Table of Contents
Overview
The median nerve provides innervation for the thenar and lateral two lumbrical muscles, while the ulnar nerve innervates the hypothenar, interossei and medial two lumbrical muscles. Palmar cutaneous innervation is largely provided by the median and ulnar nerve, while the dorsal skin is mostly innervated by the radial and ulnar nerves. Arterial supply of the hand is provided by the ulnar and radial arteries which terminate as superficial and deep palmar arches. These arteries also give off carpal branches that anastomose with each other forming also palmar and dorsal carpal arches. Dorsal/palmar metacarpal and digital arteries supply the digits. The superficial and deep palmar venous networks follow their arterial counterparts draining blood into the ulnar and radial veins; these networks also communicate with the dorsal metacarpal veins through interosseous branches, draining blood to the dorsal venous network that empties laterally to the cephalic, and medially to the basilic vein.
Keypoints
| Nerves of the hand |
Median nerve: Palmar branch, recurrent branch, common palmar digital branches, proper palmar digital branches Ulnar nerve: Dorsal digital branches, palmar branch, superficial branch (common palmar digital nerves and proper palmar digital nerves), deep branch Radial nerve: Superficial branch (dorsal digital branches) |
| Muscular innervation |
Median nerve: Thenar muscles and lumbrical muscles (1st & 2nd) Ulnar nerve: Hypothenar, interossei muscles and lumbricals (3rd & 4th) |
| Cutaneous innervation |
Median nerve: Lateral ⅔ of palm; palmar surface and dorsal distal ⅓ of lateral 3 ½ digits Ulnar nerve: Medial ⅓ of palm; palmar/dorsal surfaces of medial 1 ½ digits Radial nerve: Lateral ⅔ of dorsum of hand; dorsal proximal ⅔ of lateral 3 ½ digits |
| Arteries of the hand |
Radial artery: Palmar carpal branch, dorsal carpal branch, superficial palmar branches, deep palmar arch, dorsal metacarpal arteries, princeps pollicis artery, radialis indicis artery Ulnar artery: Dorsal carpal branch, palmar carpal branch, deep carpal branch, superficial palmar arch, common palmar digital arteries, proper palmar digital arteries |
| Veins of the hand (tributaries) |
Cephalic vein: Dorsal venous network, lateral dorsal metacarpal veins, dorsal digital veins Basilic vein: Dorsal venous network, medial metacarpal veins, dorsal digital veins Radial vein: Deep venous palmar arch, palmar metacarpal veins Ulnar vein: Superficial venous palmar arch, common palmar digital veins |
Atlas of Neurovasculature of the hand
Deep palmar arch (Arcus palmaris profundus)
anterior view
Superficial palmar arch (Arcus palmaris superficialis)
anterior view
Princeps pollicis artery (Arteria princeps pollicis)
anterior view
Dorsal digital arteries of hand (Arteriae digitales dorsales manus)
posterior view
Common palmar digital arteries (Arteriae digitales palmares communes)
anterior view
Proper palmar digital arteries (Arteriae digitales palmares propriae)
anterior view
Dorsal metacarpal arteries (Arteriae metacarpeae dorsales)
posterior view
Dorsal carpal anastomosis (Rete dorsale carpi)
posterior view
Proper palmar digital branches of median nerve (Rami digitales palmares proprii nervi mediani)
anterior view
Dorsal branch of ulnar nerve (Ramus dorsalis nervi ulnaris)
posterior view
Deep branch of ulnar nerve (Ramus profundus nervi ulnaris)
anterior view
Superficial branch of the ulnar nerve (Ramus superficialis nervi ulnaris)
anterior view
Superficial and deep palmar venous arches (Arcus venosus palmaris superficialis et profundus)
anterior view
Dorsal venous network of hand (Rete venosum dorsale manus)
posterior view
Palmar metacarpal and digital veins (Venae metacarpeae et digitales palmares)
anterior view
Reference
- https://kenhub.com
