2. The hand is a complex
biological tool that
permits a wide range of
movements that facilitate
grip, pinch, grasp, and
fine precision control of
objects
3. The hand is a complex
biological tool that
permits a wide range of
movements that facilitate
grip, pinch, grasp, and
fine precision control of
objects
These movements are
controlled by a series of
highly specialised muscles
that are either extrinsic or
intrinsic
4. Extrinsic muscles are those
which originate at the distal
humerus or in the forearm
and the tendons insert in
the hand
5. Extrinsic muscles on the
volar (or palmar) aspect
include
Flexor Pollicis Longus
Flexor Digitorum Profundus
Flexor Digitorum Superficialis
6. Flexor Pollicis Longus
Flexor Digitorum Profundus
Flexor Digitorum Superficialis
The tendons of these
muscles pass through
the carpal tunnel,
Found at the proximal
part of hand just
beyond the wrist joint
7. The Carpal Tunnel
Region on the volar
aspect of the hand
Found at the junction
between the forearm
and hand
8. The Flexor Retinaculum is
a fibrous band of tissue that forms
the roof of the carpal tunnel
9. The Flexor Retinaculum is
a fibrous band of tissue that forms
the roof of the carpal tunnel
It is attached to the carpal bones
It gives rise to a number of
muscles within the hand
19. Tendon of Flexor Digitorum Superficialis splits in two and
inserts onto either side of the middle phalanx
20. Tendon of Flexor Digitorum Superficialis splits in two and
inserts onto either side of the middle phalanx
It flexes the proximal interphalangeal joint
21. Tendon of Flexor Digitorum Profundus inserts onto the
distal phalanx
22. Tendon of Flexor Digitorum Profundus inserts onto the
distal phalanx
It flexes the distal interphalageal joint
36. Adductor Pollicis
Arises from
Oblique head: bases of
2nd and 3rd metacarpals,
capitate, trapezoid
Transverse head: anterior
surface of body of 3rd
metacarpal
Supplied by deep branch of
ulnar nerve
37. Adductor Pollicis
Arises from
Oblique head: bases of
2nd and 3rd metacarpals,
capitate, trapezoid
Transverse head: anterior
surface of body of 3rd
metacarpal
Adducts CMC joint of thumb
51. The lumbricals are
interesting muscles as they
arise from the tendons of
flexor digitorum profundus
attach to the dorsal
expansion of the digits
There are 4 lumbricals
Lumbricals
60. Useful pnemonic for
muscles in the hand
supplied by the median
nerve is
Lateral 2 lumbricals
Opponens Pollicis
A
F
61. Useful pnemonic for
muscles in the hand
supplied by the median
nerve is
Lateral 2 lumbricals
Opponens Pollicis
Abductor Pollicis Brevis
F
62. Useful pnemonic for
muscles in the hand
supplied by the median
nerve is
Lateral 2 lumbricals
Opponens Pollicis
Abductor Pollicis Brevis
Flexor Pollicis Brevis
64. Abductor Digiti Minimi
Origin Pisiform, pisohamate
ligament, flexor retinaculum
Insertion Ulnar aspect base of proximal
phalanx of little finger
Action Abducts little (5th) finger
Nerve Supply Deep branch of ulnar nerve (C8
and T1) (C8, T1)
Blood Supply Ulnar artery
Anterior Hand
65. Anterior Hand
Abductor Pollicis Brevis
Origin Flexor retinaculum and
scaphoid tubercle
Insertion Radial sesamoid of proximal
phalanx of thumb & tendon of
extensor pollicis longus
Action Abduction of thumb at MCP,
CMC
Nerve Supply Recurrent branch of median
nerve (C8 and T1) (C8, T1)
Blood Supply Superficial palmar branch of
the radial artery
66. Anterior Hand
Flexor Digiti Minimi
Origin Hook of hamate and flexor
retinaculum
Insertion Ulnar aspect base of proximal
phalanx of little finger
Action Flexes metacarpophangeal
joint little finger
Nerve Supply Deep branch of ulnar nerve (C8
and T1) (C8, T1)
Blood Supply Ulnar artery
67. Flexor Pollicis Brevis
Origin Flexor retinaculum and
tubercle of trapezium
Insertion Lateral side of base of
proximal phalanx of thumb
Action Flexes MCP joint thumb
Nerve Supply Recurrent branch of median
nerve (C8 and T1) (C8, T1)
Blood Supply Superficial palmar branch of
the radial artery
Anterior Hand
68. Adductor Pollicis
Origin Oblique head: bases of 2nd
and 3rd metacarpals, capitate,
trapezoid
Transverse head: anterior
surface of body of 3rd
metacarpal
Insertion Ulnar aspect base of proximal
phalanx of thumb and tendon
of extensor pollicis longus
Action Adducts CMC joint of thumb
Nerve Supply Deep branch of ulnar nerve (C8
and T1) (C8, T1)
Blood Supply Deep palmar arterial arch
Anterior Hand
69. Anterior Hand
Opponens Digiti Minimi
Origin Hook of hamate and flexor
retinaculum
Insertion Ulnar border 5th metacarpal
Action Opposes CMC and MCP joints
of little finger
Nerve Supply Deep branch of ulnar nerve (C8
and T1) (C8, T1)
Blood Supply Ulnar artery
70. Anterior Hand
Opponens Pollicis
Origin Flexor retinaculum and
tubercle of trapezium
Insertion Radial border 1st metacarpal
Action Opposes CMC & MCP joints of
thumb
Nerve Supply Recurrent branch of median
nerve (C8 and T1) (C8, T1)
Blood Supply Superficial palmar branch of
the radial artery
71. Palmar Interossei
Origin Anterior shaft of 2,4,5
metacarpals
Insertion Proximal phalanges and dorsal
expansion of ulnar side of
index and radial side of ring
and little fingers
Action Adducts fingers to axis of
middle finger
Nerve Supply Deep branch ulnar nerve C8,
T1
Blood Supply Branches from deep palmar
arch
Anterior Hand
72. Dorsal Interossei
Origin Bipennate from shafts of all
metacarpals
Insertion Proximal phalanges and dorsal
expansion of radial side of
index and middle fingers and
ulnar side of middle and ring
fingers
Action Abducts fingers away from axis
of middle finger
Nerve Supply Deep branch ulnar nerve C8,
T1
Blood Supply Dorsal metacarpal arteries
Posterior Hand
73. Lumbricals
Origin Four tendons of flexor
digitorum profundus, Radial
two are unipennate, Ulnar two
are bipennate
Insertion Extensor expansion radial side
2-5 digits
Action Flex MCP joints and extend
interphalangeal joints of
fingers
Nerve Supply Radial 2; median nerve
Ulnar 2; ulnar nerve
Blood Supply Dorsal metacarpal arteries
Anterior Hand