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BONES OF HAND
Total of 27 bones in
.hand and wrist
EXTRINSIC MUSCLES OF HAND
EXTRINSIC EXTENSORS
All extensors are extrinsic and supplied by radial nerve.
Except for the interosseous-lumbrical complex.
Group contains:
3 wrist extensors
A larger group of thumb and digit extensors.
The main extensors at wrist are:
•Extensor carpi radialis brevis (ECRB)
•Extensor carpi radialis longus (ECRL)
•Extensor carpi ulnaris (ECU)
EXTRINSIC EXTENSORS
Origin Lateral
supracondylar ridge of
humerus
Insertion Base of 2nd
metacarpal
Action Extends and
radially deviates at the
wrist
Innervation Radial nerve
(C6 and C7)
EXTENSOR CARPI ULNARIS
Origin Lateral
epicondyle of humerus
Insertion Base of 5th
metacarpal
Action Extends and
ulnar deviates hand at
wrist joint
Innervation - Radial
nerve
EXTENSOR DIGITORUM
Innervation Posterior
interosseous nerve
EXTENSOR INDICIS
Origin Posterior
surfaces of ulna,
Insertion Base of
1st metacarpal
Action Abducts
thumb
Innervation the
radial nerve
EXTRINSIC FLEXORS
3 wrist flexors
A larger group of thumb and digit flexors
Are innervated by the median nerve
Except for the FCU, and the FDP to the
small and ring finger, which are
innervated by the ulnar nerve.
EXTRINSIC FLEXORS
Hypothenar
muscles
Opponens Digiti. 1
Minimi
Abductor Digiti.2
Minimi
Flexor Digiti Minimi.3
Brevis
Palmaris Brevis.4
OPPONENS DIGITI MINIMI
1. Lumbricals 1 and 2
Origin: lateral 2 tendons of
flexor digitorum profundus
2. Lumbricals 3 and 4
Origin: medial 3 tendons of
flexor digitorum profundus
Dorsal metacarpal
artery
Enters the palm on the lateral side of the ulnar nerve superficial to
the flexor retinaculum
- passes lateral to the pisiform bone
(:Radial (C5-T1
:Sensory Dorsal 3 1/2 digits and
hand: via superficial
branch (dorsal digit
(branches
Dorsal wrist capsule
:otor (NONE (in hand
FLEXOR ZONE OF HAND
ZONE BOUNDARIES COMMENT
I FDS insertion to Injuries amenable to repair (e.g.
distal tip ( Jersey finger
II Midpalm Called “No man's land” because
fibroosseous tunnel . high rate of complications
to FDS insertion
III Transverse Carpal Injuries often associated with
ligament to fibro- Median nerve or arterial arch
osseous tunnel . injuries. Explore and repair all
IV Transverse carpal Uncommon site of injury. Repair
ligament (carpal usually requires carpal tunnel
( tunnel release and repair. Median nerve at
. risk
V Proximal to the TCL Injuries require end-to-end repair