First stage
Anatomy
Lec-3
28/12/2015
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د.عبدالجبار
The Hand
Sensiry nerve supply of habd are:
A-Palm by superficial branch of ulnar to medial one and half fingers ,median nerve to
supply lateral 3 and half finger ,palmer cutaneous branches of median and ulnar nerve
B-Dorsum of hand by superficial bra ch of radial nerve and dorsal ulnar cutaneous branch
The palm of the hand consists of 4 compartment
1-Thennar compartment 3 muscles abductor ,flexor and opponence pollicis brevis
supplies by recurrent branch of median nerve.
2-Hypothennar compartment has 3 ms abductor and flexor digiti minimi and opponence
digiti minimi supplies by the deep branch of ulnar nerve.
3-Central compartment contains:a-palmer aponeurosis b-superficial palmer arch c-
cutaneous branches of median nerve d-8tendons belong to flexor dugitorum
superficialis and profundus e- four lumbrical muscles associated with the 4 tendons of
flexor digitorum profundus
4-Adductor -interosseous compartment has four palmer and 4 dorsal interossei muscles
,adductor pollicis muscle , deep palmer arch , deep branch of ulnar nerve ,and
metacarpal bones
Motor innervation of hand by A-Recurrent branch of median nerve to thennar
musclesvand thd first 2 lumbrical also by median nerve.
A-Deep brnch of ulnar supplies adductor pollicis, 4palmer and 4 dorsal interossei plus
3rd abx 4th lumbrical muscles plus the hypothennar muscles
Blood supply of palm of hand
A-Deep.plamer arch which is formed mainly by deep palmer branch of radial artery and
to lesses extent by superficial.palmer branch of ulnar artery
2-Superfial palmer arch mainly by sjperficial palmer branch of ulnar artery and to lesser
extent by superficial palmer bdanch of radial artery .In addition to princeps pollicis Nd
radialis indicds from the radial artery
The palmer interossei are unipennate each one arises from the metacarpal bone of the
same finger and they act in adduction of the fingers toward the middle finger.
The dorsal interossei are bipennate each one arises from contigous sides of adjacent
metacarpal bone and acts in abduction of fingers or fanning out of fingers
Tge interossei are inserted into the extensor expansion on the back of the corresponding
finger and all interossei are supplied by deep brabch of ulnar nerve...
The extensor digitorum muscle has 4 tendons one for each finger running on the back
of the finger on reacing proximal phalanx the tendon expand on each side of the
proximal phalanx to meet together and inserts into the distal phalanx while the central
part of the tendon inserts into the middle phalanx of correspondinv finger...
Each extensor expansion receives the insertion of 3 small muscles these are one
lumbrical ,one dorsal and one palmer interossei
Spaces in the hand are:
1-The pulp space on the palmer aspect of the finger
2-The thenner space at the base of the thumb.
3-Mid-palmar space just medial to thenner space.
4-Ulnar bursa surround the tendons of flexor digitorum superficialis and profundus and
follos deep to flexor retinaculum and follows the fkexor tendon to little finger.
5-Radial bursa follw the flexor tendons of flexor pollicis longus and that to index finger.
These spaces play a role in transmition of infection التهااات اااتin the hand and with the
forearm just proximal to flexor retinaculum
The venous drainage of hand starts as dorsal venous arch which drians the fingers .From
lateral side of the arch the cephalic vein starts and from ulnar side the basilic vein starts