Wrist Joint (Radio-Carpal Joint)

and Hand

Dr. Sama ul Haque

Objectives

Understand the formation of the wrist joint and its type.

Know the movements taking place at wrist joint.

Explain the articulation of the wrist joint with carpal bones.

Define thenar and hypothenar eminences.

Explain the muscles of the hand in terms of their origin,

insertion and nerve supply.

Discuss the actions of the muscles of the hand.

Explain the movements of thumb.

Describe the fascial planes of the hand.

Wrist joint and Carpal Bones (Anterior View)

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Wrist joint and Carpal Bones (Posterior View)

• Articulation

• Type

• Capsule

• Ligaments

• Movements

Wrist joint

Articulation: Between

Distal end of the radius and the articular disc above

andscaphoid,

lunate, and triquetral bones

below

Wrist joint

Type:

Synovial of

Ellipsoid Variety

Wrist joint

Wrist joint (Capsule and Ligaments)

Wrist joint (Capsule and Ligaments)

• All carpal bones articulate via gliding or plane joints.

• A joint exists between proximal row and distal row of

bones called mid-carpal Joint (Scaphoid, Lunate and

Triquetrum with Trapezium, Trapezoid, Capitate and

Hamate).

• Pisiform is not involved.

Wrist joint

Bones of the Hand (Anterior View)

Bones of the Hand (Posterior View)

Metacarpophalangeal and interphalangeal Joints & ligaments

Muscle of the HandMuscle of the Hand

• Thenar muscles:

1. Abductor Pollicis brevis, 2. Flexor Pollicis brevis and 3. Opponens Pollicis.

• Hypothenar muscles:

1. Abductor digiti minimi, 2. Flexor digiti minimi and 3.Opponens digiti minimi.

• Small muscles of the hand:

1. Lumbricals, 2. Interossei (palmar and dorsal), and 3. Adductor Pollicis.

• Thenar muscles:

1. Abductor Pollicis brevis, 2. Flexor Pollicis brevis and 3. Opponens Pollicis.

• Hypothenar muscles:

1. Abductor digiti minimi, 2. Flexor digiti minimi and 3.Opponens digiti minimi.

• Small muscles of the hand:

1. Lumbricals, 2. Interossei (palmar and dorsal), and 3. Adductor Pollicis.

Short Muscles of the Thumb (Thenar Eminence)

Muscles forming Thenar Eminence

Short Muscles of the Little Finger(Hypothenar Eminence)

Muscles forming Hypothenar Eminence

Short Muscles of the Hand

Palmaris Brevis

Lumbricals

Short Muscles of the Hand

Palmar Interossei

Dorsal Interossei

Movements of

fingers

Synovial Sheath and

Fibrous digital sheath

http://video.about.com/ergonomics/Carpal-Tunnel-Syndrome.htm

Ulnar Nerve Radial Nerve

Median Nerve

Cutaneous Innervation of the Hand

Areas of Ulnar

& Radial Arteries Supply

Deep Palmar Arch Direct continuation of Radial artery.

Deeply placed in palm in front of the metacarpal bones &

Interosseous muscles.

The Arch on medial side is completed by deep branch of

the ulnar artery.

Deep Palmar Arch

Superficial Palmar Arch Direct continuation of Ulnar artery.

Superficially placed in palm in front of the long flexor

tendons.

The Arch on lateral side is completed by superficial

palmar branch of the radial artery.

Superficial Palmar Arch

Superficial Veins of the Upper Limb Dorsal venous arch

Veins of the Palm

Cephalic vein

Basilic vein

Dorsal venous arch

Lies in the subcutaneous tissue proximal to

Metacarpophalangeal joints

Drains on the lateral side into the Cephalic vein

Drains on the medial side into the Basilic vein

Communicates with the deep veins of the palm freely

Dorsal

Venous

Arch

Median Cubital Vein

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