Wrist and Hand
Presented by:
Selene Bonnell-Hall
Mettelisa
Jen Smart
WRIST (CARPAL) BONES
WRIST AND DISTAL PORTION OF FOREARM BONES
RADIUS STYLOID PROCESS
HEAD OF ULNA
RADIUS ULNAR NOTCH
ULNA STYLOID PROCESS
WRIST (CARPAL) BONES
WRIST (CARPAL) BONES
WRIST (CARPAL) BONES
ARTICULAR (JOINT) CAPSULE
WRIST AND HAND JOINTS
HAND LIGAMENTS
PALMER APONEUROSIS
(FASCIA)
WRIST LIGAMENTS
WRIST LIGAMENTS
EXTENSOR RETINACULUM
WRIST LIGAMENTS
COMMON FLEXOR SHEATH
HAND COMPARTMENTS AND SPACES
THENAR SPACE
THENAR
COMPARTMENT
CENTRAL COMPARTMENT
HYPOTHENAR
COMPARTMENT
ADDUCTOR
COMPARTMENT
MIDPALMER SPACE
INTEROSSEOUS
COMPARTMENT
HAND COMPARTMENTS AND SPACES
HAND COMPARTMENTS AND SPACES
HAND TEST
SURFACE ANATOMY
Site for Ulnar & Radial pulse
SURFACE ANATOMY
Distal Wrist
Crease
Median Nerve
ANATOMICAL SNUFF BOX
THENAR EMINANCE &
HYPOTHENAR EMINANCE
THENAR EMINANCE
HYPOTHENAR EMINANCE
NERVES
NERVES
PALMER CUTANEOUS BRANCHES
DORSAL CUTANOUS BRANCH
ARTERIES
Common Palmer Digitals
Superficial Palmer Arch
Deep Palmer Arch
Ulnar Artery
Radial Artery
VEINS
DORSAL
VENOUS
NETWORK
CEPHALIC VEIN
BASILIC VEIN
Carpel Tunnel Syndrome
What is it?
• A progressively painful hand/arm condition
• Caused by excessive pressure on median nerve
SYMPTOMS:
•
•
•
Tingling & Numbness
Radiating pain
Weak grip
Risk Factors:
• May be caused by repetitive
motions but studies have
not proved it.
• Most common for 30-60
y/o, esp. women.
• Cyst, tumor, bone fractures
• Anatomy = small tunnel
• Arthritis (both types) &
diabetes
• Obesity, Alcohol abuse,
fluid retention
Treatment Options
for Carpal Tunnel Syndrome
Non-Surgical Therapy: Wrist Splinting, NSAIDs,
Corticosteroids (oral & injections), Warm/Cold
compresses, Ergonomics, Exercise & Stretching
Carpal Tunnel : Median Nerve Stretches for Relieving Carpal Tunnel
http://www.youtube.com/watch?v=PvXaBrZOeIw
SURGERY
ENDOSCOPIC SURGERY
OPEN SURGERY
O-Upper 3/4s of ulna
Deep
Deep
O-Anterior surface of
radius
I-Distal phalanx of
digits 2-5
A-Flexes all three
joints of fingers (just
the tips)
I-Distal phalanx of pollex
A-Flexes all joints of the
pollex or thumb (hides
thumb)
N-Median/Ulnar
V-Ulnar Artery
N-Median
V-Radial artery
Right anterior forearm
Jen
30
Flexor Digitorum Superficialis
O-Common flexor tendon, coronoid
process and radius
I-Sides of middle phalanx of four
fingers
A-Flexes MP and PIP joints of fingers
(girly fist or bye-bye)
Intermediate
N-Median
V-Ulnar artery
Jen
31
Flexor Carpi Radialis
O-Medial epicondyle of the humerus
I-Base 2nd and 3rd metacarpals
A-Wrist flexion, radial deviation
N-Median
V-Radial/Ulnar arteries
Superficial
Jen
32
Flexor Carpi Ulnaris
O-Medial epicondyle of the humerus
I-Base 5th metacarpal, pisiform
A-Wrist flexion, ulnar deviation
N-Ulnar
V-Ulnar artery
Superficial
Jen
33
Palmaris Longus
O-Medial epicondyle of the humerus
I-Palmar fascia
A-Assists in wrist flexion
N-Median
V-Ulnar artery
Superficial
Jen
34
Tendon of
Flexor carpi
radialis
Tendon of Flexor carpi ulnaris
Tendon of Palmaris
Longus
Jen
35
Jen
36
Extensor Carpi Radialis Longus
O-Supracondylar ridge of humerus
I-Base of 2nd metacarpal
A-Wrist extension, radial deviation
N-Radial
V-Radial artery
Jen
37
Extensor Carpi Radialis Brevis
O-Lateral epicondyle of humerus
I-Base of 3rd metacarpal
A-Wrist extension
N-Radial
V-Radial artery
Jen
38
Extensor Carpi Radialis Brevis
Extensor Carpi Radialis Longus
Jen
39
Extensor Digitorum
O-Lateral epicondyle of humerus
I-Base of distal phalanx of 2nd-5th
fingers
A-Extends all three joints of the
fingers
N-Radial
V-Recurrent interosseous artery
Jen
40
Extensor Carpi Ulnaris
O-Lateral epicondyle of humerus
I-Medial side of base of 5th
metacarpal
A-Extends and adducts wrist
N-Deep radial
V-Ulnar artery
Jen
41
Jen
42
Extensor Digiti Minimi
O-Lateral epicondyle of the humerus
I-Base of distal phalanx of 5th finger
A-Extends all joints of fifth finger
N-Radial
V-Recurrent interosseus artery
Jen
43
O-Posterior distal radius
I-Base of proximal phalanx of
pollex
O-Posterior radius, interosseus
membane, middle ulna
I-Base of 1st metacarpal
A-Abducts pollex
N-Radial
V-Posterior interosseus artery
A-Extends MP joint of thumb
N-Radial
V-Posterior interosseus artery
Jen
44
O-Middle posterior ulna and
interosseus membrane
I-Base of distal phalanx of pollex
A-Extends MP and IP joints of thumb
N-Radial
V-Posterior interosseus artery
Jen
45
Tendons
Jen
46
Anatomical Snuff Box
BLOW
Jen
47
Human Anatomy Dissection 23 (part 1
of 2) Forearm and Hand - YouTube
Jen
48