Joints muscles and action of the wrist and

Joints, muscles and action of the wrist and the hand Dr. Szuák András ÁOK 2017. 10. 03 -04.

Joints • radiocarpal (aka. wrist) • midcarpal • carpometacarpal – 1 st • metacarpophalangeal • interphalangeal – proximal – distal

Radiocarpal joint • radius+articular disc – scaphoid+lunate+triquetrum • main ligaments: – – radial collateral lig. of wrist joint ulnar collateral lig. of wrist joint palmar radiocarpal dorsal radiocarpal U

Movements ellipsoidal joint (2 axes) radial – ulnar abduction palmar flexion - dorsiflexion

Midcarpal joints • proximal – distal row • main ligaments: – radiate carpal – pisohamate – palmar/interosseus/dorsal intercarpal • movements: none, only with the wrist

Carpometacarpal joints (except 1 st) • distal row – base of metacarpals • main ligmanets: – palmar/dorsal carpometacarpal – palmar/interosseus/dorsal metacarpal • movements: none

1 st carpometacarpal joint • trapezium - 1 st metacarpal • movements: – abduction – adduction – opposition - reposition (saddle joint – 2 axes)

Metacarpophalangeal joints • head of metacarpals – base of prox. phalanges • ligaments: – palmar – collateral – (deep transverse metacarpal ligament) • movements: (ball-and-socket joints) – flexion – extension – abduction – adduction – rotation (passive)

Interphalangeal joints • head – base of phalanges • ligaments – palmar – collateral • movements: – flexion – extension (hinge joint 1 axis)

Ulnar canal Content: -ulnar artery -ulnar nerve Carpal tunnel flexor retinaculum Content: -flex. digitorum superficialis -flex. digitorum profundus -flex. pollicis longus -flex. carpi radialis -median nerve pisiform & hook of hamate scaphoid & trapezium carpal bones

flexor digitorum profundus flexor digitorum superficialis vincula tendineum

The extensors… 3 5 6 2 4 1 1. abductor pollicis longus and extensor pollicis brevis 2. extensor carpi radialis longus and ext. carpi rad. brevis 3. extensor pollicis longus 1. extensor digitorum and ext. indicis 5. extensor digiti minimi 6. extensor carpi ulnaris

Muscles, which move the wrist

HYPOTHEN A R Muscles of the hand MES THE OHAR AR N E TH

Thenar • abductor pollicis brevis • opponens pollicis • flexor pollicis brevis median nerve – superficial head – deep head • adductor pollicis – transverse head – oblique head ulnar nerve

Hypothenar • abductor digiti minimi • opponens digiti minimi • flexor digiti minimi palmaris brevis ulnar nerve

Mesothenar • lumbricals - 2 radial – median nerve, 2 ulnar – ulnar nerve • interossei - ulnar nerve – dorsal (abduction) – palmar (adduction)

Thank you for your attention!