Transcript Document
1 2 The carpal tunnel formed anteriorly at wrist by a deep arch formed by carpal bones & flexor retinaculum (transverse carpal ligament) Flexor Flexor Flexor Median digitorum superficialis digitorum profundus pollicis longus nerve Pass through the carpal tunnel 3 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. 4 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. 5 Tendons of flexor digitorum superficialis and profundus cross the palm enter fibrous sheaths on the palmar aspect of the digits. o formed by fibrous arches and cruciate (cross-shaped) ligaments o hold the tendons to the bony plane o prevent the tendons from bowing when the digits are flexed. are surrounded by a synovial 6 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. 7 Palmaris brevis Thenar muscles Hypothenar muscles Adductor pollicis Lumbrical Abductor digiti minimi Flexor digiti minimi Abductor pollicis brevis Opponens pollicis Flexor pollicis brevis Interossei 8 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 9 Lumbricals flexing metacarpophalangeal joints extending interphalangeal joints medial two deep branch of the ulnar nerve lateral two median nerve 10 Palmaris brevis deepens cup of the palm by pulling on skin over the hypothenar eminence forming a distinct ridge. This may improve grip. 11 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 12 Superficial Deep palmar arch palmar arch 13 Cephalic vein originates from lateral side of dorsal venous network. Basilic vein originates from medial side of dorsal venous network. 14 Ulnar nerve medial side of the palm, medial half of the dorsum of the hand, the 5th finger, and the medial half of the 4th finger, anterior surfaces of the medial one and a half digits, Median nerve thumb,index,middle fingers,lateral side of the ring [distal parts on the dorsum of the hand] 15 Radial nerve dorsolateral side base of the carpal arch formed medially by pisiform & hook of hamate laterally by tubercles of scaphoid & trapezium SLTP TTCH 16 lateral border tendons of abductor pollicis longus APLEPB extensor pollicis brevis medial border tendon of extensor pollicis longus 17 floor scaphoid & trapezium distal ends of the tendons of extensor carpi radialis longus extensor carpi radialis brevis 18