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Learn: 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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
*N = innervation
Arteries
- Radial artery
- Main termination is the deep palmar arch
- Gives off superficial palmar branch, which joins with the superficial palmar arch
- Gives off princeps pollicis artery, which supplies blood to the thumb
- Gives off radialis indicis artery
- Ulnar artery
- Main termination is the superficial palmar arch
(remember: SUperficial arch= Ulnar artery)
- 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
- Gives off deep palmar branch, which joins with the deep palmar arch
- Main termination is the superficial palmar arch
(remember: SUperficial arch= Ulnar artery)
Nerves
- Radial nerve
- Does not innervate any intrinsic muscles of the hand
- 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)
- Median nerve
- Gives off palmar cutaneous branch, which provides sensation to central palm
- Main branch of median nerve enters hand through carpal tunnel
- 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
- 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