Anatomy of the Hand and Wrist

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Anatomy of the Hand and Wrist
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MnemonicforLearningCarpals
She Likes To Play
Lunate In the moonlight
Scaphoid A boat
Triquetrum The third T Bone
Pisiform Pea-shaped
Hamate A hambone With a hook
Trapezium Its by the thumb
Capitate
Trapezoid Is by its side
Try To Catch Her
Click R Button for Slideshow
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Bones of the Wrist (Which hand? what view?)
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Bones of Wrist (which hand?)
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Flexor Tendons

• The muscles that flex your wrist are on the
  palmer side.
• A group of the begin at the medial epicondyle of
  the humerus at the elbow

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Flexor Carpi Radialis

• Origin Medial epicondyle of humerus
• Insertion Base of 2nd metacarpal
• Action Flexes and radial deviates the hand (at
  wrist)
• Innervation Median nerve (C6 and C7)

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Flexor Digitorum Superficialis

• Origin medial epicondyle of humerus,
• Insertion middle phalanges of digits 2 - 5
• Action Flexes middle phalanges at proximal
  interphalangeal joints also flexes proximal
  phalanges at metacarpophalangeal joints and hand
• Innervation Median nerve (C7, C8 and T1)

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Flexor Carpi Ulnaris

• Origin medial epicondyle of humerus
• Insertion Pisiform bone, hook of hamate bone, and
  5th metacarpal bone
• Action Flexes and ulnar deviates hand (at wrist)
• Innervation Ulnar nerve (C7 and C8)

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Palmaris Longus

• Origin Medial epicondyle of humerus
• Insertion Distal half of flexor retinaculum and
  palmar aponeurosis
• Action Flexes hand at the wrist
• Innervation Median nerve (C7 and C8)

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Flexor Digitorum Profundus

• Origin Proximal 3/4 of ulna
• Insertion Base of the distal phalanx of digits 2
  5
• Action Flexes distal phalanges at distal
  interphalangeal joints
• Innervation
• Medial part ulnar nerveLateral part median
  nerve

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Flexor Digiti Minimi Brevis

• Origin Hook of hamate and flexor retinaculum
• Insertion Medial side of base of proximal phalanx
  of little finger
• Action Flexes proximal phalanx of little (5th)
  finger
• Innervation ulnar nerve

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Flexor Pollicis Brevis

• Origin Flexor retinaculum and tubercles of
  scaphoid and trapezium
• Insertion Lateral side of base of proximal
  phalanx of thumb
• Action Flexes thumb
• Innervation Recurrent branch of median nerve (C8
  and T1)

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 Flexor Pollicis Longus

• Origin Anterior surface of radius and adjacent
  interosseous membrane
• Insertion Base of distal phalanx of thumb
• Action Flexes phalanges of 1st digit (thumb)
• Innervation Anterior interosseous nerve from
  median nerve (C8 and T1)

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The 2 Muscles of Pronation

• Two muscles work together to turn the radius over
  the ulna and put the hand in a prone position
• Pronator teres and pronator quadratus

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Pronator Quadratus

• Origin Distal 1/4 of anterior surface of ulna
• Insertion Distal 1/4 of anterior surface of
  radius
• Action Pronates forearm
• Innervation median nerve

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Pronator Teres

• Origin Medial epicondyle of humerus
• Insertion Middle of lateral surface of radius
• Action Pronates
• Innervation Median nerve (C6 and C7)

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Abduction at Hand

• Abduction really only occurs at the thumb and
  little fingers

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Abductor Digiti Minimi

• Origin Pisiform
• Insertion Medial side of base of proximal phalanx
  of little finger
• Action Abducts little (5th) finger
• Innervation ulnar nerve (C8 and T1)

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Abductor Pollicis Brevis

• Origin scaphoid and trapezium
• Insertion Lateral side of base of proximal
  phalanx of thumb
• Action Abducts thumb
• Innervation median nerve (C8 and T1)

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Abductor Pollicis Longus

• Origin Posterior surfaces of ulna,
• Insertion Base of 1st metacarpal
• Action Abducts thumb
• Innervation the radial nerve

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Adduction

• Movement towards the midline of the body

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Adductor Pollicis

• Origin 2nd and 3rd metacarpals, capitate,
• Insertion Medial side of base of proximal phalanx
  of thumb
• Action Adducts thumb
• Innervation ulnar nerve

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Wrist Extensors

• The extensors of the wrist are on the Dorsal side
  of the forearm
• A majority of the wrist extensors begin at the
  lateral epicondyle

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Extensor Carpi Radialis Brevis

• Origin Lateral epicondyle of humerus
• Insertion Base of 3rd metacarpal
• Action Extends and radially deviates the wrist
• Innervation radial nerve (C7 and C8)

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Extensor Carpi Radialis Longus

• Origin Lateral supracondyle ridge of humerus
• Insertion Base of 2nd metacarpal
• Action Extends and radially deviates at the wrist
• Innervation Radial nerve (C6 and C7)

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Extensor Carpi Ulnaris

• Origin Lateral epicondyle of humerus
• Insertion Base of 5th metacarpal
• Action Extends and ulnar deviates hand at wrist
  joint
• Innervation Radial nerve

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Extensor Digiti Minimi

• Origin Lateral epicondyle of humerus
• Insertion 5th digit
• Action Extends 5th digit at metacarpophalangeal
  and interphalangeal joints
• Innervation Posterior interosseous nerve

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Extensor Digitorum

• Origin Lateral epicondyle of humerus
• Insertion Extensor expansions of medial four
  digits
• Action Extends the four digits and the wrist
• Innervation Posterior interosseous nerve

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Extensor Indicis

• Origin Posterior sufrace of ulna and interosseous
  membrane
• Insertion Extensor expansion of 2nd digit
• Action Extends 2nd digit and helps to extend hand
  
• Innervation Posterior interosseous nerve

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Extensor Pollicis Brevis

• Origin Posterior sufraces of radius and
  interosseous membrane
• Insertion Base of proximal phalanx of thumb
• Action Extends proximal phalanx of thumb at
  carpometacarpal joint
• Innervation Posterior interosseous nerve

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Extensor Pollicis Longus

• Origin Posterior surface of middle 1/3 of ulna
• Insertion Base of distal phalanx of thumb
• Action Extends distal phalanx of thumb at
  carpometacarpal and interphalangeal joints
• Innervation Posterior interosseous nerve

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Supination Muscles

• There are two muscles that return you to the
  anatomical position by uncrossing the radius and
  ulna

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Biceps Brachii

• Origin
• Short head tip of coracoid process of
  scapulaLong head supraglenoid tubercle of
  scapula
• Insertion Tuberosity of radius and fascia of
  forearm via bicipital aponeurosis
• Action Supinates forearm and, when it is supine,
  flexes forearm
• Innervation Musculocutaneous nerve (C5 and C6 )

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Supinator

• Origin Lateral epicondyle of humerus,
• Insertion Lateral, posterior and anterior
  surfaces of proximal 1/3 of radius
• Action Supinates forearm
• Innervation Deep branch of radial nerve (C5 and
  C6)

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Opposition

• The ability to touch your thumb and pinky

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Opponens Digiti Minimi

• Origin Hook of hamate and flexor retinaculum
• Insertion Medial border of 5th metacarpal
• Action brings little finger (5th digit) into
  opposition with thumb
• Innervation Deep branch of ulnar nerve (C8 and
  T1)

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Opponens Pollicis

• Origin Flexor retinaculum and tubercles of
  scaphoid and trapezium
• Insertion Lateral side of 1st metacarpal
• Action Draws 1st metacarpal laterally to oppose
  thumb toward center of palm
• Innervation Recurrent branch of median nerve (C8
  and T1)

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• The Three Nerves of the wrist and hand

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The median nerve

• The median nerve supplies feeling the the palmer
  side of your 1st, 2nd,3rd, and medial 4th
  fingers.
• The Median nerve is involved with carpal tunnel
  syndrome

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The Ulnar nerve

• The Ulnar nerve supplies feeling and motor
  function to the lateral 4th and 5th fingers.

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The Radial Nerve

• The radial nerve innervates most of the extensors
  and supplies the feeling on the dorsal side of
  the first three digits

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• Joint the place where two bones come together
  (4 types)

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• Ball and socket joint greatest range of motion
  allowing bones to swing in a circle

Example shoulder or hip
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• Pivot joint one bone rotates around another

Example Neck and under the Elbow
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• Hinge joint bones bend like a hinge forward and
  backward

Example Knee and Elbow
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• Gliding joint allows one bone to slide over
  another

Example Wrist and Ankle
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Joint Shapes

• Condyloid egg-shape articular surface oval
  concavity
• side-to-side, backforth movement
• (eg) metacarpophalangeal (knuckle)

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Joint Shapes
pg 225

• Saddle articular surface both concave convex
• side-to-side, back-forth movement
• (eg) carpometacarpal jt of thumb

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Hinge Joint

• In between the Phalanges are Hinge Joints
• They move in flexion and extension

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A Ligament

• A Ligament attaches a bone to bone
• An Injury to a Ligament is called a Sprain
• A Tendon Attaches a muscle to a bone
• An injury to a tendon or Muscle is a strain

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Ligaments of the hand
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Collateral Ligaments

• collateral ligaments, are found on either side of
  each finger and thumb joint. The function of the
  collateral ligaments is to prevent abnormal
  sideways bending of each joint.

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Volar Plate

• This ligament connects the proximal phalanx to
  the middle phalanx on the palm side of the joint.
  
• The ligament tightens as the joint is
  straightened and keeps the PIP joint from bending
  back too far (hyperextending).

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palmar radiocarpal ligament

• broad membranous band, attached above to the
  anterior margin of the lower end of the radius,
  to its styloid process, and to the front of the
  lower end of the ulna
• its fibers pass downward to be inserted into the
  volar surfaces of the scaphoid, lunate, and some
  being continued to the capitate.

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dorsal radiocarpal ligament

• less thick and strong than the palmer ligament
• The ligament begins on the radius
• its fibers are directed downward and medially,
  and are fixed, below, to the dorsal surfaces of
  the scaphoid and lunate

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ulnar collateral ligament

• is a rounded cord,
• attached above to the end of the styloid process
  of the ulna, and dividing below into two
• one of which is attached to the medial side of
  the triquetrium and pisiform

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The radial collateral carpal ligament

• The radial collateral carpal ligament
• attaches to the styloid process of the radius and
  the radial side of the scaphoid bone.

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transverse carpal ligament

• AKA The flexor retinaculum
• a strong, fibrous band, converting the deep
  groove on the front of the carpal bones into a
  tunnel, the carpal tunnel, through which the
  Flexor tendons of the digits and the median nerve
  pass.

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Hypothenar eminence

• is the body of muscle on the palm of the human
  hand just beneath the 5th phalange
• Abductor digiti minimi Flexor digiti minimi
  Opponens digiti minimi
• OAF

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thenar eminence

• is the body of muscle on the palm of the human
  hand just beneath the thumb.
• Abductor pollicis, Flexor pollicis brevis,
  Opponens pollicis, Adductor pollicis
• OA2F

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Deep muscles of thenar and Hypothenar groups