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Carpal bones
| Carpal bones | |
|---|---|
 | |
Labelled image showing the eight carpal bones. | |
| Details | |
| Identifiers | |
| Latin | os carpale pl. ossa carpi |
| MeSH | D002348 |
| TA98 | A02.4.08.001 |
| TA2 | 1249 |
| FMA | 23889 |
| Anatomical terms of bone | |
The carpal bones are the eight small bones that make up the wrist (carpus) that connects the hand to the forearm. The term "carpus" and "carpal" is derived from the Latin carpus and the Greek καρπός (karpós), meaning "wrist". In human anatomy, the main role of the carpal bones is to articulate with the radial and ulnar heads to form a highly mobile condyloid joint (i.e. wrist joint),[1] to provide attachments for thenar and hypothenar muscles, and to form part of the rigid carpal tunnel which allows the median nerve and tendons of the anterior forearm muscles to be transmitted to the hand and fingers.
In tetrapods, the carpus is the sole cluster of bones in the wrist between the radius and ulna and the metacarpus. The bones of the carpus do not belong to individual fingers(or toes in quadrupeds), whereas those of the metacarpus do. The corresponding part of the foot is the tarsus. The carpal bones allow the wrist to move and rotate vertically.[1]
Structure
[edit]Bones
[edit]The eight carpal bones may be conceptually organized as either two transverse rows, or three longitudinal columns.
When considered as paired rows, each row forms an arch which is convex proximally and concave distally. On the palmar side, the carpus is concave and forms the carpal tunnel, which is covered by the flexor retinaculum.[2] The proximal row comprises the scaphoid, lunate, triquetral, and pisiform bones which articulate with the surfaces of the radius and distal carpal row, and thus constantly adapts to these mobile surfaces. Within the proximal row, each carpal bone has slight independent mobility. For example, the scaphoid contributes to midcarpal stability by articulating distally with the trapezium and the trapezoid. In contrast, the distal row is more rigid as its transverse arch moves with the metacarpals.[3]
Biomechanically and clinically, the carpal bones are better conceptualized as three longitudinal columns:[4]
- Radial scaphoid column: scaphoid, trapezium, and trapezoid
- Lunate column: lunate and capitate
- Ulnar triquetral column: triquetrum and hamate
In this context the pisiform is regarded as a sesamoid bone embedded in the tendon of the flexor carpi ulnaris.[4] The ulnar column leaves a gap between the ulna and the triquetrum, and therefore, only the radial or scaphoid and central or capitate columns articulate with the radius. The wrist is more stable in flexion than in extension more because of the strength of various capsules and ligaments than the interlocking parts of the skeleton.[3]
Almost all carpals (except the pisiform) have six surfaces. Of these the palmar or anterior and the dorsal or posterior surfaces are rough, for ligamentous attachment; the dorsal surfaces being the broader, except in the lunate.
The superior or proximal, and inferior or distal surfaces are articular, the superior generally convex, the inferior concave; the medialand lateral surfaces are also articular where they are in contact with contiguous bones, otherwise they are rough and tuberculated.
The structure in all is similar: cancellous tissue enclosed in a layer of compact bone.
Joints
[edit]
| Name | Proximal/radial articulations | Lateral/medial articulations | Distal/metacarpal articulations |
|---|---|---|---|
| Proximal row | |||
| Scaphoid | radius | capitate, lunate | trapezium, trapezoid |
| Lunate | radius, articular disk | scaphoid, triquetral | capitate, hamate (sometimes) |
| Triquetrum | articular disk | lunate, pisiform | hamate |
| Pisiform | triquetral | ||
| Distal row | |||
| Trapezium | scaphoid | trapezoid | first and second metacarpal |
| Trapezoid | scaphoid | trapezium, capitate | second metacarpal |
| Capitate | scaphoid, lunate | trapezoid, hamate | third, partly second and fourth metacarpal |
| Hamate | triquetral, lunate | capitate | fourth and fifth |
Accessory bones
[edit]
Occasionally accessory bones are found in the carpus, but of more than 20 such described bones, only four (the central, styloid, secondary trapezoid, and secondary pisiform bones) are considered to be proven accessory bones. Sometimes the scaphoid, triquetrum, and pisiform bones are divided into two. [2]
Development
[edit]| Bone | Average | Variation[6] | Variation[7] |
|---|---|---|---|
| Capitate | 2.5 months | 1–6 months | 1–5 months |
| Hamate | 4–5.5 months | 1–7 months | 1–12 months |
| Triquetrum | 2 years | 5 months to 3 years | 9 months to 4 years and 2 months |
| Lunate | 5 years | 2–5.5 years | 18 months to 4 years and 3 months |
| Trapezium | 6 years | 4–8 years | |
| Trapezoid | 6 years | 4–8 years | |
| Scaphoid | 6 years | 4–7 years | |
| Pisiform | 12 years | 8–12 years |
The carpal bones are ossified endochondrally (from within the cartilage) and the ossific centers appear only after birth. [5] The formation of these centers roughly follows a chronological spiral pattern starting in the capitate and hamate during the first year of life. The ulnar bones are then ossified before the radial bones, while the sesamoid pisiform arises in the tendon of the flexor carpi ulnaris after more than ten years. [6] The commencement of ossification for each bone occurs over period like other bones. This is useful in forensic age estimation.[7]
Function
[edit]Ligaments
[edit]
There are four groups of ligaments in the region of the wrist:[8]
- The ligaments of the wrist proper which unite the ulna and radius with the carpus: the ulnar and radial collateral ligaments; the palmar and dorsal radiocarpal ligaments; and the palmar ulnocarpal ligament. (Shown in blue in the figure.)
- The ligaments of the intercarpal articulations which unite the carpal bones with one another: the radiate carpal ligament; the dorsal, palmar, and interosseous intercarpal ligaments; and the pisohamate ligament. (Shown in red in the figure.)
- The ligaments of the carpometacarpal articulationswhich unite the carpal bones with the metacarpal bones: the pisometacarpal ligament and the palmar and dorsal carpometacarpal ligaments. (Shown in green in the figure.)
- The ligaments of the intermetacarpal articulations which unite the metacarpal bones: the dorsal, interosseous, and palmar metacarpal ligaments. (Shown in yellow in the figure.)
Movements
[edit]The hand is said to be in straight position when the third finger runs over the capitate bone and is in a straight line with the forearm. This should not be confused with the midposition of the hand which corresponds to an ulnar deviation of 12 degrees. From the straight position two pairs of movements of the hand are possible: abduction (movement towards the radius, so called radial deviation or abduction) of 15 degrees and adduction (movement towards the ulna, so called ulnar deviation or adduction) of 40 degrees when the arm is in strict supination and slightly greater in strict pronation. [9] Flexion (tilting towards the palm, so called palmar flexion) and extension (tilting towards the back of the hand, so called dorsiflexion) is possible with a total range of 170 degrees. [10]
Radial abduction/ulnar adduction
[edit]
Right: Radial abduction
Right: Palmar flexion
During radial abduction the scaphoid is tilted towards the palmar side which allows the trapezium and trapezoid to approach the radius. Because the trapezoid is rigidly attached to the second metacarpal bone to which also the flexor carpi radialis and extensor carpi radialis are attached, radial abduction effectively pulls this combined structure towards the radius. During radial abduction the pisiform traverses the greatest path of all carpal bones. [9] Radial abduction is produced by (in order of importance) extensor carpi radialis longus, abductor pollicis longus, extensor pollicis longus, flexor carpi radialis, and flexor pollicis longus. [11]
Ulnar adduction causes a tilting or dorsal shifting of the proximal row of carpal bones.[9] It is produced by extensor carpi ulnaris, flexor carpi ulnaris, extensor digitorum, and extensor digiti minimi.[11]
Both radial abduction and ulnar adduction occurs around a dorsopalmar axis running through the head of the capitate bone. [9]
Palmar flexion/dorsiflexion
[edit]During palmar flexion the proximal carpal bones are displaced towards the dorsal side and towards the palmar side during dorsiflexion. While flexion and extension consist of movements around a pair of transverse axes — passing through the lunate bone for the proximal row and through the capitate bone for the distal row — palmar flexion occurs mainly in the radiocarpal joint and dorsiflexion in the midcarpal joint. [10]
Dorsiflexion is produced by (in order of importance) extensor digitorum, extensor carpi radialis longus, extensor carpi radialis brevis, extensor indicis, extensor pollicis longus, and extensor digiti minimi. Palmar flexion is produced by (in order of importance) flexor digitorum superficialis, flexor digitorum profundus, flexor carpi ulnaris, flexor pollicis longus, flexor carpi radialis, and abductor pollicis longus. [11]
Combined movements
[edit]Combined with movements in both the elbow and shoulder joints, intermediate or combined movements in the wrist approximate those of a ball-and-socket joint with some necessary restrictions, such as maximum palmar flexion blocking abduction.[10]
Accessory movements
[edit]Anteroposterior gliding movements between adjacent carpal bones or along the midcarpal joint can be achieved by stabilizing individual bones while moving another (i.e. gripping the bone between the thumb and index finger). [12]
Other animals
[edit]The structure of the carpus varies widely between different groups of tetrapods, even among those that retain the full set of five digits. In primitive fossil amphibians, such as Eryops, the carpus consists of three rows of bones; a proximal row of three carpals, a second row of four bones, and a distal row of five bones. The proximal carpals are referred to as the radiale, intermedium, and ulnare, after their proximal articulations, and are homologous with the scaphoid, lunate, and triquetral bones respectively. The remaining bones are simply numbered, as the first to fourth centralia (singular: centrale), and the first to fifth distal carpals. Primitively, each of the distal bones appears to have articulated with a single metacarpal.
However, the vast majority of later vertebrates, including modern amphibians, have undergone varying degrees of loss and fusion of these primitive bones, resulting in a smaller number of carpals. Almost all mammals and reptiles, for example, have lost the fifth distal carpal, and have only a single centrale - and even this is missing in humans. The pisiform bone is somewhat unusual, in that it first appears in primitive reptiles, and is never found in amphibians.
Because many tetrapods have fewer than five digits on the forelimb, even greater degrees of fusion are common, and a huge array of different possible combinations are found. The wing of a modern bird, for example, has only two remaining carpals; the radiale (the scaphoid of mammals) and a bone formed from the fusion of four of the distal carpals.[13]
The carpus and tarsus are both described as podial elements or (clusters of) podial bones.[14]
In some macropods, the scaphoid and lunar bones are fused into the scapholunar bone.[15]
In crustaceans, "carpus" is the scientific term for the claws or "pincers" present on some legs. (See Decapod anatomy)
Etymology
[edit]The Latin word "carpus" is derived from Greek καρπὁς meaning "wrist". The root "carp-" translates to "pluck", an action performed by the wrist.[16]
You searched for
"HEAVE" in the KJV Bible
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- Numbers 15:20chapter context similar meaning copy save
- Ye shall offer up a cake of the first of your dough for an heave offering: as ye do the heave offering of the threshingfloor, so shall ye heave it.
- Exodus 29:28chapter context similar meaning copy save
- And it shall be Aaron's and his sons' by a statute for ever from the children of Israel: for it is an heave offering: and it shall be an heave offering from the children of Israel of the sacrifice of their peace offerings, even their heave offering unto the LORD.
- Numbers 18:28chapter context similar meaning copy save
- Thus ye also shall offer an heave offering unto the LORD of all your tithes, which ye receive of the children of Israel; and ye shall give thereof the LORD'S heave offering to Aaron the priest.
- Numbers 31:29chapter context similar meaning copy save
- Take it of their half, and give it unto Eleazar the priest, for an heave offering of the LORD.
- Leviticus 7:32chapter context similar meaning copy save
- And the right shoulder shall ye give unto the priest for an heave offering of the sacrifices of your peace offerings.
- Numbers 15:21chapter context similar meaning copy save
- Of the first of your dough ye shall give unto the LORD an heave offering in your generations.
- Numbers 15:19chapter context similar meaning copy save
- Then it shall be, that, when ye eat of the bread of the land, ye shall offer up an heave offering unto the LORD.
- Numbers 18:27chapter context similar meaning copy save
- And this your heave offering shall be reckoned unto you, as though it were the corn of the threshingfloor, and as the fulness of the winepress.
- Numbers 31:41chapter context similar meaning copy save
- And Moses gave the tribute, which was the LORD'S heave offering, unto Eleazar the priest, as the LORD commanded Moses.
- Leviticus 7:14chapter context similar meaning copy save
- And of it he shall offer one out of the whole oblation for an heave offering unto the LORD, and it shall be the priest's that sprinkleth the blood of the peace offerings.
- Numbers 18:29chapter context similar meaning copy save
- Out of all your gifts ye shall offer every heave offering of the LORD, of all the best thereof, even the hallowed part thereof out of it.
- Deuteronomy 12:17chapter context similar meaning copy save
- Thou mayest not eat within thy gates the tithe of thy corn, or of thy wine, or of thy oil, or the firstlings of thy herds or of thy flock, nor any of thy vows which thou vowest, nor thy freewill offerings, or heave offering of thine hand:
- Numbers 18:26chapter context similar meaning copy save
- Thus speak unto the Levites, and say unto them, When ye take of the children of Israel the tithes which I have given you from them for your inheritance, then ye shall offer up an heave offering of it for the LORD, even a tenth part of the tithe.
- Numbers 6:20chapter context similar meaning copy save
- And the priest shall wave them for a wave offering before the LORD: this is holy for the priest, with the wave breast and heave shoulder: and after that the Nazarite may drink wine.
- Numbers 18:8chapter context similar meaning copy save
- And the LORD spake unto Aaron, Behold, I also have given thee the charge of mine heave offerings of all the hallowed things of the children of Israel; unto thee have I given them by reason of the anointing, and to thy sons, by an ordinance for ever.
- Numbers 18:24chapter context similar meaning copy save
- But the tithes of the children of Israel, which they offer as an heave offering unto the LORD, I have given to the Levites to inherit: therefore I have said unto them, Among the children of Israel they shall have no inheritance.
- Deuteronomy 12:6chapter context similar meaning copy save
- And thither ye shall bring your burnt offerings, and your sacrifices, and your tithes, and heave offerings of your hand, and your vows, and your freewill offerings, and the firstlings of your herds and of your flocks:
- Numbers 18:11chapter context similar meaning copy save
- And this is thine; the heave offering of their gift, with all the wave offerings of the children of Israel: I have given them unto thee, and to thy sons and to thy daughters with thee, by a statute for ever: every one that is clean in thy house shall eat of it.
- Leviticus 10:14chapter context similar meaning copy save
- And the wave breast and heave shoulder shall ye eat in a clean place; thou, and thy sons, and thy daughters with thee: for they be thy due, and thy sons' due, which are given out of the sacrifices of peace offerings of the children of Israel.
- Exodus 29:27chapter context similar meaning copy save
- And thou shalt sanctify the breast of the wave offering, and the shoulder of the heave offering, which is waved, and which is heaved up, of the ram of the consecration, even of that which is for Aaron, and of that which is for his sons:
- Leviticus 10:15chapter context similar meaning copy save
- The heave shoulder and the wave breast shall they bring with the offerings made by fire of the fat, to wave it for a wave offering before the LORD; and it shall be thine, and thy sons' with thee, by a statute for ever; as the LORD hath commanded.
- Leviticus 7:34chapter context similar meaning copy save
- For the wave breast and the heave shoulder have I taken of the children of Israel from off the sacrifices of their peace offerings, and have given them unto Aaron the priest and unto his sons by a statute for ever from among the children of Israel.
- Deuteronomy 12:11chapter context similar meaning copy save
- Then there shall be a place which the LORD your God shall choose to cause his name to dwell there; thither shall ye bring all that I command you; your burnt offerings, and your sacrifices, your tithes, and the heave offering of your hand, and all your choice vows which ye vow unto the LORD:
- Numbers 18:19chapter context similar meaning copy save
- All the heave offerings of the holy things, which the children of Israel offer unto the LORD, have I given thee, and thy sons and thy daughters with thee, by a statute for ever: it is a covenant of salt for ever before the LORD unto thee and to thy seed with thee.
