Palm of the hand, carpal tunnel (dave's notes)

Question 1

Describe the skin of the palm of the had

Answer 1

Charachterised by flexure creases

Question 2

What attaches to the dermis of the palm?

Answer 2

Palmaris brevis (pan carnosus)

Question 3

What is the innervation to the palm of the hand?

Answer 3

Mainly by the superficial and palmar branches of the ulnar nerve and by the median nerve (and its palmar branch) with the radial nerve over the thenar eminence.

Question 4

What forms the palmar aponeurosis?

Answer 4

The degenerating tendon of palmaris longus fanning out from the flexor retinaculum into four slips, one for each finger

Question 5

What are the insertions of the palmar aponeurosis?

Answer 5

Superficial fibres are inserted into the skin, the main part divides and inserts into the deep transverse ligament of the palm

Question 6

What is the function of the planar aponeurosis?

Answer 6

MEchanical, gibing attachemnt to the skin to aid in grip, contraction causes dupuytren’s contracture

Question 7

What is the flexor retinaculum of the wrist? What are its attachments?

Answer 7

A strong band attached radially to the scaphoid tubercle, trapezium ridge and (ulnar) to pisiform and hook of the hamate.

Question 8

What arises from the flexor retinaculum?

Answer 8

The muscles of the thenar and hypothenar eminences arise from the retinaculum

Question 9

What passes across the flexor retinaculum?

Answer 9

Tendon of palmaris longus/palmar aponeurosis is fused to the retinaculum
Ulnar nerve lies on the retinaculum on the pisiborm, with the ulnar artery lying towards the radius.
The ulnar nerve divides into superficial (cutaneous) and deep (muscular) branches

Question 10

What is the carpal tunnel? What passes through here?

Answer 10

A boney gutter with passage of superficial and profundus tendons, FCR, FPL, and the median nerve

Question 11

List the top layer of the carpal tunnel content from radial to ulnar sides

Give the remander of the content

Answer 11

FCR median nerve superficial tendons (middle/ring, index/little)

FPL, profundus tendons

Question 12

What lies deep to the median nerve in the carpal tunnel?

Answer 12

FPL

Question 13

What lies deep to the superficial tendons in the carpal tunnel?

Answer 13

The profundus tendons 
Radial side (index, middle, ring, little ) ulnar side

Question 14

Describe the sheath of the carpal tunnel

Answer 14

All 8 tendons ??? share a common synovial sheath which is reflected in (i.e. opening towards the radial side).