Unit 3 - The wrist, hand, & fingers: Anatomy
Skeletal anatomy
The radius
 “Thumb Side”

than the Ulna
 Larger at wrist, smaller at elbow
 Head is
– at the elbow
 Landmarks:
o Carpal surface
 Articulates with carpal bones
o Styloid process
The ulna
 “Pinky Side”
 Thicker proximally, smaller distally
 Head is distal –
 Landmarks:
o Head
o Styloid process
The wrist
 Common term for the carpal bones
o
carpal bones in each wrist
Carpal bones
 Proximal Row (Lateral to Medial)
o Scaphoid (Navicular)
o
o Triquetrum
o Pisiform
 Distal Row (Lateral to Medial)
o Trapezium
o Trapezoid
o Capitate
o
 Carpal trick
o Some = scaphoid
o Lefties = lunate
o Try = triquetrium
o
o That = trapezium
o They = trapezoid
o Can’t = capitate
o Handle = hamate
Metacarpals
 Knuckles - 5 per hand
o Base is
o Head is distal
 Numbered 1-5 from thumb to pinky
o ex: Thumb =1
o ex: Pinky = 5
Notes

Landmarks
o Proximal to Distal:
 Base
 Head
 Shaft
 Condyles
Phalanges
 “Fingers”
 14 bones
o 3 per finger (12)
o
(2)
 Landmarks:
o Proximal
o Middle
o Distal
Articulations
Radiocarpal joint
 “Wrist joint”
o Radius,
, & lunate
 Flex/Ext & Ulnar/Radial Deviation
 Stabilized by Radial
Ligament
Ulnocarpal joint
 “False joint”
 Separated & stabilized by cartilaginous disc
(meniscus-like)
o
 Stabilized by Ulnar Collateral Ligament
Triangular fibrocartilage complex (TFCC)
 Articular disc – the “meniscus” of the wrist
 Increases
in the distal radioulnar
joint,
the ulnocarpal joint
Radioulnar joint
 Formed by ulnar head and ulnar notch of the
radius
o Allows for
& pronation
Intercarpal joints
 Supported by interosseous membrane and
capsular ligaments
o Too numerous to list (every bone is
connected)
Carpometacarpal joints
 MC 1  trapezium
 MC 2 
 MC 3  capitate
 MC 4 & 5  hamate (single joint)
Metacarpophalangeal & interphalangeal joints
 MCP joints:
o “Knuckles”
o Numbered 1-5 thumb to pinky
Unit 3 - The wrist, hand, & fingers: Anatomy

IP joints:
o Proximal & distal in each finger
o Just
in thumb
Soft tissue anatomy - ligaments & muscles
Ligaments
 Dorsal & palmar (volar) radiocarpal ligaments
 Ulnar & radial collateral ligaments
 TFCC
 Intercarpal ligaments
 UCL & RCL for each MCP & IP joint
Radiocarpal ligaments
 Palmar (volar) RCL:
o 3 individual ligaments
o Capitate, triquetrum, scaphoid
o Limits wrist
 Dorsal RCL:
o
surface of radius
(styloid process)  lunate & triquetrum
o Limits wrist flexion
Collateral ligaments
 Ulnar Collateral Ligament
o Styloid process of ulna  TFCC 
triquetrum & pisiform
o Limits
 Radial Collateral Ligament
o Styloid process of radius  scaphoid &
trapezium
o Limits ulnar deviation
MCP & IP ligaments
 Ulnar collateral & radial collateral ligament at
each MCP & IP joint
 Stabilizes the joint through
 Named according to anatomical position (i.e.
when looking at dorsal
aspect of hand)
Muscles
 Natural Position of hand/fingers is slightly flexed
o Passively extend wrist & watch
fingers???
 Wrist extensors & wrist flexors
 Extrinsic muscles of the hand
o Muscles of the forearm that provide
strength and
of the
hand and fingers
 Intrinsic muscles of the hand
o Muscles originate in the hand and wrist
that provide
of the
hand
Notes
Wrist flexors
 Flexor carpi radialis
 Flexor carpi ulnaris

Wrist extensors
 Extensor carpi radialis longus
 Extensor carpi radialis brevis
 Extensor carpi ulnaris
Extrinsic muscles of the hand
 Muscles that move the hand/fingers
o Extensor digitorum
o Extensor
o Extensor digiti minimi
o Flexor digitorum superficialis
o Flexor digitorum profundus
 Muscles that move the thumb
o Abductor pollicis longus
o Extensor
o Extensor pollicis longus
o Flexor pollicis longus
o *Easier to remember movements if you
“rotate” thumb to correspond to fingers
Intrinsic muscles of the hand
 Thenar eminence (
)
o Adductor pollicis
o Opponens pollicis
o Abductor pollicis brevis
o Flexor pollicis brevis

eminence (pinky side)
o Abductor digiti minimi
o Flexor digiti minimi brevis (no longus)
o Opponens digiti minimi
o Palmaris brevis
 Lumbricles (4)
 Dorsal Interossei / Interossei Dorsales (4)
 Palmar Interossei / Interossei Palmares (3 or 4)
Other structures
Neurological anatomy
 Ulnar nerve (C8)
o Passes above carpal tunnel
o Sensory to
digits
 Median nerve (C7)
o Passes
carpal tunnel
o Motor nerve for thenar
eminence
o Sensory to 1st-3rd digits
 Radial nerve C6)
o Separates in forearm
o Sensory to dorsal hand
& 1st digit
Unit 3 - The wrist, hand, & fingers: Anatomy
Carpal tunnel
 Floor: Scaphoid, Trapezium/Pisiform, Hamate
 Roof: Transverse carpal ligament (Flexor
Retinaculum)
 Medial Pillars
o Pisiform
o Hook of Hamate
 Lateral Pillars
o Scaphoid Tubercle
o Trapezium Tubercle

pass through
o Four Flexor Digitorum Superficialis
tendons
o Four Flexor Digitorum Profundus
tendons
o Flexor Pollicus Longus tendon
o Median Nerve
Anatomical snuff box
 Term for area on radial aspect of wrist, proximal
to thumb
 Borders
o Anterior: Abductor Pollicis Longus and
Extensor Pollicis Brevis tendons
o Posterior: Extensor Pollicis Longus
tendon
 Contents
o Radial artery
 Floor
o
o Trapezium
Notes