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University of Connecticut School of Medicine Human Anatomy Module

Learn: Hand

Bones of Hand

THENAR COMPARTMENT

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     Abductor pollicis brevis muscle

Origin Tubercles of scaphoid and trapezium, flexor retinaculum
Insertion Proximal phalanx and extensor hood of thumb
Innervation Recurrent branch of median nerve
Artery Superficial palmar branch of radial artery
Action Abducts thumb at metacarpophalangeal joint
Abductor pollicis brevis  muscle

     Flexor pollicis brevis muscle

Origin Tubercle of the trapezium and flexor retinaculum
Insertion Proximal phalanx of the thumb
Innervation Recurrent branch of median nerve, deep branch of ulnar nerve (deep head)
Artery Superficial palmar branch of radial artery
Action Flexes thumb at metacarpophalangeal joint
Flexor pollicis brevis muscle

     Opponens pollicis muscle

Origin Tubercle of trapezium and flexor retinaculum
Insertion Lateral margin of metacarpal I
Innervation Recurrent branch of median nerve
Artery Superficial palmar branch of radial artery
Action Medially rotates thumb
Opponens pollicis muscle

HYPOTHENAR COMPARTMENT

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     Abductor digiti minimi muscle

Origin Pisiform, the pisohamate ligament, and tendon of flexor carpi ulnaris
Insertion Proximal phalanx of little finger
Innervation Deep branch of ulnar nerve
Artery Ulnar artery
Action Abducts little finger at metacarpophalangeal joint
Abductor digiti minimi muscle

     Flexor digiti minimi brevis muscle

Origin Hook of the hamate and flexor retinaculum
Insertion Proximal phalanx of little finger
Innervation Deep branch of ulnar nerve
Artery Ulnar artery
Action Flexes little finger at metacarpophalangeal joint
Flexor digiti minimi brevis muscle
From: http://en.wikipedia.org/wiki/File:Hand_dissection_8.jpg

     Opponens digiti minimi muscle

Origin Hook of hamate and flexor retinaculum
Insertion Medial aspect of metacarpal V
Innervation Deep branch of ulnar nerve
Artery Ulnar artery
Action Laterally rotates metacarpal V
Opponens digiti minimi muscle

CENTRAL COMPARTMENT

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     Lumbricals

Origin Tendons of flexor digitorum profundus
Insertion Extensor hoods of index, ring, middle, and little fingers
Innervation Medial two by the deep branch of the ulnar nerve; lateral two by digital branches of the median nerve
Artery Superficial palmar arch
Action Flex metacarpophalangeal joints while extending interphalangeal joints
Lumbricals

ADDUCTOR COMPARTMENT

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     Adductor pollicis muscle

Origin Oblique head: bases of 2nd and 3rd metacarpals, capitate
Transverse head: anterior surface of shaft of third metacarpal
Insertion Medial side of base of proximal phalanx of thumb
Innervation Deep branch of ulnar nerve
Artery Deep palmar arch
Action Adducts thumb
Adductor pollicis muscle

INTEROSSEI COMPARTMENT

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     Dorsal interossei muscles

Origin Adjacent sides of two metacarpals (bipennate muscles)
Insertion Extensor hood and base of proximal phalanges of index, middle, and ring fingers
Innervation Deep branch of ulnar nerve
Artery Dorsal metacarpal arteries, palmar metacarpal arteries
Action Abduction of index, middle, and ring fingers at the metacarpophalangeal joints
Dorsal interossei

     Palmar interossei muscles

Origin Palmar surface of second, fourth, and fifth metacarpals (unipennate muscles)
Insertion Bases of proximal phalanges; extensor expansions of second, fourth, and fifth fingers
Innervation Deep branch of ulnar nerve
Artery Palmar metacarpal arteries
Action Adduction of the thumb, index, ring, and little fingers at the metacarpophalangeal joints
Palmar interossei

Hand muscles chart
*N = innervation

Arteries

Arteries of hand

  1. Radial artery
    1. Main termination is the deep palmar arch
    2. Gives off superficial palmar branch, which joins with the superficial palmar arch
    3. Gives off princeps pollicis artery, which supplies blood to the thumb
    4. Gives off radialis indicis artery
  2. Ulnar artery
    1. Main termination is the superficial palmar arch (remember: SUperficial arch= Ulnar artery)
      1. Superficial palmar arch gives off three common palmar digital arteries, and each of these arteries divides into proper digital arteries, which supply blood to fingers 2-5
    2. Gives off deep palmar branch, which joins with the deep palmar arch

Nerves

  1. Radial nerve
    1. Does not innervate any intrinsic muscles of the hand
    2. Cutaneous innervation to the skin on the dorsal aspect of fingers 1-3 (exception: the skin on the distal dorsum of the fingers [from about the PIP joint to the tip of the finger] is innervated by the median nerve for the the first three and a half digits)
  2. Median nerve
    1. Gives off palmar cutaneous branch, which provides sensation to central palm
    2. Main branch of median nerve enters hand through carpal tunnel
      1. Gives off recurrent branch of median nerve, which innervates the abductor pollicis brevis muscle, opponens pollicis muscle, and superficial head of flexor pollicis brevis muscle
      2. Gives off common palmar digital nerves, which branch into palmar digital nerves

Mnemonics for Hand

  • Hand muscles innervated by median nerve: 1/2-LOAF-1/2 ("half loaf half")
    • 1/2-L: lateral two lumbricals
    • O: opponens pollicis
    • A: abductor pollicis brevis
    • F-1/2: flexor pollicis brevis (except deep head)
  • Interossei actions
      • Dorsal interosseous muscles ABduct fingers (DAB)
      • Palmar interosseous muscles ADduct the fingers (PAD)
    • *Note: This mnemonic just helps you remember which interosseus muscles abduct and which ones adduct. However, in addition to abduction and adduction, both the dorsal and palmar interossei muscles also flex the MCP joints and extend the PIP and DIP joints.
  • Carpals
    • Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium
    • "So long to pinky, here comes the thumb."

Quiz

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