Blood and nerve supply to the hand

Question 1

Which arteries supply blood to the hand?

Answer 1

Radial artery (towards dorsal surface) forms complex anastomosis with ulnar artery in hand so blood can reach all structures in any hand position.

Question 2

Which structures does the radial artery form?

Answer 2

Passes through anatomical snuff box, pierces first dorsal interosseous muscle to form deep palmar arch -> below long flexor tendons.
Branches -> princeps pollicis artery + radialis indicis artery.
D1 + ½ d2 -> mainly radial artery.
Superficial palmar arch -> above long flexor tendons:
Branches -> common palmer digital arteries, proper palmer digital arteries.
½ D2 to D5 -> mainly ulnar artery.

Question 3

The median nerve passes through which structure, forms which branches and what is the associated clinical significance?

Answer 3

Carpal tunnel
Branches:
palmar arch -> spared in carpel tunnel syndrome.
Recurrent branch -> thenar muscles.
digital nerves -> supplies lateral 2 lumbricals, sensory d1 to ½ d4.
Carpal tunnel syndrome.

Question 4

Which branches does the ulnar nerve give rise to as it passes between the pisiform bone and the hook of hamate?

Answer 4

Deep branch -> hypothenar muscles, interossei, medial 2 lumbricals, adductor pollicis.
Sensory branch -> sensory ½ d4 + d5

Question 5

What is its clinical significance of the ulnar nerve?

Answer 5

Clawed hand -> damage to ulnar nerve at wrist, d4+ d5 MCP joint extension, interphalangeal joint flexion.