"Tamoxifen 20mg on line, menstruation joint inflammation".
By: Q. Gorn, M.B. B.CH., M.B.B.Ch., Ph.D.
Vice Chair, University of California, Davis School of Medicine
For myeloma sufferers with hypercalcemia pregnancy 50 effaced purchase 20 mg tamoxifen mastercard, the aim is to pregnancy diarrhea order cheapest tamoxifen and tamoxifen deal with the hypercalcemia and its doubtlessly dangerous problems women's health clinic columbia mo cheap 20 mg tamoxifen with mastercard. In these sufferers pregnancy and constipation trusted tamoxifen 20 mg, hypercalcemia is at all times related to elevated bone resorption and regularly with impaired kidney operate. The finest strategy is to deal with the myeloma itself and to deal with the hypercalcemia with drugs that inhibit bone resorption, similar to bisphosphonates, and the cautious use of intravenous fluids. Until lately, these sufferers have been handled for the bone disease with symptomatic remedy, namely; analgesics for ache, orthopedic remedy for fractures, or local radiation remedy for localized bone ache. Recent studies have indicated that potent bisphosphonate drugs could have useful effects in the remedy of myeloma. Also remedy with bisphosphonates have been efficient in reducing episodes of fracture, hypercalcemia, and the need for palliative radiation remedy. One essential and unanswered query is whether or not bisphosphonates should be used when no symptoms or evidence of myeloma bone disease is evident. Conclusion the huge array of imaging modalities available at present offers clinicians extra selections of their pursuit of a analysis and remedy of musculoskeletal pathologies. Radiographers play an essential function in the well timed acquisition of high quality pictures when musculoskeletal pathology is suspected. Millions of Americans are injured every year and survive, suffering ache and inconvenience, but for some the injury leads to incapacity, chronic ache, and lifestyle change. These injuries may be reported as sprains, strains, inflammations, irritations, and dislocations. In medical literature, this broad classification of physical symptoms and complaints are referred to as wear-and-tear problems, overuse or overexertion injuries, osteoarthritis, degenerative joint diseases, chronic microtraumas, repetitive strain injuries, and cumulative trauma problems. The injurious mechanical stress could possibly be of an internal kind, when the neuromuscular system rapidly contract muscle tissue to stop the impending fall because the foot slips. This surprising muscle contraction could tear muscle tissue and tendons in the legs, again, and arms and may even dislocate joints. In other circumstances, the mechanical stress could possibly be external in nature, ensuing from the impact of the individual with an object or the ground in the course of the fall. In this case the impact stress could rupture muscle tissue and ligaments and even fracture bones. In contrast, the precise site of anatomical harm in most chronic musculoskeletal injuries or problems is much less clear. Chronic work or sports activities related injuries or problems of the higher extremity have been given a number of names together with 183 three cumulative trauma problems, repetitive trauma problems, repetitive strain injuries, overuse syndromes, and regional musculoskeletal problems. Acute and chronic work and sports activities related musculoskeletal problems present a spectrum starting from situations similar to a prolapsed lumbar disc or carpal tunnel syndrome, the place the reason for the ache or lack of operate is evident, to situations the place the precise analysis is much less evident. These situations are also fairly variable when it comes to severity and degree of impairment. In the final decade appreciable enhancements have been made towards the administration of trauma. This chapter supplies a primary evaluate of trauma care and the function of imaging examinations. The Hill Burton Act was passed in 1946 and its intent was to develop a framework which could possibly be used to decide the number of hospitals that were actually wanted for emergency care. In these early years there was no indication that hospitals wanted particular facilities to attend to trauma victims.
See Muscle drive drive-velocity relationships menstrual cycle 7 days late buy generic tamoxifen 20mg line, elements influencing menopause at 80 discount tamoxifen online master card, 8084 women's health zinio cheap 20mg tamoxifen otc, 8184 muscle actions and women's health clinic hamilton order 20 mg tamoxifen with mastercard, 79, 79 functions, sixty three groups, sixty three,sixty three hypertrophy, during resistance coaching, eighty five, eighty five illustration, sixty one injury cause and web site, 9192, 92 inactivity and, ninety three prevention, 92ninety three irritability, sixty one length, whole, 84 mechanical model, 70seventy one, seventy one neural activation, drive output and, 82 one-joint, seventy eight origin versus insertion, seventy oneseventy two, seventy two pennation angle, sixty foursixty five, sixty four energy, 424426, 426 preloading, 8283, 83, 84 roles, seventy two79 sarcopenia, 8384 soreness, after exercise, 92 strengthening. See Bone tissue Ossification, 34 Osteoarthritis, fifty twofifty three, 54 ankle joint, 225 apophyseal joints, 266 hip joint, 193 Osteoblast, 30 Osteochondral fracture, 225 Osteochondritis dissecans, 154, 225 Osteoclast, 30 Osteocyte, 30 Osteon, 31 Osteoporosis, 3536 Overhand throwing. See Throwing Overload, progressive, 87 Overuse accidents acromioclavicular joint, 142 elbow, 154 hand and fingers, 160 working shoe and, 338 wrist extensors, 154 P Pacinian corpuscle, 114, 114 Parallel axis theorem, 399 Parallel elastic component, Hill muscle model, 70, seventy one Parallel muscular tissues, sixty three, sixty three Passive insufficiency, two-joint muscle, seventy eight79 Passive peak, 378 Passive vary of movement, 116 Patella, 196, 198, 198199 compression fracture, forty accidents, 209 movements, 200, 200201 Patella alta, 199, 209 Patella baja, 199, 208 Patellar tendon, 198 Patellofemoral compression drive, 231 Patellofemoral joint, 198, 198, 198199 Patellofemoral ache extension workouts for, 205 syndrome, 208 Pelvic complicated, 173193 hip joint, 178183, 178182. See also Joint(s) cartilage, 4748 accidents, 47t ligaments, 48forty nine Ski boot fracture, 43, 44 Sliding filament theory, 67, sixty nine Slipped capital femoral epiphysis, 192 Slope, velocity and, 293, 294 Snapping hip syndrome, 193 Soccer kick, 360, 361 482 Index Soft tissue, flexibility and, 116 Soleus, 218 Soma, 102, 102 Speed angular, 328330 linear, 292 Spinal wire, 100, 100 Spinal nerves, 100101, 101 Spinal stabilization, 257 Spine. See Vertebral column Spinous process, 244 Spiral fracture, 44, forty five Spondylolisthesis, forty two, 266, 267 Spondylolysis, 41, 266, 267 Squat, 205 Stability, elements influencing, 418419, 419 Stabilizing muscular tissues, 74, 74 Stable equilibrium, 418 Stair ascent and descent, decrease extremity in, 225226, 226 Standing posture, 258 Standing toe touch, 256 Starting place, anatomical, 10, 10 Static stretching, 116 Statics angular movement, 415421, 415421 purposes, 420, 420421 versus dynamics, 9 linear movement, 364366, 365367 Step, definition, 302, 302 Sternoclavicular joint anatomy and functional characteristics, 132, 132133 accidents, 142 Stiff materials, stress-strain curve, 29, 29 Stiffness bone tissue, 38, 38 calculation, 27 Straight-line movement, 284, 284 Strain. See also Stress-strain entries bone, forty fiveforty six, forty six, 47t measurement, 27 normal, 39, 39 residual, 27 shear, 39, 39 Strain energy, 372 Strap muscle, sixty three, sixty three Streamlining of form, 359, 359 Strength bone tissue, 36, 37 development, 43, 43 definition, eighty five Strength coaching, 8491. See also Weight lifting for ankle/foot, 221222, 223 for elbow and forearm, 152, 153 for fingers and wrist, 159, 159 for hip joint muscular tissues, 189, a hundred ninety191 depth, 86 for knee joint, 196, 204205 modalities closed and open kinetic chain, 91, 91 functional coaching, 9091 isokinetic, 90, 90 isometric, 89 isotonic, 89, 8990 multivector coaching, 91 neural variations, 114115, 115 for nonathlete, 8889 ideas, eighty five89, 87, 88t program parts, eighty five relaxation intervals, 87 for shoulder muscular tissues, 142, 143144 skeletal muscle hypertrophy during, eighty five, eighty five specificity, eighty five86, 87, 115 strength progression during, 86 for trunk, 260264, 261263 core coaching, 264, 265 extensors, 260263, 261262 flexibility and, 264 flexors, 260, 260, 262 lateral flexors, 262, 263264 rotators, 262, 263264 quantity, 8788 Stress measurement, 2728 normal, 39, 39 shear, 39, 39 Stress fracture, forty five47, forty six, 47t Stress-strain curve bone, 37, 37, 70 bone vertebral segments, 26, 27 compliant, stiff, and brittle materials, 29, 29 elastic materials, 27, 28 elastic-plastic regions, 27, 27, 38 energy lost (hysteresis), 29, 29 energy saved, 28, 28 failure point, 29, 29 ligaments, 48, forty nine muscle, 70 tendon, 70 viscoelastic materials, 2829, 29 yield point, 2728, 27 Stress-strain relationship during jogging, 28, 28 safety issue, 28 Stress-strain structural analysis, 2629, 2629 Stretch-contract cycle, 82, 83, 84, 118 Stretch reflex, 109, 112, 112 inverse, 113 Stretching, flexibility and, 116118, 117 Stretching workouts, 116a hundred and twenty for ankle/foot, 222, 223 ballistic, 116 for elbow and forearm, 152, 153 for fingers and wrist, 159, 159 for hip joint muscular tissues, 189, a hundred ninety191 for knee joint, 196, 204205 overview, 116118, 117 proprioceptive neuromuscular facilitation after, 117118, 118 for shoulder muscular tissues, 142, 143144 static, 116 for trunk, 260264, 261263 core coaching, 264, 265 extensors, 260263, 261262 flexibility and, 264 flexors, 260, 261, 263 lateral flexors, 262, 263264 rotators, 262, 263264 Striated muscle, sixty one Stride definition, 302, 302 frequency, oxygen consumption and, 302303, 303 parameters, 302, 302303, 303t, 303 Structural analysis stress-strain properties, 2629, 2629 kinds of materials, 2829, 29 Subacromial bursae, 135 Subacromial bursitis, 146 Subacromial impingement syndrome, 146 Subtalar joint anatomy and performance, 210, 212213, 212, 213 forces, 231 knee and, mixed movements, 217 Superior facet, 1112, 11 Supination, 15, 15, 16, 147 foot, 213, 213 measurement, 326, 327 Support (stance) phase of gait, 304, 304 Supraspinal reflex, 109, a hundred and ten Supraspinous ligament, 251 Surface drag, 358 Swimming, 162 Synapse, 102, 103 Synarthrodial (fibrous) joint, fifty one, fifty three Synchronous movements, 108 Synovial joint. See Diarthrodial joint Synovial membrane, forty nine, 50 T T-tubule, sixty six, sixty six Tactile sensory receptors, 114, 114 Talocalcaneal joint. See Linear (translatory) movement Translational friction, 355 Transverse abdominis, 256 Transverse arch, 214, 216, 216 Transverse plane, 18, 18 Transverse plane movements, 19, 21 Transverse process, 245 Transverse tubule, sixty six, sixty six Traumatic fracture, forty five Trigger finger, 160 Trigonometric functions, 445448, 446447, 446t447t Trochlea, 147 Trochlear notch, 147 Trunk, 241275 getting older effects, 268269 conditioning workouts, 260264 core coaching, 264, 265 extensors, 260263, 261262 flexibility and, 265 flexors, 260, 261, 263 lateral flexors, 262, 264265 rotators, 262, 264265 contribution to sports abilities or movements, 269, 271272 injury potential, 264, 266, 268, 266268 joint forces, 269271, 273274, 273 motion descriptors, 16t muscular actions, 253257, 254255 extension, 253 flexion, 255257 lateral flexion, 257 rotation, 257 pelvis and, mixed motion, 176, 176, 252, 252253, 253 vary of movement, 252, 251252 evaluate questions, 275277 as phase, 10, 10 strength, 257 vertebral column, 242253. See also Vertebral column Turbulent flow, 358, 359 Twitch, 67, sixty nine Two-joint muscle, seventy eight79, 79 injury risk, 91, 92 nerves, 101 in overhand throwing, 162one hundred sixty five, 163164 plyometric workouts, 119a hundred and twenty, 119 evaluate questions, 167169 Upward rotation, 14, 15 V Valgus, 180, 181, 196 Varus, 180, 181 Vastus medialis, 201 Vectors. See also Force(s) addition, 291, 291 angular movement, 327, 327 mixture, 292293 fluid resistance, 357361, 357362 drive, composition and backbone, 349 kinematic analysis, 287290, 291, 292 multiplication, 291, 291 polarity, 327, 327 decision, 291, 291292, 292 Velocity angular, 328330 first central distance method of calculating, 294, 294295 graphical example, 296297, 297 instantaneous, 296, 296 linear, 292297, 293294, 296297, 293t numerical example, 295, 295t, 296 projection, 310311, 311 fee of change. See Acceleration relationship between angular and linear, 331332, 332, 333 slope and, 293, 294 tangential, 332, 332 Velocity curve, locomotion, 304305, 304, 305 Velocity-time curve, 296, 296297, 297 Ventral facet, 11, 12 Vertebral body, 243 Vertebral column, 242253 apophyseal joints, 245 cervical region, 247, 245251, 247, 249, 250 conditioning workouts, 260264, 261263 curvature, 242 ligaments, 244245, 246247 masses on, 269271, 273274, 273 lumbar region, 249, 250, 251 movement phase anterior, 243244, 243244 posterior, 244, 245, 246247 muscular actions, 253257, 254255 posture deviations, 259260, 259 sitting, 258259 standing, 258 working, 259 vary of movement, 252 regional variations, 249, 250 stabilization, 258 strength, 257 thoracic region, 248249, 249, 250 whole, motion characteristics, 251252, 252 Vertebral foramen, 245 Vertex, 319, 319 Vertical coordinates, 285, 286 U Ulnar collateral ligament, 147, 149 Ulnar flexion, 15 Ulnar nerve injury, 162 Ulnohumeral joint, 147, 148, 149 Unipennate muscle,sixty three, sixty five Units of measurement, 287, 441, 442t443t Unstable equilibrium, 418 Uphill strolling, 338 Upper extremity functional anatomy, 131167 elbow and radioulnar joints, 146154 shoulder complicated, 132146 wrist and fingers, 154162 in golf swing, 164, 164one hundred sixty five joint forces and moments, one hundred sixty five 484 Index Vertical jumping, 369370, 369370 Video, excessive-pace, 284 Viscoelastic materials, stress-strain curve, 2829, 29 Viscosity, fluid, 357 Viscous drag, 358 W Walking absolute angle calculations, 322, 322323, 323t absolute angle knowledge for thigh during, 329330, 329t, 330 angular kinematics, 336, 337 angular kinetics, 427429, 428429 energy parts during, 427, 427 hip, knee, and ankle angles during, 326 joint forces, 231, 231 linear kinematics, 302306, 302307, 303t linear kinetics, 377, 377381, 378 decrease extremity in, 227, 228 motor unit recruitment, 106107, 107 rearfoot movement, 338 stride parameters, 302, 302303, 303t, 303 support and double support during, 304, 304 trunk muscular tissues in, 269 two-joint muscle actions, seventy eight, seventy eight Warmup, neural effects, 115 Weight lifting. Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table Table 25. Every well being-care skilled making use of those suggestions is liable for evaluating the appropriateness of applying them within the setting of any explicit clinical scenario. All members of the Work Group are required to full, sign, and submit a disclosure and attestation type exhibiting all such relationships that could be perceived or actual conflicts of interest. In addition, the Work Group might also make ungraded statements (see Chapter 2 section on ungraded statements). Tests thought of are those who relate to the detection and monitoring of laboratory, bone, and cardiovascular abnormalities. The guideline development process followed an proof based strategy and therapy suggestions are based on systematic critiques of related therapy trials. Recommendations for testing used proof based on diagnostic accuracy or risk prediction and linked it not directly with how this may be anticipated to obtain better outcomes for sufferers via better detection, evaluation or therapy of illness. Limitations of the proof, particularly the lack of definitive clinical outcome trials, are mentioned and recommendations are provided for future research. First and foremost, guidelines help clinicians and different caregivers cope with the exponential growth in medical literature. It is unimaginable for many busy practitioners to read, perceive, and apply a quickly changing data base to daily clinical apply. Guidelines can also help to expose gaps in our data, and thereby recommend areas the place further research is needed. Methods for creating and implementing clinical apply guidelines are nonetheless comparatively new and many questions remain unanswered. Should specialists develop guidelines for their apply, or ought to unbiased, impartial clinicians and scientists develop guidelines for them? Is it potential to keep away from conflicts of interest when most consultants in a field conduct research that has been funded by industry (actually because no different funding is on the market)? Along with this perceived want has come the belief that creating excessive-quality guidelines requires substantial resources and experience.
Buy generic tamoxifen from india. Your Health: Vein Disease.
Pregnant women should seek the advice of with their main health care provider before utilizing these medication womens health education buy tamoxifen 20 mg line. Use of a decongestant with beta-adrenergic blocking medication may cause hypertension or bradycardia women's health center colorado buy tamoxifen 20mg on-line. When ephedrine is run with theophylline menstrual period age 8 purchase on line tamoxifen, the affected person is at increased threat for theophylline toxicity pregnancy low blood pressure order tamoxifen online now. It is essential to get hold of a historical past of using these products, including the name of the product used and the frequency of use. Overdosage may cause hallucinations, convulsion, and central nervous system despair. The nurse questions the affected person about attaining a therapeutic impact and the presence of any opposed reactions to the drug. Educating the Patient and Family the nurse includes the following factors within the affected person instructing plan: · Use this product as directed by the first health care provider or on the container label. If burning or stinging becomes severe, discontinue use and talk about this problem with the first health care provider, who may prescribe or suggest another drug. To administer the spray, sit upright and sniff onerous for a couple of minutes after administration. After utilizing the drops, stay with the top down and switch the top from aspect to aspect. If utilizing inhalers, warm the inhaler within the hand before use; wipe the inhaler after each use. Because a few of these products are available and not using a prescription, their use may be discovered during a affected person historical past for different medical issues. After administering a topical nasal decongestant, some patients may expertise a mild, transient stinging sensation. To minimize the occurrence of rebound nasal congestion, the drug remedy must be discontinued progressively by initially discontinuing the medicine in one nostril, followed by withdrawal from the opposite nostril. Nursing Alert Overuse of the topical form of these medication could cause "rebound" nasal congestion. Although congestion may be relieved for a quick time after the drug is used, it recurs inside a short time, which prompts the affected person to use the drug at more frequent intervals, perpetuating the rebound congestion. Discuss this term and establish nursing interactions essential when caring for a affected person experiencing anticholinergic results whereas taking an antihistamine. When antihistamines are administered to patients included in growing a instructing plan for a affected person taking a nasal decongestant. Which of the following is a typical opposed response receiving central nervous system depressants, the nurse monitors the affected person for. A affected person receives a prescription for phenylephrine seen when administering an antihistamine? Discuss essential preadministration and ongoing assessment activities the nurse should perform on the affected person taking the bronchodilators or antiasthma medication. List some nursing diagnoses specific to a affected person taking a bronchodilator or an antiasthma drug. Discuss ways to promote an optimum response to remedy, how to handle frequent opposed reactions, and essential factors to keep in mind when educating a affected person about using a bronchodilator or an antiasthma drug. Within the past few years numerous new medication have been launched to deal with respiratory issues, such as bronchial bronchial asthma and issues that produce chronic airway obstruction. This chapter discusses the bronchodilators, medication which were round for a long time but are still efficient in specific cases, and the newer antiasthma medication which have confirmed to be extremely efficient within the prophylaxis (prevention) of respiration issue. Extrinsic (also referred to as allergic bronchial asthma and triggered in response to an allergen such as pollen, mud, and animal dander) 2.
She took pyridostigmine until 2 weeks ago when she determined that it now not worked womens health vcu cheap 20mg tamoxifen mastercard. The patient is informed that she is in imminent danger of respiratory compromise and that she should be admitted to menstruation fertility tamoxifen 20mg fast delivery the hospital pregnancy news buy cheap tamoxifen. She asks if she will be able to have a prescription for her former medication and if she will be able to go residence menstrual vomiting purchase genuine tamoxifen on-line. A fifty five-yr-old man is delivered to the emergency division by paramedics forty five minutes after his daughter found him unresponsive in his house. Serum glucose focus is 44 mg/dL, and blood alcohol focus is 312 mg/dL. The most appropriate next step in management is administration of which of the next? A sixteen-yr-old boy is delivered to the emergency division due to a 6-hour history of severe proper-sided scrotal ache. A 5-yr-old boy is delivered to the emergency division due to a 5-day history of proper-sided facial droop, issue walking, and double imaginative and prescient. A 50-yr-old woman involves the workplace due to a 3-month history of a facial rash that has increased in dimension despite use of over-the-counter corticosteroid cream. She also has a 6-month history of shortness of breath with exertion and nonproductive cough, which she attributes to a sedentary lifestyle. She has no history of serious illness, takes no drugs, and has no identified drug allergies. A sixty four-yr-old man involves the clinic due to a 2-week history of severe ache and generalized muscle weak spot. Measurement of which of the next is essentially the most appropriate initial step in diagnosis? The patient stories continued ache at the website of the sting, but he has not had shortness of breath, throat tightness, loss of imaginative and prescient, or different neurologic signs. Examination of the right cheek shows an erythematous, swollen area of induration surrounding a central clear area with the stinger in situ. After the stinger is eliminated, which of the next is essentially the most appropriate next step in management? A 32-yr-old man is delivered to the emergency division after being found by his wife of their bed room with a gun in his hands. His wife stories that the patient "has not been himself" since their son was stillborn 6 months ago. She says that through the previous month, he hardly has slept and has not showered or shaved; he sits at midnight and refuses to eat. He began fluoxetine therapy 3 months ago, but his signs have continued to worsen. She has hypertension handled with amlodipine and asthma properly managed with inhaled fluticasone and inhaled albuterol as needed. According to the medical information she introduced along with her, a mammography 6 months ago confirmed no abnormalities, results of laboratory studies 1 yr ago were within the reference ranges, and colonoscopy 5 years ago confirmed no abnormalities. Her previous three Pap smears have shown no abnormalities; the newest Pap smear was 1 yr ago. Her mother has type 2 diabetes mellitus, and her maternal aunt had breast cancer at the age of fifty five years. Screening for which of the next is essentially the most appropriate next step in management?
The term body is also used when referring to women's health center peru il generic tamoxifen 20mg mastercard the main portion of the body of the scapula womens health neenah wi order tamoxifen online pills. A crest refers to menstrual bleeding for 2 weeks order 20mg tamoxifen free shipping the upper border of an ala or wing such because the crest of the ilium breast cancer risk buy tamoxifen 20mg on line. A pointed course of on a bone is referred to as a backbone and the term is commonly used when referring to a portion of the ischium. Condyle, Epicondyle, Head, Capitulum, Neck and Capitellum the term condyle is used to describe a rounded projection on a bone. A condyle helps to type an articulation such as the ones situated on the distal ends of the femur, serving to to type the knee joint, and the condyle at the distal end of the humerus, serving to to type the elbow joint. An epicondyle is a rounded projection on a bone and is situated above its companion condyle. An epicondyle often has a roughened floor to enable for the attachment of muscular tissues and ligaments. When the term neck is used in relationship to a bony landmark it means the elongated portion. The term capitellum refers to a rounded eminence such because the one at the decrease end of the humerus. Foramen, Fossa, Sulcus, Lumen, and Meatus A fissure is a groove or pure division, cleft, or slit in a bone and the term used to describe an ulcer or cleft-like sore. A foramen is a perforation or opening (often in a bone) by way of which nerves or blood vessels pass. An instance of a foramen within a bone is the foramen magnum situated inside the occipital bone of the cranium. Another instance of a foramen is the massive opening in the decrease part of the innominate bone, which is the biggest foramen in the human skeleton. A fossa refers to a pit or despair in bone and the term sulcus is used to describe a furrow, groove, or slight despair. Sesamoid bone, Symphysis, and Trochanter A sesamoid bone is an oval nodule of bone or fibrocartilage situated within a tendon enjoying over a bony floor. A trochanter is a rounded prominence on the outer or lateral border of a bone such because the larger trochanter of the femur. A tubercle is a small rounded elevation or eminence of bone such because the larger and lesser tubercles of the humerus. Terminology related to Skeletal Anomalies of the Hand and Foot the term syndactyly refers to a failure of the fingers or toes to separate throughout fetal improvement. When extra digits (fingers or toes) are current, the condition is referred to as polydactyly. Clubfoot (talipes) is a congenital malformation of the foot that prevents normal weightbearing activities. Congenital hip dislocation causes the top of the femur to be displaced superiorly and posteriorly. Anatomy of the Upper Limb the upper extremity or limb consists of the fingers, hand, wrist, elbow, forearm, humerus, shoulder, clavicle, scapula, and acromioclavicular joints. Anatomic Area Hand (phalanges, metacarpals, carpals) Phalanges (fingers and thumb) Metacarpals (palm) Carpals (wrist) Forearm (radius and ulna) Elbow joint Humerus Shoulder Clavicle Scapula Number of Bones per side 27 14 5 8 2 1 1 1. Each digit consists of two or three separate small bones called phalanges (plural) or phalanx (singular). The digits are numbered, beginning with the thumb as the first digit and ending with the little finger because the fifth digit.