Anatomy of the Hand and Wrist

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Questions and Answers

Which vein originates from the lateral side of the dorsal venous network?

Medial vein

Radial vein

Cephalic vein (correct)

Basilic vein

Which nerve is responsible for innervating the three thenar muscles of the hand?

Ulnar nerve

Musculocutaneous nerve

Median nerve (correct)

Radial nerve

What is the correct order of the deep structures of the Extensor Retinaculum from medial to lateral?

Abductor pollicis longus tendon, Extensor carpi radialis brevis tendon, Extensor pollicis longus tendon

Extensor digiti minimi tendon, Extensor carpi ulnaris tendon, Extensor digitorum tendon

Extensor carpi ulnaris tendon, Extensor digiti minimi tendon, Extensor digitorum and extensor indicis tendons (correct)

Tendon of Extensor carpi radialis longus, Extensor pollicis longus, Extensor digiti minimi

Which of the following nerves only innervates the skin on the dorsolateral side of the hand?

Radial nerve Signup and view all the answers

Which structure is attached medially to the triquetral and pisiform bones?

Extensor retinaculum Signup and view all the answers

Which carpal bone is located medial to the scaphoid?

Lunate Signup and view all the answers

What structure passes deep to the Flexor Retinaculum first, from medial to lateral?

Flexor digitorum superficialis tendons Signup and view all the answers

What is the primary function of the interosseous muscles?

To abduct and adduct the fingers Signup and view all the answers

Which group of muscles is characterized as extrinsic muscles of the hand?

Flexor digitorum superficialis Signup and view all the answers

Which muscle is NOT part of the thenar eminence?

Flexor pollicis longus Signup and view all the answers

Which nerve primarily supplies the palmar interossei muscles?

Deep branch of ulnar nerve Signup and view all the answers

Which artery provides primarily the blood supply for the thumb?

Radial artery Signup and view all the answers

Which nerve supplies the muscles of the hypothenar eminence?

Ulnar nerve Signup and view all the answers

What is the primary function of the Flexor Retinaculum?

To hold the long flexor tendons in position at the wrist Signup and view all the answers

Which of the following arteries is part of the superficial palmar arch?

Ulnar artery Signup and view all the answers

What is the main role of the lumbrical muscles in hand movement?

Flex the metacarpophalangeal joints and extend the interphalangeal joints Signup and view all the answers

Which tendon does NOT pass deep to the Flexor Retinaculum?

Ulnar artery Signup and view all the answers

Which of the following structures is found in the carpal tunnel?

Median nerve Signup and view all the answers

Which of the following arteries does NOT arise from the radial artery?

Common palmar digital arteries Signup and view all the answers

What structure is primarily supplied by the ulnar artery?

Medial side of the index finger Signup and view all the answers

Which veins follow the course of the arteries in the hand?

Deep veins Signup and view all the answers

Study Notes

University of Babylon, Hammurabi Medical College

University of Babylon, Hammurabi Medical College is an educational institution.
The year 2017 is mentioned in connection with the college.

The Hand

The hand is a complex anatomical structure.
Multiple views of the hand are shown (lateral, anterior, medial).
Images display various hand positions, like holding items or writing.

Bones of the Hand

Bones are key structural elements of the hand.
The hand includes carpals, metacarpals, and phalanges.
Various bones of the hand are detailed (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate).
Specific anatomical landmarks on the bones are labelled (heads, necks, distal, proximal, etc.).

Carpal Bones Mnemonics

A memory aid ("She Looks Too Proud, Try To Chase Her") helps remember the order of carpal bones (lateral to medial).
Carpal bones are divided into proximal and distal rows.
Specific bones are listed in their respective rows (proximal: scaphoid, lunate, triquetrum, pisiform; distal: trapezium, trapezoid, capitate, hamate).

Flexor Retinaculum

Flexor retinaculum is a deep fascia structure that holds long flexor tendons in place at the wrist.
It is attached to the pisiform bone, hook of hamate, tubercle of scaphoid, and trapezium bone.

Structures Passing Deep to Flexor Retinaculum

Structures that pass deep to the flexor retinaculum are listed in a medial-to-lateral order.
These include tendons of flexor digitorum superficialis, the median nerve, tendon of flexor pollicis longus, and tendon of flexor carpi radialis.

Structures Passing Superficial to Flexor Retinaculum

Structures passing above the flexor retinaculum are listed from medial to lateral. These include flexor carpi ulnaris tendon, the ulnar nerve, ulnar artery, palmar cutaneous branch of ulnar nerve, the palmaris longus tendon, and the palmar cutaneous branch of the median nerve

Carpal Tunnel

The carpal tunnel is a fibro-osseous canal at the wrist.
It is formed by the carpal bones and the flexor retinaculum
The contents of the carpal tunnel include tendons of flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP), tendon of flexor pollicis longus (FPL), and the median nerve.

Muscles of the Hand

Hand muscles are divided into extrinsic and intrinsic groups.
Extrinsic muscles originate outside the hand and attach to hand bones.
Intrinsic muscles are within the hand and grouped into five areas (Thenar Eminence, Hypothenar Eminence, Adductor pollicis, Interosseous muscles, Lumbrical muscles).

Thenar Eminence

Three muscles form the thenar eminence (base of the thumb).
These are the Opponens pollicis, Flexor pollicis brevis, and Abductor pollicis brevis.
The recurrent branch of the median nerve supplies these muscles.

Hypothenar Eminence

Three muscles form the hypothenar eminence (base of the little finger).
These are Opponens digiti minimi, Abductor digiti minimi, and Flexor digiti minimi brevis.
These muscles are supplied by the deep branch of the ulnar nerve.

Adductor Pollicis

The adductor pollicis has two heads (transverse and oblique).
The transverse head arises from the third metacarpal.
The oblique head arises from the capitate and adjacent bases of the second and third metacarpals.
It inserts into the proximal phalanx of the thumb and is supplied by the deep branch of the ulnar nerve. Its function is adduction.

Interosseous Muscles

The interossei are muscles between the metacarpals.
They are divided into dorsal and palmar groups.
Both groups are supplied by the deep branch of the ulnar nerve.

Lumbrical Muscles

Four worm-like muscles, associated with each finger.
They originate from the FDP tendons in the palm.
Medial two are innervated by the deep branch of ulnar nerve; lateral two are innervated by digital branches of the median nerve. They flex the metacarpophalangeal joint (MPJ) and extend the interphalangeal joint (IPJ).

Blood Vessels of the Hand

The hand is supplied by the radial and ulnar arteries.
The arteries form interconnected superficial and deep palmar arches.
The radial artery provides thumb and lateral index finger supply.
Medial digits depend on the ulnar artery.

Superficial Palmar Arch

The superficial palmar arch is formed by the ulnar artery and completed by a branch of the radial artery.
Branches include a palmar digital artery to the little finger, and three common palmar digital arteries to the other fingers.

Deep Palmar Arch

The deep palmar arch arises from branches of the radial and ulnar arteries.
This arch passes across the metacarpals, distributing branches to muscles and digits.
Two vessels, princeps pollicis and radialis indicis, originate from the radial artery in an area between interosseous and adductor pollicis.

Dorsal Carpal Arch

Dorsal carpal arch arises from the radial artery that passes into the hand.
It divides into dorsal metacarpal arteries, which further supply the digits.
The arch also gives off the first dorsal metacarpal artery to the thumb and index finger.
It gives branches like the princeps pollicis artery and the radialis indicis artery.

Veins of the Hand

Deep veins accompany the arteries.
Superficial veins create a dorsal venous network over the metacarpal bones.
The cephalic vein arises from the lateral dorsal network and enters the forearm passing through the anatomical snuffbox.
The basilic vein originates from the medial dorsal network and passes into the dorso-medial aspect of the forearm

Nerves of the Hand

The hand receives innervation from the ulnar, median, and radial nerves.
The ulnar nerve supplies most intrinsic hand muscles with the exception of the thenar muscles and two lateral lumbricals.
The radial nerve provides sensation to the dorsolateral side of the hand.

Extensor Retinaculum

A strong fibrous band crossing the back of the wrist.
It is attached to the radius anteriorly and to the triquetrum and pisiform bones medially.
Superficial structures (from medial to lateral): dorsal branch of the ulnar nerve, the basilic vein, the cephalic vein, and the superficial branch of the radial nerve.
Deep structures (from medial to lateral): extensor carpi ulnaris tendon, extensor digiti minimi tendon, extensor digitorum tendons, extension indicis tendons, extensor pollicis longus tendon, extensor carpi radialis longus and brevis tendonds, abductor pollicis longus tendon, and extensor pollicis brevis tendon.

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Test your knowledge on the anatomy of the hand and wrist with this detailed quiz. Questions cover aspects such as muscles, nerves, and carpal bones, providing a comprehensive overview of this intricate region. Perfect for students and professionals looking to refresh their understanding.