1

Repeat campaign 2008 A/L

Palmar aspect of the hand

1. Skin
(Thick , immobile, crease)
2. Superficial fascia
-subcutaneous fat is divided to compartments by
By fibrous septa
-water cushions to increase the grip
-contains
Palmaris brevis
Superficial transverse metacarpal ligament
3. Deep fascia
Invest the entire hand
Has 3 specializations
1. Flexor retinaculum
2. Palmar aponeurosis
3. Fibrous flexor sheath of finger
Palmar aponeurosis
Central , thickened , triangular part of the deep fascia of hand
Apex Flexor retinaculum + Palmaris longus
Base Divide into 4 slips and attached into fibrous flexor sheaths of fingers
Either sides connected to deep fascia above the thenar eminence and hypothenar eminence

Fibrous flexor sheath
Forms a blind fibro-osseus tunnel for the flexor tendons of fingers.
Thick and arched.
Proximally attached to palmar aponeurosis
Distally attached to base of the distal phalanx








PALM
2

Repeat campaign 2008 A/L
Dorsal aspect of the hand

Dorsal digital expansion
Small triangular aponeurosis covering the dorsum of the proximal phalanx and the MP joint.
Base -at the level of MP joint
-Tendon of the extensor digitorum blends with the central axis of the expansion

Basolateral corners attachment of the lumbricals and interossei.
Apex -level of proximal IP joint
-Tendon of extensor digitorum divide into three slips.
Middle slipbase of middle phalanx
Collateral slipsbase of the proximal phalanx.


Anatomical snuff box

Triangular concavity appears in the radial side of the wrist.
Bounded by;
Tendon of extensor pollicis longus medially
Tendon of extensor pollicis brevis
Tendon of abductor pollicis longus laterally
Floor radial styloid process, scaphoid, trapezium, base of the metacarpal
Contents 1) radial artery
(deep to all 3 tendons lies on the floor, pulsations can be felt)
2) cutaneous branch of the radial nerve
(crosses the tendons)
Roof cephalic vein
(begins from lateral aspect of dorsal venous arch)