of middle 1/3 of ulna • Insertion Base of distal phalanx of thumb • Action Extends distal phalanx of thumb at carpometacarpal and interphalangeal joints • Innervation Posterior interosseous nerve

  32. Supination Muscles • There are two muscles that return you to the anatomical position by uncrossing the radius and ulna

  33. Biceps Brachii • Origin • Short head: tip of coracoid process of scapulaLong head: supraglenoid tubercle of scapula • Insertion Tuberosity of radius and fascia of forearm via bicipital aponeurosis • Action Supinates forearm and, when it is supine, flexes forearm • Innervation Musculocutaneous nerve (C5 and C6 )

  34. Supinator • Origin Lateral epicondyle of humerus, • Insertion Lateral, posterior and anterior surfaces of proximal 1/3 of radius • Action Supinates forearm • Innervation Deep branch of radial nerve (C5 and C6)

  35. Opposition • The ability to touch your thumb and pinky

  36. Opponens Digiti Minimi • Origin Hook of hamate and flexor retinaculum • Insertion Medial border of 5th metacarpal • Action brings little finger (5th digit) into opposition with thumb • Innervation Deep branch of ulnar nerve (C8 and T1)

  37. Opponens Pollicis • Origin Flexor retinaculum and tubercles of scaphoid and trapezium • Insertion Lateral side of 1st metacarpal • Action Draws 1st metacarpal laterally to oppose thumb toward center of palm • Innervation Recurrent branch of median nerve (C8 and T1)

  38. The Three Nerves of the wrist and hand

  39. The median nerve • The median nerve supplies feeling the the palmer side of your 1st, 2nd,3rd, and medial 4th fingers. • The Median nerve is involved with carpal tunnel syndrome

  40. The Ulnar nerve • The Ulnar nerve supplies feeling and motor function to the lateral 4th and 5th fingers.

  41. The Radial Nerve • The radial nerve innervates most of the extensors and supplies the feeling on the dorsal side of the first three digits

  42. Joint – the place where two bones come together (4 types)

  43. Ball and socket joint – greatest range of motion allowing bones to swing in a circle Example: shoulder or hip

  44. Pivot joint – one bone rotates around another Example: Neck and under the Elbow

  45. Hinge joint – bones bend like a hinge forward and backward Example: Knee and Elbow

  46. Gliding joint – allows one bone to slide over another Example: Wrist and Ankle

  47. Joint Shapes • Condyloid: egg-shape articular surface + oval concavity • side-to-side, back+forth movement • (eg) metacarpophalangeal (knuckle)

  48. pg 225 Joint Shapes • Saddle: articular surface both concave + convex • side-to-side, back-forth movement • (eg) carpometacarpal jt of thumb

  49. Hinge Joint • In between the Phalanges are Hinge Joints • They move in flexion and extension

  50. A Ligament • A Ligament attaches a bone to bone • An Injury to a Ligament is called a Sprain • A Tendon Attaches a muscle to a bone • An injury to a tendon or Muscle is a strain

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