The document describes the anatomy of the human hand. It details the bones, muscles, tendons, ligaments and nerves. It provides information on the typical scans used to ultrasound the hand including dorsal, palmar, thenar and hypothenar views. Descriptions of anatomical structures visible in each scan view are given. The purpose of hand ultrasound examination and positioning of the patient is also outlined.

3. SAIRA NUZHAT

5. Normally, human hand has:
 Five digits (four fingers plus one thumb)
 27 bones not including sesamoid bone
 Metacarpal bones connect fingers and the carpal
bones of the wrist
 5 metacarpal bones and 8 carpal bones
 The 14 phalanges make up the fingers and thumb
and are numbered 1-5 in anatomical position

6. The four fingers each consist of 3 phalanx
bones:
 Proximal
 Middle
 Distal
The thumb only consists of:
 Proximal
 Distal
Nerve supply:
 Ulnar nerve
 Median nerve
 Radial nerve

7. 1. Thenar muscles:
These are 3 short muscles located at the base
of thumb:
 Abductor Pollicis Brevis
 Flexor Pollicis Brevis
 Opponens Pollicis
Origin: Tubercle of trapezium
Insertion: Lateral margin of the 1st
metacarpal of thumb

9. a muscular protrusion on the medial side of
palm, at the base of littlefinger.it contains;
 Opponens Digiti Minimi:
Origin: hook of hamate
Insertion: medial margin of metacarpal 5
 Abductor Digiti Minimi:
Origin: Pisiform and tendon of Flexor carpi
ulnaris
Insertion: base of proximal phalanx of little
finger

10.  Flexor Digiti Minimi Brevis:
Origin: Hook of hamate
Insertion: base of proximal phalanx of little
finger

11. these are 4 lumbricals in the hand each
associates with a finger.
 Origin: from tendon of the Flexor Digitorum
Profundus
 Insertion: into the extensor hood

12.  These are located between the metacarpals.
 They are divided in:
1. Dorsal interossie:
Origin: lateral and medial surfaces of the
metacarpals
insertion: Into the Extensor Hood and
proximal phalanx of fingers

13. 2.Palmar interossie:
origin: lateral and medial surface of the
metacarpals
insertion: into the Extensor hood and
proximal phalanx of each finger

14.  Origin: from the palmar aponeurosis and
flexor retinaculum
 Insertion: Into the dermis of skin on the
medial margin of hand

15.  Origin: One head from metacarpal 3 and
other head from capitate and adjacent areas
of metacarpal 2
 Insertion: Into the base of proximal phalanx
of thumb

16.  Each of the fingers has 3 joints;
1. Metacarpophalangeal joint(MCP)---the
joint at the base of finger
2. Proximal interphalangeal join(PIP)---
the joint in the middle of the finger
3. Distal interphalangeal joint(DIP)---the
joint closest to fingertip

19.  For examination, the patient is seated facing
the examiner
 Positioning of hand in an extension position
over the table or thigh
 Dynamic examination with active
flexion/extensions of finger

20.  DORSAL LONGITUDINAL SCAN
 DORSAL TRANSVERSE SCAN
 PALMAR LONGITUDINAL SCAN
 PALMAR TRANSVERSE SCAN
 THENAR LONGITUDINAL SCAN
 THENAR TRANSVERSE SCAN
 HYPOTHENAR LONGITUDINAL SCAN
 HYPOTHENAR TRANSVERSE SCAN
 LATERAL LONGITUDINAL SCAN

21. Scan shows extensor tendon, metacarpal head
and base of proximal phalanx

22. Scan shows extensor tendon, head of proximal
phalanx and base of middle phalanx

23. Scan shows finger nail, nail bed, middle phalanx
head and base of distal phalanx

24. Scan shows extensor tendon and base of phalanx

25. Scan shows second flexor tendon, metacarpal head covered
with hpoechoic cartilage and base of middle phalanx

26. Second flexor tendon, proximal phalanx on the
left and middle phalanx on the right is visualized

27. Flexor digitorum profundus insertion at the base of
distal phalanx and middle phalanx are visualized

28. Flexor tendon above metacarpal head are
visualized

29. Skin, subcutaneous fat, flexor pollicis brevis muscle, flexor
pollicis longus tendon and adductor pollicis are visualised

30. Skin, subcutaneous fat, flexor pollicis brevis muscle, flexor
pollicis longus tendon and adductor pollicis are visualized

31. Abductor digiti minimi muscle and 5th metacarpal shaft with
skin and subcutaneous fat are visualised

32. Scan shows skin, subcutaneous tissue, abductor digiti
minimi muscle and underlying shaft of 5th metacarpal
bone

33. Scan shows metacarpal head and base of
proximal phalanx

34. Proximal phalanx and middle phalanx are
visualized

35. Proximal phalanx and middle phalanx are
visualized