Podcast
Questions and Answers
Which carpal bone is located most laterally in the proximal row?
Which carpal bone is located most laterally in the proximal row?
What is the primary function of the flexor retinaculum?
What is the primary function of the flexor retinaculum?
Which of the following structures passes deep to the flexor retinaculum?
Which of the following structures passes deep to the flexor retinaculum?
What is the primary nerve supply to the muscles of the thenar eminence?
What is the primary nerve supply to the muscles of the thenar eminence?
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Which muscles are included in the hypothenar eminence?
Which muscles are included in the hypothenar eminence?
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What forms the carpal tunnel?
What forms the carpal tunnel?
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Which two nerves supply the intrinsic muscles of the hand?
Which two nerves supply the intrinsic muscles of the hand?
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Which muscle is NOT part of the thenar eminence?
Which muscle is NOT part of the thenar eminence?
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How is the flexor pollicis longus tendon classified in relation to the flexor retinaculum?
How is the flexor pollicis longus tendon classified in relation to the flexor retinaculum?
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Which muscle originates from the anterior aspect of the shaft of the 3rd metacarpal?
Which muscle originates from the anterior aspect of the shaft of the 3rd metacarpal?
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What is the primary function of the palmar interossei muscles?
What is the primary function of the palmar interossei muscles?
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Which nerve supplies all the interosseous muscles?
Which nerve supplies all the interosseous muscles?
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What is the role of the lumbrical muscles in finger movement?
What is the role of the lumbrical muscles in finger movement?
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Which artery primarily supplies the thumb and lateral side of the index finger?
Which artery primarily supplies the thumb and lateral side of the index finger?
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Where is the deep palmar arch primarily formed?
Where is the deep palmar arch primarily formed?
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Which branches arise from the deep palmar arch?
Which branches arise from the deep palmar arch?
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Which muscles are associated with the flexor digitorum profundus tendons?
Which muscles are associated with the flexor digitorum profundus tendons?
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What completes the superficial palmar arch?
What completes the superficial palmar arch?
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Which of the following is true about dorsal interossei?
Which of the following is true about dorsal interossei?
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What is the primary arterial supply for the medial side of the little finger?
What is the primary arterial supply for the medial side of the little finger?
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Which artery branches off the radial artery and contributes to the dorsal carpal arch?
Which artery branches off the radial artery and contributes to the dorsal carpal arch?
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What does the first dorsal metacarpal artery primarily supply?
What does the first dorsal metacarpal artery primarily supply?
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Which nerve innervates all intrinsic muscles of the hand except three thenar muscles and two lateral lumbricals?
Which nerve innervates all intrinsic muscles of the hand except three thenar muscles and two lateral lumbricals?
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What is the main function of the extensor retinaculum?
What is the main function of the extensor retinaculum?
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Where does the basilic vein originate?
Where does the basilic vein originate?
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Which artery is responsible for supplying blood to the thumb?
Which artery is responsible for supplying blood to the thumb?
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What structure does the radial nerve innervate?
What structure does the radial nerve innervate?
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Which structure is NOT part of the deep structures listed in the extensor retinaculum?
Which structure is NOT part of the deep structures listed in the extensor retinaculum?
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Which of the following is a superficial structure from medial to lateral in the extensor retinaculum?
Which of the following is a superficial structure from medial to lateral in the extensor retinaculum?
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What is the role of the ulnar nerve in the hand?
What is the role of the ulnar nerve in the hand?
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What structure is primarily responsible for draining the lateral side of the dorsal venous network in the hand?
What structure is primarily responsible for draining the lateral side of the dorsal venous network in the hand?
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Which muscle is innervated solely by the median nerve in the hand?
Which muscle is innervated solely by the median nerve in the hand?
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Which artery gives rise to dorsal metacarpal arteries?
Which artery gives rise to dorsal metacarpal arteries?
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What is the primary function of the extensor retinaculum?
What is the primary function of the extensor retinaculum?
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Which nerve innervates the skin on the dorsolateral side of the hand?
Which nerve innervates the skin on the dorsolateral side of the hand?
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What is primarily contained within the carpal tunnel?
What is primarily contained within the carpal tunnel?
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Which muscle is NOT part of the adductor pollicis?
Which muscle is NOT part of the adductor pollicis?
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Which of the following structures passes superficial to the flexor retinaculum?
Which of the following structures passes superficial to the flexor retinaculum?
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Which blood vessel primarily supplies the muscles located in the thenar eminence?
Which blood vessel primarily supplies the muscles located in the thenar eminence?
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What mnemonic can be used to remember the carpal bones from lateral to medial?
What mnemonic can be used to remember the carpal bones from lateral to medial?
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Study Notes
Carpal Bones
- Mnemonic: She Looks Too Proud, Try To Chase Her
- Proximal Row: Scaphoid, Lunate, Triquetrum, Pisiform
- Distal Row: Trapezium, Trapezoid, Capitate, Hamate
Flexor Retinaculum
- Thickening of deep fascia that holds long flexor tendons at the wrist
- Attached medially to the pisiform bone and hook of the hamate
- Attached laterally to the tubercle of the scaphoid and the trapezium bones
Structures Deep to Flexor Retinaculum (Medial to Lateral)
- Flexor digitorum superficialis tendons (FDP)
- Median nerve
- Flexor pollicis longus tendon
- Flexor Carpi Radialis (FCR)
Structures Superficial to Flexor Retinaculum (Medial to Lateral)
- Flexor carpi ulnaris tendon
- Ulnar nerve
- Ulnar artery
- Palmar cutaneous branch of the ulnar nerve
- Palmaris longus tendon
- Palmar cutaneous branch of the median nerve
Carpal Tunnel
- Formed anteriorly at the wrist by the carpal bones and the flexor retinaculum
- Contents:
- Tendons of Flexor Digitorum Superficialis (FDS)
- Tendons of Flexor Digitorum Profundus (FDP)
- Tendon of Flexor Pollicis Longus (FPL)
- Median nerve
Muscles of the Hand
- Extrinsic Group: Muscles originate outside the hand and insert into the hand bones (e.g., FDS, FDP)
-
Intrinsic Group:
- Thenar Eminence: Opponens pollicis, Flexor pollicis brevis, Abductor pollicis brevis (supplied by recurrent branch of median nerve)
- Hypothenar Eminence: Opponens Digiti minimi, Abductor Digiti minimi, Flexor Digiti minimi brevis (supplied by deep branch of ulnar nerve)
-
Adductor Pollicis:
- Transverse head originates from the anterior shaft of the 3rd metacarpal
- Oblique head originates from the capitate and adjacent bases of the 2nd and 3rd metacarpals
- Inserts into the medial side of the base of the proximal phalanx
- Supplied by deep branch of ulnar nerve
- Responsible for adduction
-
Interosseous Muscles:
- Located between and attached to the metacarpals, inserting into the proximal phalanx of each digit
- Divided into two groups: dorsal and palmar
- Supplied by deep branch of ulnar nerve
- Palmar interossei responsible for adduction
- Dorsal interossei responsible for abduction
-
Lumbrical Muscles:
- Four worm-like muscles associated with each finger
- Originate from the tendons of FDP in the palm
- Medial two lumbricals innervated by deep branch of ulnar nerve
- Lateral two lumbricals innervated by digital branches of the median nerve
- Flex MPJ (metacarpophalangeal joint) and extend IPJ (interphalangeal joint)
Blood Vessels of the Hand
- Radial and Ulnar Arteries: Supply blood to the hand, forming two interconnected vascular arches (superficial and deep) in the palm
-
Superficial Palmar Arch:
- Formed by ulnar artery on the medial side of the palm, completed by palmar branch of radial artery
- Branches:
- Palmar digital artery to the medial side of the little finger
- Three large, common palmar digital arteries
-
Deep Palmar Arch:
- Formed by radial artery on the lateral side of the palm, completed by deep branch of ulnar artery
- Lies across the metacarpals just distal to their bases
- Branches:
- Three palmar metacarpal arteries
- Three perforating branches
- Princeps pollicis artery
- Radialis indicis artery
-
Dorsal Carpal Arch:
- Formed by dorsal carpal branch of the radial artery
- Supplies dorsal metacarpal arteries, which divide into small dorsal digital arteries that enter the fingers
- Also provides the first dorsal metacarpal artery (supplies the index finger and thumb), princeps pollicis artery, and radialis indicis artery
Veins of the Hand
- Deep veins follow the arteries
- Superficial veins drain into a dorsal venous network on the back of the hand
- Cephalic Vein: Originates from the lateral side of the dorsal venous network, passes over the anatomical snuffbox into the forearm
- Basilic Vein: Originates from the medial side of the dorsal venous network, passes into the dorsomedial aspect of the forearm
Nerves of the Hand
- Ulnar Nerve: Innervates all intrinsic muscles of the hand except for the three thenar muscles and the two lateral lumbricals
- Median Nerve: Innervates the three thenar muscles and the two lateral lumbricals
- Radial Nerve: Only innervates skin on the dorsolateral side of the hand
Extensor Retinaculum
- Strong, fibrous band extending obliquely across the back of the wrist
- Attached laterally to the anterior border of the radius, medially to the triquetral and pisiform bones
-
Superficial Structures (Medial to Lateral):
- Dorsal (posterior) cutaneous branch of the ulnar nerve
- Basilic vein
- Cephalic vein
- Superficial branch of the radial nerve
-
Deep Structures (Medial to Lateral):
- Extensor carpi ulnaris tendon
- Extensor digiti minimi tendon
- Extensor digitorum and extensor indicis tendons
- Extensor pollicis longus tendon
- Extensor carpi radialis longus and brevis tendons
- Abductor pollicis longus and extensor pollicis brevis tendons
Carpal Bones
- Mnemonic: She Looks Too Proud, Try To Chase Her
- Proximal Row: Scaphoid, Lunate, Triquetrum, Pisiform
- Distal Row: Trapezium, Trapezoid, Capitate, Hamate
Flexor Retinaculum
- A thickened deep fascia at the wrist
- Holds long flexor tendons in position
- Attached medially: Pisiform bone and hook of hamate
- Attached laterally: Tubercle of scaphoid and trapezium bones
Structures Deep to Flexor Retinaculum
-
Medial to Lateral:
- Flexor digitorum superficialis tendons (FDP)
- Median nerve
- Flexor pollicis longus tendon
- FCR (Flexor Carpi Radialis)
Structures Superficial to Flexor Retinaculum
-
Medial to Lateral:
- Flexor carpi ulnaris tendon
- Ulnar nerve
- Ulnar artery
- Palmar cutaneous branch of the ulnar nerve
- Palmaris longus tendon
- Palmar cutaneous branch of the median nerve
Carpal Tunnel
- Fibro-osseous canal at the wrist
- Formed by the carpal bones and flexor retinaculum
- Contents:
- Tendons of FDS (Flexor Digitorum Superficialis)
- Tendons of FDP (Flexor Digitorum Profundus)
- Tendon of FPL (Flexor Pollicis Longus)
- Median nerve
Muscles of the Hand
- Extrinsic Group: Muscles originating outside the hand and inserting into hand bones (e.g., FDS, FDP)
-
Intrinsic Group: Arranged into five parts:
- Thenar Eminence
- Hypothenar Eminence
- Adductor Pollicis
- Interosseous Muscles
- Lumbrical Muscles
Thenar Eminence
-
Three Muscles:
- Opponens pollicis
- Flexor pollicis brevis
- Abductor pollicis brevis
- All supplied by the recurrent branch of the median nerve
Hypothenar Eminence
-
Three Muscles:
- Opponens Digiti minimi
- Abductor Digiti minimi
- Flexor Digiti minimi brevis
- All supplied by the deep branch of the ulnar nerve
Adductor Pollicis
- Two heads:
- Transverse Head: Anterior aspect of 3rd metacarpal shaft
- Oblique Head: Capitate bone and adjacent bases of 2nd and 3rd metacarpals
- Inserts into medial side of the proximal phalanx base
- Supplied by the deep branch of the ulnar nerve
Dorsal Carpal Arch
-
From Radial Artery:
- Dorsal Carpal Branch: Forms dorsal carpal arch, gives rise to dorsal metacarpal arteries, which divide into dorsal digital arteries
- First Dorsal Metacarpal Artery: Supplies adjacent sides of index finger and thumb
- Princeps Pollicis Artery
- Radialis Indicis Artery
Veins of the Hand
- Deep veins follow the arteries
- Superficial veins drain into a dorsal venous network on the back of the hand
- Cephalic Vein: Originates laterally, passes over the anatomical snuffbox into the forearm
- Basilic Vein: Originates medially, passes into the dorsomedial aspect of the forearm
Nerves of the Hand
- Hand is supplied by ulnar, median, and radial nerves
- Ulnar Nerve: Innervates all intrinsic hand muscles EXCEPT the thenar muscles and two lateral lumbricals
- Median Nerve: Innervates the thenar muscles and two lateral lumbricals
- Radial Nerve: Only innervates skin on the dorsolateral side of the hand
Extensor Retinaculum
- Strong fibrous band across the back of the wrist
- Attached laterally to the radius and medially to the triquetral and pisiform bones
Structures Superficial to Extensor Retinaculum
-
Medial to Lateral:
- Dorsal (posterior) cutaneous branch of the ulnar nerve
- Basilic vein
- Cephalic vein
- Superficial branch of the radial nerve
Structures Deep to Extensor Retinaculum
-
Medial to Lateral:
- Extensor carpi ulnaris tendon
- Extensor digiti minimi tendon
- Extensor digitorum and extensor indicis tendons
- Extensor pollicis longus tendon
- Extensor carpi radialis longus and brevis tendons
- Abductor pollicis longus and extensor pollicis brevis tendons
Interosseous Muscles
- Located between and attached to metacarpals, inserted into proximal phalanx of each digit
- Dorsal Interossei: Abduction
- Palmar Interossei: Adduction
- All supplied by the deep branch of the ulnar nerve
Lumbrical Muscles
- Four worm-like muscles
- Originate from FDP tendons in the palm
- Medial two lumbricals: Supplied by deep branch of ulnar nerve
- Lateral two lumbricals: Supplied by digital branches of median nerve
- Function: Flex MPJ (Metacarpophalangeal joint) and extend IPJ (Interphalangeal joint)
Blood Vessels of the Hand
- Blood supplied by radial and ulnar arteries
- Form two interconnected arches (superficial and deep) in the palm
- Radial Artery: Contributes mainly to thumb and lateral side of index finger
- Ulnar Artery: Contributes mainly to remaining digits and medial side of index finger
Superficial Palmar Arch
- Formed by the ulnar artery medially, completed by palmar branch of the radial artery
- Branches:
- Palmar digital artery to the medial side of the little finger
- Three large, common palmar digital arteries
Deep Palmar Arch
- Formed by the radial artery laterally, completed by the deep branch of the ulnar artery
- Lies across the metacarpals distal to their bases
- Branches:
- Three palmar metacarpal arteries
- Three perforating branches
- Princeps pollicis artery and radialis indicis artery arise from the radial artery between the first dorsal interosseous and adductor pollicis.
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Description
This quiz tests your knowledge of the carpal bones and flexor retinaculum anatomy. You'll explore mnemonics, structures deep and superficial to the flexor retinaculum, as well as the carpal tunnel's contents. Perfect for students of anatomy and medical professionals alike.
