Wrist and Hand

Original Editors - Rachael Lowe

Top Contributors - Kim Jackson, Rachael Lowe, Lucinda hampton, Laura Ritchie, George Prudden, Joao Costa, Wendy Snyders, Cheryl Rentchler, Mande Jooste, Admin, Evan Thomas, Nikhil Benhur Abburi, Abdallah Ahmed Mohamed and Tony Lowe

Introduction[edit | edit source]

The upper limb has sacrificed locomotor function and stability for mobility, dexterity and precision.  The hand sits at the end of the upper limb and is a combination of complex joints whose function is to manipulate, grip and grasp- this is made possible by the opposing movement of the thumb.[1]  

Anatomy[edit | edit source]

The hand and wrist have a total of 27 bones arranged to roll, spin and slide[2]; allowing the hand to explore and control the environment and objects. The hand is divided into three regions[3]:

  • Proximal region of the hand is the carpus (wrist)
  • The middle region the metacarpus (palm)
  • The distal region the phalanges (fingers).

Bones[edit | edit source]

The carpus consists of eight bones, sitting in two rows, with four bones in each row (figure).  The carpus controls length-tension relationships in the multiarticular hand muscles and to allow fine adjustment of grip.[4] 

Three of the bones in the proximal row articulate with the radius forming the radiocarpal joint and distally with the distal carpal forming the midcarpal joint.  The four carpal bones in the distal row articulate with the bases of the five metacarpal bones forming the carpometacarpal joints[5].  The joints formed between the carpal bones are known as the intercarpal joints and most are of the plane synovial type[1], as the bones interlock with each other the rows are sometimes referred to as two single synovial joints[1].   

The arrangement of the bones and ligaments allows very little movement between bones[1], but they do slide contributing to the finer movements of the wrist (Functional anatomy: musculoskeletal anatomy. Kinesiology and palpation for manual therapists).  The exception to this is the capitate which has a larger range of movement[1].  The small bones are named after the shape they resemble.


Clinical Examination[edit | edit source]

Conditions[edit | edit source]

Procedures[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Palastanga N, Soames R. Anatomy and Human Movement: Structure and Function. 6th Ed. London: Churchill Livingstone, 2012.
  2. ↑ Maitland, G.D. Maitland's Peripheral Manipulations. 3rd Edition Edinburg: Elsevier Butterworth-Heinemann, 1999.
  3. ↑ Physical Examination of the Spine and Extremities. Hoppenfield, S. New York: Appleton-Century-Crofts, 1976.
  4. ↑ Levangie PK, Norkin CC. Joint Structure and Function: A Comprehensive Analysis. 5th Ed. Philadelphia: F A Davis Company, 2011
  5. ↑ Principles of Anatomy & Physiology. Tortora GJ, Derrickson B. 13th Ed. NJ: John Wiley & Sons, Inc, 2012.
Retrieved from "https://www.physio-pedia.com/index.php?title=Wrist_and_Hand&oldid=193949"