Joints, muscles and action of the wrist and the hand Dr. Szuák András ÁOK 2017.10.03-04.

Joints radiocarpal (aka. wrist) midcarpal carpometacarpal metacarpophalangeal interphalangeal proximal distal http://www.davidlnelson.md/images/Xray_normal_hand_PA.jpg

Radiocarpal joint radius+articular disc – scaphoid+lunate+triquetrum main ligaments: radial collateral lig. of wrist joint ulnar collateral lig. of wrist joint palmar radiocarpal dorsal radiocarpal U https://radiopaedia.org/cases/normal-wrist-mri-1

Movements ellipsoidal joint (2 axes) radial – ulnar abduction palmar flexion - dorsiflexion

Midcarpal joints proximal – distal row main ligaments: radiate carpal pisohamate palmar/interosseus/dorsal intercarpal movements: none, only with the wrist http://ok-t.ru/studopediaru/baza8/824261054806.files/image359.jpg http://www.anatomyexpert.com/app/structure/15324/914/

Carpometacarpal joints (except 1st) distal row – base of metacarpals main ligmanets: palmar/dorsal carpometacarpal palmar/interosseus/dorsal metacarpal movements: none https://clinicalgate.com/wp-content/uploads/2015/03/B9780443066849500585_gr15.jpg

1st carpometacarpal joint trapezium - 1st metacarpal (saddle joint – 2 axes) movements: abduction – adduction opposition - reposition http://www.mychhs.colostate.edu/david.greene/Functional_Mechanical_Antomy/Motion_gifs/thumb-finger-sweep/opposition/opposition.gif

Metacarpophalangeal joints head of metacarpals – base of prox. phalanges ligaments: palmar collateral (deep transverse metacarpal ligament) movements: (ball-and-socket joints) flexion – extension abduction – adduction rotation (passive)

Interphalangeal joints head – base of phalanges ligaments palmar collateral movements: (hinge joint 1 axis) flexion – extension

Carpal tunnel Ulnar canal flexor retinaculum scaphoid & trapezium Content: -ulnar artery -ulnar nerve flexor retinaculum pisiform & hook of hamate scaphoid & trapezium carpal bones Content: -flex. digitorum superficialis -flex. digitorum profundus -flex. pollicis longus -flex. carpi radialis -median nerve https://upload.orthobullets.com/topic/6018/images/url..jpg

flexor digitorum profundus flexor digitorum superficialis vincula tendineum

The extensors… 3 2 4 5 1 6 abductor pollicis longus and extensor pollicis brevis extensor carpi radialis longus and ext. carpi rad. brevis extensor pollicis longus extensor digitorum and ext. indicis 5. extensor digiti minimi 6. extensor carpi ulnaris 3 2 4 5 1 6

Muscles, which move the wrist http://www.coroflot.com/tomrolain/medical-illustration

Muscles of the hand MESO- HYPOTHENAR THEHAR THENAR Live long and prosper. - Spock HYPOTHENAR THENAR

Thenar abductor pollicis brevis opponens pollicis flexor pollicis brevis superficial head deep head adductor pollicis transverse head oblique head median nerve http://teachmeanatomy.info/upper-limb/muscles/hand/ ulnar nerve

Hypothenar abductor digiti minimi opponens digiti minimi flexor digiti minimi ulnar nerve http://teachmeanatomy.info/upper-limb/muscles/hand/ palmaris brevis

Mesothenar lumbricals - 2 radial – median nerve, 2 ulnar – ulnar nerve interossei - ulnar nerve dorsal (abduction) palmar (adduction) http://teachmeanatomy.info/upper-limb/muscles/hand/

Thank you for your attention!