THE HAND

DDM 3-B Ganancial Lorenzo Moreno Villas

Skeleton Of The HAND

Carpal Bones (8) Metacarpal Bones (5) Phalanges (14) Total of 27 Bones in the hand

CARPAL BONES (8)

Irregular shapes and surfaces

1. Scaphoid 2. Lunate 3. Triquetrum 4. Pisiform 5. Trapezium 6. Trapezoid 7. Capitate 8. Hamate

Proximal Row

Distal Row

An easy way to remember them all:

"Some Lovers Try Positions That They Can't Handle"

METACARPAL BONES (5)

Numbered 1 through 5 (lateral to medial) The metacarpal bone of the thumb is the shortest and most mobile. Represent most of length of hand All have base, shaft and head from proximal to distal BASE- articulate w/ the distal row of the carpal bones. SHAFT-slightly concave forward and is triangular in transverse section. HEAD-form the knuckles, articulate the proximal phalanges.

1 2

PHALANGES (14)
Each phalange has base, shaft and head from proximal to distal All fingers except the thumb have proximal, middle and distal phalanges

The Thumb has only proximal and distal phalanges.

JOINTS of the Hand

The intercarpal joints are the articulations between the individual carpal bones.

The carpometacarpal joints are the articulations between the distal row of carpals and the bases of the first through fifth metacarpals

The PALM of the Hand

Skin -thick and hairless -shows many flexure creases at the site of skin movement.

Deep Fascia

When the skin is removed, there are two dense connective tissue structures identifiable:

Flexor Aponeurosis
Carpal Bones: 1 scaphoid 3 pisiform

-crosses over the carpal bones, forming a bony tunnel (Carpal Tunnel)
2 trapezium 4 hamate

Palmar aponeurosis - has 4 bands of longitudinal fibers, one

band to each of digits 2 to 5. This sheet of tissue is under the skin of the palm and helps to form the ridges in the palm.

CARPAL TUNNEL - space between the carpal bones and the flexor retinaculum. Allows passage of the flexor tendons and the median nerve into the hand.

Floor proximal row of carpal bones Roof transverse carpal ligament Contents (10 structures) Median nerve Flexor pollicis longus tendon 4 tendons of flexor digitorum superficialis 4 tendons of flexor digitorum profundus

Small Muscles Of The Hand

Palmaris Brevis Muscle

ORIGIN Flexor retinaculum, Palmar Aponeurosis INSERTION Skin of Palm ACTION Corrugates skin to improve grip of the palm.

SMALL MUSCLES OF THE HAND

Palmar Interossei Muscle (4)

ORIGIN Base of the first metacarpal; remaining three from anterior surface of shafts of second, fourth and fifth metacarpal. INSERTION Proximal phalanges of thumb, index ring and little finger and dorsal extensor expansion of each finger ACTION Adducts finger toward center of third finger.

SMALL MUSCLES OF THE HAND

Dorsal Interossei Muscle (4)

ORIGIN Contiguous sides of shafts of metacarpal bones. INSERTION Proximal phalanges of thumb, index ring and little finger and dorsal extensor expansion of each finger. ACTION Abduct fingers from enter of he third finger; both palmar and dorsal flex metacarpophalageal joints and extend interphalageal joints.

SMALL MUSCLES OF THE HAND

Short Muscles Of The THUMB

Muscles of the THENAR GROUP

Abductor Pollicis Brevis Muscle

ORIGIN Schapoid, trapezium, flexor retinaculum INSERTION Base of the proximal phalanx of thumb. ACTION Abduct the thumb.

SHORT MUSCLES OF THE THUMB

Flexor Policis Brevis Muscle

ORIGIN Flexor retinaculum INSERTION Base of the proximal phalanx of thumb ACTION Flexes metacarpophalangeal joint of the thumb.

SHORT MUSCLES OF THE THUMB

Opponens Pollicis Muscle

ORIGIN Flexor retinaculum INSERTION Shaft of metacarpal bone of thumb ACTION Pulls thumb medially and forward across palm

SHORT MUSCLES OF THE THUMB

Adductor Pollicis Muscle

ORIGIN Oblique head; second and third metacarpal bones; transverse head; third metacarpal bone. INSERTION Base of proximal phalanx of thumb ACTION Adduction of thumb

SHORT MUSCLES OF THE THUMB

Short Muscles Of LITTLE FINGER

Muscles of the Hypothenar Group

Abductor Digiti Minimi Muscle

ORIGIN Pisiform bone INSERTION Base of the proximal phalanx of little finger ACTION Abducts the little finger

SHORT MUSCLES OF LITTLE FINGER

Flexor Digiti Minimi Muscle

ORIGIN Flexor retinaculum INSERTION Base of the proximal phalanx of little finger ACTION Flexes little finger

SHORT MUSCLES OF LITTLE FINGER

Opponens Digiti Minimi Muscle

ORIGIN Flexor retinaculum INSERTION Middial border of the fifth metacarpal bone ACTION Pulls fifth metacarpal forward as in cupping the palm.

SHORT MUSCLES OF LITTLE FINGER

Extensor Region of Forearm

Divided into: SUPERFICIAL GROUP and DEEP GROUP

SUPERFICIAL GROUP

Extensor Carpi Brevis Radialis

Extensor Digitorum Extensor Digiti Minimi Exensor Carpi Ulnaris

DEEP GROUP

Anconeus Supinator Abductor Pollicis Longus Extensor Pollicis Brevis Extensor Pollicis Longus Extensor Indicis

Extensor Retinaculum
-It holds the tendons of the extensor muscles in place

Extensor Digitorum Tendons

The DORSUM of the Hand

Skin

-Thin, hairy and freely mobile on underlying tendons and bones

Dorsal Venous Arch

-is a network of veins formed by the dorsal metacarpal veins. -It is found on the back of the hand and drains to the cephalic vein and the basilic vein.

POSITION S OF THE HAND

The position of rest The position of function

MOVEMENTS OF THE INDEX, MIDDLE, RING AND LITTLE FINGERS

MOVEMENTS OF THE THUMB

Flexion Extension Abduction Adduction Opposition Cupping the hand Making a fist

Flexion Extension Abduction Adduction Opposition

Hand Soap

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