anatomy of muscles, blood vessels, and nerves of the hand. venous drainage of the upper limb

1. Anatomy Department
UPPER ARM
ALAZHAR UNIVERSITY
Faculty of Medicine for Girls
Year 1-Semester II
Academic year: 2021 / 2022
Module Name: Musculoskeletal and skin
Course code: IMP 07- 10212
Credit hours: 8 crh

2. 1- Understand the
deep fascia of the
hand.
2- Describe the
muscle groups,
vessels and nerves
of the hand.
3- Explain venous
drainage of upper
limb.
At the end of the lecture, students should be able to:

3. Deep fascia of the hand
Definition: It is thickened sheet of the deep fascia in the
center of the palm.
Shape: It is triangular having:
1. Apex: is directed proximally fusing with the flexor
retinaculum& receiving the insertion of the palmaris
longus tendon.
2. Base: is directed distally and divided into 4 slips for the
medial 4 fingers.
3. Medial margin: blends with the fascia covering the
hypothenar muscles.
4. Lateral margin: blends with the fascia covering the
thenar muscles

4. • Structures undercover of palmar aponeurosis:
1. Tendon of flexor digitorum superficialis and
profundus.
2. Superficial palmar arch and its branches
3. Terminal branches of the median and ulnar
nerves.
• Function of the palmar aponeurosis:
1. Protection of underlying tendon, vessels and
nerves.
2. Fixation of skin of the palm improving the
grip.

5. Muscles of the Hand
I-Short muscle of the Thumb: they are 4 muscles:
Thenar muscle
eminence.
1) Laterally:
Abductor
pollicis brevis
3) Opponens
pollicis: deep
to the first 2
muscle.
2) Medially:
flexor pollicis
brevis
+ 4) Adductor
pollicis.

6. Hypothenar muscle
eminence.
1) Laterally:
flexor digiti
minimi.
3) Oppones digiti
minimideep to the
first 2 muscle.
2) Medially:
abductor digiti
minimi
II-Short muscle of the Little Finger : they are 3 muscles:

7. 1) 4 Lumbricals 3) 4 Dorsal interosseoi
2) 4 palmar interosseoi
III-intermediate muscles of the hand:

8. Nerve supply of the Hand
I. Cutaneous innervation of the hand:
1. Palmar surface 2. Dorsal surface

9. II. Muscle innervation of the hand:
1. Median nerve (its recurrent
branch):
- Thenar muscles.
- Lateral 2 lumbricals
2. Deep branch of ulnar nerve:
- Hypothenar muscles.
- Adductor pollicis muscle.
- Medial 2 2 lumbricals
- Interossei muscles.

10. 1. What is the sensory nerve supply of the palmar surface of index finger?
A. Ulnar nerve
B. Median nerve.
C. Radial nerve.
D. Palmar cutaneous branch of ulnar nerve.
2. Corresponding to the interossei muscles of the hand which of the
following is true?
A. The interossei muscles arise from the sides of the metacarpal bones.
B. The dorsal interossei are supplied by median nerve.
C. The palmer interossei are supplied by median nerve.
D. The palmar interossei arise from the tendons of the flexor digitorum profundus.

11. Arterial supply of the Hand
1- Anterior (palmar) carpal arch:
1- Anterior carpal branch from radial artery.
2- Anterior carpal branch from ulnar artery.
2- Posterior (dorsal) carpal arch
1-Posterior carpal branch from radial artery.
2- Posterior carpal branch from ulnar artery
3-superficial palmer arch:
1-Termination of ulnar artery.
2- Superficial branch of the radial artery.
4-deep palmer arch:
1-Termination of radial artery.
2- Deep branch of the ulnar artery

12. Do you know the joints of the
Hand ???

13. Venous drainage of upper limb
• They are divided into two groups: superficial and deep.
1. Dorsal venous arch:
- It lies in the superficial fascia of the back
of the hand
- It receives 3 dorsal metacarpal veins
which are formed by the union of the
dorsal digital veins.
I-Superficial veins include:

14. 2. Cephalic vein
• Beginning: usually forms the lateral end of the
dorsal venous arch.
• Course: It proceeds along the lateral border of the
wrist and the anterolateral surface of the proximal
forearm and arm.
- Anterior to the elbow, it communicates with the
median cubital vein.
• Ending: by joining the terminal part of the
axillary vein
3. Basilic vein
• Beginning: from the medial end of the dorsal venous
arch.
• Course: It passes along the medial border of the
wrist, medial side of the forearm and the inferior part
of the arm
• Ending: it continues as axillary vein.

15. II. Deep veins of upper limb:
- It Comprise the venae comitantes, which accompany all the large arteries, usually in pairs.
Axillary Vein:
- Formation: It is formed at the lower
border of the teres major muscle by the
union of the venae comitantes of the
brachial artery and the basilic vein.
- Ending: at the lateral border of the
first rib by becoming the subclavian
vein.
- Tributaries:
The tributaries which correspond to the
branches of the axillary artery, and the
cephalic vein.

16. 1. Which of the following is true regarding the ulnar artery?
A. It passes superficial to the flexor retinaculum.
B. It enters the hand medial to the ulnar nerve at the wrist.
C. Is the major contributor to the deep palmar arch.
D. It is overlapped by palmaris longus tendon at the wrist.
2. Where dose the cephalic vein begins?
A. At the lateral end of the palmar venous arch
B. At the medial end of the dorsal venous arch
C. At the lateral end of the dorsal venous arch
D. As a deep vena commitant.
1) What is the sensory nerve supply of the palmar surface of the index finger?
A. Ulnar.
B. Superficial branch of radial.
C. Median.
D. Deep branch of radial.
1) Which of the following arteries supplies the hand?
A. Anterior carpal arch.
B. Profunda brachii.
C. Anterior radial collateral.
D. Anterior ulnar collateral.

17. 1. Enumerate muscles of the thenar eminence
2. Enumerate muscles of the hypothenar eminence
3. Enumerate muscles of the intermediate group of the hand.
4. Enumerate 4 arteries suppling the hand?
5. Mention begins and end of the cephalic vein.