Anatomy of the hand general applied anatomy, muscles tendons, nerves , action , intrinsic muscles, forearm muscle tendons, spaces, compartments,sensory , motor, innervation,nerve supply

1. Dr.H.Budhichandra Singh

2. • The radiocarpal or wrist joint between distal surfaces of the radius
and the convex proximal surfaces of the scaphoid, lunate and
triquetral bones
• Movements at the joint are flexion and extension, adduction (ulnar
deviation) and abduction (radial deviation). These four movements
occurring in sequence produce circumduction.

3. • The thenar eminence is made up of the three short thumb muscles
• Abductor pollicis brevis
• Flexor pollicis brevis
• Opponens pollicis
• All three muscles are supplied by the muscular (recurrent) branch of
the median nerve

4. • Adductor pollicis
• Nerve supply. By the deep branch of the ulnar nerve
• Action. To approximate the thumb to the index finger, whatever the
original position of the thumb.

6. • In name the muscles that form the hypothenar eminence on the ulnar
side of the palm are similar to the three thenar muscles
• Abductor digiti minimi
• Flexor digiti minimi brevis
• Opponens digiti minimi
• Nerve supply is by the deep branch of the ulnar nerve

8. • Lumbrical muscles (4)arise from the four profundus tendons to be
inserted by their tendons into the extensor expansions on the dorsum
of the proximal phalanges
• Characteristically, the two ulnar lumbricals are innervated by the
ulnar nerve and the two radial lumbricals by the median nerve

9. • The interossei are in two groups, palmar (3)and dorsal(4)
• The formula ‘PAD and DAB’ indicates that palmar adduct and dorsal
abduct the fingers relative to the axis of the palm, which is the third
metacarpal bone and middle finger.
• . All the interossei are supplied by the deep branch of the ulnar nerve

12. • The cutaneous innervation of the dorsum is by the terminal branches
of the radial nerve and the dorsal branch of the ulnar nerve They
share the hand and its digits 2½ to 2½
• , The cutaneous innervation of the palm is mainly by the median
nerve 3½ to 1½ with the superficial and palmar branches of the ulnar
nerve

13. • Radial nerve injury : Wristdrop
• Ulnar nerve (Musician’s nerve) injury : Clawhand
• Median nerve (labourer’s nerve) injury : Benediction hand or Pointing
finger

18. • Synovial flexor sheaths In the carpal tunnel the flexor tendons are
invested with synovial sheaths that extend proximally for about 2.5
cm into the lower part of the forearm and proceed distally to a
varying extent