The Hand The Hand
Prof. Dr. Selda Önderoğlu Prof. Dr. Selda Önderoğlu
22.oct.2014
CUTANEOUS INNERVATION CUTANEOUS INNERVATION
PALMAR SURFACE
PALMAR SURFACE
CUTANEOUS INNERVATION CUTANEOUS INNERVATION
DORSAL ASPECT
DORSAL ASPECT
SUPERFICIAL VEINS SUPERFICIAL VEINS
DORSAL ASPECT DORSAL ASPECT
Begin as DORSAL DIGITAL VEINS Begin as DORSAL DIGITAL VEINS
They unite to form on the dorsum of the hand the They unite to form on the dorsum of the hand the
dorsal metacarpal veins dorsal metacarpal veins
which in turn form the dorsal venous network.
which in turn form the dorsal venous network.
From the lateral side of the network begins the cephalic From the lateral side of the network begins the cephalic
vein, from its medial aspect emerges the basilic vein.
vein, from its medial aspect emerges the basilic vein.
SUPERFICIAL VEINS SUPERFICIAL VEINS
PALMAR ASPECT PALMAR ASPECT
Begin as Begin as palmar digital veins palmar digital veins which which communicate with the dorsal veins communicate with the dorsal veins
through intercapitular veins.
through intercapitular veins.
They drain into the They drain into the superficial palmar superficial palmar plexus
plexus from which begins the from which begins the median vein median vein of the forearm.
of the forearm.
The plexus is superficial to the palmar The plexus is superficial to the palmar aponeurosis.
aponeurosis.
Deep Fascia Deep Fascia and the flexor and the flexor
Retinaculum Retinaculum
(Flexor
(Flexor
Aspect)
Aspect)
Palmar Aponeurosis Palmar Aponeurosis
-deep fascia of hand on the flexor aspect
-Triangular in shape
-superficially attached to skin -Deeply: intrinsic mm.of hand -Proximally attached to
flexor retinaculum
-distally: divides into 4 parts , each of which goes to each finger
-Sends 2 septa towards deep part of the hand so;
3 compartments:
1- thenar
2-middle (central) 3- hypothenar
Palmaris brevis muscle Palmaris brevis muscle
Superficial muscle on the ulnar side of the hand O: palmar apon.+flexor retinaculum
i: skin on the ulnar margin of the hand n.: ulnar n.
F: wrinkles the skin of the palm ( important in gripping)
There are synovial sheaths under the flexor and extensor retinaculum.
The extensor and flexor mm.’s tendons are Enclosed
within these
synovial sheaths either as one or group of muscles.
F: to prevent the tendons against the retinaculum and the bones of the wrist
Deep Fascia Deep Fascia
and the and the extensor extensor
Retinaculum Retinaculum
(extensor (extensor
aspect)
aspect)
Palmar Aponeurosis and muscular Palmar Aponeurosis and muscular
compartments in hand compartments in hand
-deep fascia of hand on the flexor aspect
-Sends 2 septa towards deep part of the hand so;
3 compartments(regions):
1- thenar
2-middle (central) 3- hypothenar
Muscles of the Thenar Region Muscles of the Thenar Region
Abductor Pollicis Abductor Pollicis Brevis
Brevis
( median n.)( median n.)
Flexor Pollicis Flexor Pollicis Brevis
Brevis
--has superf. part(median n.) has superf. part(median n.)
- -deep part (ulnar n.)deep part (ulnar n.)
Opponens Pollicis Opponens Pollicis
-median n.-median n.
Adductor Pollicis Adductor Pollicis - -
deepest m.deepest m.-has transverse head -has transverse head -oblique head-oblique head
- ulnar n. - ulnar n.
Deeper Layer of the Thenar Region
Deeper Layer of the Thenar Region
Intermediate Compartment (Lumbricals) Intermediate Compartment (Lumbricals)
O: flexor digitorum profundus’
m. Tendons
i: radial margin of dorsal digital expansion
N: first 2 ( index and middle fingers) by median n.
3 and 4 ( by ulnar n.)
F: flex the phalanges at their metacarpophalangeal j.
and extend at the interphalangeal j.
Muscles of the Hypothenar Region Muscles of the Hypothenar Region
Palmaris Brevis Palmaris Brevis
Abductor Digiti Abductor Digiti Minimi
Minimi
Flexor Digiti Minimi Flexor Digiti Minimi
Opponens Digiti Opponens Digiti Minimi
Minimi
N:all by ulnar n N:all by ulnar n
-
Abductor Digiti Minimi -Flexor Digiti Minimi
-Opponens Digiti Minimi
Interossei muscles Interossei muscles
Deepest group of mm.Deepest group of mm.
4 dorsal,3 palmar4 dorsal,3 palmar
DORSAL INTEROSSEIDORSAL INTEROSSEI
occupy the space bw.the metacarpal bones and ins. To the dorsal digital occupy the space bw.the metacarpal bones and ins. To the dorsal digital exp.exp.
F: abducts the fingers F: abducts the fingers N:ulnar n.
N:ulnar n.
PALMAR INTEROSSEIPALMAR INTEROSSEI
occupy the space bw.the metacarpal bones and ins. To the dorsal digital occupy the space bw.the metacarpal bones and ins. To the dorsal digital exp. (radial side)
exp. (radial side)
F: adducts the fingers F: adducts the fingers N: ulnarN: ulnar
The Interossei
The Interossei
The Interossei
The Interossei
Superficial Palmar Arch Superficial Palmar Arch
Formed mainly by the ulnar joining With a branch from radial a.
Common palmar digital aa.
2 Proper palmar digital aa
The Deep Palmar Arch The Deep Palmar Arch
Formed mainly by radial a.
( takes a branch from ulnar a.namely deep palmar br.) Palmar metacarpal aa.
Which drain into common palmar digital aa.
