Muscle Thenar Muscles Abductor Pollicis Brevis flexor Pollicis brevis superficial head deep head Opponens Pollicis

Hypothenar muscles abductor digiti minimi Flexor Digiti minimi Opponens Digiti minimi Other hand muscles Adductor Pollicis transverse head oblique head

Origin flexor retinaculum flexor retinaculum (scaphoid, and trapezium

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

abducts thumb flexion

uses radial sesamoid

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

median recurrent nerve

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)

deep ulnar nerve

opposition and flexion

uses ulnar sesamoid deep superficial

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

deep ulnar nerve

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

major contributor ulnar artery

lateral sides of fingers passes through hypothenar eminence

major contributor radial artery major contributor radial artery Notes

course Guyon's canal (pisiform, hamate, aponeoursis) travels under hypothenar muscles. Heads laterally after passing extensor retinaculum

deep ulnar nerve superificial ulnar nerve Superificial Radial

intrinsic muscles of hand cutaneous innervation to 5th and 1/2 of 4th digits

Median nerve Wrist joints radial-ulnar

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

articulate with proximal carpal row. Flexion 40%. Extension - 60%

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

midpalmer and thenar space

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

Notes sheath for tendon 5 extends up to tip

extensor hood

connects to lateral band attaches lumbrical and interosseous msucles

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