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Bone and Muscles of the Hand
1. COLLEGE OF ALLIEDCOLLEGE OF ALLIED
HEALTH AND SCIENCESHEALTH AND SCIENCES
ANATOMYANATOMY
MUSKULOSKELETALMUSKULOSKELETAL
UPPER LIMB (PART 5)UPPER LIMB (PART 5)
Carpals, Metacarpals andCarpals, Metacarpals and
PhalangesPhalanges
By : HERMIZAN BIN HALIHANAFIAH
2.
3. HANDHAND
IntroductionIntroduction
Gross motor skills and fine motor skills.Gross motor skills and fine motor skills.
5 Digits / fingers5 Digits / fingers
Thumb – pollexThumb – pollex
Index finger – digitus indicisIndex finger – digitus indicis
Middle finger – digitus tertiusMiddle finger – digitus tertius
Ring finger – digitus annulusRing finger – digitus annulus
Little finger – digitus minimiLittle finger – digitus minimi
4. HandHand
Hand composed by a bony framework :Hand composed by a bony framework :
8 carpals bones8 carpals bones
5 metacarpals5 metacarpals
14 phalanges14 phalanges
5.
6. Carpal BonesCarpal Bones
The names reflect on their shapeThe names reflect on their shape
Divide in two rows; proximal and distal rowDivide in two rows; proximal and distal row
Proximal row:Proximal row:
From lateral to medialFrom lateral to medial
Scaphoid, lunate, triquetrum and pisiformScaphoid, lunate, triquetrum and pisiform
Distal rowDistal row
From lateral to medialFrom lateral to medial
Trapezium, trapezoid, capitate and hamateTrapezium, trapezoid, capitate and hamate
7.
8. 8 bones of Carpals8 bones of Carpals
A – Scaphoid (boatlike)A – Scaphoid (boatlike)
B – Lunate (moon-shaped)B – Lunate (moon-shaped)
C – Triquatrum (three-cornered)C – Triquatrum (three-cornered)
D – Pisiform (pea-shaped)D – Pisiform (pea-shaped)
E – Trapezium (four sided figure)E – Trapezium (four sided figure)
F – TrapezoidF – Trapezoid
G – Capitate (head-shaped)G – Capitate (head-shaped)
H – Hamate (hooked)H – Hamate (hooked)
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9.
10. CapitateCapitate
Largest carpal boneLargest carpal bone
Rounded projectionRounded projection
Head articulate with lunate boneHead articulate with lunate bone
LunateLunate
Large hook-projection on its anteriorLarge hook-projection on its anterior
11. ScaphoidScaphoid
70 % fractures involve the scaphoid70 % fractures involve the scaphoid
Fall on outstretched hand – force isFall on outstretched hand – force is
transmitted from the capitate throughtransmitted from the capitate through
the scaphoid to the radiusthe scaphoid to the radius
12. Carpal TunnelCarpal Tunnel
Concave space formed by the pisiform and hamate (on theConcave space formed by the pisiform and hamate (on the
ulnar side), and the scaphoid and trapezium ( on the radialulnar side), and the scaphoid and trapezium ( on the radial
side) plus the flexor retinaculum (deep fascia)side) plus the flexor retinaculum (deep fascia)
Long flexor tendons of the digits and thumb (flexorLong flexor tendons of the digits and thumb (flexor
digitorum superficialis, flexor digitorum profundus, flexordigitorum superficialis, flexor digitorum profundus, flexor
pollicis longus) and the median nerve pass through thepollicis longus) and the median nerve pass through the
carpel tunnelcarpel tunnel
Narrowing of the carpel tunnel may give rise to a conditionNarrowing of the carpel tunnel may give rise to a condition
calledcalled carpal tunnel syndromecarpal tunnel syndrome ..
15. Flexor RetinaculumFlexor Retinaculum
TheThe flexor retinaculumflexor retinaculum ((transverse carpaltransverse carpal
ligamentligament, or, or anterior annular ligamentanterior annular ligament ) is a) is a
strong, fibrous band, which arches over thestrong, fibrous band, which arches over the
carpus.carpus.
Converting the deep groove on the front of theConverting the deep groove on the front of the
carpal bones into a tunnel, thecarpal bones into a tunnel, the carpal tunnelcarpal tunnel
Flexor tendons of the digits and the medianFlexor tendons of the digits and the median
nerve pass.nerve pass.
17. Extensor RetinaculumExtensor Retinaculum
TheThe extensor retinaculumextensor retinaculum ((dorsal carpaldorsal carpal
ligamentligament) is an anatomical term for the fascia) is an anatomical term for the fascia
that holds the tendons of the extensor musclesthat holds the tendons of the extensor muscles
in place.in place.
It is located on the back of the forearm, justIt is located on the back of the forearm, just
proximal to the hand.proximal to the hand.
19. Joints of the Carpal BonesJoints of the Carpal Bones
Intercarpal /midcarpalIntercarpal /midcarpal
jointjoint
Articulation betweenArticulation between
carpals bone.carpals bone.
Planar jointPlanar joint
Biaxial movement –Biaxial movement –
gliding movement( backgliding movement( back
– forth , side – side)– forth , side – side)
21. It consists of five cylindrical bones which areIt consists of five cylindrical bones which are
numbered from the radial (lateral ) to the ulnarnumbered from the radial (lateral ) to the ulnar
(medial) side.(medial) side.
1.1. First metacarpal boneFirst metacarpal bone
2.2. Second metacarpal boneSecond metacarpal bone
3.3. Third metacarpal boneThird metacarpal bone
4.4. Fourth metacarpal boneFourth metacarpal bone
5.5. Fifth metacarpal boneFifth metacarpal bone
MetacarpalsMetacarpals
23. Joints of the MetacarpalsJoints of the Metacarpals
Carpometacarpal jointsCarpometacarpal joints
Proximal based of metacarpals articulate with distalProximal based of metacarpals articulate with distal
row of carpal bones.row of carpal bones.
11stst
metacarpal articulate with trapezium bonesmetacarpal articulate with trapezium bones
The second metacarpal articulates primarily with theThe second metacarpal articulates primarily with the
trapezoid and secondarily with the trapezium andtrapezoid and secondarily with the trapezium and
capitate.capitate.
The third metacarpal articulates primarily with theThe third metacarpal articulates primarily with the
capitate,capitate,
The fourth metacarpal articulates with the capitateThe fourth metacarpal articulates with the capitate
and hamate.and hamate.
The fifth metacarpal articulates with the hamate.The fifth metacarpal articulates with the hamate.
24. CarpometacarpalCarpometacarpal
The 1The 1stst
CMC (between trapezium and 1CMC (between trapezium and 1stst
metacarpal) is a saddle jointmetacarpal) is a saddle joint
Also known as a trapeziometacarpal jointAlso known as a trapeziometacarpal joint
(TMC)(TMC)
Produce triaxial diarthrosisProduce triaxial diarthrosis
The rest CMC – condyloid jointThe rest CMC – condyloid joint
Produce biaxial diarthrosisProduce biaxial diarthrosis
Joints of the MetacarpalsJoints of the Metacarpals
25. Metacarpophalangeal jointMetacarpophalangeal joint
Distal head of metacarpals articulate withDistal head of metacarpals articulate with
proximal phalanges.proximal phalanges.
Condyloid jointCondyloid joint
Produce biaxial diarthrosis ; flexion –Produce biaxial diarthrosis ; flexion –
extension / abduction - adductionextension / abduction - adduction
Joints of the MetacarpalsJoints of the Metacarpals
26. PhalangesPhalanges
14 bones14 bones
Numbered 1-5 same with metacarpalsNumbered 1-5 same with metacarpals
Each phalanx consist:Each phalanx consist:
Proximal baseProximal base
Intermediate shaftIntermediate shaft
Distal headDistal head
2 phalanges in thumb, 3 the other fingers.2 phalanges in thumb, 3 the other fingers.
27. Phalanges can divide into:Phalanges can divide into:
Proximal phalanxProximal phalanx
Middle phalanxMiddle phalanx
Distal phalanxDistal phalanx
Except thumb; only proximal and distal part.Except thumb; only proximal and distal part.
PhalangesPhalanges
28. Joint of the PhalangesJoint of the Phalanges
Interphalangeal jointInterphalangeal joint
Joint between phalangesJoint between phalanges
Proximal and distal IPProximal and distal IP
except thumbexcept thumb
Hinge jointHinge joint
Permits monoaxialPermits monoaxial
diarthrosis ; flexion anddiarthrosis ; flexion and
extensionextension
29.
30. Movement of Hand and DigitsMovement of Hand and Digits
ulnar and radial deviation at RCulnar and radial deviation at RC
Wrist flexion and extension at RCWrist flexion and extension at RC
Flexion and extension digit at MCPFlexion and extension digit at MCP
Abduction and adduction digits at MCPAbduction and adduction digits at MCP
Abduction and adduction thumb at 1Abduction and adduction thumb at 1stst
CMCCMC
Opposition and reposition thumb at 1Opposition and reposition thumb at 1stst
CMCCMC
Flexion and extension digits at IPFlexion and extension digits at IP
37. Muscles of the Forearm Move theMuscles of the Forearm Move the
Wrist, Hand, Thumb and FingersWrist, Hand, Thumb and Fingers
Group of muscles that act on the digits are known asGroup of muscles that act on the digits are known as
extrinsic hand musclesextrinsic hand muscles because originate outsidebecause originate outside
the hand and insert within it.the hand and insert within it.
There is 2 groups of forearm muscles:There is 2 groups of forearm muscles:
Anterior compartment (flexor muscles)Anterior compartment (flexor muscles)
Posterior compartment (extensor muscles)Posterior compartment (extensor muscles)
39. Anterior compartment ofAnterior compartment of
Forearm MusclesForearm Muscles
Muscle of the forearm originate on theMuscle of the forearm originate on the
humerushumerus
Insert on the carpals, metarcarpals, andInsert on the carpals, metarcarpals, and
phalangesphalanges
Act as flexorAct as flexor
Divide into superficial or deep muscles.Divide into superficial or deep muscles.
40. Posterior compartment ofPosterior compartment of
Forearm MusclesForearm Muscles
Muscle of the forearm originate on theMuscle of the forearm originate on the
humerushumerus
Insert on the carpals, metarcarpals, andInsert on the carpals, metarcarpals, and
phalangesphalanges
Act as extensorAct as extensor
Divide into superficial or deep muscles.Divide into superficial or deep muscles.
42. Superficial Anterior CompartmentSuperficial Anterior Compartment
MusclesMuscles
Arrange in following order from lateral to medial:Arrange in following order from lateral to medial:
1.1. Flexor carpi radialisFlexor carpi radialis
2.2. Palmaris longusPalmaris longus
3.3. Flexor carpi ulnarisFlexor carpi ulnaris
4.4. Flexor digitorum superficialis – deep to theFlexor digitorum superficialis – deep to the
other 3 muscles and is a largest superficialother 3 muscles and is a largest superficial
muscle in the forearm.muscle in the forearm.
45. Deep Anterior CompartmentDeep Anterior Compartment
MusclesMuscles
Arrange in following order from lateral toArrange in following order from lateral to
medial:medial:
1.1. Flexor pollicis longusFlexor pollicis longus
2.2. Flexor digitorum profundusFlexor digitorum profundus
46. Deep Flexor Muscles: From lateral to Medial : Flexor Pollicis Longus,
Flexor Digitorum Profundus (deep to flexor digitorum superficialis)
47. Superficial Posterior CompartmentSuperficial Posterior Compartment
MusclesMuscles
Arrange in following order from lateral toArrange in following order from lateral to
medial:medial:
1.1. Extensor carpi radialis longusExtensor carpi radialis longus
2.2. Extensor carpi radialis brevisExtensor carpi radialis brevis
3.3. Extensor digitorumExtensor digitorum
4.4. Extensor digiti minimiExtensor digiti minimi
5.5. Extensor carpi ulnarisExtensor carpi ulnaris
49. Deep Posterior CompartmentDeep Posterior Compartment
MusclesMuscles
Arrange in following order from lateral toArrange in following order from lateral to
medial:medial:
1.1. Abductor pollicis longusAbductor pollicis longus
2.2. Extensor pollicis brevisExtensor pollicis brevis
3.3. Extensor pollicis longusExtensor pollicis longus
4.4. Extensor indicisExtensor indicis
50. From lateral to medial : abductor pollicis longus, extensor pollicis brevis,
extensor pollicis longus, extensor indicis.
51. Flexor Carpi RadialisFlexor Carpi Radialis
Origin – medial epicodyle ofOrigin – medial epicodyle of
humerushumerus
Insertion –base of SecondInsertion –base of Second
and third metacarpalsand third metacarpals
ActionAction
Flexion and abductionFlexion and abduction
hand (radial deviation) athand (radial deviation) at
wrist jointwrist joint
Nerve innervations – medianNerve innervations – median
nerve
52. Palmaris longusPalmaris longus
Origin – medial epicondyle ofOrigin – medial epicondyle of
humerushumerus
Insertion – flexor retinaculumInsertion – flexor retinaculum
and palmar aponeurosisand palmar aponeurosis
(deep fascia in center of palm)(deep fascia in center of palm)
ActionAction
Weakly flexes hand at wristWeakly flexes hand at wrist
jointjoint
Nerve innervations – medianNerve innervations – median
nervenerve
53. Flexor Carpi UlnarisFlexor Carpi Ulnaris
Origin – medial epicondyleOrigin – medial epicondyle
of humerus, proximalof humerus, proximal
posterior of ulnaposterior of ulna
Insertion – pisiform, hamate,Insertion – pisiform, hamate,
and base of fifth metacarpal.and base of fifth metacarpal.
Action – flexion andAction – flexion and
adduction hand (ulnaradduction hand (ulnar
deviation) at wrist joint.deviation) at wrist joint.
Nerve innervations – ulnarNerve innervations – ulnar
nervenerve
54. Flexor digitorum superficialisFlexor digitorum superficialis
Origin – medial epicondyle of humerus, coronoid process ofOrigin – medial epicondyle of humerus, coronoid process of
ulna, ridge along lateral margin of anterior surface of radius.ulna, ridge along lateral margin of anterior surface of radius.
Insertion – middle phalanx of each fingers (2Insertion – middle phalanx of each fingers (2ndnd
– 5– 5thth
digits)digits)
ActionAction
Flexion the proximal interphalangeal joints of 2Flexion the proximal interphalangeal joints of 2ndnd
throughthrough
55thth
digitsdigits
Assist flexion metacarpophalangealAssist flexion metacarpophalangeal
Assist wrist flexionAssist wrist flexion
Nerve innervations – Medial nerveNerve innervations – Medial nerve
56. Flexor Pollicis LongusFlexor Pollicis Longus
Origin – anterior surface of radiusOrigin – anterior surface of radius
and interosseous membrane,and interosseous membrane,
medial epicondyle of humerusmedial epicondyle of humerus
Insertion – base of distal phalanxInsertion – base of distal phalanx
of thumbof thumb
Action – flexes distal phalanx ofAction – flexes distal phalanx of
thumb at interphalangeal joint.thumb at interphalangeal joint.
Nerve innervations – MedianNerve innervations – Median
nervenerve
57. Flexor Digitorum ProfundusFlexor Digitorum Profundus
Origin - anterior medial surface of proximal body of ulnaOrigin - anterior medial surface of proximal body of ulna
Insertion – base of distal phalanx of each finger (2Insertion – base of distal phalanx of each finger (2ndnd
– 5– 5thth
))
ActionAction
Flexion distal interphalangeal joint of 2Flexion distal interphalangeal joint of 2ndnd
– 5– 5thth
digitsdigits
Assist flexion proximal interphalangeal and MCPAssist flexion proximal interphalangeal and MCP
Assist wrist flexionAssist wrist flexion
Nerve innervations – index and middle (median nerve),Nerve innervations – index and middle (median nerve),
ring and digiti minimi (ulnar nerve)ring and digiti minimi (ulnar nerve)
59. Flexor Digitorum Profundus (FDP)
& Superficialis (FDS)
Flexor digitorum superficialis
(FDS) insert into middle
phalanx.
Flexor digitorum profundus
(FDP) runs deep to the FDS
until the level of the MP joint
where FDS bifurcates.
FDP inserts at the base of
the distal phalanx and acts
primarily to flex the DIP joint
as well as all other joints
flexed by FDS.
60. Extensor Carpi Radialis LongusExtensor Carpi Radialis Longus
Origin – lateralOrigin – lateral
supracondylar ridge ofsupracondylar ridge of
humerushumerus
Insertion – dorsal surfaceInsertion – dorsal surface
of base second metacarpalof base second metacarpal
Action – extend and abductAction – extend and abduct
hand at wrist jointhand at wrist joint
Nerve innervations – RadialNerve innervations – Radial
nervenerve
61. Extensor Carpi Radialis BrevisExtensor Carpi Radialis Brevis
Origin – lateral epicondyle ofOrigin – lateral epicondyle of
humerushumerus
Insertion – dorsal surface ofInsertion – dorsal surface of
base third metacarpalbase third metacarpal
Action - Extend and adductAction - Extend and adduct
hand at wrist jointhand at wrist joint
Nerve innervations – RadialNerve innervations – Radial
nervenerve
62. Extensor digitorumExtensor digitorum
Origin – lateral epicondyle of humerusOrigin – lateral epicondyle of humerus
Insertion – dorsum of distal and middle phalanges of eachInsertion – dorsum of distal and middle phalanges of each
fingers (2fingers (2ndnd
- 5- 5thth
digits).digits).
ActionAction
Extends proximal of each finger at metacarpophalangealExtends proximal of each finger at metacarpophalangeal
jointjoint
Extends distal and middle phalanges of each fingers atExtends distal and middle phalanges of each fingers at
interphalangeal joint.interphalangeal joint.
Assists in Extends hand at wrist jointAssists in Extends hand at wrist joint
Nerve innervation – Radial nerveNerve innervation – Radial nerve
64. Extensor digiti minimiExtensor digiti minimi
Origin – lateral epicondyle ofOrigin – lateral epicondyle of
humerushumerus
Insertion – tendon of extensorInsertion – tendon of extensor
digitorum on fifth phalanx.digitorum on fifth phalanx.
ActionAction
Extends proximal phalanx of littleExtends proximal phalanx of little
finger at metacarpophalangealfinger at metacarpophalangeal
Extend the interphalangeal ofExtend the interphalangeal of
little finger.little finger.
Nerve supply – Radial nerveNerve supply – Radial nerve
65. Extensor Carpi UlnarisExtensor Carpi Ulnaris
Origin – lateral epicondyleOrigin – lateral epicondyle
of humerus and posteriorof humerus and posterior
border of ulnaborder of ulna
Insertion –base of fifthInsertion –base of fifth
metacarpalmetacarpal
Action – extends andAction – extends and
adducts hand at wrist joint.adducts hand at wrist joint.
Nerve innervations – RadialNerve innervations – Radial
nervenerve
66. Abductor Pollicis LongusAbductor Pollicis Longus
Origin – posterior surface of middleOrigin – posterior surface of middle
of radius and ulna andof radius and ulna and
interosseous membraneinterosseous membrane
Insertion – base of firstInsertion – base of first
metacarpalsmetacarpals
ActionAction
Abducts and extends thumb atAbducts and extends thumb at
carpometacarpal jointcarpometacarpal joint
Abducts hands at wrist jointAbducts hands at wrist joint
Nerve innervations – Radial nerveNerve innervations – Radial nerve
67. Extensor pollicis brevisExtensor pollicis brevis
Origin – posterior surface of middle of radius andOrigin – posterior surface of middle of radius and
interosseous membrane.interosseous membrane.
Insertion – base of proximal phalanx of thumbInsertion – base of proximal phalanx of thumb
ActionAction
Extends proximal phalanx of thumb atExtends proximal phalanx of thumb at
metacarpophalangeal jointmetacarpophalangeal joint
Extends1Extends1stst
metacarpal of thumb at carpometacarpalmetacarpal of thumb at carpometacarpal
jointjoint
Assists in radial deviation at wrist jointAssists in radial deviation at wrist joint
Nerve innervations – Radial nerveNerve innervations – Radial nerve
69. Extensor Pollicis LongusExtensor Pollicis Longus
Origin – posterior surface of middle of ulna andOrigin – posterior surface of middle of ulna and
interosseous membraneinterosseous membrane
Insertion – base of distal phalanx of thumbInsertion – base of distal phalanx of thumb
ActionAction
extend distal phalanx of the thumb at interphalangealextend distal phalanx of the thumb at interphalangeal
jointjoint
Assist in extension of thumb at metacarpophalangealAssist in extension of thumb at metacarpophalangeal
and carpometacarpal joint.and carpometacarpal joint.
Assist radial deviation and extension hand at wristAssist radial deviation and extension hand at wrist
joint.joint.
Nerve innervations - Radial nerveNerve innervations - Radial nerve
71. Extensor IndicisExtensor Indicis
Origin – posterior surface of ulna,Origin – posterior surface of ulna,
interosseous membraneinterosseous membrane
Insertion – tendon of entensorInsertion – tendon of entensor
digitorum of index fingerdigitorum of index finger
Action – extend distal and middleAction – extend distal and middle
phalanx at IP joint, extendphalanx at IP joint, extend
proximal phalanx at MCPproximal phalanx at MCP
Deep radial nerveDeep radial nerve
72. Surface anatomy of hand
The tendons that are
palpated with thumb
abducted and extended
form an anatomic snuff-
box
73. Surface anatomy of hand
Flexor Tendons:
Flexor carpi
radialis, flexor
carpi ulnaris,
and palmaris
longus primarily
flex the wrist
74.
75. Intrinsic Hand MusclesIntrinsic Hand Muscles
Has a origins andHas a origins and
insertions within theinsertions within the
handhand
Produce weak butProduce weak but
intricate and preciseintricate and precise
movements of themovements of the
digits (Fine motordigits (Fine motor
skills)skills)
76. Intrinsic Hand MusclesIntrinsic Hand Muscles
The intrinsic muscle of the hand divided into 3The intrinsic muscle of the hand divided into 3
groups:groups:
Thenar musclesThenar muscles
Hypothenar musclesHypothenar muscles
Intermediate musclesIntermediate muscles
77. Thenar MusclesThenar Muscles
Thenar (lateral aspect of palm)
Abductor pollicis brevis
Opponens pollicis
Flexor pollicis brevis
Adductor pollicis
Move the thumb (pollex)
This 4 muscles form the thenar eminence, lateral
rounded contour on the palm. (ball of the thumb)
78.
79. Abductor PollicisAbductor Pollicis
BrevisBrevis OriginOrigin
Flexor retinaculumFlexor retinaculum
ScaphoidScaphoid
TrapeziumTrapezium
InsertionInsertion
Lateral side of proximalLateral side of proximal
phalanx of thumbphalanx of thumb
ActionAction
Abduct of thumb at CMCAbduct of thumb at CMC
joint.joint.
Median NerveMedian Nerve
80. Opponens PollicisOpponens Pollicis
OriginOrigin
Flexor retinaculumFlexor retinaculum
TrapeziumTrapezium
InsertionInsertion
Lateral side of 1Lateral side of 1stst
metacarpalmetacarpal
(thumb)(thumb)
ActionAction
Opposition thumb at CMC joint.Opposition thumb at CMC joint.
Median nerveMedian nerve
81. Flexor Pollicis BrevisFlexor Pollicis Brevis
OriginOrigin
Flexor retinaculumFlexor retinaculum
TrapezoidTrapezoid
TrapeziumTrapezium
CapitateCapitate
InsertionInsertion
Lateral side of proximal phalanxLateral side of proximal phalanx
of thumb.of thumb.
ActionAction
Flexion thumb at CMC andFlexion thumb at CMC and
MCP joint.MCP joint.
Median and ulnar nervesMedian and ulnar nerves
82. Adductor PollicisAdductor Pollicis
OriginOrigin
Oblique head – Capitate and 2Oblique head – Capitate and 2ndnd
and 3and 3rdrd
metacarpalsmetacarpals
Transverse head – 3Transverse head – 3rdrd
metacarpalmetacarpal
InsertionInsertion
Medial side of proximal phalanx ofMedial side of proximal phalanx of
thumbthumb
Action – adduct thumb at CMC andAction – adduct thumb at CMC and
MCPMCP
Ulnar NerveUlnar Nerve
83. Hypothenar Muscles
Medial aspect of palm
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Move the digiti minimi
This 3 muscles form the
hypothenar muscles (medial
rounded contour in the palm) –
ball of the little finger
84.
85. Abductor digiti minimiAbductor digiti minimi
OriginOrigin
Tendon flexor carpi ulnarisTendon flexor carpi ulnaris
PisiformPisiform
InsertionInsertion
Medial side of proximal phalanxMedial side of proximal phalanx
of little fingers.of little fingers.
ActionAction
Abduction little finger at MCPAbduction little finger at MCP
Assist flexion little finger atAssist flexion little finger at
MCPMCP
86. Flexor digiti minimiFlexor digiti minimi
brevisbrevis
OriginOrigin
Flexor retinaculumFlexor retinaculum
HamateHamate
InsertionInsertion
Medial side of proximalMedial side of proximal
phalanx of little fingersphalanx of little fingers
Action – flexion little finger atAction – flexion little finger at
MCP, assist opposition little fingerMCP, assist opposition little finger
at CMCat CMC
Ulnar nerveUlnar nerve
87. Opponens DigitiOpponens Digiti
MinimiMinimi
OriginOrigin
Flexor retinaculumFlexor retinaculum
HamateHamate
InsertionInsertion
Medial side of entire lengthMedial side of entire length
fifth metacarpals (little finger)fifth metacarpals (little finger)
ActionAction
Opposition little finger atOpposition little finger at
CMCCMC
Ulnar nerveUlnar nerve
88. Intermediate MuscleIntermediate Muscle
Midpalmar / intermediate (11 muscles)
Lumbricals
Palmar interossei
Dorsal interossei
Acts on all the digits
Important muscles for movements in skilled activities
(playing piano , writing, typing, precision handling etc)
89. Lumbricals
Consists of 4 musclesConsists of 4 muscles
OriginOrigin
Lateral and adjacent side of tendons of flexorLateral and adjacent side of tendons of flexor
digitorum profundus of each fingers (2digitorum profundus of each fingers (2ndnd
– 5– 5thth
))
InsertionInsertion
Lateral side of tendon of extensor digitorum onLateral side of tendon of extensor digitorum on
proximal phalanges of each fingers (2proximal phalanges of each fingers (2ndnd
– 5– 5thth
))
ActionAction
Flexion each finger at MCP and extend each finger atFlexion each finger at MCP and extend each finger at
IPIP
Median and ulnar nerveMedian and ulnar nerve
94. Palmar interosseiPalmar interossei
4 muscles
Origin
Sides of shafts of metacarpals
of all digits (except the middle
one)
Insertion
Side of bases of proximal
phalanges of all digits (except
the middle finger)
Action
Adduction each finger at MCP
assists in Flexion each finger at
MCP
Ulnar nerves
95.
96. Dorsal InterosseiDorsal Interossei
4 muscles4 muscles
OriginOrigin
Adjacent side of metacarpalsAdjacent side of metacarpals
InsertionInsertion
Proximal phalanx of each fingerProximal phalanx of each finger
ActionAction
Abduction Finger 2-4 at MCPAbduction Finger 2-4 at MCP
Assist Flexion Finger 2-4 at MCPAssist Flexion Finger 2-4 at MCP
and extension at IP at the sameand extension at IP at the same
fingerfinger
Ulnar nerveUlnar nerve
97.
98. Carpal TunnelCarpal Tunnel
Concave space located at the palmarConcave space located at the palmar
surface of the wrist.surface of the wrist.
Formed by medially by pisiform andFormed by medially by pisiform and
hamate and laterally by scaphoid andhamate and laterally by scaphoid and
trapezium.trapezium.
Cover by flexor retinaculum on the roofCover by flexor retinaculum on the roof
side.side.