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Ch. 20 Wrist and Hand

Ch. 20 Wrist and Hand. Anatomy. 27 bones in the hand and wrist Nerves Medial Ulnar Radial Flexor and extensor tendon for each finger. Anatomy. Carpals. Scaphoid Lunate Triquetral Pisiform Trapezium Trapezoid Capitate Hamate. Carpals. Scaphoid-Sally Lunate-Likes Triquetral -To

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Ch. 20 Wrist and Hand

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  1. Ch. 20 Wrist and Hand

  2. Anatomy • 27 bones in the hand and wrist • Nerves • Medial • Ulnar • Radial • Flexor and extensor tendon for each finger

  3. Anatomy

  4. Carpals • Scaphoid • Lunate • Triquetral • Pisiform • Trapezium • Trapezoid • Capitate • Hamate

  5. Carpals • Scaphoid-Sally • Lunate-Likes • Triquetral-To • Pisiform-Party • Trapezium-Trooper • Trapezoid-Taylor • Capitate-Can • Hamate-Hit

  6. Muscles

  7. Muscles • Flexors • Flexor Carpi Radialis • Flexor Carpi Ulnaris • Palmaris Longus • Extensors • Extensor Carpi Radialis • Extensor Carpi Ulnaris • Supinator • Pronator Teres and Pronator Quadratus

  8. Dislocations • Displacement of any bone from normal position • Subluxation: abnormal movement of one of the bones that constitutes a joint

  9. Colles’ Fracture • Fracture of the distal radius or ulna just above the wrist • From falling on outstretched hand • Splint and refer to doctor

  10. Boxer’s Fracture • Fracture to the 5th metacarpal • Most commonly seen in someone who has punched something solid

  11. Mallet Finger • Occurs when a ball strikes the tip of the finger • Also known as baseball finger • Tearing of extensor tendon

  12. Jersey Finger • Occurs when grabbing a jersey • Tearing of flexor tendon • Treatment usually involves surgery

  13. Boutonniere Deformity • Caused by blow to bent finger or arthritis • The proximal interphalangeal joint is in flexion and the distal interphalangeal joint is in hyperextension

  14. Scaphoid Fracture • Pain over anatomic snuffbox • Common fracture in athletics • Fall on outstretched hand • Not well vascularized

  15. Contusions • Subungual hematoma-bleeding under the nail • Pain is from the pressure created • Puncture nail to relieve pressure

  16. Gamekeeper’s Thumb • Sprain of ulnar collateral ligament of the metacarpophalangeal joint • Common in skiing • Use special test to diagnose • Tape and protect

  17. deQuervain’s Tenosynovitis • Inflammation of the extensor pollicusbrevis and abductor pollicuslongus • Use signs and symptoms to diagnosis • Special test • Treat with RICE or cortisone shot

  18. Carpal Tunnel Syndrome • Carpal tunnel is a passageway that runs from the forearm through the wrist • Median nerve runs through • CTS occurs when linings of tendons are inflamed or ligaments thicken

  19. Carpal Tunnel Syndrome • S/S: pain, numbness, tingling in wrist, hand, and fingers • May drop objects • Usually caused by overuse • Phalan’s Test • Treat conservatively, surgery if needed

  20. Ganglion Cyst • Ganglion cyst is a small, usually hard lump around a tendon or in a joint capsule • Common in bowlers, tennis players • Usually on back of wrist • Resolves on its own

  21. Rehab • Wrist Extension • Wrist Flexion • Wrist Supination • Wrist Pronation • WristUlnarDeviation • Wrist Radial Deviation

  22. Rehab • Elbow Flexion • Elbow Extension • Hand Intrinsic Muscles • Grip Strength

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