Anatomy of Wrist and Hand
Anatomy of Wrist and Hand
Anatomy of Wrist and Hand
CARPAL BONES
INTRINSIC MUSCLES
EXTRINSIC MUSCLES OF THE HAND- Muscles from the forearm inserting on wrist and
hand
EXTRINSIC MUSCLES: ANTERIOR COMPARTMENT
The dorsal extensors also receive the interosseous tendons and lumbrical
tendons.
PALMAR ARCHES
RADIAL NERVE
Enters the snuff box then supplies the lateral half of the dorsum and dorsum
of the lateral 3 and half fingers up to the middle phalanx
PALMAR INNERVATIONS
DORSUM OF HAND
Sensory nerve supply:
Superficial branch of the radial nerve
Supplies the lateral 2/3 of the dorsum
Supplies the lateral 3 and half fingers
Posterior cutaneous branch of the ulnar nerve
Supplies the medial third of the dorsum
Supplies the medial 1 and half fingers
Dorsal digital nerves never extend beyond the proximal phalanx.
DORSAL INNERVATIONS
Thenar space
separated by second septum from mid palmar space
Contains 1st lumbrical muscle and posterior to long flexor tendons of
index finger and in front of adductor pollicis muscle
Mid palmar space
Contains 2nd, 3rd and 4th lumbricals
Posterior to long flexors of middle, ring and little fingers
In front of interossei and 3rd 4th and 5th metacarpal bones
Lumbrical canal surrounds each lumbrical muscle and continuous with one
of the palmar spaces.
CARPAL TUNNEL
Concave anterior carpal surface
Converted to tunnel by flexor
retinaculum
Contents: FPL, FDS (4), and FDP
tendons (4) and Median nerve
FS and FDP tendons have
common synovial sheath form
lateral side
SYNOVIAL FLEXOR SHEATH
Starts at the lateral side
Small finger: continues distally without
interruption
Ring middle and index fingers: ends at the
middle of the palm. Digital synovial sheath for
the phalanges.
Thumb: FPL has its own sheath (in 50% of pop,
they communicate with FDS and FDP sheath
FIBROUS FLEXOR SHEATH
From head of metacarpal to distal phalanx
Thumb
Flexion Flexor pollicis longus
Extension extensor pollicis longus
CLINICAL CONDITIONS
COMPARTMENT SYNDROMES
Carpal tunnel syndrome
Trigger fingers
Tenosynovitis
FRACTURES
Distal
Radius Fractures
Smiths Fracture
Colles' Fracture
Bartons Fracture
Metacarpal fractures
Base of Metacarpal
Metacarpal Shaft
Phalangeal fractures
DEFORMITIES
Heberden's Nodes
Distal interphalangeal joints
Bouchards Nodes
Proximal interphalangeal joints
Mallet Deformity
Boutonnieres Deformity
Rupture of the extensor central slip
Volar displacement of the lateral slips
Changes the direction of the pull
PIP extension to PIP flexion
Lateral slips still functions as DIP extensor
NERVE INJURIES
Ulnar Nerve
Motor - Intrinsic muscles of the hand
Sensory Medial 1 and half fingers
Radial Nerve
Motor - none
Sensory lateral dorsum of the hand
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