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83 terms

Chapter 5

Fingers, Hand and Wrist Anatomy & Positioning
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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
Phalanges
Consists of 14 bones
Metacarpals
Consists of 5 bones
Carpals
Consists of 8 bones
Digit
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:
Tuft
distal phalanx, the head or tip of phalanx
Metacarpals
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:
8
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.
Pisiform
Pea-shaped
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)
Wedged-shaped
Hook-like process called the hamulus or hamular process located on the anterior surface
Carpal Canal or Carpal Tunnel
demonstrates the carpal sulcus
Synovial
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.
Triquetrum
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.
2
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
Dislocation
displacement of a bone from a joint. Most of upper extremity involve the shoulder, fingers, and thumb.
Sprain
Forced wrenching or twisting of a joint resulting in a partial rupture or tearing of supporting ligaments
Fracture
Break in the bone; a break in the structure of the bone caused by a force.
simple/closed
does not break through the skin
compound/open
breaks through the skin
comminuted
broken into three or more pieces
impacted
fragments driven into one another
complete
break is complete and includes cross section of bone. Broken into two pieces
Incomplete/greenstick
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
Osteoarthritis
Degenerative Joint Disease (DJD); Non-inflammatory joint disease characterized by deterioration of the articular cartilage with bone formation at the joint margins.
Osteomyelitis
Infection of bone or bone marrow that may be caused by bacteria introduced by trauma or surgery
Osteopetrosis
Marble Bone Disease; Hereditary disease which has abnormally dense bone. Common for fractures to occur in effected bone.
Osteoporosis
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.
Subluxation
partial dislocation
Contusion
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