Anterior Hand Flashcards
what are the four compartments of the anterior hand?
thenar
hypothenar
central
abbductor-interosseous
the deep fascia of the palm continuous with antebrachial fascia at the wrist is called-
palmar carpal ligament
the three types of deep fascia are
thenar fascia
hypothenar fascia
palmar aponeurosis
what components are included in the thenar compartment
abductor pollicis brevis opponens pollicis flexor pollicis brevis tendon of flexor pollicis longus recurrent branch of median nerve arterial branch to the superficial palmar arch (from radial artery, joins with branch from ulnar artery)
what artery and nerve supplies the muscles in the thenar compartment
recurrent branch of the median nerve
superficial palmar branch of the radial artery
what muscles are included in the hypothenar compartment
abductor digiti minimi opponens digiti minimi flexor digiti minimi arterial branches from ulnar artery branches from superficial and deep branches of ulnar nerve
what artery and nerve supplies the muscles in the hypothenar compartment
deep branch of ulnar nerve
superficial and deep branches of ulnar artery
what muscles/components are included in the central compartment?
4 lumbrical muscles
8 flexor tendons (superficialis and profundus) and their synovial sheaths
superficial palmar arterial arch
digital and muscular branches of the median and ulnar nerves
what arteries and nerves supply the central compartment?
digital and muscular branches of superficial pamar arch (joining of radial and ulnar arteries, arch is action “formed” by the ulnar artery)
ulnar and medial nerves (ulnar supplies medial two lumbricals, median nerve supplies lateral two lumbricals)
what muscles are included in the adductor-interosseous compartment?
adductor pollicis (transverse and oblique heads) muscle 3 palmar interosseous muscles 4 dorsal interosseous muscles
what arteries and nerves supply the adductor-interosseous compartment
deep palmar arterial arch and branches
deep branch of ulnar nerve
abductor pollicis brevis
origin = lateral end of flexor retinaculum insertion = lateral side of base of proximal phalanx of first digit, with flexor pollicis brevis innervation = recurrent branch of median nerve action = abduction of thumb
origin = lateral end of flexor retinaculum insertion = lateral side of base of proximal phalanx of first digit, with flexor pollicis brevis innervation = recurrent branch of median nerve action = abduction of thumb
thenar compartment
abductor pollicis brevis
opponens pollicis
origin = lateral end of flexor retinaculum insertion = shaft of first metacarpal innervation = recurrent branch of median nerve action = opposition of thumb
origin = lateral end of flexor retinaculum insertion = shaft of first metacarpal innervation = recurrent branch of median nerve action = opposition of thumb
origin = lateral end of flexor retinaculum insertion = shaft of first metacarpal innervation = recurrent branch of median nerve action = opposition of thumb
flexor pollicis brevis
origin = lateral end of the flexor retinaculum insertion = lateral side of base of proximal phalanx of first digit, with abductor pollicis brevis innervation = recurrent branch of median nerve action = flexes the thumb
origin = lateral end of the flexor retinaculum insertion = lateral side of base of proximal phalanx of first digit, with abductor pollicis brevis innervation = recurrent branch of median nerve action = flexes the thumb
flexor pollicis brevis
abductor digiti minimi
origin = medial end of the flexor retinaculum insertion = medial side of proximal phalanx of fifth digit innervation = deep branch of ulnar nerve action = abducts the little finger
origin = medial end of the flexor retinaculum insertion = medial side of proximal phalanx of fifth digit innervation = deep branch of ulnar nerve action = abducts the little finger
abductor digiti minimi
opponens digiti minimi
origin = medial end of flexor retinaculum insertion = medial side of entire fifth metacarpal innervation = deep branch of ulnar nerve action = opposition of little finger
origin = medial end of flexor retinaculum insertion = medial side of entire fifth metacarpal innervation = deep branch of ulnar nerve action = opposition of little finger
opponens digiti minimi
flexor digiti minimi
origin = medial end of flexor retinaculum insertion = medial side of base of proximal phalanx of little finger, with abductor digiti minimi innervation = deep branch of ulnar nerve action = flexes little finger
origin = medial end of flexor retinaculum insertion = medial side of base of proximal phalanx of little finger, with abductor digiti minimi innervation = deep branch of ulnar nerve action = flexes little finger
flexor digiti minimi
lumbrical muscles
4 muscles
origin = tendons of the flexor digitorum profundus insertion = radial (thumb) side of extensor tendons on posterior hand innervation = first two (lateral two) innervated by median nerve (proper digital nerves); second two (medial two) innervated by ulnar nerve (deep palmar branch) action = helps to flex metacarpophalangeal joints (MCP) and extend the interphalangeal joints
origin = tendons of the flexor digitorum profundus insertion = radial (thumb) side of extensor tendons on posterior hand innervation = first two (lateral two) innervated by median nerve; second two (medial two) innervated by ulnar nerve action = helps to flex metacarpophalangeal joints (MCP) and extend the interphalangeal joints
lumbrical muscles
adductor pollicis muscles
origin = transverse head: from second, third, fourth metacarpal bones; oblique head: from capitate in distal row of carpal bones insertion = medial side of first phalanx of thumb innervation = deep branch of the ulnar nerve action = adducts the thumb
origin = transverse head: from second, third, fourth metacarpal bones; oblique head: from capitate in distal row of carpal bones insertion = medial side of first phalanx of thumb innervation = deep branch of the ulnar nerve action = adducts the thumb
adductor pollicis
palmar interosseous muscles
origin = metacarpal bone of digit acted upon insertion = proximal phalax and extensor tendon of digit acted upon innervation = deep branch of ulnar nerve action = adduction of palm
none on middle finger, because the mid line runs through this digit
3 muscles
origin = metacarpal bone of digit acted upon insertion = proximal phalax and extensor tendon of digit acted upon innervation = deep branch of ulnar nerve action = adduction of palm
3 muscles
palmar interosseous muscles
dorsal interosseous muscles
origin = from adjacent metacarpal bones of digit acted on insertion = base of proximal phalanx and extensor tendon (does not insert on little finger?) innervation = deep branch of ulnar nerve action = abduction of palm
4 muscles
origin = from adjacent metacarpal bones of digit acted on insertion = base of proximal phalanx and extensor tendon (does not insert on little finger?) innervation = deep branch of ulnar nerve action = abduction of palm
4 muscles
dorsal interosseous muscles
what is the purpose of synovial sheathes and what are the two important sheaths in the anterior hand?
reduce friction as flexor tendons pass under the flexor retinaculum
ulnar bursa
radial bursa
ulnar bursa contains:
8 tendons of flexor digitorum superficialis and flexor digitorum profundus
continues into the little finger but not the second, third, or fourth fingers
sheath covering 8 tendons of flexor digitorum superficialis and flexor digitorum profundus
continues into the little finger but not the second, third, or fourth fingers
ulnar bursa
radial bursa contains:
tendon of flexor pollicis longus
continues into thumb
what are fascial clefts?
- potential spaces
- planes of cleavage between fasical membranes
- may be inside compartments or between compartments
- midpalmar cleft (medially)
- thenar cleft (laterally)
describe the branching pattern of the median nerve in the anterior hand
gives off 3 common palmar digital nerves
these common nerves divide into proper digital nerves that flank the fingers
-proper palmar digital nerves supply the cutaneous innervation to the sides of the digits and the lateral two lumbrical muscles
sudescribe the branching pattern of the ulnar nerve in the anterior hand
- does not go through flexor retinaculum
- palmar cutaneous branch is given off in forearm; above the flexor retinaculum
- superficial palmar branch : sensory innervation to medial 1 1/2 fingers
- deep palmar branch : motor innervation to all the muscles in the hypothenar and adductor-interosseous compartments and the medial two lumbricals
