Ch. 20 Wrist and Hand

Ch. 20 Wrist and HandAnatomy27 bones in the hand and wristNervesMedialUlnarRadialFlexor and extensor tendon for each finger

Anatomy

CarpalsScaphoidLunateTriquetralPisiformTrapeziumTrapezoidCapitateHamate

CarpalsScaphoid-SallyLunate-LikesTriquetral-ToPisiform-PartyTrapezium-TrooperTrapezoid-TaylorCapitate-CanHamate-Hit

Muscles

MusclesFlexorsFlexor Carpi RadialisFlexor Carpi UlnarisPalmaris LongusExtensorsExtensor Carpi RadialisExtensor Carpi UlnarisSupinatorPronator Teres and Pronator Quadratus

DislocationsDisplacement of any bone from normal positionSubluxation: abnormal movement of one of the bones that constitutes a joint

Colles Fracture

Fracture of the distal radius or ulna just above the wristFrom falling on outstretched handSplint and refer to doctor

Boxers FractureFracture to the 5th metacarpalMost commonly seen in someone who has punched something solid

Mallet FingerOccurs when a ball strikes the tip of the fingerAlso known as baseball fingerTearing of extensor tendon

Jersey FingerOccurs when grabbing a jersey Tearing of flexor tendonTreatment usually involves surgery

Boutonniere DeformityCaused by blow to bent finger or arthritis The proximal interphalangeal joint is in flexion and the distal interphalangeal joint is in hyperextension

Scaphoid Fracture

Pain over anatomic snuffboxCommon fracture in athleticsFall on outstretched handNot well vascularized

ContusionsSubungual hematoma-bleeding under the nailPain is from the pressure createdPuncture nail to relieve pressure

Gamekeepers ThumbSprain of ulnar collateral ligament of the metacarpophalangeal jointCommon in skiingUse special test to diagnose Tape and protect

deQuervains TenosynovitisInflammation of the extensor pollicus brevis and abductor pollicus longusUse signs and symptoms to diagnosisSpecial testTreat with RICE or cortisone shot

Finkelsteins17Carpal Tunnel SyndromeCarpal tunnel is a passageway that runs from the forearm through the wristMedian nerve runs through CTS occurs when linings of tendons are inflamed or ligaments thicken

Transverse carpal ligament18Carpal Tunnel SyndromeS/S: pain, numbness, tingling in wrist, hand, and fingersMay drop objectsUsually caused by overusePhalans TestTreat conservatively, surgery if needed

Ganglion CystGanglion cyst is a small, usually hard lump around a tendon or in a joint capsuleCommon in bowlers, tennis playersUsually on back of wristResolves on its own

RehabWrist ExtensionWrist FlexionWrist SupinationWrist PronationWrist Ulnar DeviationWrist Radial Deviation

Rehab

Elbow FlexionElbow ExtensionHand Intrinsic MusclesGrip Strength