Professional Documents
Culture Documents
& hand
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A- Bones
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These eight bones of the wrist
are arranged in two rows of
four ( proximal and distal
rows).
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metacarpal bone & phalangeal bone divide into :
Base- shaft – head
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B- The joints of the hand.
1- wrist :
the distal end of the radius articulates
with two bones of the proximal raw of
the carbal bone which are the lunate &
the scaopoid & triquetrum to form the
wrist joint
2- Intercarpal joints :
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3- carpometacarpal joints :
The base of metacarpals articulate with
the distal raw of the carpal bones .
1st metacarpal ….. Trapezium
2nd metacarpal ….trapezoid , trapezium
., capitate .
3rd metacarpal …….capitate.
4th metacarpal ……hamate , capitate .
5th metacarpal …..hamate.
4- metacarpophalangeal joint :
The head of the metacarpals articulate
with the base of thr proximal phalnges
5- interphalangeal joint :
Which are 9 joints articulate between
the phalnges .
Ther is distal & proximal phalangeal
joints .exept the thumb .
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C- Muscles and tendons
The muscles of the hand subdivided
into :
1- The intrinsic muscles are located
within the hand itself.
1- thenar .
2- hypothenar .
3- lumbrical.
4- Interossei.
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Extrinsic extensors
They can be divided into:
A - primary action is wrist extension
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2- primary action is at the digits
Extends the MCP of the thumb Extends the IP joint of the thumb
Extends the fingers from II –V @ the MCJ, Extend little finger @ the MCP
p.S : all of the extrinsic extnsor group innerated by the radial nerve .
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Extrinsic flexors
There are 3 layers of extrinsic flexors:
1- the superficial muscle: their primary action at the wrist or palm.
2- the intermediate muscle : Flexes PIP joints of 2-5 digits, assists in flexion of the MCP
joints and in wrist flexion.
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1- Thenar
The thenar group consists of :
Opponens
pollicis
.
Abducts the CMC and MCP joints of the thumb. Pull the thumb medially & dorward
across the palm
Flexes the MCP joint of the little finger Abducts, assists in opposition
p.S : all the muscle of this group innervated by the deep branch of the ulnar .
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Lumbricals
The lumbrical muscles contribute to:
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Interossei
The interossei group consists of :
3 palmar muscles
4 dorsal muscles
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End of the part
1 st
By Mohad Mubarak
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Nerves
The hand is innervated by 3 nerves:
1- median nerve.
2- ulnar nerve.
3- radial nerve.
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Median nerve
#Originates from the lateral and medial
cords of the brachial plexus (C5-T1).
#Palmar cutaneous branch provides
sensation at the thenar eminence.
#Recurrent motor branch innervates the
thenar and lumbrical muscles.
Sensory digital branches provide
sensation to:
1-Thumb
2-Index
3-Ring finger (radial side)
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Ulnar nerve
Innervates the muscles involved in the power grasping function
of the hand.
It originates at the medial cord of the brachial plexus (C8-T1).
Motor branches innervate:
Flexor carpi ulnaris
Flexor digitorum profundus
@At the hand, the superficial branch forms the digital nerves.
Provide sensation at the small finger and ulnar aspect of the ring finger
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Radial Nerve
Innervating the wrist extensors
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BLOOD SUPPLY
The radial and ulnar arteries, which are branches of the
brachial artery, provide the blood supply to the hand.
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The radial artery runs distally in the
forearm between the brachioradialis
and flexor carpi radialis muscles.
The ulnar artery runs distally in the
forearm under the flexor carpi
ulnaris muscle.
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The superficial palmar arch : is formed mainly by the ulnar artery with a
contribution of the radial artery, the arch gives raise to common palmar digital arteries
wich supply the palm & each divide into a pair of proper palmar digital arteries which
supply the finger
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Veins
Veins generally follow the deep
arterial system as venae comitantes.
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Dorsal digital veins : pass along the sides of the fingers and are joined to one
another by oblique communicating branches. Those from the adjacent sides of the fingers
unite to form three dorsal metacarpal veins
Dorsal metacarpal veins: which end in Dorsal venous network of hand
opposite the middle of the metacarpus.
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Palmar metacarpal veins :
drains the metacarpal region of the palm, eventually draining into the deep palmar
venous arch. & then to the radial veins which drain the lateral aspect of the arm
Proper palmar digital : which drain into the common palmar digital veins then
drain to the superficial palmar venous arch and eventually draining to the ulnar
veins which drain the medial aspect of the arm .
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