Hand Anatomy

Aka: Hand Anatomy, Radial Nerve, Median Nerve, Ulnar Nerve, Superficial Palmar Arch, Deep Palmar Arch, Hand Muscle

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II. Anatomy: Bones

  1. orthoAnteriorBoneForearm.jpg Also available as a Poster size image. See printing instructions and image restrictions.
  2. orthoPosteriorBoneForearm.jpg Also available as a Poster size image. See printing instructions and image restrictions.
  3. orthoArmHandBonesLtVolarGrayBB219.gif Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  4. orthoArmHandBonesLtDorsalGrayBB220.gif Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  5. orthoArmHandFingerJointsApGrayBB337.gif Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  6. orthoArmHandFingerJointsLatGrayBB338.gif Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)

III. Anatomy: Muscles and Tendons

  1. Palm
    1. orthoArmHandPalmTendonsGrayBB423.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    2. orthoArmHandPalmTendonsGrayBB1233.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    3. orthoArmHandPalmAponeurosisGrayBB425.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    4. orthoArmHandPalmLtGrayBB427.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    5. orthoArmHandVolarInterosseiGrayBB429.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
  2. Dorsum
    1. orthoArmHandDorsumTendonsGrayBB424.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    2. orthoArmHandDorsumInterosseiGrayBB428.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
    3. orthoArmHandTendonsDorsumGrayBB1234.gifLewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)

IV. Anatomy: Muscles

  1. Intrinsic (Originate in hand)
    1. General
      1. Delicate finger movements
    2. Thenar and Hypothenar muscles
      1. Position thumb and small finger for pinching
    3. Interossei and Lumbricals
      1. Insert into proximal phalanges and extensor hoods
      2. Metacarpal phalangeal joint flexion
      3. Interphalangeal joint extension
  2. Extrinsic (Originate in Forearm)
    1. Wrist flexors and extensors
      1. Stabilize wrist in slight dorsiflexion
    2. Finger Flexors
      1. Deep Flexors (5)
        1. Flex distal phalanges of fingers and thumb
      2. Superficial Flexors (4)
        1. Flex middle phalanges of fingers
      3. Course
        1. Under Annular ligaments (Pulleys)
        2. Between distal palmar crease and IP joint
      4. Conditions
        1. DIP Flexor Tendon Avulsion
        2. Flexor Tendon Laceration
    3. Finger Extensors
      1. Course dorsally over fingers and thumb
      2. Extend proximal phalanges
      3. Conditions
        1. Extensor Tendon Laceration
        2. DIP Extensor Tendon Avulsion

V. Anatomy: Blood Supply

  1. Neurovascular bundles
    1. Contain digital artery, vein, and nerve
    2. Two bundles: one radial and the other ulnar
  2. Radial and Ulnar arteries join in 2 arches
    1. Superficial Palmar Arch: superficial to flexor tendon
      1. Located at base of first web space
    2. Deep Palmar Arch (deep to flexor tendons)
      1. Proximal to superficial arch by 1 cm

VI. Anatomy: Nerve

  1. Ulnar Nerve
    1. Motor
      1. Allows for power grip
      2. Innervates all hand intrinsic muscles except:
        1. Does not innervate two radial lumbricals
        2. Does not innervate thenar muscles
    2. Sensation
      1. Ulnar 1.5 fingers (palmar)
    3. Course
      1. Passes with ulnar artery via Guyon's Canal in wrist
    4. Test function
      1. Finger abduction against resistance
      2. Palpate belly of first dorsal interosseus muscle
    5. Conditions
      1. Cubital Tunnel
      2. Ulnar Tunnel
  2. Median Nerve
    1. Motor
      1. Allows for fine control of pincer grasp
      2. Innervates thenar muscles and two radial lumbricals
    2. Sensation
      1. Radial 3.5 fingers, and their dorsal tips
      2. Cutaneous innervation Image
        1. NeuroMedianNerve.jpg
    3. Course
      1. Passes via Carpal Tunnel through volar wrist
    4. Test function
      1. Opposition of thumb to each finger
      2. Observe thenar muscles for contractions
    5. Conditions
      1. Carpal Tunnel
  3. Radial Nerve
    1. Motor
      1. Innervates extrinsic wrist and finger extensors
      2. Does not innervate any intrinsic muscles
    2. Sensation
      1. Dorsally for 3.5 fingers
      2. Cutaneous innervation image
        1. NeuroRadialNerve.jpg
    3. Test function
      1. Wrist and hand extension against resistance
    4. Conditions
      1. Radial Tunnel (elbow)
      2. Handcuff Neuropathy (wrist)

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Ontology: Hand (C0018563)

Definition (NCI_CDISC) The distal portion of the upper extremity. It consists of the carpus, metacarpus, and digits. (NCI)
Definition (NCI) The distal portion of the upper extremity. It consists of the carpus, metacarpus, and digits.
Definition (CSP) part of the upper limb distal to the wrist including carpus, metacarpus and fingers.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D006225
SnomedCT 117625000, 85562004
HL7 HAND
LNC LP7279-5, MTHU002685, LA16719-9
English Hand, Hands, Manus, Terminal segment of free upper limb, hands, hand structure, hand, manus, HAND, Hand, NOS, Hand (Anatomy)
Swedish Hand
Czech ruka
Finnish Käsi
Russian KIST' RUKI, RUKI KIST', KIST', КИСТЬ, КИСТЬ РУКИ, РУКИ КИСТЬ
Portuguese Mãos, Mão (Anatomia)
Croatian ŠAKA
Latvian Not Translated[Hand]
Polish Ręka, Dłoń, Ręce
Norwegian Hånd, Hand
Spanish Manos, Mano
French Main
German Hand, Manus
Italian Mano
Dutch Hand
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Structure of median nerve (C0025058)

Definition (NCI_CDISC) A branch of the brachial plexus that extends along the anterior aspect of the forearm and the hand. (NCI)
Definition (NCI) A branch of the brachial plexus that extends along the anterior aspect of the forearm and the hand.
Definition (MSH) A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D008475
SnomedCT 38464002
English Median Nerve, Median Nerves, Nerve, Median, Nerves, Median, Nervus medianus, median nerves, median nerve, nerve median, NERVE, MEDIAN, Median nerve, Structure of median nerve (body structure), Structure of median nerve, Median nerve, NOS
Swedish Mediannerv
Czech nervus medianus
Finnish Keskihermo
Russian SREDINNYI NERV, СРЕДИННЫЙ НЕРВ
Latvian Vidus nervs
Polish Nerw pośrodkowy
Norwegian Nervus medianus, Medianusnerve
Croatian Srednji ručni živac, MEDIJANUS
Spanish estructura del nervio mediano (estructura corporal), estructura del nervio mediano, nervio mediano, Nervio Mediano
French Nerf médian
German Nervus medianus
Italian Nervo mediano
Dutch Nervus medianus
Portuguese Nervo Mediano
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Structure of radial nerve (C0034518)

Definition (NCI) A large nerve that arises from the brachial plexus and enervates the extensor muscles and skin of the entire upper limb's posterior aspect.
Definition (NCI_CDISC) A large nerve that arises from the brachial plexus and enervates the extensor muscles and skin of the entire upper limb's posterior aspect. (NCI)
Definition (MSH) A major nerve of the upper extremity. In humans the fibers of the radial nerve originate in the lower cervical and upper thoracic spinal cord (usually C5 to T1), travel via the posterior cord of the brachial plexus, and supply motor innervation to extensor muscles of the arm and cutaneous sensory fibers to extensor regions of the arm and hand.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D011826
SnomedCT 8079007
English Nerve, Radial, Nerves, Radial, Radial Nerve, Radial Nerves, Nervus radialis, radial nerve, radial nerves, nerve radial, NERVE, RADIAL, Radial nerve, Structure of radial nerve (body structure), Structure of radial nerve, Radial nerve, NOS
Swedish Radialnerv
Czech nervus radialis
Finnish Värttinähermo
Russian LUCHEVOI NERV, ЛУЧЕВОЙ НЕРВ
Croatian NERVUS RADIALIS
Latvian Spieķa nervs
Polish Nerw promieniowy
Norwegian Radialisnerve, Nervus radialis
Spanish estructura del nervio radial (estructura corporal), estructura del nervio radial, nervio musculoespiral, nervio radial, Nervio Radial
French Nerf radial
German Nervus radialis
Italian Nervo radiale
Dutch Nervus radialis
Portuguese Nervo Radial
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Structure of ulnar nerve (C0041602)

Definition (NCI_CDISC) A nerve in the arm that runs along the inside of the upper arm down to the palm and little finger.
Definition (MSH) A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm.
Concepts Body Part, Organ, or Organ Component (T023)
MSH D014459
SnomedCT 58696008
English Nerve, Ulnar, Nerves, Ulnar, Ulnar Nerve, Ulnar Nerves, Nervus ulnaris, N. ulnaris, ulnar nerve, NERVE, ULNAR, Ulnar nerve, Structure of ulnar nerve (body structure), Structure of ulnar nerve, Ulnar nerve, NOS
French Nerf cubital, Nerf ulnaire
Swedish Ulnarnerv
Czech nervus ulnaris, loketní nerv, ulnární nerv, n. ulnaris
Spanish Nervio Cubital, estructura de nervio cubital, estructura del nervio cubital (estructura corporal), estructura de nervio cubital (estructura corporal), estructura del nervio cubital, nervio ulnar, Nervio Ulnar, nervio cubital
Finnish Kyynärhermo
Russian LOKTEVOI NERV, ЛОКТЕВОЙ НЕРВ
Croatian NERVUS ULNARIS
Latvian Elkoņa nervs
Polish Nerw łokciowy
Norwegian Nervus ulnaris, Albuebensnerve, Ulnarisnerve, Albuebeinsnerve
German Nervus ulnaris
Italian Nervo ulnare
Dutch Nervus ulnaris
Portuguese Nervo Ulnar
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Superficial palmar arterial arch (C0226433)

Concepts Body Part, Organ, or Organ Component (T023)
SnomedCT 26818002
English Superficial volar arch, Superficial volar artery, Superficial palmar arch, Arcus palmaris superficialis, Superficial palmar arch structure (body structure), Superficial palmar arch structure, Superficial palmar arterial arch, Superficial Palmar Arch
Spanish arco palmar superficial, arco volar superficial, arcus palmaris superficialis, arteria volar superficial, estructura del arco palmar superficial (estructura corporal), estructura del arco palmar superficial
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Deep palmar arterial arch (C0226441)

Concepts Body Part, Organ, or Organ Component (T023)
SnomedCT 285748007, 10119003
English Deep palmar arch (body structure), Deep palmar arterial arch, Deep palmar arch, Deep palmar arch of radial artery, Deep volar arch of radial artery, Arcus palmaris profundus, Structure of deep volar arch of radial artery (body structure), Structure of deep volar arch of radial artery
Spanish arco palmar profundo (estructura corporal), arcus palmaris profundus, arco palmar profundo de la arteria radial, arco volar profundo de la arteria radial, estructura del arco palmar profundo de la arteria radial (estructura corporal), estructura del arco palmar profundo de la arteria radial
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Muscle structure of hand (C0581668)

Concepts Body Part, Organ, or Organ Component (T023)
SnomedCT 110540008
English Hand musculature, Set of muscles of hand, Hand muscle, Musculature of hand, Muscle group of hand, Muscles of hand, hands muscles, hand muscles, hand muscle, Muscle of hand, Muscle structure of hand, Muscle structure of hand (body structure)
Spanish estructura muscular de la mano (estructura corporal), estructura muscular de la mano, músculo de la mano
Derived from the NIH UMLS (Unified Medical Language System)

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