1. Anatomy of the hand IN 14 QUESTIONS Kaan Yücel M.D., Ph.D
27.March.2014 Thursday

2. 1. ...bones of the hand ?

3. 2. What are flexor retinaculum & carpal tunnel?
The carpal tunnel formed
anteriorly at wrist by a deep arch formed by
carpal bones & flexor retinaculum
(transverse carpal ligament)
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Median nerve
Pass through the carpal tunnel

4. 2. What are flexor retinaculum & carpal tunnel?
The carpal tunnel formed
anteriorly at wrist by a deep arch formed by
carpal bones & flexor retinaculum
(transverse carpal ligament)
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Median nerve (anterior to tendons)
Pass through the carpal tunnel

5. 2. What are flexor retinaculum & carpal tunnel?
The carpal tunnel formed
anteriorly at wrist by a deep arch formed by
carpal bones & flexor retinaculum
(transverse carpal ligament)
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Median nerve (anterior to tendons)
Pass through the carpal tunnel

6. BONES OF THE HAND Carpal arch
The carpal bones do not lie in a flat plane; rather, they form an arch, whose base is directed anteriorly.
lateral side of this base formed by tubercles of the scaphoid and trapezium.
medial side
formed by pisiform & hook of hamate.
head
base

7. 3. What is extensor retinaculum (dorsal carpal ligament)?
The extensor tendons pass into the hand in six compartments defined by an extensor retinaculum:
extensor digitorum & extensor indicis posterior surface of the wrist
extensor carpi ulnaris & extensor digiti minimi medial side of the wrist
abductor pollicis longus & extensor pollicis brevis
extensor carpi radialis longus & extensor carpi radialis brevis
extensor pollicis longus
through three compartments on the lateral surface of the wrist.

8. 4. What is palmar aponeurosis?
A triangular condensation of deep fascia that covers the palm and is anchored to the skin in distal regions.
Continuous with the palmaris longus tendon, when present; otherwise, anchored to the flexor retinaculum.

10. 5. …Fibrous digital sheaths?
Tendons of flexor digitorum superficialis and profundus cross the palm
enter fibrous sheaths on the palmar aspect of the digits.
formed by fibrous arches and cruciate (cross-shaped) ligaments
hold the tendons to the bony plane
prevent the tendons from bowing when the digits are flexed. are surrounded by a synovial

11. 6. What are extensor hoods for?
Tendons of the extensor digitorum extensor pollicis longus muscles expand over the proximal phalanges to form "extensor hoods" or "dorsal digital expansions".
Tendons of the extensor digiti minimi, extensor indicis, extensor pollicis brevis join these hoods.

12. 7. Which are the intrinsic muscles of the hand?
Palmaris brevis
Thenar muscles
Abductor pollicis brevis
Abductor
digiti minimi
Hypothenar muscles
Opponens
pollicis
Adductor pollicis
Flexor
digiti minimi
Flexor pollicis brevis
Lumbrical
Interossei

13. 8. …functions the intrinsic muscles of the hand?
Palmar interossei
adduct the thumb, index, ring, and little fingers with respect to a long axis through the middle finger
Dorsal interossei
major abductors of the index, middle, and ring fingers, at the metacarpophalangeal joints

14. Lumbricals 8. …functions the intrinsic muscles of the hand?
flexing metacarpophalangeal joints
extending interphalangeal joints
medial two deep branch of the ulnar nerve
lateral two median nerve

15. Palmaris brevis 8. …functions the intrinsic muscles of the hand?
deepens cup of the palm by pulling on skin over the hypothenar eminence
forming a distinct ridge.
This may improve grip.

16. 9. How are the intrinsic muscles innervated?
All of the intrinsic muscles of the hand
by deep branch of the ulnar nerve
Except
three thenar & two lateral lumbrical muscles
by median nerve

17. Superficial palmar arch
arteries of the hand?
Superficial palmar arch
Deep palmar arch
palmar digital artery
common palmar digital arteries
princeps pollicis artery
radialis indicis artery
• three palmar metacarpal arteries
•three perforating branches

18. Before penetrating the back of the hand, the radial artery gives rise to two vessels:
dorsal carpal branch passes medially as the dorsal carpal arch, across the wrist
dorsal metacarpal arteries
dorsal digital arteries
first dorsal metacarpal artery
supplies adjacent sides of the index finger and thumb.

21. 11....veins of the hand? Cephalic vein originates from
lateral side of dorsal venous network.
Basilic vein originates from
medial side of dorsal venous network.

22. 12. ...sensory innervation of the hand?
Ulnar nerve medial side of the palm, medial half of the dorsum of the hand, 5th finger, medial half of the 4th finger, anterior surfaces of medial ½ digits
Median nerve palmar surfaces of the lateral 3 ½ digits and cutaneous regions over the dorsal aspects of the distal phalanges (nail beds) of the same digits
Radial nerve dorsolateral aspect of the palm, dorsal aspects of the lateral three,one-half digits distally to approximately the terminal interphalangeal joints

23. 12. Median nerve

24. 12. Ulnar nerve

25. 12. Radial nerve

29. base of the carpal arch formed
carpal tunnel?
base of the carpal arch formed
medially by
pisiform & hook of hamate
laterally by
tubercles of scaphoid & trapezium
SLTP
TTCH

30. 14. ....anatomical snuffbox? lateral border tendons of
abductor pollicis longus APLEPB
extensor pollicis brevis
medial border
tendon of extensor pollicis longus

31. 14. ....anatomical snuffbox? floor scaphoid & trapezium
distal ends of the tendons of extensor carpi radialis longus extensor carpi radialis brevis