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Hypothenar muscles abductor digiti minimi Flexor Digiti minimi Opponens Digiti minimi Other hand muscles Adductor Pollicis transverse head oblique head
Innervation median recurrent proximal phalanx nerve base of proximal phalanx median recurrent of thumb nerve base of proximal phalanx median recurrent of thumb nerve
Insertion
Action
Notes
flexor retinaculum capitate bone and trapezium flexor retinaculum (and radial border of 1st trapezium) metacarpal 5th digit pisiform and flexor ulnar side of proximal retinaculum phalanx deep ulnar nerve flexor retinaculum and hook of hamate base of proximal phalanx deep ulnar nerve flexor retinaculum and hook ulnar border of 5th of hamate metacarpal deep ulnar nerve abduction at MCP, extension at IP MCP - flexion oppostition and some flexion
opposition
shaft of 1st metacarpal palmar surface of 3rd metacarpal capitate bone and base of second metacarpal radial side of flexor digitorum profundus (at CMC)
Lumbrical (6)
metacarpals on dorsal side, Dorsal Interossei only one from 5th and 1st (4) digits, rest have two origins Palmar Interossei (3)
base of proximal phalanx on lateral side and extensor expansion midshaft phalanx and extensor expansion insert on side away from center line
1 & 2 - medial recurrent nerve. 3 & 4 MP joint - flexion. - deep ulnar IP joint - extension abduction and flexion at MP, extension at IP Adduction and flexion at MP, extension at IP
on palmar side of base of proximal phalanx metacarpal - face center line and extensor expansion deep ulnar nerve
are bipennate and 1st muscle is largest unipennate, no origin/insertion for 3rd digit
Arteries
termination
pathways emerges from snuff box to associate with arches then goes deep to abductor pollicis brevis emerges deep to adductor pollicis
Notes
Radial princips pollicis Superifical palmar arch Common palmar digits Deep palmar arch Dorsal palmar arch Nerves Ulnar nerve
princips pollicis, radial indicis, 3 arches thenar muscles proper artery (5th digit), 3 common palmar digits give rise to a pair of proper palmar digital arteries common palmar digital arteries dorsal metacarpal arteries terminations deep and superificial ulnar nerves
course Guyon's canal (pisiform, hamate, aponeoursis) travels under hypothenar muscles. Heads laterally after passing extensor retinaculum
intrinsic muscles of hand cutaneous innervation to 5th and 1/2 of 4th digits
supplies area over snuf box palmar sensory branch, recurrent branch, cutaneous branch components radius and ulna Notes has articular disk
can be palpated along abductor pollicis longus innervates thenars and 3 & 2 lumbricals
radius-carpal
intercarpal
scaphoid, lunate, triquiterum and pisiform and radius proximal row scaphoid/lunate/triquiterum/ pisiform and distal row trapezium/trapezoid/capitate /hamate
supported by lateral radial and medial collateral ligaments on each side flexion - 60%. Extension 40%
compartments of hand Contents hypothenar compartment hypothenar muscles thenar comaprtment thenar muscles central compartment flexor digitorums adductor compartment adductor pollicis extensor compartment extensor digitorum
Bursa and bands Contents ulnar bursa radial bursa long flexor digital sheath flexor digitorums surrounds flexor pollicis longus surrounds flexor digitorum superficial and profundus sheaths
extensor hood
lateral band
MP joint area to tip triangular shaped, widest over MP joint and narrows distally allows lumbricals and interossei to act as extensors at IP joint