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Carpals-8 Scaphoid Trapezium Trapezoid Capitate Hamate Pisiform Triquetral Lunate www.eatonhand.com http://www.gwc.maricopa.edu/class/bio201/hand/anhand.htm. Metacarpals-5 Phalanges - 5 1-5 1=Thumb 5=Pinky. Wrist/Hand Anatomy. Wrist/Hand Anatomy (2).

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Wrist hand anatomy

Carpals-8

Scaphoid

Trapezium

Trapezoid

Capitate

Hamate

Pisiform

Triquetral

Lunate

www.eatonhand.comhttp://www.gwc.maricopa.edu/class/bio201/hand/anhand.htm

Metacarpals-5

Phalanges - 5

1-5

1=Thumb

5=Pinky

Wrist/Hand Anatomy


Wrist hand anatomy 2
Wrist/Hand Anatomy (2)

  • Radiocarpal joints (beween wrist and hand)

  • Metacarpal joints

  • Metacarpalphalangeal Joints

  • Phalangeal joints-PIP and DIP

    • Normal resting position

    • Proximal, Middle, Distal phalanx

  • Blood Supply -______________________

  • Nerve supply

    • Radial

    • Medial

    • Ulnar


Colles fracture
Colles Fracture

  • ______________________________________

  • HOPS:

    • ______________________________________

    • extreme pain

    • __________________________________

    • numbness along the median nerve distribution, extreme pain

  • Treatment: splint, refer

  • http://orthopedics.about.com/library/xray/blxray-fxapcolles.htm


Wrist hand anatomy

http://www.eatonhand.com/hw/colles1.gif

http://sfghed.ucsf.edu/ClinicImages/Colle's fracture.jpg


Carpal tunnel syndrome 1
Carpal tunnel syndrome (1)

  • Carpal tunnel is located in the anterior of the wrist.

  • ____________________, their synovial sheaths and the median nerve lie in the tunnel

  • _____________________________________________________________



Carpal tunnel 2
Carpal Tunnel (2)

  • Overuse condition caused by repeated wrist flexion, ulnar deviation

  • HOPS

    • numbness, tingling, median nerve area

    • muscle atrophy (in advanced cases)

    • decreased RROM in thumb movement

    • + Phalen’s test, pn w/ compression of carpal tunnel

    • + Tinel Sign

  • Tx: rest, wrist splint, anti-inflammatory medication, if severe, surgery



Scaphoid fracture 1
Scaphoid Fracture (1)

  • ________________________________

  • Lies beneath the “anatomical snuff box”

  • Does not have a good blood supply – often does not heal – “non-union”



Scaphoid fracture 2
Scaphoid Fracture (2)

  • HOPS

    • fall on the outstretched hand

    • some swelling

    • pain in anatomic snuff box

  • Tx: refer to physician, immobilization x 6 weeks, protection against impact for 3 months


Mallet finger
Mallet finger

  • “Baseball”, “basketball” finger

  • __________________________________________________________________

  • HOPS:

    • MOI: blow to tip of finger,

    • pain over the DIP joint

    • bent DIP joint (about 30 degrees)

    • inability to extend the DIP joint

  • TX: refer, splint in extension 6 – 8 weeks


Mallet finger1
Mallet Finger

www.eatonhand.com

http://www.utahmountainbiking.com/firstaid/pics/fing-mal.jpg


Boutonneire deformity
Boutonneire Deformity

  • ____________________________________________________________

  • HOPS:

    • forced flexion of the interphalangeal joint

    • swelling, flexion deformity of PIP joint

    • point tenderness over middle phalanx (dorsal side)

    • ____________________________

  • Tx: refer, splint in extension


Boutonneire deformity1
Boutonneire Deformity

www.eatonhand.com


Jersey finger
Jersey Finger

  • _________________________________________________________________

  • ________________________________

  • HOPS:

    • MOI: rapid ext. of the finger while actively flexed

    • Swelling

    • point tenderness over DIP joint

    • ____________________________

  • Tx: Refer to physician


Jersey finger1
Jersey Finger

http://www.handlibrary.org/images/jnslide5-s.jpg


Gamekeeper s thumb
Gamekeeper’s thumb

  • Sprain of ulnar collateral ligament in thumb

  • MOI: ________________________________ ___________________

  • HOPS:

    • Swelling over palmar aspect

    • Instabilty in the joint

    • Laxity in thumb flexion

  • Tx: refer to physician, tape, rest, surgery



Boxer s fracture
Boxer’s Fracture

  • Fracture to the 4th and/or 5th metacarpal(s).

  • MOI - caused by punching something harder than the hand, such as a wall or another person's head. The end of the metacarpal bone takes the brunt of the impact, which usually breaks through the narrowest area near the end (the "neck"), and bends down toward the palm. 




Boxer s fracture 2
Boxer’s Fracture – (2)

  • HOPS- _________________________ ____________________________

    • Swelling/Discoloration in area

    • Deformity

    • Pain Pt tender at location of fracture

    • ___________________________________

  • Treatment- Splint, refer for x-rays, possible surgery


Rom strength testing
ROM/Strength Testing

  • Wrist Flexion-Palmaris Longus

  • Wrist Extension-Extensor Digitorum

  • Wrist Radial Deviation-Flexor/Extensor Carpi Radialis

  • Wrist Ulna Deviation-Flexor/Extensor Carpi Ulnaris

  • Finger Flexion/Extension-Flexor Digitorum/ Extensor Digitorum

  • Finger Abduction/Adduction

  • Opposition


Wrist hand anatomy
Test

  • Valgus Stress Test - Ulna Collateral Ligament - +sign laxity

  • Varus Stress Test - Radial Collateral Ligament - +sign laxity

  • Phalen’s- Median Nerve - +sign numbness/tingling

  • Tinel’s – Ulna and Median Nerve - +sign numbness/tingling

  • Fracture Testing- Compression, Flick