Carpals

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

Bone	Articulating metacarpal	Proximal Carpal	Distal carpal
Trapezium	1st 2nd	Scaphoid,	Trapezoid
Trapezoid	2nd	Scaphoid	Trapezium, Capitate
Capitates	3rd	Scaphoid, lunate	Trapezoid , hsmste
Hamate	4th, 5th	Triquetral,	capitate

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