Lecture on Wrist and Hand Anatomy and Kinesiology

Overview

The lecture covers the anatomy and kinesiology of the wrist and hand, focusing on their structure, function, and common pathologies. Key points include the bones, joints, ligaments, and their roles in movement and load transmission.

Structure of the Wrist

• *Key Functions of the Wrist:

  • Transmits load and forces from the hand through the forearm, upper arm, and shoulder.
  • Positions the hand for better performance of hand functions.

• *Bones and Joints:

  • The wrist consists of multiple bones and joints.
  • Stabilized by numerous ligaments.
  • Three main joints: distal radioulnar joint, radiocarpal joints, and midcarpal joints.

• *Bony Structure:

  • Composed of the radius, ulna, and eight carpal bones.
  • Important ligaments: flexor retinaculum and transverse carpal ligament.*

Carpal Tunnel and Its Importance

• *Contents of Carpal Tunnel:
  • Four tendons, one artery, and the median nerve pass through the carpal tunnel.
  • Increased pressure in the tunnel can compress the median nerve, leading to carpal tunnel syndrome.
  • Commonly seen in computer users and esports athletes.*

Carpal Bones

• *Two Rows of Carpal Bones:
  • Proximal row: scaphoid, lunate, triquetrum, pisiform.
  • Distal row: hamate, capitate, trapezoid, trapezium.
  • Mnemonic to remember: "So Long To Pinky, Here Comes The Thumb."*

Wrist Joints

• *Categories of Joints:

  • Radiocarpal Joint: formed by the radius, scaphoid, and lunate.
  • Ulnocarpal Joint: includes the TFCC (triangular fibrocartilage complex).
  • Midcarpal Joint: between the first and second row of carpal bones.
  • Carpometacarpal Joint: articulation between the distal carpal bones and the base of the metacarpal bones.

• *Distal Radioulnar Joint:

  • Primary motion is pronation and supination.

Ligaments and Stability

• *Importance of Ligaments:
  • Numerous ligaments contribute to the stability of the wrist.
  • Damage to one ligament can affect the entire structure.
  • TFCC: a critical structure for wrist stability and function.*

Functional Movements and Pathologies

• *Midcarpal Joint Movement:

  • Radial and ulnar deviation involves the capitate bone.
  • The capitate's convex shape influences its movement during these deviations.

• *Common Pathologies:

  • Carpal tunnel syndrome.
  • Injuries affecting the TFCC and other ligaments.

Conclusion

Understanding the anatomy and kinesiological aspects of the wrist and hand is essential for diagnosing and treating related pathologies. The interplay between bones, joints, and ligaments is crucial for proper hand function and stability.