E1F Flashcards
Hand
flexor fibrous sheaths
head of metacarpal to base of distal phalanges
thumb: flexor pollicis longus
digits: flexor digitorum superficially and profundus
short muscles of the thumb
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
adductor pollicis (not part of thenar eminence)
abductor pollicis brevis origin
scaphoid, trapezium and flexor retinaculum
abductor pollicis brevis insertion
lateral aspect of base of proximal phalanx of thumb, together with flexor pollicis brevis (small sesamoid bone is present in common tendon of insertion)
abductor pollicis brevis innervation
recurrent branch median nerve
abductor pollicis brevis action
abduction of thumb at metacarpophalangeal and carpometacarpal joints
flexor pollicis brevis origin
trapezium and flexor retinaculum
flexor pollicis brevis insertion
lateral aspect of base of proximal phalanx of thumb, together with abductor pollicis brevis (small sesamoid bone is present in common tendon of insertion)
flexor pollicis brevis innervation
median nerve (recurrent branch)
flexor pollicis brevis action
flexion of thumb at metacarpophalangeal and carpometacarpal joints
opponens pollicis origin
trapezium and flexor retinaculum
opponens pollicis insertion
lateral aspect of shaft of 1st metacarpal
opponens pollicis innervation
median nerve (recurrent branch)
opponens pollicis action
opposition of thumb (acts only at carpometacarpal joint)
adductor pollicis origin
oblique head: originates from bases of 2nd and 3rd metacarpals and capitate
transverse head: originates from shaft of 3rd metacarpal
adductor pollicis insertion
medial aspect of base of proximal phalanx of thumb (small sesamoid bone is present in common tendon of insertion)
adductor pollicis innervation
deep branch of ulnar nerve
adductor pollicis action
adduction of thumb at metacarpophalangeal and carpometacarpal joints
hypothenar eminence
abductor digiti minimi
flexor digiti minimi brevis
opponens digiti minimi
abductor digiti minimi origin
pisiform bone
abductor digiti minimi insertion
medial side of base of proximal phalanx of little finger
abductor digiti minimi innervation
deep branch ulnar nerve
abductor digiti minimi action
abduction of little finger (mainly at metacarpophalangeal joint)
flexor digiti minimi brevis origin
hook of hamate and flexor retinaculum
flexor digiti minimi brevis insertion
medial side of base of proximal phalanx of little finger
flexor digiti minimi brevis innervation
deep branch ulnar nerve
flexor digiti minimi brevis action
flexion of little finger (mainly at metacarpophalangeal joint)
opponens digiti minimi origin
hook of hamate and flexor retinaculum
opponens digiti minimi insertion
medial aspect of shaft of 5th metacarpal
opponens digiti minimi innervation
deep branch of ulnar nerve
opponens digiti minimi action
flexion and lateral rotation of 5th metacarpal (at carpometacarpal joint) helps to bring little finger into opposition with thumb
lumbrical muscles origin
tendons of flexor digitorum profundus
lumbrical muscles insertion
lateral side of extensor expansions of 2nd to 5th digits
lumbrical muscles innervation
1 and 2 median
3 and 4 deep ulnar
lumbrical muscles action
flexion of metacarpophalangeal joints and extension of interphalangeal joints
palmar interossei origin
from metacarpal of corresponding digit (2nd, 4th and 5th metacarpals)
palmar interossei insertion
1st palmar interosseous: medial side of base of proximal phalanx of index finger
2nd and 3rd palmar interossei : lateral side of base of proximal phalanx of ring and little fingers (all of them also insert into extensor expansion of corresponding digit)
palmar interossei innervation
deep ulnar
palmar interossei action
adduct digits at metacarpophalangeal joints
flex metacarpophalangeal joints and extend interphalangeal joints
dorsal interossei insertion
1st: lateral side of base of proximal phalanx of index finger
2nd and 3rd: lateral and medial sides, respectively, of base of proximal phalanx of middle finger
4th: medial side of base of proximal phalanx of ring finger (all of them also insert into extensor expansion of corresponding digit)
dorsal interossei innervation
deep ulnar
dorsal interossei action
abduct digits at metacarpophalangeal joints
flex metacarpophalangeal joints and extend interphalangeal joints
ulnar artery
- enters hand anterior (superficial) to flexor retinaculum and gives off deep palmar branch (accompanies deep branch of ulnar nerve) then continues into palm as superficial palmar arch
- superficial palmar arch is a direct continuation of ulnar artery and curves laterally, deep to palmar aponeurosis, and superficial to long flexor tendons then completed laterally by superficial palmar branch of radial artery
- superficial palmar arch gives off palmar digital arteries and usually supply medial side of index finger and both sides of middle, ring and little fingers
radial artery
- after running through anatomical snuffbox, it leaves dorsum of hand by passing between two heads of 1st dorsal interosseous muscle and then passes between two heads of adductor pollicis and continues medially as deep palmar arch
- in the plane between 1st dorsal interosseous and adductor pollicis muscles, it usually gives off branches for thumb and lateral side of index finger (princeps pollicis and radialis indicis arteries, respectively)
- deep palmar arch is a direct continuation of radial artery and curves medially, deep to long flexor tendons then completed medially by deep palmar branch of ulnar artery
- deep palmar arch gives off palmar metacarpal arteries, which join palmar digital branches of superficial palmar arch
median nerve
enters palm of hand through carpal tunnel
muscular branches
median nerve
recurrent branch : supplies 3 muscles of thenar eminence
branches to 1st and 2nd lumbrical muscles
cutaneous branches median
palmar digital branches: supply palmar aspect of lateral 3½ digits and distal part of dorsal aspect of same digits
ulnar nerve
enters palm of hand anterior (superficial) to flexor retinaculum and divides into superficial and deep terminal branches
superficial branch
ulnar nerve
- muscular branch to palmaris brevis
- cutaneous branches: palmar digital branches and supply palmar aspect of medial 1½ digits and distal part of dorsal aspect of same digits
deep branch
ulnar nerve
- passes through hypothenar eminence and then runs with deep palmar arch
- gives muscular branches to: 3 hypothenar muscles, all interossei (palmar and dorsal), 3rd and 4th lumbricals and both heads of adductor pollicis
ulnar canal (of Guyon)
located medially, on anterior aspect of wrist
contains ulnar nerve and ulnar artery and veins
ulnar canal (of Guyon) boundaries
- floor (posterior wall): flexor retinaculum (transverse carpal ligament)
- roof (anterior wall): palmar (volar) carpal ligament (fibrous band, continuous with deep fascia of forearm, that blends laterally with flexor retinaculum)
- proximal (superior): pisiform
- distal (inferior): hook of hamate
