Presentation on theme: "Wrist and Hand Wrist is the most complex joints of the body due to the numerous joints combined to create one."— Presentation transcript:
1Wrist and HandWrist is the most complex joints of the body due to the numerous joints combined to create one.
2Wrist and Hand AnatomyCarpal bones- Create a Mnemonic for them. S-L-T-P-T-T-C-H
3Wrist and Hand Anatomy Two rows of bones starting on the thumb side. Scaphoid, lunate, triquetrum, pisiform
4Palpate the ScaphoidYou would palpate the scaphoid in the anatomical snuff box.
5Wrist and Hand Anatomy Second row of carpals bones, is more proximal Trapezium, trapezoid, capitate, Hamate.
6Wrist and Hand AnatomyMedial and Lateral epicondyle are where many of the wrist and hand muscles originate.
7Wrist and Hand AnatomyStyloid process- projection at distal end of radius and ulna where the collateral ligaments attach.
8Wrist and Hand JointsRadiocarpal Joint- distal end of the radius and scaphoid, lunate, and triquetrum. There is a radioulnar disk in between the radius and other bones. It is a condyloid joint.
9Wrist and Hand JointsMidcarpal joint- between the two rows of carpal bones. Plane joints that allow gliding motion, but assist with wrist motions.
10Wrist and Hand JointsCarpometacarpal joint- between the distal row of carpal bones and proximal end of the metacarpal bones. Provide more stability than mobility.
11Ligaments of handPalmar radiocarpal ligament-broad band attaches anterior surface of distal radius and ulna to anterior surface of the proximal carpal bones and the capitate. Limits wrist extension. So repeated falls in extension would injur it.
12Wrist and Hand Injuries Fractures of the Wrist and HandFinger FracturesBoxer’s Fracture- fracture of 5th metacarpal. Hitting something with fisted hand.
13Wrist and Hand Injuries Fractures of the Wrist and HandFinger FracturesScaphoid Fracture- fracture of scaphoid which you call palpate in anatomical snuffbox. Occurs with fall on hand in extension.
14Wrist and Hand Injuries Wrist FracturesColles’s fracture- fracture of the radius just above the wrist. A result of a fall with wrist extended.
15Tendon InjuriesMallet Finger- hitting something with the tip of a finger and causing the extensor tendon to tear.Jersey Finger- grabbing something and tearing the flexor tendon.
16Tendon Injuries Boutonniere deformity- extensor tendon injury affectingtwo joints of the finger. It isan injury to the central tendonon top of the finger.It may appear as a “jammed finger” that cannot be extended from the PIP joint.Treatment should be in an extended position so the tendon can heal.
17Dislocations/Subluxations Dislocations occur in the fingers and wrist bones.Point tenderness and swelling, possible deformity.Physicianinterventionmay benecessary.
18Wrist and Hand MusclesExtensor Carpi Ulnaris- superficial muscle that arises from the common extensor tendon on the lateral epicondyle. It runs the medial side of the posterior arm and attaches to the fifth metcarpal. What does it do?
19Wrist and Hand MusclesFlexor carpi radialis- superficial muscle running from the medial epicondyle diagonaly across the anterior forearm to attach to lateral base of second and third metacarpal. What is the motions?
20Wrist and Hand MusclesPalmaris Longus- superficial muscle running down the anterior surface of the forearm from common flexor attachment of medial epicondyle to the midline of the palmar fascia.Missing in 21%of people.Flexor
21Wrist and Hand MusclesFlexor Digitorum superficialis- deep to the wrist flexors and palmaris longus muscle. Starts at the common flexor tendon of medial epicondyle and coranoid process, inserts to the sides of digits 2-5.
22Wrist and Hand MusclesAbductor pollicis brevis- proximal attachment is the scaphoid, trapezium and inserts to the base of the proximal phalange of the thumb.
23Hand GripsGraspsPower grip is when an object needs to be held forcefully and then moved by more proximal muscles.Precision Grip is when an object is manipulated with fingers
24Hand GripsPower gripsCylindrical grip is fingers flexed around an object. Thumb on one side fingers on other, like gripping a hammer or racquet.Spherical grip is fingers and thumb are together around anobject. Like grabbingan apple or doorknob.
25Hand GripsPower GripHook grip involves the second through fifth fingers flexed around an object in a hooklike manner. Thumb is extended and not involved at all. Only possible grip forsomeone with no thumb ormedian nerve ability.
26Hand Grips Precision Grips- Pad to pad Pinch grip is the thumb and one finger grippingThree jaw chuck is holding a pencil, three fingers and thumb.
27Hand Grips Precision Grips Tip to Tip grip Pincer grip is tip of thumb against tip of a finger, like to pick up a coin. Difficult with long fingernails
28Hand Grips Precision Grips Lumbrical grip or plate grip has the MCP and PIP joint flexed and the DIP extended. The thumb opposes and this grip is used to hold something horizontal like a plate. Lumbricals is used they flex the MCP joint.