Systems Anatomy

Ovid: Hand and Wrist

Authors: Doyle, James R.
Title: Hand and Wrist, 1st Edition
> Table of Contents > Section I – Basic Anatomy > 1 – Anatomy > 1.2 – Systems Anatomy

Systems Anatomy
The following figures and discussion represent and are
designed to provide an overall perspective on the deeper anatomy—the
skeletal, muscular, vascular, and neural anatomy—of the upper
extremity. The perspective spans from the shoulder and neck for
discussions of the skeletal, neural, and vascular anatomy, and from the
elbow for the muscular system.
Skeletal Anatomy
The osseous structures of the upper limb include the
humerus, the radius and ulna, eight carpal bones, five metacarpals, and
14 phalanges. The upper extremity skeleton is depicted in Figure 1.2-1.



Figure 1.2-5
Schematic illustration of the brachial plexus, associated major
branches, peripheral branches and muscles they innervate. A, nerve to
subclavius; B, lateral pectoral nerve; C, subscapular nerve; D,
thoracodorsal nerve; E, medial antebrachial cutaneous nerve; F, medial
brachial cutaneous nerve; G, medial pectoral nerve.

Figure 1.3-1 Currently accepted terminology and depiction of movement in the forearm, wrist, fingers: wrist, forearm (A), thumb (B).

Table 1.3-1 Anatomic Basis for Movement in the Upper Extremity
Joint/Motion Muscle Nerve Root
Flexion Brachialis Musculocutaneous C5+C6+C7
  Biceps Musculocutaneous C5+C6
Extension Triceps Radial C6+C7+C8
Supination Biceps Musculocutaneous C5+C6
  Supinator Radial C7+C8
Pronation Pronator teres Median C6+C7
  Pronator quadratus Anterior interosseous branch of median C7+C8
Flexion Flexor carpi radialis Median C6+C7
  Flexor carpi ulnaris Ulnar C7+C8+T1
Extension Extensor carpi radialis longus Radial C6+C7
  Extensor carpi radialis brevis Radial C7+C8
  Extensor carpi ulnaris Radial C7+C8
Finger MCP
Flexion Medial two lumbricals Ulnar C8+T1
  Lateral two lumbricals Median C8+T1
Extension Extensor digitorum communis, extensor indicis, extensor digiti minimi Posterior interosseous of radial C7+C8
Abduction Dorsal interossei* Ulnar C8+T1
  Abductor digiti minimi Ulnar C8+T1
Adduction Palmar interossei* Ulnar C8+T1
Finger PIP
Flexion Flexor digitorum superficialis Median C8+T1
Extension Extensor digitorum communis, extensor indicis, extensor digiti minimi Posterior interosseous of radial C7+C8
Finger DIP
Flexion Flexor digitorum profundus Ulnar; anterior interosseous of median C8+T1
Extension Extensor digitorum communis, extensor indicis, extensor digiti minimi Posterior interosseous of radial C7+C8
Palmar abduction Abductor pollicis longus Radial C7+C8
  Abductor pollicis brevis Median C8+T1
Dorsal adduction Adductor pollicis Ulnar C8+T1
Thumb MCP
Flexion Flexor pollicis brevis deep head Ulnar C8+T1
  Flexor pollicis brevis superficial head Median C8+T1
Extension Extensor pollicis brevis Radial C7+C8
Thumb IP
Flexion Flexor pollicis longus Median C7+C8
Extension Extensor pollicis longus Radial C7+C8
DIP, distal interphalangeal; IP, interphalangeal; MCP, metacarpophalangeal; PIP, proximal interphalangeal.
* The dorsal and
palmar interossei are abductors and adductors, respectively, of the
fingers. They also flex the MCP joints and extend the PIP and DIP
joints. These so-called intrinsic muscles are the balancing and
mediating forces between the powerful extrinsic flexors and extensors of the fingers.
Loss of the intrinsic muscles results in significant deformity in the
hand and the reader is referred to the Doyle/Botte reference in
Suggested Reading, pages 581–595 and chapter 13 of this text for a
comprehensive discussion of the anatomy and function of these muscles.

Muscular Anatomy
The muscles of the forearm are depicted in Figure 1.2-2 and the hand in Figure 1.2-3.
Vascular Anatomy
The vascular anatomy from the axillary artery to the hand is depicted in Figure 1.2-4.
Neural Anatomy
The brachial plexus, median, ulnar, and radial nerves and the muscles they innervate are depicted in Figure 1.2-5.

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