Monday, September 29, 2008


    largest bone of proximal row of carpal bones: scaphoid

    largest bone of carpal bones; capitate

    proximal row: lateral to medial: scaphoid, lunate, tiquetral, pisiform

    sesmoid bone of carpus: pisiform, other sesmoid bones: patella, fibula

    that articulate with radius: scaphoid, lunate

    that articulate with radio ular joint :triquetral

    distal row of carpals : Trapezium, trapezoid, capitate, hamate

    carpal bone without articulation : pisiform

    Trapezium : articulates with the 1st and 2nd metacarpals, scaphoid, and trapezoid bones

    Trapezoid: articulates with the 2nd metacarpal, trapezium, capitate, and scaphoid bones

    Capitates: articulates primarily with the 3rd metacarpal distally, and with the trapezoid, scaphoid, lunate, and hamate

    Hamate: articulates with the 4th and 5th metacarpal, capitate, and triquetral bones


    Articulating metacarpal

    Proximal Carpal

    Distal carpal


    1st 2nd






    Trapezium, Capitate



    Scaphoid, lunate

    Trapezoid , hsmste


    4th, 5th



    3rd metacarpal is distinguished by a styloid process on the lateral side of its base

    Applied anatomy

    The scaphoid is the most frequently fractured carpal bone. It often results from a fall on the palm when the hand is abducted

    not visualised radiologically eary after trauma, but can be seen after 10-14 days, as bone resorption occurs

    avascular ncrosis of scaphoid occurs

    fracture hamate: may end in non union, due to traction of muscles, structures likely to get damaged: ulnar nerve, ulnar artery

    metacarpal #s heal good, du to ggod blood supply and also due to good stability

    Boxer's fracture: # 5th metacarpal, flexion deformity

    When the upper limb is in the anatomical position, the:

    • Superior angle of the scapula lies at the level of the T2 vertebra.
    • Medial end of the root of the scapular spine is opposite the spinous process of the T3 vertebra.
    • Inferior angle of the scapula lies at the level of the T7 vertebra, near the inferior border of the 7th rib and 7th intercostal space

    lunate and trapezoid are not alable on surface

    When the upper limb is abducted and the hand is placed on the back of the head, the scapula is rotated, elevating the glenoid cavity such that the medial border of the scapula parallels the 6th rib and thus can be used to estimate its position and, deep to the rib, the oblique fissure of the lung

    tennis elbow : superficial extensor muscles of the forearm : lateral epicondylitis

    Mallet or Baseball Finger

    Sudden severe tension on a long extensor tendon may avulse part of its attachment to the phalanx, deformity results from the distal interphalangeal joint suddenly being forced into extreme flexion , thus avulse the attachment of the tendon to the base of the distal phalanx, resulting in , the inability to extend the distal interphalangeal joint

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