Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

welcome Doctors!

No description
by

aseelah n

on 13 February 2015

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of welcome Doctors!

Objectives:
1) Identify the carpal bones on plain radiographs.
2) Show movements possible at the wrist joint.
3) Analyze the findings on clinical examination based on the anatomical knowledge.
Clinical case:

Ebtihal is a 25 year-old female who fell down on her outstretched hands. She presented soon after the fall to the emergency department complaining of pain and swelling in her right wrist. On examination her wrist is swollen and movement is restricted because of pain. She has tenderness over the snuff box.
Her x-rays showed a scaphoid fracture and therefore her wrist was immobilized in a thumb spica splint.
3 years later, Ebtihal is now a 28 year-old Coach and a mother of a 2 year old boy; she came complaining of gradually increasing pain in her right thumb when doing her exercises.
There is recently some tender swelling at her wrist.
On examination there is a firm tender swelling over the styloid process of the right radius. Percussion is very painful. Forced ulnar deviation of the wrist is also very painful. Resisted abduction and dorsiflexion of the CMC joint of the thumb is painful.

Anatomy Of The Hand
What We See In X-ray Of the hand !
Interphalangeal joints (IP)
-All fingers have 3 phalanges
EXCEPT
the thumb has 2 phalanges .
The wrist joints
Movement of the wrist

Extensor Retinaculum
The End
Welcome Doctors!
Your Way To Future Begins !
- All fingers have 2 IP joints ( proximal & distal )
EXCEPT
the thumb has 1 IP joint .
structures passing
deep
to ER :

Ext.carpi ulnaris .
Ext.digiti minimi .
Ext.digitorum .
Ext.indicis .
Ext.pollicis longus .
Ext.carpi radialis brevis .
Ext.carpi radialis longus .
Ext.pollicis brevis .
Abductor pollicis longus .
( from medial to lateral )
structures
superficial
to ER :
(
P
anadora
B
oy
C
lean &
S
traight )
P
osterior cutaneous branch of ulnar nerve.
B
asilic vein.
C
ephalic vein.
S
uperficial branch of radial nerve.
1. The following structures pass
superficial
to the extensor retinaculum of the wrist,
EXCEPT
:

A. Beginning of cephalic vein.
B. Beginning of basilic vein.
C. Superficial branch of radial nerve.
D. Tendon of extensor digiti minimi.


2. Which of the following structures pass
deep
to the extensor retinaculum?

A. Basilic vein.
B. Cephalic vein.
C. Radial nerve.
D. Radial artery.
E. Flexor carpi ulnaris tendon.


Scaphoid Bone
The
scaphoid
is a carpal bone in the wrist.
It sits on the radial or lateral side of the wrist near the thumb.
It is the
largest
bone in the wrist's
proximal row
.( Lunate, triquetral, and pisiform ) are the remaining bones in the proximal row.
(Trapezium, trapezoid, capitates, and hamate ) are bones in the distal row.

Blood supply
of Scaphoid bone
Radial artery
dorsal branches
Palmar branches
distal & middle
distal third
IMPORTANT
The scaphoid has a special blood supply ; the proximal portion has
NO
blood supply
put it in your mind
Function of scaphoid bone

The
scaphoid
involved in movement of the wrist .

along with the
lunate
, articulates with the radius and ulna to form the major bones involved in movement of the wrist.
The scaphoid serves as a

link
between the two rows of carpal bones. With wrist movement,

Snuff Box

Anatomic snuffbox
Triangular skin depression on the lateral side of the wrist .

boundaries :
- Medially: tendon of the extensor pollicis longus.

- Laterally:tendone of the extensor pollicis brevis
Abductor pollicis longus

Floor:
Trapezium and scaphoid bons.


you would palpate the scaphoid bone in the anatomical snuff box . it represents the
floor
of the snuff box .


What Is It ?
It is a progressive stenosing tenosynovitis which affects the tendon sheaths of the 1st compartment degeneration and thickening of the tendon sheath

scaphoid fracture
Scaphoid fractures are common injuries in vehicle and sports related accidents. These fractures typically occur when the body falls on an outstretched wrist.


60% of all carpal fractures are scaphoid related.

X-Ray

Scaphoid fracture


Symptoms:
Pain , Swelling at the base of the thumb. In some cases, the pain is not severe, and may be mistaken for a sprain.
Any pain in the wrist that does not go away within a day of an injury may be a sign of a fracture. A simple "sprained" wrist is very rare and it is important to see a doctor if pain persists.

Examination and Tests :

1-Palpation .
2- X-ray .
3- MRI .
Treatment of scaphoid fracture
Nonsurgical
surgical
Fracture Near the Thumb

Fracture Near the Forearm

- heal in weeks with proper protection ,This part of the scaphoid bone has a good supply of blood, which is necessary for healing.
- healing is more difficult. These areas of the scaphoid do not have a very good blood supply.
Do you remember ?
The Scaphoid has a special blood supply; the proximal part has
no
blood supply and it is the part where the
avascular

necrosis
will occur

De Quervain's Tendinosis
- There is Twenty-four extrinsic tendons cross the wrist ,covered by a slippery thin soft-tissue layer.

- There are six separate compartments we are gonna foucs to the first compatment,The first one is over the radial styloid.
- first compartment contains :
1-Extensor pollicis brevis

2-Abductor pollicis longus
De Quervain's Tendinosis
Aetiology :
Inflamation of the synovial sheaths result from continuous repititive use of EPB and APL muscle.
scarring and thickening of tendon sheaths
stenosing, increase friction
inflammation
degeneration
causes:
overuse injury
- Associated with pregnancy and rheumatoid disease
repititive tasks
arthiritis
Activities :
hammering
painting
Lifting heavy objectives
cutting with scissors
skiing
Incidence and Prevalence:

- Occurs most often in individuals age between 30 and 50 y.o.
- 10 times more common in
women
(Tenovaginitis).
- Higher risk for workers / sports.
- musicians .

- Localised swelling and tenderness
- Pain

treatment:

- surgical incision


Diagnosis:
- Finkelstein test.
sympotoms:
Done by:
Aseelah Alrasheedi
Amani Aljabrti
Amjad Alshangeti
Nuha Alzahrani
Rawan Alamri
Atheer Asseri
Ebtihal Alamoudi
Maryam Bajuaifar
S
am
L
ikes
T
o
P
ush
T
he
T
oy
C
ar
H
ard
Snuff Box
Scaphoid fracture
Normal
Symptoms
Treatment by injection
Finkelstein test.
Full transcript