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Flexor & Extensor
retinaculum of the hand
Dr M Idris Siddiqui
Flexor Retinaculum
(Transverse carpal ligaments)
• Thick connective tissue which forms the roof
of the carpal tunnel.
• Tu...
The flexor retinaculum
The flexor retinaculum is a strong fibrous
band, measuring 2–3 cm transversely and
longitudinally, ...
The Carpal Tunnel
• The Carpal Tunnel is located at the wrist and is
anteriorly composed by a deep arch.
• Carpal tunnel i...
The carpal tunnel
• The median nerve is anterior to the tendons in the
carpal tunnel. With the exception of the tendon of
...
The carpal tunnel
• The ulnar artery, ulnar nerve, and
tendon of the palmaris longus do not
pass through the carpal tunnel...
Contents of carpal tunnel
• A total of 9 tendons, surrounded by synovial
sheaths.
– The 4 tendons of the flexor digitorum ...
Structures on the Anterior Aspect of the Wrist
Superficial to the flexor retinaculum from medial to lateral
Flexor carpi u...
Structures on the Anterior Aspect of the Wrist
Deep to the flexor retinaculum from medial to lateral
Flexor digitorum supe...
Extensor retinaculum
Its proximal attachment is to the anterolateral border
of the radius above the styloid process.
It is...
Extensor retinaculum
From the deep surface of the
extensor retinaculum fibrous
septa pass to the bones of the
forearm, div...
Extensor retinaculum
1. The most lateral compartment lies over the
lateral surface of the radius at its distal extremity,
...
Extensor retinaculum
3. The groove on the ulnar side of the radial tubercle lodges
the tendon of extensor pollicis longus,...
Extensor retinaculum
Structures on the Posterior Aspect of
the Wrist
Superficial to the extensor retinaculum from medial to lateral
Dorsal (pos...
Structures on the Posterior Aspect of the Wrist
Deep to the extensor retinaculum from medial to lateral
Extensor carpi uln...
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
Flexor & extensor retinaculum of the hand
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Flexor & extensor retinaculum of the hand Slide 1 Flexor & extensor retinaculum of the hand Slide 2 Flexor & extensor retinaculum of the hand Slide 3 Flexor & extensor retinaculum of the hand Slide 4 Flexor & extensor retinaculum of the hand Slide 5 Flexor & extensor retinaculum of the hand Slide 6 Flexor & extensor retinaculum of the hand Slide 7 Flexor & extensor retinaculum of the hand Slide 8 Flexor & extensor retinaculum of the hand Slide 9 Flexor & extensor retinaculum of the hand Slide 10 Flexor & extensor retinaculum of the hand Slide 11 Flexor & extensor retinaculum of the hand Slide 12 Flexor & extensor retinaculum of the hand Slide 13 Flexor & extensor retinaculum of the hand Slide 14 Flexor & extensor retinaculum of the hand Slide 15 Flexor & extensor retinaculum of the hand Slide 16 Flexor & extensor retinaculum of the hand Slide 17 Flexor & extensor retinaculum of the hand Slide 18 Flexor & extensor retinaculum of the hand Slide 19 Flexor & extensor retinaculum of the hand Slide 20 Flexor & extensor retinaculum of the hand Slide 21 Flexor & extensor retinaculum of the hand Slide 22 Flexor & extensor retinaculum of the hand Slide 23 Flexor & extensor retinaculum of the hand Slide 24 Flexor & extensor retinaculum of the hand Slide 25 Flexor & extensor retinaculum of the hand Slide 26 Flexor & extensor retinaculum of the hand Slide 27 Flexor & extensor retinaculum of the hand Slide 28 Flexor & extensor retinaculum of the hand Slide 29 Flexor & extensor retinaculum of the hand Slide 30 Flexor & extensor retinaculum of the hand Slide 31 Flexor & extensor retinaculum of the hand Slide 32 Flexor & extensor retinaculum of the hand Slide 33
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Flexor & extensor retinaculum of the hand

  1. 1. Flexor & Extensor retinaculum of the hand Dr M Idris Siddiqui
  2. 2. Flexor Retinaculum (Transverse carpal ligaments) • Thick connective tissue which forms the roof of the carpal tunnel. • Turns the carpal arch into the carpal tunnel by bridging the space between the medial and lateral parts of the arch. • Originates on the lateral side and inserts on the medial side of the carpal arch. • Laterally: split into two laminae; the superficiala & Deep lamina: (The tendon of flexor carpi radialis lies between the 2 lamina).
  3. 3. The flexor retinaculum The flexor retinaculum is a strong fibrous band, measuring 2–3 cm transversely and longitudinally, which lies across the front of the carpus at the proximal part of the hand. • Its proximal limit lies at the level of the distal, dominant skin crease on the front of the wrist.
  4. 4. The Carpal Tunnel • The Carpal Tunnel is located at the wrist and is anteriorly composed by a deep arch. • Carpal tunnel is an important site because major neurological, circulatory, skeletal structures pass through it. • As the hand plays important function in everyday life, the importance of carpal tunnel increases significantly in anatomical studies.
  5. 5. The carpal tunnel • The median nerve is anterior to the tendons in the carpal tunnel. With the exception of the tendon of the flexor pollicis longus, all the tendons of the flexor digitorum profundus as well as flexor digitorum superficialis are incorporated by simply one synovial sheath: a various sheath encompasses the tendon of the flexor pollicis longus. • The tendon of the flexor carpi radialis is covered by a synovial sheath and undergoes a tubular area produced by the attachment of the lateral element of the flexor retinaculum to the margins of a groove on the medial aspect of the tubercle of the trapezium.
  6. 6. The carpal tunnel • The ulnar artery, ulnar nerve, and tendon of the palmaris longus do not pass through the carpal tunnel and therefore go into the hand anterior to the flexor retinaculum in carpal tunnel. • The tendon of the palmaris longus isn’t enveloped by a synovial sheath.
  7. 7. Contents of carpal tunnel • A total of 9 tendons, surrounded by synovial sheaths. – The 4 tendons of the flexor digitorum profundus – The 4 tendons of the flexor digitorum superficialis – The tendon of the flexor pollicis longus surrounded by its own synovial sheath. • The median nerve. – The palmar cutaneous branch of the median nerve is given off prior to the carpal tunnel, travelling superficially to the flexor retinaculum. • Sometimes the carpal tunnel contains another tendon, the flexor carpi radialis tendon. – But this is located within the flexor retinaculum and not within the carpal tunnel itself. surrounded by a single synovial sheath
  8. 8. Structures on the Anterior Aspect of the Wrist Superficial to the flexor retinaculum from medial to lateral Flexor carpi ulnaris tendon ending on the pisiform bone. (This tendon does not actually cross the flexor retinaculum but is included for the sake of completeness) Ulnar nerve lies lateral to the pisiform bone. Ulnar artery lies lateral to the ulnar nerve. Palmar cutaneous branch of the ulnar nerve Palmaris longus tendon (if present) passing to its insertion into the flexor retinaculum and the palmar aponeurosis Palmar cutaneous branch of the median nerve
  9. 9. Structures on the Anterior Aspect of the Wrist Deep to the flexor retinaculum from medial to lateral Flexor digitorum superficialis tendons & posterior to these, the tendons of the flexor digitorum profundus both groups of tendons share a common synovial sheath Median nerve Flexor pollicis longus tendon surrounded by a synovial sheath Flexor carpi radialis tendon going through a split in the flexor retinaculum. The tendon is surrounded by a synovial sheath.
  10. 10. Extensor retinaculum Its proximal attachment is to the anterolateral border of the radius above the styloid process. It is not attached to the ulna; its distal attachment is to The Pisiform and triquetral bones.
  11. 11. Extensor retinaculum From the deep surface of the extensor retinaculum fibrous septa pass to the bones of the forearm, dividing the extensor tunnel into six compartments.
  12. 12. Extensor retinaculum 1. The most lateral compartment lies over the lateral surface of the radius at its distal extremity, and through it pass the tendons of abductor pollicis longus and extensor pollicis brevis, each usually lying in a separate synovial sheath. 2. The next compartment extends as far as the dorsal tubercle, and conveys the tendons of the radial extensors of the wrist (longus and brevis), each lying in a separate synovial sheath.
  13. 13. Extensor retinaculum 3. The groove on the ulnar side of the radial tubercle lodges the tendon of extensor pollicis longus, which lies within its own compartment invested with a synovial sheath. 4. Between this groove and the ulnar border of the radius is a shallow depression in which all four tendons of extensor digitorum lie, crowded together over the tendon of extensor indicis. All five tendons in this compartment are invested with a common synovial sheath. 5. The next compartment lies over the radioulnar joint and transmits the tendon of extensor digiti minimi in a synovial sheath. 6. Lastly, the groove near the base of the ulnar styloid transmits the tendon of extensor carpi ulnaris in its synovial sheath.
  14. 14. Extensor retinaculum
  15. 15. Structures on the Posterior Aspect of the Wrist Superficial to the extensor retinaculum from medial to lateral Dorsal (posterior) cutaneous branch of the ulnar nerve Basilic vein Cephalic vein Superficial branch of the radial nerve
  16. 16. Structures on the Posterior Aspect of the Wrist Deep to the extensor retinaculum from medial to lateral Extensor carpi ulnaris tendon grooves the posterior aspect of the head of the ulna Extensor carpi ulnaris tendon grooves the posterior aspect of the head of the ulna Extensor carpi ulnaris tendon grooves the posterior aspect of the head of the ulna Extensor pollicis longus tendon winds around the medial side of the dorsal tubercle of the radius. Extensor carpi radialis longus and brevis tendons share a common synovial sheath and are situated on the lateral part of the posterior surface of the radius. Abductor pollicis longus and the extensor pollicis brevis tendons have separate synovial sheaths but share a common compartment.
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anatomy upper limb

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