Structure and Functions of the Body: A Hand-Book of Anatomy and Physiology for Nurses and Others Desiring a Practical Knowledge of the SubjectFiske, Annette
Science
Structure and Functions of the Body: A Hand-Book of Anatomy and Physiology for Nurses and Others Desiring a Practical Knowledge of the Subject
Fiske, Annette
Human anatomy; Physiology
The two forearm bones are more frequently _broken_ together than
separately and generally by direct violence, the lower fragment being
usually drawn up by the action of the flexor and extensor muscles and
producing a swelling on the palmar surface of the forearm. Indirect
violence usually causes fracture of the radius only. In both cases, but
especially in fracture of both bones, there is a tendency for membrane
to get between the fragments, so the arm is put up in splints with the
hand midway between pronation and supination in order to separate the
bones as far as possible. Care must be taken not to have the bandage
too tight or gangrene of the fingers may result. In most fractures of
the arm it is put up bent, but in _fracture of the olecranon_ it is put
up fully extended, as the fragment is sure otherwise to be displaced by
the pull of the triceps. In fact, the olecranon is sometimes fractured
by the muscular force of the triceps, though usually its fracture,
which is frequent, is due to direct violence. The ulna is also often
fractured in the middle by direct violence or the styloid process may
be broken. Fracture of the neck or shaft of the radius is very common,
the most important arm fracture being that of the lower end of the
radius or _Colles’ fracture_. This and the corresponding fracture in
the leg, _Pott’s fracture_, are two of the commonest fractures. In
_dislocation of the wrist_ the normal relation of the two styloid
processes remains unchanged, but in Colles’ fracture the lower fragment
often projects on the back of the hand, making a typical deformity
called the _silver fork deformity_.
The bones of the wrist and hand had best be described before the
forearm muscles are taken up, as the muscles of the forearm are
distributed largely to the fingers.
=The Wrist.=--The wrist or _carpus_ is made up of eight bones arranged
in two rows of four each. In the first row are the _scaphoid_ and
_semilunar bones_, on the outer side, articulating with the radius, the
_cuneiform_ articulating with the fibro-cartilage of the wrist-joint,
and the _pisiform_. In the second row, in corresponding positions,
are the _trapezium_, _trapezoid_, _os magnum_, and _unciform_. The
eminence felt on the radial side of the wrist is the protuberance of
the scaphoid, while the pisiform is generally felt on the ulnar side.
[Illustration: FIG. 73.--Right carpal bones, dorsal surface. _T_,
trapezium; _T´_, trapezoid; _7_, os magnum; _U_, unciform; _S_,
scaphoid; _L_, semilunar; _C_, cuneiform; _P_, pisiform.]
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