wrist and hand

Wrist and HandPresented by:

Selene Bonnell-HallMettelisa Jen Smart

WRIST (CARPAL) BONES

WRIST AND DISTAL PORTION OF FOREARM BONES

ULNA STYLOID PROCESS

HEAD OF ULNA

RADIUS ULNAR NOTCH

RADIUS 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

CENTRAL COMPARTMENT

THENAR SPACE

MIDPALMER SPACE

ADDUCTOR COMPARTMENT

THENAR COMPARTMENT

HYPOTHENAR COMPARTMENT

INTEROSSEOUS COMPARTMENT

HAND COMPARTMENTS AND SPACES

HAND COMPARTMENTS AND SPACES

HAND TEST

SURFACE ANATOMYSite 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 Optionsfor Carpal Tunnel Syndrome

Non-Surgical Therapy: Wrist Splinting, NSAIDs, Corticosteroids (oral & injections), Warm/Cold compresses, Ergonomics, Exercise & Stretching

SURGERY

ENDOSCOPIC SURGERY OPEN SURGERY

Carpal Tunnel : Median Nerve Stretches for Relieving Carpal Tunnel  http://www.youtube.com/watch?v=PvXaBrZOeIw

Jen 30

O-Upper 3/4s of ulna

I-Distal phalanx of digits 2-5

A-Flexes all three joints of fingers (just the tips)

N-Median/Ulnar

V-Ulnar Artery

O-Anterior surface of radius

I-Distal phalanx of pollex

A-Flexes all joints of the pollex or thumb (hides thumb)

N-Median

V-Radial artery

Right anterior forearm

Deep

Deep

Jen 31

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)

N-Median

V-Ulnar artery

Intermediate

Jen 32

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 33

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 34

Palmaris Longus

O-Medial epicondyle of the humerus

I-Palmar fascia

A-Assists in wrist flexion

N-Median

V-Ulnar artery

Superficial

Jen 35

Tendon of Palmaris Longus

Tendon of Flexor carpi ulnarisTendon of Flexor carpi radialis

Jen 36

Jen 37

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 38

Extensor Carpi Radialis Brevis

O-Lateral epicondyle of humerus

I-Base of 3rd metacarpal

A-Wrist extension

N-Radial

V-Radial artery

Jen 39

Extensor Carpi Radialis Brevis Extensor Carpi Radialis Longus

Jen 40

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 41

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 42

Jen 43

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

Extensor Digiti Minimi

Jen 44

O-Posterior distal radius

I-Base of proximal phalanx of pollex

A-Extends MP joint of thumb

N-Radial

V-Posterior interosseus artery

O-Posterior radius, interosseus membane, middle ulnaI-Base of 1st metacarpalA-Abducts pollexN-RadialV-Posterior interosseus artery

Jen 45

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 46

Tendons

Jen 47

Anatomical Snuff Box

BLOW

Jen 48

Human Anatomy Dissection 23 (part 1 of 2) Forearm and Hand - YouTube