palac - digitus primus manus – pollex
TRANSCRIPT
![Page 1: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/1.jpg)
Asist. mr sci. med. dr Jelena Zvekić-Svorcan
student: Nataša Igić
![Page 2: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/2.jpg)
KOSTI ŠAKE(ossa manus)
27 kostiju
Podela :
kosti ručja (ossa carpi s. carpus)
kosti doručja (ossa metacarpi s. metacarpus)
kosti prstiju (ossa digitorum s. digiti manus)
Nazivi prstiju :
palac (digitus primus – pollex)
kažiprst (digitus secundus – index)
srednji prst (digitus tertius – digitus medius)
domali prst (digitus quartus - digitus anularis)
mali prst (digitus quintus – digitus minimus)
Strane šake :
prednja– palma manus
zadnja– dorsum manus
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 3: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/3.jpg)
Palac - digitus primus manus - pollex
![Page 4: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/4.jpg)
KOSTI PRSTIJU(ossa digitorum s. phalanges)
Kosti prstiju (ossa digitorum) nazivaju se članci (phalanges)
ukupno ih je 14.
Kostur svakog prsta je izgrađen od tri članka, izuzev
palca, kome nedostaje srednji članak.
Članci su tipa dugih kostiju (ossa longa) na kojima
razlikujemo telo i dva okrajka.
U odnosu na položaj u kosturu prsta, članci se
označavaju:
- gornji članak (phalanx proximalis)
- srednji članak (phalanx media)
- donji članak (phalanx distalis)
SEZAMOIDNE KOSTI (ossa sesamoidea)
Nalaze se na dlanskoj strani šake u blizini zglobova
kostiju doručja sa prvim člancima prstiju.
Nestalne su, promenjivog broja, obično ih ima od 2 do 7.
Najstalnije i najveće sezamoidne kosti nalaze se oko
zgloba prve kosti doručja sa prvim člankom palca.
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
phalanx proximalis
phalanx distalis
![Page 5: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/5.jpg)
TOPOGRAFIJA PALCA
1. phalanx proximalis
2. phalanx distalis
phalanx proximalis
plalanx distalis
Laekeman M, Kreutzer R. Großer Bildatlas der Palpation Anatomische Strukturen gezielt lokalisieren und begreifen. Italy: Springer Medizin Verlag Heidelberg, 2009.
![Page 6: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/6.jpg)
ZGLOBOVI ŠAKE
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 7: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/7.jpg)
Zglob između ručja i prve metakarpalne kosti (art.carpometacarpalis pollicis)
Zglobne površine
Proksimalna - konkavna donja strana os trapezium
Distalna - konveksna baza I metakarpalne kosti
Tip zgloba art.sellaris, dvoosovinski zglob
Zglobna čaura Labava, tanka omogućava veliku amplitudu pokreta
Pokreti
f l e x i o / e x t e n s i o , a b d u c t i o / a d d u c t i o ,
o p p o s i t i o / r e p o s i t i o , c i r c u m d u c t i o
Opozicija/repozicija pokret karakterističan samo za čoveka.
Opozicija palca je pokret pri kom vrh palca dodiruje
jagodice ostalih prstiju. Repozicija palca je pokret pri kom
se vrh palca odmiče od ostalih prstiju
Mišići
m.flexor pollicis longus et brevis
m.extensor pollicis longus et brevis
m.adductor pollicis
m.abductor pollicis longus i brevis
m.opponens pollicishttp://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 8: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/8.jpg)
art. sellaris
Zglob između ručja i prve metakarpalne kosti art.carpometacarpalis pollicis
TIP ZGLOBA, ZGLOBNE POVRŠINE I ČAURA
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 9: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/9.jpg)
Zglob između ručja i prve metakarpalne kosti art. carpometacarpalis pollicis
POKRETI
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 10: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/10.jpg)
Merenje obima pokreta - art.carpometacarpalis pollicis
POČETNI POLOŽAJ
FLEKSIJA 15° EKSTENZIJA 20°
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 11: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/11.jpg)
Merenje obima pokreta - art.carpometacarpalis pollicis
POČETNI POLOŽAJ
ABDUKCIJA 70°
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 12: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/12.jpg)
Merenje obima pokreta - art.carpometacarpalis pollicis
OPOZICIJA
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 13: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/13.jpg)
Zglob I kosti doručja sa gornjim člankom palca
(art.metacarpophalangealis pollicis)
Zglobne površine
Proksimalna
distalni okrajci glave (caput ossis
metacarpi) I metakarpalne kosti
Distalna
proksimalni okrajak - baza (basis)
proksimalnog člaka palca
Zglobna čaura Tanka i labava.
Zglobne veze
Prednje i bočne veze, transverzalna vlakna palmarne
aponeuroze
Pokreti
flexio, extensio, abductio, adductio, circumductio
*Abdukcija/addukcija podrazumeva se pokret
odvođenja/privođenja prstiju od središnje osovine šake
koja prolazi kroz srednji prst
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 14: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/14.jpg)
Zglob I kosti doručja sa gornjim člankom palca (art.metacarpophalangealis pollicis)
ZGLOBNE POVRŠINE, ČAURA I VEZE
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 15: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/15.jpg)
Zglob I kosti doručja sa gornjim člankom palca
(art.metacarpophalangealis pollicis)POKRETI
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 16: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/16.jpg)
Merenje obima pokreta u art. metacarpophalangealis pollicis
POČETNI POLOŽAJ
FLEKSIJA 50° EKSTENZIJA 0°
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 17: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/17.jpg)
Zglob između gornjeg i donjeg članka palca
(art. interphalangealis pollicis)
Zglobne površine
Proksimalna
Konveksna zglobna površina se
nalazi na distalnom okrajku (glavi)
proksimalnog članka, oblika valjka
Distalna
Konkavna zglobna površina je na
proksimalnom okrajku (bazi)
distalnog članka
Zglobna čaura Tanka i labava
Zglobne veze Prednje i bočne veze, transverzalna vlakna palmarne
aponeuroze
Pokreti
Pokreti koji se vrše u ovom zglobu su pregibanje i
opružanje (flexio/extensio)
Zglob je po tipu šarke (gynglimus)
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 18: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/18.jpg)
Zglob između gornjeg i donjeg članka palca(art. interphalangealis pollicis)
ZGLOBNE POVRŠINE, ČAURA I VEZE
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 19: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/19.jpg)
Zglob između gornjeg i donjeg članka palca(art. interphalangealis pollicis)
POKRETI
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 20: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/20.jpg)
Merenje obima pokreta u art. interphalangealis pollicis
POČETNI POLOŽAJ
FLEKSIJA 80° EKSTENZIJA 20°
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 21: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/21.jpg)
m.adductor pollicis
m.opponens pollicis
m.flexor pollicis brevis
m.abductor pollicis brevis
MIŠIĆI
POKRETAČI
PALCA
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 22: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/22.jpg)
TOPOGRAFIJA
MIŠIĆA POKRETAČA PALCA
m. flexor pollicis longus
http://www.slideshare.net/ssuserc33ffb/manuelni-misicni-test-misici-sake-hand-muscle-testing-42673989
m. flexor pollicis brevis
Laekeman M, Kreutzer R. Großer Bildatlas der Palpation Anatomische Strukturen gezielt lokalisieren und begreifen. Italy: Springer Medizin Verlag Heidelberg, 2009.
![Page 23: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/23.jpg)
m. extensor pollicis longus
m. extensor pollicis brevis
TOPOGRAFIJA
MIŠIĆA POKRETAČA PALCA
http://www.slideshare.net/ssuserc33ffb/manuelni-misicni-test-misici-sake-hand-muscle-testing-42673989Laekeman M, Kreutzer R. Großer Bildatlas der Palpation Anatomische Strukturen gezielt lokalisieren und begreifen. Italy: Springer Medizin Verlag Heidelberg, 2009.
![Page 24: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/24.jpg)
TOPOGRAFIJA
MIŠIĆA POKRETAČA PALCA
m. abductor pollicis longus
http://www.slideshare.net/ssuserc33ffb/manuelni-misicni-test-misici-sake-hand-muscle-testing-42673989
m. abductor pollicis brevis
Laekeman M, Kreutzer R. Großer Bildatlas der Palpation Anatomische Strukturen gezielt lokalisieren und begreifen. Italy: Springer Medizin Verlag Heidelberg, 2009.
![Page 25: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/25.jpg)
TOPOGRAFIJA
MIŠIĆA POKRETAČA PALCA
m. adductor pollicis
http://www.slideshare.net/ssuserc33ffb/manuelni-misicni-test-misici-sake-hand-muscle-testing-42673989Laekeman M, Kreutzer R. Großer Bildatlas der Palpation Anatomische Strukturen gezielt lokalisieren und begreifen. Italy: Springer Medizin Verlag Heidelberg, 2009.
![Page 26: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/26.jpg)
m. opponens pollicis
TOPOGRAFIJA
MIŠIĆA POKRETAČA PALCA
http://www.slideshare.net/ssuserc33ffb/manuelni-misicni-test-misici-sake-hand-muscle-testing-42673989Laekeman M, Kreutzer R. Großer Bildatlas der Palpation Anatomische Strukturen gezielt lokalisieren und begreifen. Italy: Springer Medizin Verlag Heidelberg, 2009.
![Page 27: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/27.jpg)
Biomehanika
https://upload.wikimedia.org/wikipedia/commons/thumb/3/32/Hand-arches.svg/2000px-Hand-arches.svg.png
Takozvani položaj mirovanja
šake:
Dlan udubljen, prsti povijeni, a
palac postavljen blago nasuprot
dlanu.
Pokret hvatanja:
Koštani skelet formira niz lukova
koji se protežu u tri različita
pravca.
![Page 28: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/28.jpg)
FUNKCIJA PALCA
Palac može da se kreće i koristi potpuno nezavisno jer je
funkionalno odvojen od ostalih prstiju.
![Page 29: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/29.jpg)
HVATOVI
Precizni
Predmet se hvata između jagodica prstiju koji se raspoređuju oko
njega u skladu sa njegovim oblikom.
Snažni
Predmet se hvata između jagodica prstiju ali se koristi i šaka jer je potrebna značajna
sila.
![Page 30: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/30.jpg)
PRECIZNI HVATOVI
Terminalna opozicija
1. PINCET HVAT
Subterminalna opozicija
1. TROKRAKI HVAT
2. ŠTIPALjKA HVAT
Subterminalno -lateralni hvat
1. KLjUČ HVAT
![Page 31: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/31.jpg)
Pincet hvat Hvat terminalne opozicije palca
![Page 32: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/32.jpg)
Trokraki hvatHvat subterminalne opozicije palca
![Page 33: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/33.jpg)
Štipaljka hvat Hvat subterminalne opozicije palca
![Page 34: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/34.jpg)
Ključ hvat Subterminalni - lateralni hvat palca
![Page 35: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/35.jpg)
Snažni hvatovi
Kosi
dlanski hvat
Hvat lopte
Lučni hvat
Cilindrčni hvat
![Page 36: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/36.jpg)
Kosi dlanski hvat
![Page 37: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/37.jpg)
Hvat lopte
![Page 38: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/38.jpg)
Lučni hvat
![Page 39: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/39.jpg)
Cilindričan hvat
![Page 40: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/40.jpg)
n.ulnaris n.ulnaris
n.radialis
n.medianus
Dorsum manus Palma manus
SENZORNA INERVACIJA PALCA - DERMATOMI
http://www.slideshare.net/ssuserc33ffb/wrist-and-hand-rucni-zglob-i-saka
![Page 41: Palac - digitus primus manus – pollex](https://reader031.vdocuments.mx/reader031/viewer/2022012311/5882885c1a28abca6d8b4949/html5/thumbnails/41.jpg)
MOTORNA INERVACIJA MIŠIĆA
POKRETAČA PALCA
http://www.slideshare.net/ssuserc33ffb/manuelni-misicni-test-misici-sake-hand-muscle-testing-42673989