Hand Flashcards
Cutaneous Innervation of the hand (Nerves)
Green: Musculocutaneous nerve
Pink: Radial nerve
Purple: Medial cutaneous nerve of forearm
Blue: Ulnar nerve
Yellow: Median nerve
Where does the Median nerve begin and end?
Enters the forearm between the 2 heads of the pronator teres–> gives muscular branches/motor branches in forearm–> hand region (sensory branches) to dorsal and palmar.
Where does the Ulnar nerve begin and end?
Branch coming from the brachial plexus (no branch in arm regoin)–>enters forearm under flexor carpi ulnaris–>intervenes flexor carpi ulnaris and flexor medial digitorum profundus–> enters hand region (gives motor branches to some muslces and sensory branches)
Green:Dorsal digital veins
Purple: Metacarpal vein
Superficial vein of the hand on the dorsal surface?
Dorsal digital vein–>Metacarpal vein–>Dorsal venous plexus–>Cephalic vein(radial side) and Basilic vein (ulnar side)
What is the clinical importance of the superficial veins?
Sometimes you withdraw or give drugs through them
What is the path of the Cephalic vein and what side does it pass on?
passes on the radial side. In the arm region it is called the Brachial cephalic vein–> passes between the deltoid muscle and pectoralis major–> drains into Axillary vein
What’s the path of the Basilic vein and what side does it pass on?
It passes on the ulnar side (Anterbrachial basilic vein)–> Continues in arm region as Brachial basilic vein–> pierces structure and becomes deep–> Continues as Axillary vein
Top: Basilic vein
Down: Dorsal venous Arch
Left: Cephalic vein
Superficial vein of the hand on the Palmar surface?
Palmar digital veins–> Palmar venous plexus–> Median vein of forearm(usually drains into the medial cubital vein but a deviation is dividing into 2 branches- cephalic and basilic vein)
What is the Synovial sheath?
Wherethetendon
crossjoints(wrist joint),theyare
sheathedinthin
membranesare knownas
synovial membrane (bursae)
Function of Synovial sheath
providelubricatonto decrease friction.
Inflammation of bursae
Bursitis
Clinical importance of ulna and radial bursa communicating with each other
If there is inflammation in Ulnar bursa it can affect Radial bursa
Synovial sheaths: Flexor aspect
- Flexor digitorum superficialis
Flexor digitorum profundus - Flexor policis longus
- Flexor carpi radialis
Ulnar bursae
1. Flexor digitorum superficialis
Flexor digitorum profundus
(continues up to distal phalanx of little finger)
(8 tendons)
Radial bursa
2. Flexor policis longus
(continues to distal phalanx of thumb)
- Flexor carpi radialis
Synovial sheaths: Extensor aspect
- Extansor pollicis brevis
Abductor pollicis longus - Extansor carpi radialis longus
Extansor carpi radialis brevis - Extansor pollicis longus
- Extansor digitorum communis
Extansor indicis proprius - Extansor digiti minimi
- Extansor carpi ulnaris
- Extansor digitorum communis
Extansor indicis proprius
- Extansor carpi radialis longus
Extansor carpi radialis brevis
- Extansor pollicis longus
- Extansor pollicis brevis
Abductor pollicis longus
- Extansor digiti minimi
- Extansor carpi ulnaris
Palmar aponeurosis
What does the Palmar aponeurosis recieve insertion?
Proximally receive insertion of palmaris longus and partly attach to flexor retinaculum
What does the Palmar aponeurosis divide into?
Distally divide into 4 slips–> attach to base of proximal phalanx of medial 4 fingers and attaches to dorsal digital expansion
Dorsal Digital Expansion
What is the Dorsal Digital Expansion, its location and function?
A triangular fibrous tissue, at the metacharpal phalangeal joint at dorsal surface. Recieves insertion of function.
Palmaris brevis
Palmaris brevis origin
palmar aponeurosis, flexor retinaculum
Palmaris brevis insertion
skin on the ulnar side of the hand
Palmaris brevis function
Important in gripping,
Tenses the palmar aponeurosis
Palmaris brevis nerve
Ulnar nerve
In between: Intermediate compartment
Thenear region muscles
- Abductor pollicis brevis
- Flexor pollicis brevis
- Opponens pollicis
- Adductor policis
How can the Opponens pollicis be seen?
After reflecting Abductor pollicis brevis
and Flexor pollicis brevis
Abductor pollicis brevis origin
Flexor retinaculum, scaphoid & trapezium
Abductor pollicis brevis insertion
radial side base of proximal phalanx of thumb
Abductor pollicis brevis nerve
Median nerve
Abductor pollicis brevis function
Abducts the thumb
Flexor pollicis brevis origin
2 heads
superficial head: Flexor retinaculum & trapezium
Deep head: trapezoid & capitate
Flexor pollicis brevis origin
radial side base of proximal phalanx of thumb
Flexor pollicis brevis nerve
superficial head: Median nerve
deep head:Ulnar nerve
Flexor pollicis brevis function
Flexes the thumb
Opponens pollicis origin
Flexor retinaculum, scaphoid & trapezium
Opponens pollicis insertion
radial side of 1st metecarpal bone of thumb
Opponens pollicis function
Rotates the 1st metecarpal bone medially, it brings the thumb into opposition with the other fingers
Opponens pollicis nerve
Median nerve
Adductor pollicis muscle
Adductor pollicis origin
2 heads
transverse head: anterior surface of 3rd metecarpal bone
Oblique head: capitate & base of 2nd, 3rd metecarpal bone
Adductor pollicis insertion
ulnar side base of proximal phalanx of thumb
Adductor pollicis nerve
Ulnar nerve
Adductor pollicis function
Adducts the thumb
Hypothenear region
Abductor digiti minim
Flexor digiti minim
Opponens digiti minim
What nerves intervenes all the muscles in the Hypothenear region.
Ulnar nerve
Abductor digiti minimi origin
pisiform bone, pisohamate ligament, tendon of flexor carpi ulnaris muscle
Abductor digiti minimi insertion
ulnar side of the base of proximal phalanx of 5th digit
Abductor digiti minimi nerve
Ulnar nerve
Abductor digiti minimi function
Abducts the little finger
Flexor digiti minimi origin
hamate bone, flexor retinaculum
Flexor digiti minimi insertion
ulnar side of the base of proximal phalanx of 5th digit
Flexor digiti minimi nerve
Ulnar nerve
Flexor digiti minimi function
flexes the little finger
