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