JA

• Main groups of the upper limb

  • Hand and wrist
  • Forearm
  • Arm (humerus)
  • Shoulder girdle
• Bones of the hand and wrist

  • Phalanges (fingers and thumb) 14
  • Metacarpals (palm) 5
  • Carpals (wrist) 8
• Phalanges


  Most distal bones of the hand which constitute the digits (fingers and thumb)
• Metacarpals


  Second group of bones, these bones make up the palm of each hand
• Carpals


  Third group of bones, consists of the bones of the wrist
• Phalanges of the fingers and thumb

  • Proximal
  • Middle
  • Distal
• Each of the four fingers (digits 2, 3, 4, and 5) is composed of three phalanges
• The thumb or first digit has two phalanges
• Parts of each phalanx

  • Distal rounded head
  • Body (shaft)
  • Expanded base, similar to that of the metacarpals
• Metacarpals


  The second group of bones of the hand, which make up the palm, consists of the five metacarpals
• Parts of each metacarpal

  • Head - distally, the rounded portion
  • Body (shaft) - is the long curved portion (the anterior part is concave in shape, and the posterior, or dorsal, portion is convex)
  • Base - is the expanded proximal end, which articulates with associated carpals
• The joints, or articulations, between the individual bones of the upper limb are important in radiology because small chip fractures may occur near the joint spaces
• Thumb (first digit)


  Has only two phalanges, the joint between them is called the interphalangeal (IP) joint
• First metacarpophalangeal (MCP) joint


  The joint between the first metacarpal and the proximal phalanx of the thumb
• For radiographic purposes, the first metacarpal is considered part of the thumb and must be included in its entirety in a radiograph of the thumb—from the distal phalanx to the base of the first metacarpal
• Joints of the fingers (second through fifth digits)

  • Distal interphalangeal (DIP) joint
  • Proximal interphalangeal (PIP) joint
  • Metacarpophalangeal (MCP) joint
• Metacarpal joints


  • Metacarpophalangeal (MCP) Joints - metacarpals articulate with the phalanges at their distal ends
  • Carpometacarpal (CMC) joints - at the proximal end, the metacarpals articulate with the respective carpals
• Carpals (bones of the wrist)

  • Scaphoid
  • Lunate
  • Triquetrum
  • Pisiform
  • Trapezium
  • Trapezoid
  • Capitate
  • Hamate
• Scaphoid


  Beginning on the lateral or thumb side, is the sometimes referred to as the navicular, boat-shaped bone is the largest bone in the proximal row and articulates with the radius proximally
• Lunate


  Moon-shaped bone, is the second carpal in the proximal row; it articulates with the radius
• Triquetrum


  Third carpal, has three articular surfaces and is distinguished by its pyramidal shape and anterior articulation with the small pisiform
• Pisiform


  Pea-shaped, the smallest of the carpal bones, is located anterior to the triquetrum and is most evident in the carpal sulcus view
• Trapezium


  On the lateral or thumb side, a four-sided irregularly shaped bone, located medial and distal to the scaphoid and proximal to the first metacarpal
• Trapezoid


  Wedge-shaped also four-sided, is the smallest bone in the distal row
• Capitate


  Largest of the carpal bones (capitate means "large bone"), it is identified by its large rounded head that fits proximally into a concavity formed by the scaphoid and lunate bones
• Hamate


  Last carpal in the distal row on the medial aspect, which is easily distinguished by the hooklike process called the hamulus or hamular process, which projects from its palmar surface
• Carpal sulcus (canal or tunnel view)

  This view demonstrates the carpal sulcus formed by the concave anterior or palmar aspect of the carpals. The anteriorly located pisiform and the hamulus process of the hamate are visualized best on this view. This concave area or groove is called the carpal sulcus (carpal tunnel or canal), through which major nerves and tendons pass.
• The term hamate means hooked, which describes the shape of the hamate in the illustration. The trapezium and its relationships to the thumb and trapezoid are well demonstrated.
• Bones of the forearm


  • Radius (lateral or thumb side)
  • Ulna (medial side)
• Styloid process


  Small conical projections, are located at the extreme distal ends of both the radius and the ulna
• Radial styloid process


  Can be palpated on the thumb side of the wrist joint, extends more distally than the ulnar styloid process
• Ulnar notch


  Is a small depression on the medial aspect of the distal radius, head of the ulna fits into the ulnar notch to form the distal radioulnar joint
• Head of the ulna

  Located near the wrist at the distal end of the ulna, when the hand is pronated, the ulnar head and the styloid process are easily felt and seen on the "little finger" side of the distal forearm
• Head of the radius

  Located at the proximal end of the radius near the elbow joint
• Radial tuberosity


  The rough oval process on the medial and anterior side of the radius, just distal to the neck
• Olecranon and coronoid processes

  The two beaklike processes of the proximal ulna
• Olecranon process


  Can be palpated easily on the posterior aspect of the elbow joint
• Coronoid tubercle


  The medial margin of the coronoid process opposite the radial notch (lateral)
• Trochlear notch (semilunar notch)


  Large concave depression, or notch, that articulates with the distal humerus
• Radial notch


  Small, shallow depression located on the lateral aspect of the proximal ulna