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Equine Carpus Anatomy
The carpus has 3 joints - the antebrachiocarpal, middle carpal, and carpometacarpal joints. The middle carpal and carpometacarpal joints always communicate. There are 8 carpal bones arranged in 2 rows. Various ligaments and tendon sheaths stabilize the carpal bones and allow for flexion and extension. The carpal canal encloses tendons and nerves within the palmar annular ligament. Anatomy of the carpus is complex with multiple bones, joints, ligaments, and tendon sheaths that require careful study to understand carpal function and regional anesthesia.
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Equine Carpus Anatomy
- 1. Carpal Anatomy Radiology Rounds December15th, 2014
- 2. Anatomy • 3 joints –Antebrachiocarpal joint – Middle carpal joint – Carpomatacarpal joint • MCJ and CMCJ always communicate • Palmar outpauching of CMCJ extends distal – Inadvertent anesthesia of joint when blocking prox metacarpal joint
- 3. Anatomy • Diffusion ofmepivacaine between: – ABCJ and MCJ occurred in 84% of limbs – MCJ and ABCJ occurred in 96% of limbs (Gough MR et al. EVJ 2002) • Consider evaluation of whole region – Carpus – Carpal canal – Proximal metacarpus
- 4. Anatomy • Bones – Radius –Proximal row • RCB, ICB, UCB, ACB – Distal row • IICB, IIICB, IVCB, occasionally ICB and rarely VCB – Metacarpal • IIMCB, IIIMCB, IVMCB
- 5. Anatomy • Soft-tissues: – Intercarpalligaments – Collateral ligaments – Fibrous joint capsule – Palmar carpal ligament
- 6. Anatomy • Dorsal: – Extensorcarpi radialis (sheath) • Dorsolateral: – Common digital extensor tendon (sheath) • Extensor retinaculum – distal radius at physeal scar – stabilize ECR and CDET
- 7. Tendon sheaths j Flexcarpi radialis (resected) k Ext carpi radialis m CDE (humeral head) n CDE (radial head) o DDF p Lat dig flexor q Ulnaris lateralis r Flexor carpi ulnaris (resected) s Ext carpi obliquus All tendons passing over carpus have sheath, except: • Short tendon of Ulnaris lateralis • Flexor carpi ulnaris
- 8. Dorsal aspect 1 Radius 2ECRT 3 Long dig abductor T 4 CDET 5 Extensor retinaculum 7 Lat digital extensor T L
- 9. Dorsal aspect 1 Radius 2Groove for the Long dig adbuctor T. 3 Groove for the ECRT 4 Groove CDET 6 MCL 7 RCB 8 /10/17 Dorsal intercarpal ligament 9 ICB 11 UCB 12 LCL 14 IIICB 15 IVCB 16 Dorsal metacarpal ligament L
- 10. Palmar aspect (no ACB) Plantarintercarpal ligaments 1-2 RCB and Radius 3 ICB and Radius 4 Stump of ligament connecting ICB and ACB 5 RCB and IICB (med palmar intercarpal lig) 6 IICB and IIIMB 7 IIICB and IIIMB 8 Ulnar and III and IVCB (lateral palmar intercarapal lig) 9 Short MCL
- 11. Palmar aspect (retinaculum hasbeen removed) 1 Extensor carpi ulnaris T 2 Flex dig profundus T 3 Flex carpi ulnaris T 4 Flex carpi radialis T 5 Ext dig lateralis T 6 Ext carpi ulnaris to the ACB 7 Ext carpi ulnaris 10 Flex dig superficialis T ACB L IV II
- 12. Lateral aspect 1 Extensorcarpi radialis T 3 CDET 4 Ext dig lateralis T 5 DDF muscle (humeral head) 6 Ext carpi ulnaris (M. ulnaris lateralis) to the ACB 7 DDF (ulnar head) 8 Flex carpi ulnaris 9 Ext retinaculum 11 LCL 12 Accessory ulnar lig 13 Accessory IVCB lig 14 Accessory metacarpal lig L ACB
- 13. Lateral aspect (joint capsuleis removed) L LCL 1/2/3/4 Dorsal intercarpal ligament 5 Prox lig ACB 6 Middle lig ACB 7/8 Distal lig ACB 9 Groove Lat ext T 10 Groove Ulnaris lat T 11 Interosseous lig
- 14. Lateral aspect (deeper dissection) 1Groove to the CDET 2 Ext dig lat T 3 Flex carpi ulnaris T 5 Accessory radial (cubital) lig 6 Groove to the ulnaris lateralis T 8 ICB 9 Dorsal intercarapal ligament (ICB and UCB) 10 UCB 11 LCL 12 Accessory UCB lig 14 IIICB 15 Dorsal intercarpal lig (III and IVCB) 17 Accessory IVCB lig 18 Accessory metacarpal lig 19 Dorsal metacarpal lig ACB L IV
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- 16. 1 Medial PalmarIntercarp lig 2 Lat Palmar Intercarp lig 3 Radiocarpal lig 4 Lat collateral branch 5 Transverse intercarp lig 6 Palmar carpometacarpal lig
- 17. Medial aspect (joint capsuleis removed) Ca ACB M MCL MC II IIMB MC III IIIMB C3 IIICB Cr RCB R Radius
- 18. Carpal Canal • Palmarannular ligament / Carpla flexor retinaculum – Connective tissue – Encloses: • SDFT and DDFT • FCRT • Involved in the carpal sheath • Nerves and blood vessels
- 19. Carpal Canal • Palmarannular ligament / Carpla flexor retinaculum – Originates from the palmar border of ACB and inserts medially at the palmar aspect of the CB + MCL • It it subdivided in several compartments – Proximal border: level of prox margin of ACB – Distal border: close to the head of splint bones
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- 25. DPDD View –Distal Radius
- 26. DPDD View –Prox Row
- 27. DPDD View –Distal Row
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Editor's Notes
- #23 ----- Meeting Notes (6/16/14 00:40) -----