Slideshow: Hand The Funky Professor videos can viewed here: http://publishing.rcseng.ac.uk/journal/video?videoTaxonomy=FUNK

1. The Hand

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

10. CT reconstruction of Right Wrist
Radius

11. Ulna
CT reconstruction of Right Wrist

12. Radial attachment of the Flexor Retinaculum
Scaphoid
(tubercle)

13. Radial attachment of the Flexor Retinaculum
Trapezium
(ridge)

14. Ulnar attachment of the Flexor Retinaculum
Pisiform

15. Ulnar attachment of the Flexor Retinaculum
Hamate
(hook)

16. Bony attachments of Flexor Retinaculum

17. Bony attachments of Flexor Retinaculum

18. Tendons of Long Flexors

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

23. Intrinsic muscles are
those which originate and
insert within the hand
itself

24. Intrinsic muscles may be
classified as follows;
Thenar Muscles
Adductor Pollicis
Hypothenar Muscles
Lumbricals
Interossei Muscles

25. Thenar Muscles
control movements of the
thumb

26. 3 Thenar Muscles
Abductor Pollicis Brevis
Flexor Pollicis Brevis
Opponens Pollicis

27. 3 Thenar Muscles
Abductor Pollicis Brevis
Flexor Pollicis Brevis
Opponens Pollicis
All supplied by the median nerve

28. Thenar Muscles

29. Opponens Pollicis
Arises from
Flexor Retinaculum
Tubercle of Trapezium
Rotates CMC & MCP
joints of thumb

30. Opponens Pollicis
Arises from
Flexor Retinaculum
Tubercle of Trapezium
Supplied by
median nerve
Rotates CMC & MCP
joints of thumb

31. Abductor Pollicis Brevis
Arises from
Flexor Retinaculum
Scaphoid Tubercle

32. Abductor Pollicis Brevis
Abducts thumb at
MCP, CMC joints
Arises from
Flexor Retinaculum
Scaphoid Tubercle

33. Flexor Pollicis Brevis
Arises from
Flexor Retinaculum
Tubercle of Trapezium

34. Flexor Pollicis Brevis
Flexes MCP joint
of thumb
Arises from
Flexor Retinaculum
Tubercle of Trapezium

35. Adductor Pollicis
Supplied by deep branch of
ulnar nerve
Also acts on thumb, but is not
part of the thenar muscles

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

38. Hypothenar Muscles
control movements of the
Little Finger

39. 3 Hypothenar muscles
Abductor Digiti Minimi
Flexor Digiti Minimi Brevis
Opponens Digiti Minimi

40. 3 Hypothenar muscles
Abductor Digiti Minimi
Flexor Digiti Minimi Brevis
Opponens Digiti Minimi
All supplied by the deep branch of
the ulnar nerve

41. Abductor Digiti Minimi
Abducts the little finger

42. Flexor Digiti Minimi Brevis
Flexes the little finger

43. Opponens Digiti Minimi
Opposes the
Carpometacarpophalangeal joints
Metacarpophalangeal joints of the
little finger

44. Interossei Muscles

45. Interossei Muscles
There are two sets of Interossei
Palmar Interossei

46. Interossei Muscles
There are two sets of Interossei
Palmar Interossei
Dorsal Interossei

47. Interossei Muscles
Palmar Interossei
ADDuct the fingers

48. Interossei Muscles
Dorsal Interossei
ABduct the fingers

49. Useful Pnemonic
PAD and DAB

50. Useful Pnemonic
PAD
Palmar Interossei
ADDuct the fingers
DAB
Dorsal Interossei
ABduct the fingers
PAD and DAB

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

52. 1st
Lumbrical

53. The lumbricals have a dual
nerve supply
Lumbricals

54. The lumbricals have a dual
nerve supply
Lateral two are by Median nerve
Lumbricals

55. The lumbricals have a dual
nerve supply
Lateral two are by Median nerve
Medial two are by Ulnar nerve
Lumbricals

56. Nerves

57. All Intrinsic muscles of
the hand are supplied
by the Ulnar Nerve
EXCEPT
The lateral 2 lumbricals
and thenar muscles

58. L
O
A
F
Useful pnemonic for
muscles in the hand
supplied by the median
nerve is

59. Useful pnemonic for
muscles in the hand
supplied by the median
nerve is
Lateral 2 lumbricals
O
A
F

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

63. Summary of Muscles in the Hand

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