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Ch. 20 Wrist and Hand.

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Presentation on theme: "Ch. 20 Wrist and Hand."— Presentation transcript:

1 Ch. 20 Wrist and Hand

2 Anatomy 27 bones in the hand and wrist Nerves
Medial Ulnar Radial Flexor and extensor tendon for each finger

3 Anatomy

4 Carpals Scaphoid Lunate Triquetral Pisiform Trapezium Trapezoid
Capitate Hamate

5 Carpals Scaphoid-Sally Lunate-Likes Triquetral-To Pisiform-Party
Trapezium-Trooper Trapezoid-Taylor Capitate-Can Hamate-Hit

6 Muscles

7 Muscles Flexors Extensors Supinator
Flexor Carpi Radialis Flexor Carpi Ulnaris Palmaris Longus Extensors Extensor Carpi Radialis Extensor Carpi Ulnaris Supinator Pronator Teres and Pronator Quadratus

8 Dislocations Displacement of any bone from normal position
Subluxation: abnormal movement of one of the bones that constitutes a joint

9 Colles’ Fracture Fracture of the distal radius or ulna just above the wrist From falling on outstretched hand Splint and refer to doctor

10 Boxer’s Fracture Fracture to the 5th metacarpal
Most commonly seen in someone who has punched something solid

11 Mallet Finger Occurs when a ball strikes the tip of the finger
Also known as baseball finger Tearing of extensor tendon

12 Jersey Finger Occurs when grabbing a jersey Tearing of flexor tendon
Treatment usually involves surgery

13 Boutonniere Deformity
Caused by blow to bent finger or arthritis The proximal interphalangeal joint is in flexion and the distal interphalangeal joint is in hyperextension

14 Scaphoid Fracture Pain over anatomic snuffbox
Common fracture in athletics Fall on outstretched hand Not well vascularized

15 Contusions Subungual hematoma- bleeding under the nail
Pain is from the pressure created Puncture nail to relieve pressure

16 Gamekeeper’s Thumb Sprain of ulnar collateral ligament of the metacarpophalangeal joint Common in skiing Use special test to diagnose Tape and protect

17 deQuervain’s Tenosynovitis
Inflammation of the extensor pollicus brevis and abductor pollicus longus Use signs and symptoms to diagnosis Special test Treat with RICE or cortisone shot Finkelstein’s

18 Carpal Tunnel Syndrome
Carpal tunnel is a passageway that runs from the forearm through the wrist Median nerve runs through CTS occurs when linings of tendons are inflamed or ligaments thicken Transverse carpal ligament

19 Carpal Tunnel Syndrome
S/S: pain, numbness, tingling in wrist, hand, and fingers May drop objects Usually caused by overuse Phalan’s Test Treat conservatively, surgery if needed

20 Ganglion Cyst Ganglion cyst is a small, usually hard lump around a tendon or in a joint capsule Common in bowlers, tennis players Usually on back of wrist Resolves on its own

21 Rehab Wrist Extension Wrist Flexion Wrist Supination Wrist Pronation
Wrist Ulnar Deviation Wrist Radial Deviation

22 Rehab Elbow Flexion Elbow Extension Hand Intrinsic Muscles
Grip Strength

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