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Fingers, Hand and Wrist Anatomy & Positioning

Hand and Wrist, Forearm, Humerus, Shoulder Girdle

4 main groups of the upper limb

27 bones

Hand and wrist consist of ______ ______

Phalanges, Metacarpals, Carpals

3 subdivided groups of the hand and wrist


Consists of 14 bones


Consists of 5 bones


Consists of 8 bones


What each finger and thumb are called:

Phalanges (Phalanx)

Each digit consists of two or three separate bones called:

Long bone

type of bone of the phalanx

2 thru 5 digit

Has 3 phalanx in these digits

First digit

Only has 2 phalanx in this digit

Proximal and Distal Phalanx

Name of the two bones in the thumb

Proximal, Middle, and Distal Phalanx

Name of the three bones in digits 2 - 5.

Distal phalanx

the phalanges that do not have two articular ends.

Head, body/shaft, base

Each phalanx consists of these three parts:


distal phalanx, the head or tip of phalanx


Make up the palm of the hand

Head, body/shaft, base

Each metacarpal consists of these three parts:

Interphalangeal joints

Have 3 criteria: Joints are differentiated as either proximal or distal, By the digit number, Named as either left or right

Interphalangeal joint

Joint between the phalanges of the thumb

Distal Interphalangeal joint

Most distal joint of the digits

Distal interphalangeal, Proximal interphalangeal, Metacarpophalangeal joint

Three joints of digits 2-5

Metacarpophalangeal joint

The joint between the first metacarpal and proximal phalanx of the thumb

Carpometacarpal joint

At the proximal end of the metacarpals they articulate with the carpals to form the:


The wrist have this many carpal bones

Proximal row

Row of bones nearest the forearm, beginning on the lateral side of the thumb

Scaphoid (Navicular), Lunate (Semilunar), Triquetrum (Triangular), Pisiform

Bones located on the proximal row

Scaphoid (Navicular)

Boat-shaped bone
Articulates with the radius proximally. Most frequently fractured carpal bone.

Lunate (Semilunar)

Moon-shaped (cresent shaped). Articulates with the radius.

Triquetrum (Triangular)

Pyramidal shape
Has three articular surfaces and articulates anteriorly with the pisiform.


Smallest of the carpal bones.

Distal Row

Row that articulates with the five metacarpal bones.

Trapezium (Greater Multangular), Trapezoid (Lesser Multangular), Capitate (Os Magnum), Hamate (Unciform)

Bones of the distal row

Trapezium (Greater Multangular)

Irregular shaped, four sided. Articulates with the base of the first metacarpal

Trapezoid (Lesser Multangular)

Four sided, wedge-shaped. Smallest bone on the distal row

Capitate (Os Magnum)

Largest of the carpal bones. Most centrally located. Articulates with the base of the third metacarpal.

Hamate (Unciform)

Hook-like process called the hamulus or hamular process located on the anterior surface

Carpal Canal or Carpal Tunnel

demonstrates the carpal sulcus


All joints of the upper limb are classified as this:

Interphalangeal joints

ginglymus (hinge); allows only flexion and extension

Metacarpophalangeal joints

Ellipsoid (condyloid); allows flexion and extension, abduction and adduction, circumduction

First carpometacarpal joint

Sellar (saddle); Allows flexion and extension, abduction and adduction, circumduction and opposition

2-5 carpometacarpal joints

Plane (gliding)

Intercarpal joints

these joints are also plane (gliding)

Wrist joint (Radiocarpal joint)

Ellipsoid (condyloid); Made up of the articulation between the radius, scaphoid, and lunate.


Part of the wrist joint although it does not articulate with the radius.

Ulnar deviation

Hand pronated and moved toward the pinky side of the forearm. Opens up carpal joints on the lateral side of wrist.

Ulnar deviation

Carpal best demonstrated: scaphoid, trapezium, trapezoid

Radial deviation

Hand pronated and moved toward the thumb side. Opens up carpal joint on medial/little finger side.

Radial deviation

Carpals best demonstrated: lunate, triquetrum, pisiform, hamate

Fat pads, fat stripes, or fat bands

Important to see radiographically. displacement or absence of may be an indication of a fracture or disease within a joint.

Fat pads

located outside the synovial sac but within the joint capsule.


number of fat pads in the wrist joint

Scaphoid and Pronator fat stripe

2 fat pads in the wrist joint

Scaphoid fat stripe

lateral to the scaphoid on PA and oblique views

Pronator fat stripe

seen 1 cm from the anterior surface of the radius

lateral side

where to place markers on IR

Part parallel to IR, CR perpendicular to part and IR, Correct CR centering

3 things to remember when centering for the hand


displacement of a bone from a joint. Most of upper extremity involve the shoulder, fingers, and thumb.


Forced wrenching or twisting of a joint resulting in a partial rupture or tearing of supporting ligaments


Break in the bone; a break in the structure of the bone caused by a force.


does not break through the skin


breaks through the skin


broken into three or more pieces


fragments driven into one another


break is complete and includes cross section of bone. Broken into two pieces


fracture is on one side only. One side is broken and the other side is bent.

carpal tunnel syndrome

painful disorder of the wrist and hand that results from the compression of the median nerve as it passes through the center of the wrist

Barton's fracture

intra-articular fracture and dislocation of the posterior lip of the distal radius

Bennett's fracture

longitudinal fracture of the base of the first metacarpal. If untreated can lead to reduction or loss of range of movement of thumb.

Boxer's fracture

fracture of the distal fifth metacarpal

Colle's fracture

common fracture of the distal radius with the distal fragment displaced posteriorly

Smith's fracture

Reverse Colles'- fracture of distal radius with anterior displacement of the distal fragment


Degenerative Joint Disease (DJD); Non-inflammatory joint disease characterized by deterioration of the articular cartilage with bone formation at the joint margins.


Infection of bone or bone marrow that may be caused by bacteria introduced by trauma or surgery


Marble Bone Disease; Hereditary disease which has abnormally dense bone. Common for fractures to occur in effected bone.


A reduction in the quantity of bone or atrophy of skeletal tissue.

Pagets disease

Chronic disease that has a destructive phase followed by a reparative phase of overproduction of very dense yet soft bones that tend to fracture easily.


partial dislocation


Bruise without a fracture

Styloid processes

located at the extreme distal ends of both radius and the ulna

hamulus or hamate process

projects from its palmar surface; easily distinguished by the hooklike process

ulnar notch

small depression on the medial aspect of the distal radius

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