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OA 3.6 PowerPoint Presentation

OA 3.6

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OA 3.6

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  1. OA 3.6 • How many bones are in each arm, from the wrist to the finger tips?

  2. Chapter 16 (pp.416-425) The Wrist, Hand,& Fingers

  3. skeletal anatomy

  4. complicated…

  5. the radius • “Thumb Side” • Shorter than the Ulna • Larger at wrist, smaller at elbow • Head is proximal – at the elbow

  6. the radius Landmarks: • Carpal surface • Articulates with carpal bones • Styloid process

  7. the ulna • “Pinky Side” • Thicker proximally, smaller distally • Head is distal – at the wrist

  8. the ulna Landmarks: • Head • Styloid process

  9. the wrist • Common term for the carpal bones • 8 carpal bones in each wrist

  10. Distal Row (Lateral to Medial) carpal bones Proximal Row (Lateral to Medial) Scaphoid (Navicular) Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate

  11. carpal bones

  12. carpal trick • Some = scaphoid • Lefties = lunate • Try = triquetrium • Plays = pisiform • That = trapezium • They = trapezoid • Can’t = capitate • Handle = hamate

  13. metacarpals • Knuckles - 5 per hand • Base is proximal • Head is distal • Numbered 1-5 from thumb to pinky • ex: Thumb =1 • ex: Pinky = 5

  14. metacarpal landmarks Landmarks: • Proximal to Distal: • Base • Shaft • Head • Condyles

  15. phalanges • “Fingers” • 14 bones • 3 per finger (12) • 2 per thumb (2) • Landmarks: • Proximal • Middle • Distal

  16. articulations

  17. radiocarpal joint • “Wrist joint” • Radius, scaphoid, & lunate • Flex/Ext & Ulnar/Radial Deviation • Stabilized by Radial CollateralLigament

  18. ulnocarpal joint • “False joint” • Separated & stabilized by cartilaginous disc (meniscus-like) • TFCC • Stabilized by Ulnar Collateral Ligament

  19. triangular fibrocartilage complex (TFCC) • Articular disc – the “meniscus” of the wrist • Increases stabilityin the distal radioulnar joint, extendsthe ulnocarpal joint

  20. radioulnar joint • Formed by ulnar head and ulnar notch of the radius • Allows for supination& pronation

  21. intercarpal joints • Supported by interosseous membrane and capsular ligaments • Too numerous to list (every bone is connected)

  22. carpometacarpal joints • MC 1  trapezium • MC 2  trapezoid • MC 3  capitate • MC 4 & 5  hamate (single joint)

  23. OA 3.7 • Identify the similarities between the ankle/foot and wrist/hand. • #of bones (by group), function

  24. metacarpophalangeal & interphalangeal joints MCP joints: • “Knuckles” • Numbered 1-5 thumb to pinky IP joints: • Proximal & distal in each finger • Just IPin thumb DIP PIP IP

  25. Soft tissue anatomy ligaments & muscles

  26. ligaments • Dorsal & palmar (volar) radiocarpal ligaments • Ulnar & radial collateral ligaments • TFCC • Intercarpal ligaments • UCL & RCL for each MCP & IP joint

  27. wrist joint ligaments

  28. radiocarpal ligaments • Palmar (volar) RCL: • 3 individual ligaments • Capitate, triquetrum, scaphoid • Limits wrist hyperextension • DorsalRCL: • Posteriorsurface of radius (styloid process)  lunate & triquetrum • Limits wrist flexion

  29. radiocarpal ligaments Palmar (Volar) Ligaments Dorsal Ligaments

  30. collateral ligaments • Ulnar Collateral Ligament • Styloid process of ulna  TFCC  triquetrum & pisiform • Limits radial deviation • Radial Collateral Ligament • Styloid process of radius  scaphoid & trapezium • Limits ulnar deviation

  31. collateral ligaments

  32. MCP & IP ligaments • Ulnar collateral & radial collateral ligament at each MCP & IP joint • Stabilizes the joint through flexion & extension • Named according to anatomical position (i.e. backwardswhen looking at dorsal aspect of hand)

  33. muscles • Natural Position of hand/fingers is slightly flexed • Passively extend wrist & watch fingers???

  34. muscles • Wrist extensors & wrist flexors • Extrinsic muscles of the hand • Muscles of the forearm that provide strength and crude control of the hand and fingers • Intrinsic muscles of the hand • Muscles originate in the hand and wrist that provide fine control of the hand

  35. wrist flexors • Flexor carpi radialis • Flexor carpi ulnaris • Palmaris longus

  36. wrist extensors • Extensor carpi radialislongus • Extensor carpi radialisbrevis • Extensor carpi ulnaris

  37. extrinsic muscles of the hand • Muscles that move the hand/fingers • Extensor digitorum • Extensor indicis • Extensor digitiminimi • Flexor digitorumsuperficialis • Flexor digitorumprofundus

  38. extrinsic muscles of the hand • Muscles that move the thumb • Abductor pollicislongus • Extensor pollicisbrevis • Extensor pollicislongus • Flexor pollicislongus *Easier to remember movements if you “rotate” thumb to correspond to fingers

  39. intrinsic muscles of the hand • Thenar eminence (thumb side) • Adductor pollicis • Opponenspollicis • Abductor pollicisbrevis • Flexor pollicisbrevis • Hypothenareminence (pinky side) • Abductor digitiminimi • Flexor digitiminimibrevis (no longus) • Opponensdigitiminimi • Palmaris brevis

  40. intrinsic muscles of the hand • Lumbricles (4) • Dorsal Interossei / InterosseiDorsales (4) • Palmar Interossei / InterosseiPalmares (3 or 4)

  41. Lumbricles PIs DIs

  42. other structures

  43. neurological anatomy • Ulnar nerve (C8) • Passes above carpal tunnel • Sensory to 4th & 5th digits

  44. neurological anatomy • Median nerve (C7) • Passes through carpal tunnel • Motor nerve for thenareminence • Sensory to 1st-3rd digits