1. PTA 106 Unit 3 presentation by: Lisa, Bobbi, Deanna, Chris
WRIST & HAND
PTA 106 Unit 3 presentation by: Lisa, Bobbi, Deanna, Chris

2. Surface Anatomy

3. Surface Anatomy

4. Anatomical Snuff Box

5. Compartments & Spaces

6. Wrist Bones

7. Wrist Bones
Some
Lovers
Try
Positions
That
They
Can’t
Handle

8. Hand Bones

9. Cartilage Articular Cartilage
Is smooth shiny material that covers the bones of the hand and wrist. It absorbs forces of impact and provides for low friction motion.

10. Articular Capsule Synovial Membrane Fibrous Layer
Is the inner membrane of a joint made up of loose connective tissue.
Secretes synovial fluid which services to lubricate the joint and reduce the friction between bones in joints.
Supplies nutrients to the joint
Formed by dense irregular connective tissue attached to the periosteum surface of joints.
Allows for movement.
Provides stability

11. Metacarpo-phalangeal Joint
Joints
Metacarpo-phalangeal Joint

12. Joints
Proximal Interphalangeal Joint
Distal Interphalangeal Joint

13. Types of Joints
Hinge Joints- Convex surface of one bone fits into the concave surface of the adjoining bone
Example: interphalangeal joints
Condyloid Joints- Convex oval-shape projection of one bone fits into the oval-shaped depression of another bone
Example: MCPJ and radio-scapho-lunate joint

14. Types of Joints
Saddle Joints- articular surface of one bone is the saddle-shaped, and the articular surface of the other bone fits into the “saddle” as a sitting rider would sit.
Example: CMCJ between the trapezium and the thumb
Planar Joints- Flat or slightly curved bones joined together that allow back and forth and side to side movements.
Example: Intercarpal joints

15. Ligaments Palmar Aponeurosis Flexor Retinaculum
It gives firm attachment to the skin of the palm to improve the grip, and it protects the underlying tendons
Flexor Retinaculum
Is a strong band that is attached on the radial side to the tubercle of the scaphoid ridge of the trapezium and on the ulnar side to the pisiform and hook of the hamate. Serves as the top sheath of the carpal tunnel for which the flexor tendons and median nerve pass through.

16. Ligaments Common Flexor Sheath Extensor Retinaculum
Surrounds the eight tendons of the superficial and deep flexors of the digits of the hand as they pass through the carpal canal.
Extensor Retinaculum
Consists of a group of heavy connective fibers in the tissues of the wrist. It connects the lateral margin of the radius with the inside border of the ulna.

17. Motions of the Wrist Flexion: 80-90 degrees Extension: 75-85 degrees
Radial deviation: 20 degrees
Ulnar deviation: 35 degrees
Supination: 90 degrees
Pronation: 90 degrees

18. Motions of the Fingers
Abduction: degrees MCPJ flexion: degrees MCPJ extension: degrees
PIPJ flexion: degrees, 0 degrees extension
DIPJ flexion: degrees, 0 degrees extension

19. Range of Motion of the Thumb
CMCJ flexion: degrees
Flexion at MCPJ: degrees
Abduction: degrees
Opposition- combined motion of abduction, flexion, and rotation of the thumb.

20. Posterior Muscles of Wrist and Hand

21. Anterior Muscles of Wrist and Hand

22. Nerve, Artery/ Veins of the Hand and Wrist Debrief:

23. The Sinistra Nervous Family

24. Central Nervous System
Aka “The Boss”

25. The “Under Boss”

26. Capo # 1 The median nerve:
- Is responsible for the innervations of the following soldiers.
1. Flexor carpi radialis
2 .Flexor digitorum superficialis
3. Flexor digitorum profundus
4. Flexor pollicis longus
5. Palmaris longus
Gives humans the ability to oppose the thumb joint

27. Capo # 2
- Is responsible for the innervations of the following soldiers.
1. Flexor carpi radialis
2. Flexor digitorum profundus

28. Capo # 3 The Radial Nerve:
- Is responsible for the innervations of the following muscles
1. Extensor carpi radialis longus
2. Extensor carpi radialis brevis
3. extensor digitorum
4. extensor carpi ulnaris
5. Abductor pollicis longus
6. Extensor digiti minimi
7. extensor pollicis brevis
8. Extensor pollicis longus

29. Other known associates
Dorsal cutaneous branch Vaga and Palmer cutaneous branch Winfield

30. Median Associate #1 - The Palmer cutaneous branch:
- splits off the median nerve before crease of the wrist

31. Ulnar Associate #1 The dorsal cutaneous branch:
Known for famous debilitating wrist lock

32. There Will Be Blood

33. The Five Burrows Arteries: 1. Deep palmar arch
2. Superficial palmar arch
3. Common palmar digital arteries

34. The Radial artery supplies blood to:
1. Flexor carpi radialis
2. Extensor carpi radialis longus
3. Extensor carpi radialis brevis
4. Flexor pollicis longus
The Ulnar artery supplies blood to:
2. Flexor carpi ulnaris
3. Extensor carpi ulnaris
4. Flexor digitorum superficialis
5. Flexor digitorum profundus
6. Palmaris longus

35. Reccurent Interosseous Artery
-supplies:
-Extensor digitorum
-Extensor digiti minimi

36. Posterior Interosseous Artery
-supplies:
- Abductor pollicis longus
-Extensor pollicis brevis
-Extensor pollicis longus

37. Waste Management 1. Cephalic vein 2. Basillic vein
3. Superficial dorsal venous arch (network)
4. Deep dorsal venous arch (network)

38. Clinical Concerns Carpal tunnel Ganglion cyst
The transverse carpal ligament in the wrist puts pressure on the medial nerve
- possible cause: overuse, hormonal
Is a fluid filled cyst that develops out of a joint.
- possible cause: joint trauma

39. De Quervain’s Tenosynovitis
-irritation of the sheath around the tendon
- affects the tendons on the thumb side of the wrist
- possibly caused by repetitive actions, over use -

40. Spoiler Alert