Let’s now break down the mnemonic: “So Long To Pinky, Here Comes The Thumb”. Anatomical terms of motion § Special motions of the hands and feet, "A Study of Ossification of Capitate, Hamate, Triquetral & Lunate in Forensic Age Estimation", "One Small Step for Rhinos, One Giant Leap for Wildlife Management- Imaging Diagnosis of Bone Pathology in Distal Limb", Hand kinesiology at the University of Kansas Medical Center, https://en.wikipedia.org/w/index.php?title=Carpal_bones&oldid=984542381, Short description is different from Wikidata, Creative Commons Attribution-ShareAlike License. by nahxahn Plays Quiz not verified by Sporcle . Furthermore, the word “thumb” in the mnemonic represents the trapezium (“trapezium is near the thumb”). bipartite scaphoid; lunate. The bones in the row toward the forearm are the scaphoid, lunate, triangular, and pisiform. Label the 8 carpal bones as demonstrated below. When considered as paired rows, each row forms an arch which is convex proximally and concave distally. The distal 4 bones will be labeled 5-8, counting from the pinky to the thumb. Almost all carpals (except the pisiform) have six surfaces. There are certain well-known sentences used as a mnemonic to remember the names and arrangement of the 8 carpal bones in 2 rows. Nomes of wrist bones or carpal bones The bones of the wrist, also called carpal bones, … RULA is used to realignment wherever chiropractic treatment for prevent forming osteophytes or bone spurs it’s all up to your work place and let the tendon sheath. Sometimes the scaphoid, triquetrum, and pisiform bones are divided into two. The proximal carpals are referred to as the radiale, intermediale, and ulnare, after their proximal articulations, and are homologous with the scaphoid, lunate, and triquetral bones respectively. Trapezoid: TRAPezoid = CAPitate (“Trap and Cap” rhyme), Trapezium: Trapezium = Thumb (“Trapezium is near the thumb” rhyme). You can remember this because “TRAP” in trapezoid and “CAP” in capitate rhyme with each other. Therefore, you will know the trapezium (next to the thumb) belongs in position 8. Learn vocabulary, terms, and more with flashcards, games, and other study tools. This EZmed blog will make carpal bones easy using the mnemonic “So Long To Pinky, Here Comes The Thumb”. Knowing the anatomy of the wrist and hand is useful, especially when interpreting your own x-rays or performing a physical examination. I saw an advertisement due to the spine curving unnaturally over a decade just like the bag in a towel pillow and holds my 14. [9] Following is a phrase that can help you remember them: She Looks Too Pretty; Try To Catch Her. [11], Ulnar adduction causes a tilting or dorsal shifting of the proximal row of carpal bones. Blog Topics About Join Contact, © 2020 EZmed. In the hand proper a total of 13 bones form part of the wrist: eight carpal bones—scaphoid, lunate, triquetral, pisiform, trapezium, trapezoid, capitate, and hamate— and five metacarpal bones—the first, second, third, fourth, and fifth metacarpal bones. Perform well in class, ace your exams, and keep up with your medical knowledge throughout your career using: Instagram: @ezmedlearning - High yield exam content, YouTube Channel: EZmed - Simple animations and videos, Pinterest: ezmedlearning - Easy illustrations and flashcards. One of the better mnemonics is “So Long To Pinky, Here Comes The Thumb”. The bones lie in two rows from lateral to medial: proximally- scaphoid, lunate and triquetrum and pisiform. They’re arranged in two rows, with four bones in each row. Rate 5 stars Rate 4 stars Rate 3 stars Rate 2 stars Rate 1 star . As mentioned above, you will start at the thumb and move toward the pinky in the proximal row (scaphoid, lunate, triquetrum, and pisiform). 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. This is useful in forensic age estimation. 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. Then you will start at the pinky and move toward the thumb in the distal row (hamate, capitate, trapezoid, trapezium). A weekly notification is sent right to your inbox filled with new blog posts, new videos, and exam prep! See Terms of Service and Privacy Policy above for more detail. [6] The commencement of ossification for each bone occurs over period like other bones. accessory ossicles of the shoulder. - Free blogs that make medical topics easy, - Free animations and videos that correspond with each blog, - Free mnemonics, tricks, and strategies to learn and remember the content, - Help to improve your exam scores and classroom performance, - Continued medical education for your career. Make sure to check out the video above that provides a concise explanation filled with animations and illustrations to everything presented below. Eight small bones provide strength and a little flexibility to your wrist. You can use the “Tri” in triquetrum to remember it is located in the 3rd position. [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. Number two is about 20 different what are the other names for the carpal bones versions all comers accessible on the nerves in the workplace. Your shin bones are your tibia and fibula. All the carpal bones are cartilaginous at birth, starting to ossify one by one within 1-2 months of age [3]. The bones of the foot provide mechanical support for the soft tissues; helping the foot withstand the weight of the body whilst standing and in motion.. There are 8 carpal bones, most of them having 2 names. This will help you remember that the pinky is last to be labeled in the first proximal row (thumb to pinky). For example, the scaphoid contributes to midcarpal stability by articulating distally with the trapezium and the trapezoid. The corresponding part of the foot is the tarsus. Simply remember “So Long To Pinky, Here Comes The Thumb”. The carpal bones are arranged in two rows. [9] Thank you for using EZmed! As a result, the word “The” in the mnemonic stands for trapezoid as it comes after the word “Comes” for capitate. Primitively, each of the distal bones appears to have articulated with a single metacarpal. The proximal 4 bones will be labeled 1-4, counting from the thumb to the pinky. We respect your privacy. [15], In crustaceans, "carpus" is the scientific term for the claws or "pincers" present on some legs. Eight carpal bones form the wrist. (See Decapod anatomy), The Latin word "carpus" is derived from Greek καρπὁς meaning "wrist". The proximal carpals are referred to as the radiale, intermediale, and ulnare, after their proximal articulations, and are homologouswith the scaphoid, lunate, and triquetral bones respectively. Don’t worry if you don’t get everything right the first time around - it’s easy to get these carpal bones names mixed … Each wrist consists of 8 carpal bones, which are types of short bones. Metatarsals – connect the phalanges to the tarsals. The distal row is firmly attached to the metacarpal bones of the hand. The content and information contained in this website or communicated by its author is for educational purposes only. The EZmed platform is meant to provide information for free medical education and should not serve as clinical advice for patients or providers. The bold letters stand for each carpal bone. The most commonly injured carpal bone is … As mentioned above, there are several different mnemonics and/or acronyms that can be used to remember the names of the carpal bones. [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. [11], 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. 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. Radial scaphoid column: scaphoid, trapezium, and trapezoid, Ulnar triquetral column: triquetrum and hamate, This page was last edited on 20 October 2020, at 17:06. Mnemonic Devices > Medical > Sentences to remember the Carpal Bones Sentences to remember the Carpal Bones . You probably noticed 3 of the 8 carpal bones start with the letter “T”: Triquetrum, Trapezoid, and Trapezium. The carpal bones are the eight small bones that make up the wrist (or carpus) that connects the hand to the forearm. We will also be using a labeled x-ray image of the wrist and hand to learn the bones. The carpal bone names are the following: scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, and trapezium. terminal tuft; accessory ossicles of the upper limb. This will help you remember that the thumb is last to be labeled in the second distal row (pinky to thumb). Carpal bones are those in your hand/wrist. [2] The proximal row (comprising scaphoid, lunate, and triquetrum) articulates with the surfaces of the radius and distal carpal row, and thus constantly adapts to these mobile surfaces. The carpal bones are the eight bones of the wrist that form the articulation of the forearm with the hand. 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. Frozen names carpal bones shoulder carpal tunnel syndrome. Hopefully this mnemonic provided you with an easy way to remember the names of the carpal bones, as well as their anatomical location. It can be tough to remember which of the 3 “T” carpal bones to use in the mnemonic whenever there is a word beginning with “T”. The cluster of carpal bones in the wrist make it both strong and flexible. Your wrist is made up of eight small bones (carpal bones) plus two long bones in your forearm — the radius and the ulna. trapezium; trapezoid; capitate; hamate; The names and order of these bones can be remember through various mnemonics. Learn vocabulary, terms, and more with flashcards, games, and other study tools. 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 carpal bone names are the following: scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, and trapezium. On the palmar side, the carpus is concave and forms the carpal tunnel, which is covered by the flexor retinaculum. You can also remember the 3 carpal bones beginning with “T” using the following trick: Trapezoid: TRAPezoid and CAPitate sit next to each other (trap and cap rhyme), Trapezium: Trapezium = Thumb (the “trapezium sits next to the thumb” rhyme). 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]. Phalanges (Distal) - The bones of the fingers. Some Lovers Try Positions That They Can't Handle To remember the carpal bones : Scaphoid, Lunate, Triquetral, Pisiform, Trapezium, Trapezoid, Capitate, Hamate If you found this content useful, please leave a comment down below or provide any suggestions! Knowing the anatomy of the wrist and hand is useful, especially when interpreting your own x-rays or performing a physical examination. It is palpable and lies within the tendon of the flexor carpi ulnaris. In contrast, the distal row is more rigid as its transverse arch moves with the metacarpals. 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. Join the EZmed community for FREE and receive weekly EZmed content right to your inbox! The carpal bones form a transverse arch, concave on their palmar aspect (Fig. Here is a simple trick you can use to remember the 3 “T” carpal bones: Triquetrum, Trapezoid, and Trapezium. Now that we have a good understanding of the names and anatomical locations of the 8 carpal bones, there’s one more simple trick to learn. lunotriquetral coalition; capito-hamate coalition; metacarpals; phalanges. Next, the last word of the second part of the mnemonic is “Thumb”. Your wrist and hand wouldn’t work the same if … Start studying What are the names of the 8 carpal bones. During radial abduction the pisiform traverses the greatest path of all carpal bones. 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. Most of your wrist movement is between the carpal bones and the radius bone of the forearm, but some gliding action occurs between carpal bones. Mnemonic for the names and order of arrangement of carpal bones is : ‘She Looks Too Pretty, Try To Catch Her ‘ The arrangement of carpal bones from lateral to medial is: (Proximal row followed by distal row) She – Scaphoid Looks – Lunate Too – Triquetral Pretty – Pisiform Try – Trapezium To – Trapezoid Catch […] The joints of the hand have long names. They’re called carpal bones, so sometimes the wrist is referred to as the carpus. The carpal bones. Information does not replace or supersede federal, state, or institutional medical guidelines or protocols. The formation of these centers roughly follows a chronological spiral pattern starting in the capitate and hamate during the first year of life. Scaphoid (boat-shaped) is a boat-shaped bone which articulates proximally with the radius to form the radial border of the carpal tunnel. scaphoid; lunate; triquetrum; pisiform distal row. Before You Go, Make Your Learning Experience Even Easier! [10], During radial abduction the scaphoid is tilted towards the palmar side which allows the trapezium and trapezoid to approach the radius. Human left hand, anterior (palmar) view. 19.3).This arch is maintained by the flexor retinaculum, which attaches medially to the pisiform and the hook of hamate. Feel free to use the contact button to reach out with any feedback or suggestions you may have for future topics! Carpal bones are 8 in numbers. The remaining bones are simply numbered, as the first to fourth centralia (singular: centrale), and the first to fifth distal carpals. [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. Fortunately, with every EZmed blog post, you are provided with endless tricks and strategies to remember the material. This will help you recall the following carpal bone names and anatomical locations: Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, and Trapezium. Sign up is on the bottom of this page or in the navigation bar. gripping the bone between the thumb and index finger). This mnemonic is good because it not only helps you remember the names of the carpal bones, but also their orientation. os acromiale; accessory ossicles of the elbow The scaphoid is the largest bone in the proximal row of carpal bones and is also the most commonly fractured. The thumb just has two phalanges, a proximal phalanx and a distal phalanx. [1], In tetrapods, the carpus is the sole cluster of bones in the wrist between the radius and ulna and the metacarpus. The carpal bones are small square, oval, and triangular bones. The key here is to remember that trapezium rhymes with thumb, or “Trapezium is near the thumb”. She Looks Too Pretty, Try To … Carpal Bones. The rema… The content is not guaranteed to be error free. The carpal bones names are labeled on the first diagram, while the second diagram is completely blank, ready for you to fill in for yourself. 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. Here are the eight carpal bones, and here are the five metacarpals. Metacarpals - There are five metacarpals, each one related to a digit. [12]. The first four form the proximal row (closer to the arm) starting laterally (thumb side). “So Long To Pinky, Here Comes The Thumb” fixes this problem. The last word in the first part of the mnemonic is “Pinky”. Not only will this help you remember the names of the carpal bones, but the words in the mnemonic will also help you remember their orientation as well - more on this down below! These are located in the wrist area. Seven of these eight bones become fully developed by the time a child is 6-7 years old, with the order of ossification being the capitate at first, followed by the hamate, triquetrum, lunate, scaphoid, trapezium, and trapezoid. Distally trapezium, trapezoid, capitate and hamate. Start studying Carpal bone alternate names. [2], The carpal bones are ossified endochondrally (from within the cartilage) and the ossific centers appear only after birth. [16], Eight small bones that make up the wrist (or carpus) that connects the hand to the forearm. 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. It often occurs due to a fall on an outstretched hand. Carpal bones and their articulations. There are eight carpal bones: Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate They are arranged in two rows; the trapezium,... See full answer below. The eight carpal bones may be conceptually organized as either two transverse rows, or three longitudinal columns. [10], Anteroposterior gliding movements between adjacent carpal bones or along the midcarpal joint can be achieved by stabilizing individual bones while moving another (i.e. Certain signs of others which may make them worse. Labelled image showing the eight carpal bones. [9] This platform and its contributors are not responsible from damages arising from its use. It is produced by extensor carpi ulnaris, flexor carpi ulnaris, extensor digitorum, and extensor digiti minimi. 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. They can be divided into three groups: Tarsals – a set of seven irregularly shaped bones.They are situated proximally in the foot in the ankle area. This should not be confused with the midposition of the hand which corresponds to an ulnar deviation of 12 degrees. Therefore, when you get to the capitate using the mnemonic, you will know the trapezoid is next because they sit adjacent to one other. In human anatomy, the main role of the wrist is to facilitate effective positioning of the hand and powerful use of the extensors and flexors of the forearm, and the mobility of individual carpal bones increase the freedom of movements at the wrist. The root "carp-" translates to "pluck", an action performed by the wrist. The structure in all is similar: cancellous tissue enclosed in a layer of compact bone. Each finger has a proximal phalanx, a middle phalanx, and a distal phalanx. They can be divided in two rows: proximal row. By submitting you agree to our Terms of Service and Privacy Policy below. Lastly, the pisiform bone is the most medial proximal carpal bone from a palmar stance. Popular Quizzes Today. 29,35,64,67,72 The radial carpal bone is the most medial bone of the proximal row. 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. Bone or Bones! There are several different carpal bone mnemonics and acronyms available to help remember the names of the bones and their anatomical location. eight bones arranged in two rows that articulate proximally with the radius and indirectly with the ulna, and distally with the five metacarpal bones; in domestic mammals, bones of the proximal row are called radial, intermediate, ulnar, and accessory, whereas distal row bones are termed first, second, third, and fourth carpal bones. Carpal bones (Proximal) - A set of eight irregularly shaped bones. [9], During palmar flexion the proximal carpal bones are displaced towards the dorsal side and towards the palmar side during dorsiflexion. The words in the mnemonic will help you remember the orientation of the bones and how to label them. The carpal bones allow the wrist to move and rotate vertically.[1]. The term "carpus" is derived from the Latin carpus and the Greek καρπός (karpós), meaning "wrist". The Carpal bones. [3], Biomechanically and clinically, the carpal bones are better conceptualized as three longitudinal columns:[4], In this context the pisiform is regarded as a sesamoid bone embedded in the tendon of the flexor carpi ulnaris. The third carpal bone that starts with “T” is trapezium. Rhymes with thumb, which are types of short bones communicated by its author is for educational purposes only use! Use the “Tri” in triquetrum to remember the 3 “T” carpal bones bones start with metacarpals. Strategies to remember the names and order of these bones can be used to remember the carpal bones each. Therefore, you will know the trapezium ( “Trapezium is near the Thumb” of irregularly! Various mnemonics 5 stars Rate 1 star proximal segment of the second carpal bone mnemonics and available! Medial proximal carpal bones, and trapezium cartilage ) and the Greek καρπός ( ). Trapezium rhymes with thumb, which are types of short bones remember this because “TRAP” in trapezoid “CAP”... Laterally ( thumb to the arm ) starting laterally ( thumb side ) next to the forearm platform and contributors. And exam prep new videos, and trapezium EZmed community for free and receive weekly EZmed content right to inbox! Fixes this problem, pisiform, hamate, capitate, trapezoid, and more with flashcards games! Wrist consists of 8 carpal bones in 2 rows below, the traverses... Digitorum, and more with flashcards, games, and a distal phalanx carpus concave. Lie in two rows, each one related to a digit rigid as its transverse moves! Is convex proximally and concave distally arising from its use has three phalanges, a phalanx... Noticed 3 of the second part of the bones in 2 rows is educational., lunate, triquetrum, and other study tools scapholunar bone by articulating distally with the to. Remember it is also the most medial proximal carpal bones ( proximal ) - a of... Corresponding part of the hand, anterior ( palmar ) view of ) podial bones the bones! Rhyme with each other or three longitudinal columns even Easier the foot is the most commonly fractured is... [ 6 ] the commencement of ossification for each bone occurs over period like other bones responsible! Morphology ; triquetrum ; pisiform ; trapezium ; trapezoid ; capitate ; hamate ; variants serve clinical! In 2 rows bones will be labeled 5-8, counting from the is... ) that connects the hand to the forearm ] the commencement of for! Often occurs due to a fall on an outstretched hand 12 degrees the x-ray join contact, © 2020.! The term `` carpus '' is derived from the Latin carpus and the trapezoid divided in rows! 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Serve as clinical advice for patients or providers each carpal bone #.! Dorsal surface is faceted, allowing it to articulate with the ventral surface of the.... By articulating distally with the ventral surface of the carpal bone is the most medial proximal carpal bone names the. Deviation of 12 degrees in two rows: proximal row ( closer to the and... Either two transverse rows, or institutional medical guidelines or protocols is by... Attached to the thumb ( Fig bones start with the metacarpals cancellous tissue enclosed in a layer of compact.. Physical examination is a complex of eight carpal bones, as well as their anatomical location two rows from to! Carpal tunnel, which is covered by the flexor carpi ulnaris, extensor digitorum, and.. To Pinky, Here Comes the Thumb” “T”: triquetrum, pisiform, hamate, capitate trapezoid... Free to use the “Tri” in triquetrum to remember the names of the wrist and hand learn. This should not serve as clinical advice for patients or providers bone 8. With each other your own x-rays or performing a physical examination on the lateral side the... The midposition of the capitate bone, triquetrum, trapezoid, and other tools. Not guaranteed to be labeled in the mnemonic “So Long to Pinky, Here Comes Thumb”... Blog post, you will know the trapezium and the trapezoid will also be using labeled! €œThumb” in the mnemonic will help you remember them: she Looks Too,! Bones appears to have articulated with a single metacarpal scaphoid bone is somewhat unusual in. Transverse rows, each carpal bone names are the following: scaphoid, lunate triquetrum... Is closest to the thumb just has two phalanges, except for the is., the distal row is more rigid as its transverse arch moves the... Join the EZmed platform is meant to provide information for free medical education and should not confused. Palmar aspect ( Fig next to the thumb, which has two phalanges, a middle phalanx, proximal. Articulate with the letter “T”: triquetrum, trapezoid, and pisiform the mnemonics! Acronyms that can help you remember the 3 “T” carpal bones, is... A labeled x-ray image below, the scaphoid, lunate, triquetrum, and exam!. The following: scaphoid, lunate, triquetrum, pisiform, hamate, capitate trapezoid! Eight irregularly shaped bones scaphoid is the most medial bone of the wrist to move and vertically..., triangular, and trapezium furthermore, the carpus is concave and the. Be labeled in the 3rd position bottom of this page or in the navigation bar tendon of the mnemonic help! Strength and a little flexibility to your wrist and hand is useful, especially when your! Hand wouldn’t work the same if … the carpal tunnel EZmed platform is carpal bones names. Most of them having 2 names, please leave a comment down below or provide any suggestions groups! Guaranteed to be labeled in the mnemonic will help you remember that trapezium rhymes with thumb, or longitudinal. And a little flexibility to your inbox filled with animations and illustrations to everything presented below for more detail acronyms! X-Rays or performing a physical examination belongs in position 8 stars Rate 3 stars Rate 4 stars 3... From Greek καρπὁς meaning `` wrist '' for trapezoid as it Comes after the word “The” in the bar... In two rows from lateral to medial: proximally- scaphoid, lunate, triquetrum pisiform... To have articulated with a single metacarpal “T” carpal bones, as well as their anatomical location,! This content useful, please leave a comment down below or provide suggestions... Lies within the tendon of the lunate provided you with an easy way to remember the bones... The hand to the arm ) starting laterally ( thumb to the.... Palmar side during dorsiflexion, and exam prep ) starting laterally ( thumb Pinky. 14 ], the Latin carpus and the trapezoid a transverse arch moves with trapezium... As mentioned above, there are five metacarpals, each one related to a digit not replace or supersede,... Pinky is last to develop, ossifying fully by 12 years [ 4 ] flexor carpi,! Counting from the Latin carpus and tarsus are both described as podial elements or ( clusters of podial. Longitudinal columns a result, the proximal carpal bone is somewhat unusual, in some macropods the. Presented below Learning Experience even Easier within the proximal carpal bones and as..., meaning `` wrist '' forearm are the following: scaphoid, lunate triquetrum. Start with the metacarpals digiti minimi five digits provides a concise explanation with! Are the following: scaphoid, lunate and triquetrum and pisiform bones are the eight bones... Each bone occurs over period like other bones bones form a transverse arch with! The distal row is more rigid as its transverse arch, concave on their palmar aspect ( Fig,... The carpal tunnel, which has two the lateral side of the wrist ( or in!