RADIUS BONE - Jinnah Sindh Medical University
RADIUS BONE & BONES OF HAND
LEARNING OBJECTIVES
Students should able to
Recognize the bones of forearm &hand
Determine side of bones.
Identify the features of bones.
Identify the muscles attached to bones.
Identify clinical significance of bones.
RADIUS BONE
Lateral bone of forearm
Three Parts
Upper end
Head
Neck
Tuberosity
Shaft
Lower end
DETERMINATION OF SIDE
Upper end rounded & bears the head.
Lower end more wider than the upper end
Lateral surface of shaft is convex & its anterior surface is concave in lower part
Styloid process projects from lateral surface of the lower end
HEAD
Disc-shaped, overhangs the neck on all sides
Medially it articulates with radial notch of ulna.
Upper surface articulates with capitulum-- form elbow joint
It is covered with hyaline cartilage.
Medial surface articulates with radial notch of ulna to form superior radio-ulnar joint
Attachment
Annular ligament to the articular cicumference of head
NECK
Constricted part below head
Surrounded by lower part of annular ligament
Attachments:
Supinator is inserted into the lateral anterior &posterior aspects of neck
TUBEROSITY
Lies below the medial part of the neck.
Attachments:
Biceps brachii is inserted into rough posterior part.
Smooth anterior part is related to bursa.
SHAFT
Narrow above, broader below
Three borders.
Interosseous(medial)
Anterior
Posterior
Three surfaces
Anterior
Posterior
Lateral
BORDERS
INTEROSSEOUS (MEDIAL) BORDER
Sharp except at its upper part
Begins from posterio-inferior part of radial tuberosity
Lower end form posterior boundary of small triangular area above ulnar notch of radius
Attachment on interosseous border
Pronator quadratus is inserted
Gives attachment to interosseous membrane in lower 3\4
ANTERIOR BORDER
Begins just below antero-lateral part of radial tuberosity
Upper & lower parts are sharp
Attachments on anterior border
Origin of Flexor digitorum superficialis from upper & lower parts
Extensor retinaculum is attached to lower edge
POSTERIOR BORDER
Begins from posterio-inferior part of tuberosity
End in dorsal tubercle at back of lower end
Prominent in middle part
SURFACES
ANTERIOR SURFACE
Lies between anterior and interosseous border
Presents nutrient foramen directed up ward
Attachments on anterior surface
Origin to flexor pollicis longus from upper 2\3
Insertion to pronator quadratus in lower 1\4
POSTERIOR SURFACE
Lies between interosseous & posterior borders
Origin of Abductor pollicis longus from upper part
Origin of Extensor pollicis brevis from lower part
LATERAL SURFACE
Lies between anterior&posterior borders
Rough ridge in middle part gives insertion to pronator teres
Insertion to supinator into V Shape area at upper part
Brachioradialis is inserted just above styloid process
LOWER END
Expanded &rectangular
Has five surfaces
Lateral surface
Medial surface
Anterior surface
Posterior surface
Inferior surfaces
LATERAL SURFACE
Present styloid process
Radial collateral ligament of wrist joint is attached at tip of styloid process
Brachiodialis is inserted into lower part of lateral surface
Two grooves lateral to styloid process for tendons of Abductor pollicis longus &Extensor pollicis brevis
MEDIAL SURFACE
Bears ulnar notch for articulation with head of ulna
Articular disc of inferiorradio-ulnar joint is attached to ridge at lower part.
ANTERIOR SURFACE
In form of thick prominent ridge
Radial artery is palpated as radial pulse
Pronator quadratus is inserted into the lower part of anterior surface
POSTERIOR SURFACE
Irregular
Present dorsal tubercle(of lister)
Four grooves for extensor tendons
INFERIOR SURFACE
Bears triangular area for Scaphoid bone
Medially, quadrangular area for Lunate
Takes part in forming wrist joint
CLINICAL ANATOMY
Fractures of radius
Fracture of head
Can occur from fall on outstretched hand
Fracture of neck of radius
Occur in young children
FRACTURES OF SHAFT OF RADIUS
May or may not occur with ulna
Displacement of fractured fragment depends on pull of muscle
Supinator and biceps supinate the proximal fragment
Pronator quadratus pronates the distal fragment
Brachioradialis and extensor carpi radialis and brevis shortens the fore arm
COMBINE FRACTURES OF RADIUS AND ULNA
Shaft of ulna fractured by a force from behind
Bowing forward of ulnar shaft with anterior dislocation of radial head
Rupture of annular ligament
COMBINE FRACTURES OF RADIUS AND ULNA
Proximal third of radius is fractured
Distal end of ulna is dislocated at distal radio ulnar joint
FRACTURES OF DISTAL END
Colles’ fracture
Fall on outstretched hand
Distal fragment is displaced posteriorly and superiorly
The fore arm and wrist resembles the shape of dinner fork
Dinnerfork deformity
Reverse colles’s fracture
Distal fragment displaced anteriorly
Fall on back of hand
BONES OF HAND
Eight carpal bones
Five metacarpal bones
Fourteen phalanges
CARPAL BONES
Eight carpal bones
Arranged in two rows
Proximal row
Medial to lateral
Scaphoid
Lunate
Triquetral
Pisiform
Distal row
Trapezium
Trapezoid
Capitate
Hamate
CHARACTERISTICS OF EACH BONE
Each bone has six surfaces.
Scaphoid is boat –shaped
tubercle on its lateral side
Lunate is half moon shaped or crescentic
Triquetral is pyramidal shape
has oval facet on distal part of palmar surface
Pisiform is pea shaped
only one oval facet on proximal part of dorsal surface
Trapezium is quadrangular in shape
crest & groove anteriorly
Trapezoid resemble shoe of baby
Capitate is largest with rounded head
Hamate is wedge –shaped with hook near base
ATTACHMENTS
Most important structure related with carpal bones --------- FLEXOR RETINACULUM
Attachment:
Lateral
scaphoid
anterior border of lower end
Medial
Pisiform
Hamitate
CLINICAL ANATOMY
Fracture of scaphoid
Most common fractured bone among carpal bone
Non union & avascularity common problem
Tenderness & swelling in anatomical snuff box
Dislocation of lunate
Most common dislocated bone of carpal bone
May compress median nerve in front of wrist
Carpal tunnel syndrome
CARPAL TUNNEL SYNDROME
Carpal tunnel:
osseofibrous space formed by anterior concave surface of carpus and flexor retinaculum
Passage of long flexor tendon and median nerve
CARPAL TUNNEL SYNDROME
Syndrome is caused by compression of median nerve due to reduced size of canal
Pain and paraesthesia of lateral one and half finger
Weakness of thenar muscle
METACARPAL BONES
Short long bones
Numbered from lateral to medial side
1st metacarpal Shorter & thicker articulates with trapezium.
Other metacarpal bones
Expanded bases articulate with distal row of carpal bones & with each other
Middle metacarpal show styloid process
Heads has boldly rounded articular facets
Form concavity for palm
Heads form knuckles of fist
PHALANGES
14 in number
Parts
Base
Shaft
Head
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