OTA Hand Wrist presentation
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Transcript OTA Hand Wrist presentation
Wrist and Hand
CREATED BY:
BRIANA OCHOA
ELIZABETH RICH
DAVID SNYDER
Surface Anatomy
Ulnar Styloid Process
Pisiform
Ulnar Pulse
Radial Pulse
Surface Anatomy
Distal Wrist Crease
Tendon of Flexor
Carpi Ulnaris
Radial Artery
Tendon of Flexor
Carpi Radialis
Tendon of Palmaris
Longus
Surface Anatomy
Hypothenar Eminence
Thenar Eminence
Surface Anatomy
•
•
Anatomical Snuff Box
Tendons of:
• Extensor Digitorum
• Extensor Pollicis
Longus (EPL)
• Abductor Pollicis
Longus (APL)
Median Nerve
Bones
Head
Ulna
Ulnar Notch
Radius
Styloid Process
Bones
• Fingers numbered 1-5
• Thumb side is always #1
Carpals
Carpals
Some Lovers Try Positions That They Can’t Handle
Joints
Bones of Wrist and Hand
Articular Capsule
Synovial Membrane
Produces synovial fluid for lubrication and shock absorption
Fibrous Layer
Enclose synovial sheaths
(outer membrane)
May contain ligaments
Membrane and Cartilage
Articular Cartilage
Ligaments
Common Flexor Sheath
Through carpal canal to cover flexor tendons of digits
Palmar Aponeurosis
Insertion of palmaris longus
Common Flexor Sheath
Ligaments
Extensor Retinaculum
Connects lateral margin of radius to medial margin of ulna
Flexor Retinaculum
Crosses over carpal bones
Extensor Retinaculum
Wrist Movement
Actions
Actions
Extension
Adduction aka Ulnar
Extensor carpi ulnaris
Extensor carpi radialis brevis
Extensor carpi radialis longus
Deviation
Extensor carpi ulnaris
Flexor carpi ulnaris
Assist in Extension
Extensor digitorum
Extensor indicis
Flexion
Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus
Flexor digitorum superficialis
Flexor digitorum profundus
Abduction Deviation aka
Radial Deviation
Extensor carpi radialis brevis
Extensor carpi radialis longus
Flexor carpi radialis
Pronation
Pronator quadratus
Extrinsic Extensor Muscles
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris muscle
Extrinsic Muscles: Anatomical Snuff Box
Extensor
pollicis longus
Extensor
indicis
Abductor pollicis longus
Extensor pollicis
longus
brevis
Extrinsic Flexor Muscles
Extrinsic Muscles of the 1st Digit
Extensors
Extensor pollicis longus
Extensor pollicis brevis
Abductors
Abductor pollicis longus
Flexors
Flexor pollicis longus
Extrinsic Pollicis Muscles
Abduction, Extension, and Flexion
Movements of the Pollicis at the MCP and
CMC Joints
Movements of the Pollicis at the CMC Joint
Abduction
Abductor pollicis longus
Abductor pollicis brevis
Adduction
Adductor pollicis: transverse and oblique heads
Thumb Movement
Extension
Extensor pollicis longus
Extensor pollicis brevis
Flexion
Flexor pollicis brevis
Thumb Movement
Opposition
Opponens pollicis
Reposition
Abductor pollicis
Compartments and Spaces-Intrinsic Muscles
Thenar Compartment
Flexor pollicis brevis
Abductor pollicis brevis
Opponens pollicis
Hypothenar Compartment
Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi
Compartments and Spaces of Hand
Adductor Compartment
Central Compartment
Adductor
pollicis
palp
Contents: long flexor tendons, digital nerves, su
Thenar and Midpalmer Spaces
Thenar Space
1st lumbrical muscle
Flexor digitorum profundus
tendon of digit 2
Midpalmer Space
Lumbricals 2-4
Flexor digitorum profundus
tendons of digits 3-5
Actions of Lumbrical Muscles:
Flex MCP joints
Extend IP joints (PIP & DIP)
Interosseous Compartment
Dorsal Interossei
Arise from 4 medial metacarpal
bones
Action: Abduction
Mnemonic: DAB
Dorsal: Abduction
Palmer Interossei
Arise from metacarpal bones 2,
4, 5
Action: Adduction
Mnemonic: PAD
Palmar: Adduction
Movement of Medial Digits at the MCP Joints
Extension
Extensor digitorum
Extensor indicis
Extensor digiti minimi
Flexion
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor digiti minimi
Lumbricals
Medial Digit Movement
Abduction
Abductor digiti minimi
Dorsal interossei (digits 2-4)
Adduction
Palmer interossei (digits 2,4,5)
Opposition
Opponens digiti minimi
Digital Movement
Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi
Digital Movement-Abduction and Adduction
Dorsal Interossei (4)
Arise from 4 medial metacarpal
bones
Action: Abduction
Mnemonic: DAB
Dorsal: Abduction
Palmer Interossei (3)
Arise from metacarpal bones 2,
4, 5
Action: Adduction
Mnemonic: PAD
Palmar: Adduction
Digital Movement at PIP and DIP Joints
Flexion
D1
IP: Flexor pollicis longus
D2-5
PIP: Flexor digitorum
superficialis
DIP: Flexor digitorum
profundus
Extension
D1: Extensor pollicis longus
D2-D4
PIP: Lumbricals, Interossei
and Extensor digitorum
DIP: Lumbricals, Interossei
and Extensor digitorum
D2: Extensor indicis
D3: Dorsal interosseus
D5
PIP – Palmar interosseus and
Extensor digiti minimi
DIP - Palmar interosseus and
Extensor digiti minimi
Nerves
Nerves
Nerves
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome:
Condition in which the median nerve
is pinched inside of the carpal tunnel
Carpal Tunnel Syndrome
Common Causes:
-frequent or extreme use of wrist
-vibration of wrist
-excessive force with use of fingers
Carpal Tunnel Syndrome
Arteries
Arteries
Arteries
Veins
Veins
Cadaver Video Hand Dissection
http://www.youtube.com/watch?feature=
player_detailpage&v=WfXTehI1PWo