Nov 09, 2016 part 2 is devoted to the surface anatomy of the structures of the wrist, forearm, and hand nearly 150 illustrations, anatomical drawings, and photos of anatomy in vivo. Also required is knowledge of surface anatomy and the corresponding underlying structures. Greulich and pyle, last published in 1959 as a second edition, has long been the reference of choice for bone age interpretation for most practitioners in the united states. Successful clinical evaluation of the wrist requires a thorough knowledge of wrist anatomy, biomechanics, and pathology. An understanding of the anatomy is invaluable when such small structures as described here are to be evaluated. View the insertions of the extrinsic flexor muscles of the hand.
Diagnosis of upper extremity injuries depends on knowledge of basic anatomy and biomechanics of the hand and wrist. Clinical anatomy and mechanics of the wrist and hand jospt. The wrist is a complex joint that connects the radius and ulna the 2 bones in the forearm to the carpals in the hand. Because mr imaging reveals greater detail, radiologists are obliged to use the information available to benefit the clinician and the patient. Operating without a sound fundamental knowledge of anatomy can be compared to stirring around in the soup. Chief of sports medicine, orlando health chief medical officer, orlando city soccer club. The analysis of the carpal mechanism warrants detailed examination of the morphology of the wrist. Part 2 is dedicated to the surface anatomy of the structures of the forearm, wrist, and hand. This joint is commonly referred to as the knuckle joint. There are 3 major types of bones in the hand itself, including. All muscles of the hand are innervated by the brachial ple. Skeletal development of the hand and wrist 2011 pdf.
Kwire fixation is a simple method for bony stabilisation but can be a demanding. Labels on this drawing include the distal phalanx, middle phalanx. The first relates to the static and functional anatomy of the hand and the wrist in the broad sense since the book begins with the radioulnar proximales and distal articulations, then the wrist, the inch, the palm of the hand and the fingers. A common rule of thumb is that any muscle tendon that crosses a joint will act on that joint.
The tendons that attach the forearm extensor muscles to the finger and hand bones on the backside of the hand and wrist and serve to straighten the fingers, thumb and wrist. Cook, md, phd, stephanie simonson, md, woojin kim, md keywords normal wrist and hand anatomy wrist and hand magnetic resonance imaging normal variants magnetic resonance mr imaging is the optimal neutral position during imaging. The thumb only consists of a metacarpal and 2 phalanges. When there is a problem with any of these structures, pain or impaired function may result. Also, forearm movements occur in concert with both hand and shoulder movements 47. Carpal bones all carpal bones participate in wrist function except for the pisiform. The structure of the human hand is a highly complex. Wrist and hand in human anatomy, the hand consists of the wrist and the fingers. The radiographic atlas of skeletal development of the hand and wrist, by drs. Chief of sports medicine, orlando health chief medical officer, orlando city soccer club orthopedic institute thank you dr. The trapezium articulates with the first metacarpal hence trapezi um with the th um b, next to which lies the trapezoid. This makes the extensor carpi ulnaris ecu tendon to appear in the ulnarmost portion of the wrist.
The anatomy of wrist, thumb and hand is complex because of the presence of many different functional joints. Almost 150 illustrations, anatomical drawings, and photos of anatomy in vivo. Elbowwristhand anatomy osseous structures of the elbow. The metacarpal bones connect the fingers and the carpal bones of the wrist. Describe the all the main actions of the muscle compartments of the forearm. These metacarpals have a head, a shaft, and a base. Wadsworth, ms, lpt hand rehabilitation is an area with the potential for providing orthopaedic physical therapists a challenging and rewarding practice. The ulnar, median, and radial nerves provide innervation of the hand and wrist. This complex structure connects the entire hand to the radius and ulna, facilitates the passage of tendons together with the above mentioned neurovascular structures from the forearm to the hand, and permits us to exploit all its movements. Normal anatomy of the hand and wrist sciencedirect.
Hubs1105 anatomy workbook week 4 the elbow, forearm, wrist 25. Part 1 deals with the anatomy and functional anatomy of the hand. These evolved sections allow the human hand to grip in two distinct ways vital to the tool making process. At the volar wrist level, the tendons assume a specific anatomical arrange ment fig. The ulna articulates with the pyramidshaped triquetrum via a pad of triangular fibrocartilage. Flexor and extensor tendons cross the wrist to allow function of the hand and digits. Jun, 2017 this book is divided into two great parts. A number of anatomical studies and improved imaging methods of. In a group make up pneumonic wrist and hand anatomy the metacarpals form the structure of the hand. For example, muscles of the forearm that cross the carpometacarpal. Anatomy of the hand and wrist bones medical illustration, human anatomy drawing. Napier, with these advancements, the human hand can accomplish two types of grips, the precision grip and the power grip napier 903. There are eight carpal bones in the normal hand table 9.
The wrist is a highly complex joint in a very compact space. The 14 bones that are found in the fingers of each hand and also in the toes of each foot. The palm has five bones known as metacarpal bones, one to each of the 5 digits. All volar tendons pass through the carpal tunnel with the exception of the.
Normal hand anatomy numerous blood vessels, nerves, and soft tissue refer fig. They were firstinjected atvarious sites, asdescribed below. The wrist is comprised of 8 bones called carpal bones. N o r m a l a n d va r i a n t a n a t o m y o f th e wri s t a n d h a n d on mr imaging joel m. Pdf normal and variant anatomy of the wrist and hand on. Knowledge is the key to success for ourselves and our patients. The product only includes the ebook, hand and wrist anatomy and biomechanics. Mar 24, 2021 the anatomy of the hand is incomplete without understanding the wrist. Osseous structures of the wrist normally, 27 bones make up the wrist and hand complex. The wrist and hand allow for the manipulation of objects in space and provide us with the dexterity required for fine motor skills.
Hence, to a degree we think and feel with our hands, and, in turn, our hands contribute to the mental processes of. The 2nd and 3rd metacarpals mc and the distal row of the carpus are the fixed elements of the hand. Normal sonographic anatomy of the wrist with emphasis on. In some cases, sesamoid bones may increase the total of bones in the wrist table 9. In most textbooks youll find the wrist s purpose stated as. Section through radius, lunate, capitate, and the bony structure of digit iii, showing. Hello and welcome to this program from scs continuing education. A hand is a prehensile, multifingered appendage located at the end of the forearm or forelimb. All the joints of the hand and wrist have basic anatomic forms. This indicates the joint region they had greatest involvement and consequence if injured 9.
The carpal bones are table 1 bone s and joint of the han wrist. Normal sonographic anatomy of the wrist and hand radiographics. These wrist bones connect to 5 metacarpal bones that form the palm of the hand. Wrist anatomy new york, ny handsport surgery institute. Affiliation 1 department of radiology, staten island university hospital, new york, usa. Magnetic resonance imaging clinics of north america. The structure and function of the anatomy of the hand and wrist are responsible for an almost infinite combination of skilled movements of the digits, supported by stability of the wrist and elbow, arches of the hand and the joints of the upper extremity. Essentials of wrist morphology serve as a basis for the concept of the interdependent carpal articulation chains. Hand and wrist anatomy and biomechanics pdf free download. The anatomy of the wrist and hand is best described by considering the extensor and flexor surfaces separately. The remaining 8 hand bones are the carpals, located in the wrist.
This medical illustration diagram shows the bones of the hand and wrist as seen from the palmar view. Hand and wrist anatomy and biomechanicsbernhard hirt 20161109 there is a saying that hand surgery without a tourniquet is like repairing a clock in a barrel full of dark ink. Movements of the hand are made more effective through proper hand positioning by the elbow, shoulder joint, and shoulder girdle. The anatomy of human hand is quite unique and includes the configuration of bones, joints, veins and muscles. In this concept the wrist joint functions with 3 parallel longitudinal chains. Hubs1105 anatomy workbook week 4 the elbow, forearm, wrist 8. A thorough and accurate understanding of the gross and arthroscopic anatomy of the wrist and distal radioulnar joints is a prerequisite for effective arthroscopy. Basic hand and wrist anatomy hand institute of charleston. The carpal extensor retinaculum divides the dorsal extensor tendons into six separate synovial compartments, which are demarcated by the points of its attachment to the radius and ulna. View the flexor synovial sheaths coloured purple encasing the tendons of extrinsic muscles of the hand. Oct 27, 2020 knowledge of anatomy is a necessary prerequisite to assess and plan the means and methods to deal with traumatic wrist injuries. There are 29 bones in the hand and wrist if you include the radius. The functional structure oe the hand the bones the bones of the hand, shown in figure 1, naturally group themselves into the carpus, comprising eight bones which make up the wrist and root of the hand, and the digits, each composed of its metacarpal and phalangeal segments table 1.
The deep fascia is thin over the thenar and hypothenar, it is thick in the middle. The phalanges and the 4th and 5th metacarpals are the mobile part of the hand and allow grasping around objects. Material hands and wrists iniocadavers were utilized. Wrist and hand anatomy the wrist is made up of 8 wrist bones called carpals. Anatomy and radiography of the wrist, hand, and fingers. Identify and label the styloid processes of radius and ulna note where each forearm bone is largest. The physiological interconnection and structure of these parts are responsible for the structure of the human hand. The digits fingers the landmarks of this regions are. Just click on the dissection notes button to open the pdf that you can print. The wrist allows not only for the classic, or cardinal, motions of flexion.
On the other hand, pin site infections are much more common with reported rates of up to 7% in the hand or wrist. There are 27 bones in the hand including the wrist. It is obvious to all that the human hand represents a mechanism of the most intricate fashioning and one of great complexity and utility. The distal part of the upper limb is divided in to three regions. Each metacarpal bone connects to one finger or a thumb at a joint called the metacarpophalangeal joint, or mcp joint. Wrist flexors the muscles attaching to the medial epicondyle and running down the front of the forearm that serve to flex the wrist and hand. Arthroscopic anatomy of the wrist and distal radioulnar joint. Free anatomy quiz anatomy of the hand bones quiz 1. Hand anatomy overview bones, blood supply, muscles geeky. A clear understanding of normal sonographic anatomy is required to prevent misdiagnosis and ensure optimal patient care. Clinical anatomy and mechanics of the wrist and hand. Apr 04, 1983 clinical anatomy and mechanics of the wrist and hand carolyn t.
The 14 bones that are found in the fingers of each hand. Mor s n d thom asj ef r onu iv ty h p l mri of the wrist occult fracture ganglion cyst tumor ligament tear avascular necrosis arthritis tendon pathology nerve impingement infection occult fracturenot visible on initial radiographsfollowup xray, ctmri. Author links open overlay panel nancy prendergast md a wolfgang rauschning md, phd b. The anatomy of the wrist and hand is best described by considering the extensor and. The radius articulates with the cashew shaped scaphoid bone laterally and the croissantshaped lunate. Detailed explanations of the scanning techniques and sonographic appearance of the wrist structures are provided in the figure legends. Normal anatomy of the hand and wrist magn reson imaging clin n am. The anatomy and basic biomechanics of the wrist joint. The carpal extensor retinaculum divides the dorsal extensor tendons into six separate syno. The hand is composed of many different bones, muscles, and ligaments that allow for a large amount of movement and dexterity.
The subcutaneous tissue contain fibrous septums which pass it from skin to palmer aponeurosis and make cells full with fat tissue. Hand and wrist usually appear normal, but may show thenar atrophy provocative tests. Classic anatomy instruction covers only a fraction of the. However, success in treating the patient with hand dysfunction is closely associated with the therapists understand. The phalanges and the 4th and 5th metacarpals are the mobile part. Anatomy of the hand and wrist bones medical illustration. Knowledge of anatomy is a necessary prerequisite to assess and plan the means and methods to deal with traumatic wrist injuries. Hand anatomy overview bones, blood supply, muscles. It is composed of skin, blood vessels, nerves, tendons, ligaments, bones and joints. The skeleton of the hand, wrist and forearm consists of 29 bones diagram 1. But beyond this it is intimately correlated with the brain, both in the evolution of the species and in the development of the individual. The keys to a successful examination are to link the symptoms with the. The skin is thick because it is required at the work and play it is richly supplied with sweat glands 2. Chapter 7 the wrist and hand joints kean university.
1147 1033 496 1166 921 1327 936 597 508 1012 1362 1601 665 1529 192 716 673 41 208 399 1198 521 260