hello um because of the complexity we will spend two weeks uh discussing uh the recent hand the first uh part of the recent hand we will touch base on the anatomy and Kinesiology uh for this region in the second part of uh the recent hand we will uh explore more about how recent hand collaborate with each other and uh to contribute to uh human movement and also we will uh learn some um commonly uh seen pathologies in this region for the part two for the wrist um the wrist function is to transmit load en forces from the hand and then all the way and deliver uh delivered it all the way up to uh through forearm upper arm and then to shoulder or the OU way around and also uh doing some hand movement wrists kind of help to position the hand for um to uh for a better performance of the hand function so this is the two key function of the wrist and the structure of the wrist is kind of interesting because um it has uh multiple bones that formulate articulate multiple joints um so um um the stabilization of the wrist is really important and specifically um this um region is stabilized by a lot of ligaments which we will explore a little bit more um later um so um generally uh there are three main joints uh that uh make up on the wrist uh one is the distal radio owner joint and radio carpal joints and meat carpal joints um so uh before we look at the joints we need to know uh the structure the Bony structure of the wrists and um as seen in this picture you can see uh this whole region um is the complex of the wrist um the wrist is uh consist uh of uh the radius Onna and then eight uh corpal bones um and from the Vol side of the uh R region and often times you can see uh there's say uh ligaments uh we call it a flexor retinaculum and in some textbooks uh they mix the uh flexor r inoculum with transverse carbal ligaments and in some textbooks um they separate the two uh into different uh two different uh tissues um but if you look at uh the structure actually it is really like they're really close and then they're going to blend it into uh each each other so um but don't be surprised that some textbook separate them and some textbook U mix them Al together and why is this Factor rum so important or transverse caroal I'm sorry transverse carbo ligament so important you can see that from the V side um this uh riculum um and the eight uh couple bones they uh form a a carbo Tel So within this carbo Tel you can expect that there are faor tendons um one artery and then one medium nerve kind of uh pass through this carbo Turnal um when we um use the faor muscle like um too often um that would actually um increase the pressure within the Caro Turnal and because of the increased pressure that would uh compress um the nerve uh which is the medium nerve and of often times people show uh nerve symptoms uh for the medium nerve which is uh the first three digit uh first three digits um so if you if you look at the structure here you can see that this is a structure that we commonly especially uh we use computer a lot and the the place that we are in contact with the table um at the wrist is a very close to uh the flexor of retinaculum that means by doing so if we use the computer for you know a long period of time we um we un intentially increase the pressure within the Caro turnel and that is um very common uh that we see especially for computer users that they develop caroal syndrome especially for the Esports uh ethics so what are um the eight Caro bones um um starting from the there are two rows of cble Bones the first rows starts from the scaffo lunate um Trum and then uh PC form PC form is a tiny little bone above it and then a second row of the couple bones are uh hate mate cavitate uh trapezoid and trap trapezium um it's kind of hard to remember so um here's um what I used to remember it so I take the first uh letter of each bones and then I C it so long to Pinky here comes the thumb so so long to pinky here comes the thumb and there's uh two T's right here so um I uh memorize it um as D comes before and so uh trapezoid comes before the trapezium so this is how I remember the at a couple bones so long to pinky um here comes the um and um as shown in this picture um you can see that this is a very kind of mobile um um um place especially um here you can see the space here is kind of large especially on the owner side so we can expect that this part is not as stable as this part right and because of the irregular um carple bones right here so we can expect that the move m m um Within These um joint space can be very limited so the majority of the movement uh will be here right so um so that's look at the joints um within the wrists uh region so uh roughly uh the wrist can be categorized into three um joints we have uh radio Coral joint joints specifically when we talk about uh radio caral joints we mean um the uh scat for lunate and radius now these three bones uh form um the um radial Carle joints and then for the owner uh couple joints um we have another name we call it uh tfcc which I will talk about that later you can see that this uh part of the joint can be uh very uh mobile um the second part of joint uh we categorize it as mid carbo joints which is the first um the joint space between the first row of the couble bones and the second row of the coule bones um and then there is a couple made of couple joints that is the second row of the couple bones articulate with uh each of the uh base of the um MBO bones you can see because of the space joint um shape like this um they there AR much movement going on so we can expect that some movement in mid Cobble like major u p primarily uh the sliding or gliding movement and more movement that we can expect within the um radio couble joints so when we look at the uh disto radio oner joint joint you can see that it is um um a joint that form U with the radius and Ona joint right here and you can see that this this is a joint that we see in the forarm region right so the the primary uh motion for this uh distal radio on the joint is really the uh pronation and superation however because it is it also uh articulate with the uh first row of the couple bones um this uh this so radio on the joint also helped um um collaborate with u the hand movement um especially uh when we do some kind of functional task uh such as turning the door knobs driving or turning the page something like that um the radio couble joints is a uh con deloid joint uh imant uh formed uh with the radius scapo and lunate okay you can see that the joint space is much closer compared to the owner side right um and um on the owner side here you can see that because of the space is kind of larger compared to the radio side right here here um so a lot of stability comes uh from um the ligaments uh to secure um this uh part so you can see that uh from on side of a doso hand we have so many uh ligaments going on from the B side we have so many ligaments going on um because this is a um course that help you be become a general OT so I'm not going to ask you to memorize name of the each uh name of the each uh ligament if you uh intend to become a hand therapist then I I highly encourage you to get familiar with um the this part of the ligaments because um it's very uh complicated and um one bone got damaged or affected it would actually affect all uh ligaments because the whole stability within this region um will be um impacted and we have a name for this part um of the structure so both Doo side and B sign um we call it triangular fibral cartilage complex triangular because this is a you know Tri triangle area and the ligaments is uh fiol kind of um tissue and it's complex so we call it triangular fibrocartilage complex and AKA um tfcc so you will hear people talk about tfcc a lot because every type of risk injury U not the nerve r u the bones the tendon or the muscle injury uh tfcc is most likely will be affected okay all right so let's move dist to the mid couble U joint right here it is actually uh the the the first row and the second row of the coule bones on the joint space if you see here the citate here is really uh the primary um key move uh bones right here you can see it's the convex uh articulating with the lunate and scapo uh laterally with the scapo and dist with the lunate and they're all concave kind of shape uh with the uh capitate so that being said um if we um look at uh the movement within this kind of mid couple uh joints especially uh we observe it in uh radial oner deviation of the wrist uh we use this citate to kind of uh as a as a reference to see uh the movement so being said so what that being said so the radial side is right here so when we do radial deviation you can see that the capitate will actually roll to this side and glide to on the side so that will shows uh because because of this a convex kind of um shape it goes to the opposite uh Direction which we will talk more um when we talk about wrist motion um I did not spend time to talk about the couple m a couple joints because there is very minimum movement going on