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Muscles of Hand

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Intrinsic Muscles of Hand and Their Nerve Supply.


There are total 20 intrinsic muscles of the hand which are grouped into five
groups.

1. Thenar muscles:
 Abductor pollicis brevis
 Flexor pollicis brevis
 Opponens pollicis brevisAdductor pollicis ( does not form thenar eminence)
2. Hypothenar muscles:
 Abductor digiti minimi
 Flexor digiti minimi
 Opponens digiti minimi
 Palmaris brevis
3. Four Lumbricals (one for each digit except thumb)
4. Four Palmar interossei (third digit /middle finger does not have palmar
interrossei).
5. Four dorsal interrossei ( thumb and the fifth digit/little finger do not have
dorsal interrossei, whereas middle finger has two dorsal interrosei)

Nerve supply Of Intrinsic Muscles


The intrinsic muscles of the hand are on the palmar aspect and are innervated
by branches of the ulnar and median nerves.

 Five muscles are supplied by the median nerve:


 Muscles forming thenar eminence:
 Abductor pollicis brevis
 Flexor pollicis brevis
 Opponens pollicis brevis and
 1st and 2nd lumbricals
 Fifteen muscles are supplied by ulnar nerve
 Four hypothenar muscles
 3rd and 4th lumbricals
 Four parmar interrossei
 Four dorsal interrossei
 Adductor pollicis
Lumbricals

 Arise from the tendons of the flexor digitorum profundus


 Are numbered 1st, 2nd, 3rd and 4th from lateral to medial side.
 Lumbrical 1st and 2nd take origin from lateral side of the tendons of flexor
digitorum profundus.
 Lumbricals 3rd and 4th take origin from the adjacent sides of the tendons of
flexor digitorum profundus.
 They are inserted into the lateral side of the dorsal digital expansion of 2nd to
5th digits.
 Medial 2 lumbricals are innervated by the ulnar nerve and lateral 2 lumbricals
by the median nerve.
 Flex the metacarpophalangeal joints and extend the interphalangeal joints.

Interrossei muscles
Four dorsal interossei:

 There is one dorsal interossei for index and ring finger and two dorsal
interossei for the middle finger. They are numbered 1-4 from lateral to medial
side.
 They are bipennate .
 They take origin from the adjacent sides of the shafts of the metacarpal bones.
 Are inserted into the dorsal digital expansion (DGE) and base of proximal
phalanx of the difgits ( 1st and 2nd on the lateral side of DGE and 3rd and 4th
on the medial side of DGE.
 They are the abductors of digits (Dorsal ABduct = DAB).
 All are supplied by deep branch of ulnar nerve.
Three palmar interossei

 There is one palmar interossei for index, ring and little finger. They are
numbered 1-3 from lateral to medial side.
 They are unipennate.
 They take origin from the anterior aspect of metacarpals 2, 4 and 5,
 They are inserted into dorsal digital expansion (DGE) of the difgits ( 1st on the
medial side of DGE and 2nd and 3rd on thelateral side of DGE.
 They are the adductors of digits (Palmar ADduct = PAD).
 They are innervated by the deep branch of ulnar nerve.

Extensor expansion/Dorsal digital expansion

 It is a triangular aponeurosis of extensor dgiitorum longus (EDL)


which coves the metacarpophalangeal joint and the dorsal surface of
proximal phalanx.
 The tendons of the lumbricals and interossei are inserted via it.
 It forms a functional unit to for coordinated action of EDL, lumbricals and
interossei muscles to perform extension at the proximal and distal
interphalangeal joints.
 The expansion divides into three bands at its distal end:
 Lateral bands pass on either side of the proximal phalanx and are attached to
the dorsal surface of the base of the distal phalanx.
 Median band is attached on the dorsal surface of the base of the middle
phalanx.

Origin, Insertion, Action and nerve Supply of Thenar Muscles


NERVE
MUSCLE ORIGIN INSERTION ACTION
SUPPLY

Abductor Flexor retinaculum Lateral side of Abduction of Median

pollicis brevis Tubercle of scaphoi base of thumb nerve

Crest of trapezium proximal

phalanx of

thumb
NERVE
MUSCLE ORIGIN INSERTION ACTION
SUPPLY

Flexor pollicis Flexor retinaculum Base of Flexion of thumb Median

brevis Trapezoid and proximal nerve

Capitate bones phalanx of

thumb

Opponens Flexor retinaculum Lateral half of Opposition of Median

pollicis and crest of palmar surface thumb (pulls nerve

trapezium of 1st thumb medially

metacarpal. and forwars

towards the

fingers

Adductor Oblique head from Medial aspect Adduction of Deep

pollicis (is not bases of 2nd and 3rd of base of thumb branch of

part of thenar metacarpals proximal ulnar

eminence) Transverse head from phalanx of nerve

shaft of 3rd thumb

metacarpal
Origin, Insertion, Action and nerve Supply of Thenar Muscles
MUSCLE ORIGIN INSERTION ACTION NERVE SUPPLY

Abductor Flexor Base of proximal Abduction of Deep branch of

digiti minimi retinaculum phalanx of little little finger ulnar nerve

Pisiform finger.

Flexor digiti Flexor Base of proximal Flexion of little Deep branch of

minimi retinaculum phalanx of little finger ulnar nerve

Pisiform finger

Opponens Flexor Medial border of Pulls little finger Deep branch of

digiti minimi retinaculum 5th metacarpal. forward ulnar nerve


MUSCLE ORIGIN INSERTION ACTION NERVE SUPPLY

Palmaris Flexor Skin of palm of Wrinkles skin of superficial

brevis retinaculum medial side pam to improve branch of ulnar

grip nerve

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