The upper limb

山东大学医学院 解剖教研室
李振华
The muscles of back
Superficial group
 Trapezius 斜方肌

 Latissimus dorsi 背阔肌

 Levator scapulae 肩胛提肌

 Rhomboideus 菱形肌

Deep group
 Erector spinae 竖脊肌

 Splenius 夹肌

 Thoracolumbar fascia 胸腰
筋膜
The muscles of thorax
Extrinsic muscles
 Pectoralis major 胸大肌

 Pectoralis minor 胸小肌

 Serratus anterior 前锯肌

Intrinsic muscles
 Intercostales externi
肋间外肌
 Intercostales interni
肋间内肌
 Intercostales intimi
肋间最内肌
Major muscles of the trunk
Trapezius
 Origin: superior nuchal line, external o
ccipital protuberance, ligamentum nuc
hae and spinous processes of seven
th cervical and all thoracic vertebrae
 Insertion: lateral third of clavicle, acro
mion, and spine of scapulartery
 Acton: upper fibers elevate scapula, l
ower fibers depress scapula; if scapul
a is fixed, one side acting along, draw
s head toward the same side, and tur
n face to opposite side; both sides tog
ether, draw head directly backward
Latissimus dorsi
 Origin: spinous processes

of lower six thoracic and a

ll lumbar vertebrae, media
n sacral crest, and posteri
or part of iliac crest.
 Insertion: floor of intertube

rcular groove of humerus.

 Action: trunk fixed, extend

s, adducts and medially ro

tates arm ; arm fixed, elev
ates trunk.
Erector spinae
 Position: fills the vert
ebral groove on each
side of the spine
 Action: extends verte
bral column (draw hea
d backwar)
Pectoralis major
 Origin: medial half of clavi

cle,sternum,1th-6th costal
cartilages.
 Insertion: crest of greater t

ubercle of humerus.
 Action: flexes, adducts an

d rotates arm medially; ar

m fixed, elevates trunk; el
evates ribs 1-6,aidding in f
orced inspiration.
 The Muscles of Upper Limb

Muscles of shoulder
 Deltoid

 supraspinatus

 Infraspinatus

 Teres minor

 Teres major

 subscapularis
Muscles of arm
 Antererior group
 Biceps brachii
肱二头肌
 Coracobrachialis
喙肱肌
 Brachialis
肱肌

 Posterior group
– triceps brachii
肱三头肌
Muscles of forearm

 Superficial layer
 Brachioradialis 肱桡肌
 Pronator teres 旋前圆肌
 Flexor carpi radialis 桡侧腕屈肌
 Palmaris longus 掌长肌
 Flexor carpi ulnaris 尺侧腕屈肌
 Third layer
 Flexor digitorum profund
us 指深屈肌
 Flexor pollicis longus 拇
长屈肌
 Fourth layer － pronat
or quadratus 旋前方肌
Action: flex radiocarpal j
oint and fingers, prona
te forearm
 Second layer －
flexor digitorum supe
rficials 指浅屈肌
Posterior group (10)
 Superficial layer (5)
 Extensor carpi radialis l
ongus 桡侧腕长伸肌
 Extensor carpi radialis
brevis 桡侧腕短伸肌
 Extensor digitorum 指
伸肌
 Extensor digiti minimi
小指伸肌
 Extensor carpi ulnaris
尺侧腕屈肌
Deep layer (5)
 Supinator 旋后肌

 Abductor pollicis longus

拇长展肌
 Extensor pollicis brevis
拇短伸肌
 Extensor pollicis longus
拇长伸肌
 Extensor indicis 示
指伸肌
 Action: extend radiocapr
al joint and fingers, and s
upinate forearm
Muscles of hand
 Lateral group － thenar 鱼际 (4)
 Abductor pollicis brevis 拇短展肌
 Flexor pollicis brevis 拇短屈肌
 Opponens pollicis 拇对掌肌
 Adductor pollicis 拇收肌
 Action: flex, abduct, adduct an
d oppose thumb
 Medial group － hypothenar (3)
 Abductor digiti minimi 小指展肌
 Flexor digiti minimi brevis 小指短屈
肌
 Opponens digiti minimi 小指对掌肌
 Action: flex, abduct , and oppose l
ittle finger
Intermedial group
 Lumbricales 蚓状肌 (4) －

flex fingers at MP joints; e

xtend fingers at IP joints
 Palmar interossei 骨间掌

侧肌 (3) － adduct fingers

towards middle finger at M
P joints
 Dorsal interossei 骨间背

侧肌 (3) － abduct fingers

away from middle finger at
MP joints
Major muscles of upper limb

Deltoid
 Origin: lateral third of clavicl

e, acromion, and spine of sc

apula
 Insertion: deltoid tuberosity

of humerus
 Action: abducts ， flexes an

d medically rotates, extends

, and laterally rotates arm
Teres major
 Origin: dorsal surface
of inferior angle of sca
pula
 Insertion: crest of less
er tubercle of humeru
s
 Action: medially rotate
s and adducts arm
Biceps brachii
 Origin: long head, supraglen
oid tubercle; short head, cor
acoid process
 Insertion: radical tuberosity
 Action: supinator of forearm,
flexor of elbow joint, weak fle
xor of should joint
Pronator teres
 Origin: medical epicondyle of
humerus and deep fascia of f
orearm
 Insertion: middle of lateral su
rface of radius
 Action: pronation of forearm
and flexion of elbow
Triceps brachii
 Origin: long head, infraglen
oid tubercle; lateral head, a
bove groove for radical n.,
medical head, below groove
for radical n.
 Insertion: olecranon of ulna
 Action: extends elbow joint),
long head can extend and a
dduct shoulder joint
Supinator
 Origin: lateral epicondyle
of humerus and upper pa
rt of lateral border of ulna
 Insertion: upper third of a
nterior surface of radius
 Action: supination of fore
arm
Arteries of upper limb
Axillary artery
 Continuation of subclavian artery at
lateral border of first rib
 Becomes brachial artery at lower bo
rder of teres major
 Divided into three parts by overlying
pectoralis minor
 First portion, above muscle － gives ris
e to thoracoacromial a. 胸肩峰动脉
 Second portion, behind muscle － give
s rise to lateral thoracic a. 胸外侧动脉
 Third portion, below muscle － gives ri
se to subscapular a. 肩胛下动脉 , ante
rior and posterior humeral circumfle
x a. 旋肱前、后动脉 ; the former then div
ides into throcodorsal a. 胸背动脉 an
d circumflex scapular a. 旋肩胛动脉
Brachial artery
 Continuation of axillary art
ery
 Divides into radial and uln
ar arteries at level of neck
of radius
 Branches
 Deep brachial a. 肱深动脉
－ accompanies with radi
al nerve
 Superior ulnar collaeral a.
尺侧上副动脉－ accompani
es with ulnar nerve
 Inferior ulnar collateral a.
尺侧下副动脉
Radial artery and branches
 Radial recurrent a. 桡侧返动脉

 Superfical palmar branch 掌浅支

 Principal artery of thumb 拇主要动脉

Ulnar artery and branches

 Ulnar recurrent a. 尺侧返动脉

 Common interosseous artery

骨间总动脉
 Anterior interossous a. 骨间前动脉
 Posterior interosseous a. 骨间后动脉
 Deep palmar branch 掌深支
Superficial palmar arch 掌
浅弓
 Formed by ulnar artery an
d superficial palmar branc
h of radial artery
 Curve of arch lies across t
he palm, level with the dist
al border of fully extended
thumb
 Gives rise to three commo
n palmar digital arteries e
ach then divides into two
proper palmar digital arteri
es
Deep palmar arch 掌深弓
 Formed by radial artery an

d deep palmar branch of u

lnar artery
 Curve of arch lies across

upper part of palmar at lev

el with proximal border of
extended thumb
 Gives rise to three palmar

metacarpal arteries
Veins of the upper limb
Deep veins: accompany the arteri
es of the same region and bear
similar names
Superficial veins
 Cephalic vein 头静脉
 Arises from the lateral side of th
e dorsal venous rete of hand
 Ascends on radial side of the for
earm to the elbow and then in th
e lateral side of biceps brachii fu
rrow, continues up the arm in th
e deltopectoral groove and then
to the infraclavicular fossa, wher
e it pierces clavipectoral fascia t
o drain into axillary vein
 Basilic vein 贵要静脉
 Arises from the medial side of
the dorsal venous rete of han
d
 Ascends on the ulnar side of f
orearm to the elbow and then
in the medial bicepital brachii f
urrow to middle of the arm wh
ere it pierces the deep fascia
and joins the brachial vein or
axillary vein
 Median cubital vein 肘正中静
脉
links cephalic vein and basilic
vein in the cubital fossa. It is a
frequent site for venipuncture
to remove a sample of blood
or add fluid to the blood
The lymphatic drainage of upper limb
Lymphatic vessels
 Superficial － follow the superfic
ial veins, drain into supratrochle
ar and axillary lymph nodes
 Deep － accompany main vess
els, end in axillary lymph nodes
lymph nodes
 Cubital lymph node: lies above
medial epicondyle of humerus
 Axillary lymph node － arranged
in five groups
Axillary lymph nodes 腋淋巴结
－ arranged in five groups
 Lateral lymph nodes 外侧淋巴结－
lie around the distal end of axillary
vein , receiving drainage from the ar
m, forearm, and hand
 Pectoral lymph nodes 胸肌淋巴结
－ lie along lateral thoracic vessels, r
eceive afferents from anterior thoraci
c wall including central and lateral po
rtion of mamma
 Subscapular lymph node 肩胛下淋
巴结－ along subscapular vessels, re
ceive lymph from nape and scapular
region
 Efferents above three groups pass to
central lymph node
 Central lymph node 中央淋
巴结－ lie in fat of axillary fos
sa, receive drainage from all
the above nodes, efferents p
ass to apical lymph node
 Apical lymph node 尖淋巴结
 Lie in the apex of the axilla, a
long the proximal end of axill
ary vessels
 Receive drainage chiefly fro
m central lymph node , upper
portion of mamma
 Efferents form subclavian tru
nk, the right subclavian trunk
joints the right lymphatic duct
; left usually drains directly in
to thoracic duct
Brachial plexus 臂丛
Formation:
 Five roots: formed by anterior ram
i of C5-C8 and T1 spinal nerves, r
oots C5 ～ C7give rise to long th
oracic n. 胸长神经
 Three trunks
 The upper trunk is formed by the j
oining of root C4,C5,C6.
 The middle trunk is the continuatio
n of root C7.
 The lower trunk is formed by the j
oining of root C8 and T1.
 Six divisions: above clavicle, trun
ks form anterior and posterior divi
sions
 Three cords: below clavicle, divisi
ons form three cords that surroun
d the second portion of axillary a.
Position:
passes through the scalene fissure to poste
rosuperior of subclavian artery, then enters
the axilla to form lateral, medial and posterio
r cords
Main branches
 Lateral cord
 Musculocutaneous n. 肌皮神经

 Lateral root to median n. 正中神经外侧根

 Medial cord
 Medial root to median n. 正中神经内侧根

 Ulnar n. 尺神经

 Medial brachial cutaneous n. 臂内侧皮神

经
 Medial antebrachial cutaneous n.
前臂内侧皮神经
 Posterior cord
 radial n. 桡神经
 axillary n. 腋神经
 thoracodorsal n. 胸
背神经
 Musculocutaneous
肌皮神经
Distribution: Biceps b
rachii, brachalis and c
oracobrachialis ‘BBC
nerve’; skin on anterio
r aspect of forearm
 Median 正中神经
 Distribution: Flexor of fore
arm except brachioradialis,
flexor carpi ulnaris and ulna
r half of flexor digitorum pro
fundus, thenar except addu
ctor pollicis, first two lumbri
cals; skin of thenar, central
part of palm, palmar aspect
of radial three and one-half
fingers, including middle an
d distal fingers on dorsum
 Injury: Apehand 猿手
produces sign of benediction, i
n which the index and midd
le fingers cannot be flexed
and the thumb cannot be o
pposed
 Ulnar nerve
 Distribution: Flexor carp
i ulnaris, ulnar half of flex
or digitorum profundus, h
ypothenar muscles, inter
ossei, 3rd and 4th lumbri
cals and adductor pollicis
; skin of hypothenar, pal
mar surface of ulnar one
and one-half fingers, ulna
r half of dorsum of hand,
posterior aspect of ulnar t
wo and one-half fingers
 Injury: clawhand
 Radial 桡神经
 Distribution: Extensor
muscles of arm and for
earm, brachioradialis; s
kin on back of arm, fore
arm, and radial side of
dorsum of hand and ra
dial two and one-half fin
gers
 Injury: Wristdrop
 Axillary 腋神经
 Distribution: Deltoid
and teres minor mus
cle; skin over deltoid an
d upper posterior aspec
t of arm
 Injury: result in deltoid
andteres minor paralysi
s (loss of shoulser abdu
tion and weel external r
otation) with loss of sen
sation over the deltoid
Regional anatomy of upper limb

山东大学医学院 解剖教研室
李振华
Parts and regions
 Shoulder region － junction of ar
m and trunk
 Arm － between should and elbo
w
 Elbow － bend of arm, joint betw
een arm and forearm
 Forearm － between elbow and h
and
 Hand
Surface anatomy
 Shoulder region: acromion, spine of scapula,
coracoid process, greater tubercle, anterior an
d posterior axillary folds
 Arm － medial and lateral biceps brachii furro
w, deltoid tuberosity
 Elbow － medial and lateral epicondyles, head
of radius, olecranon, tendon of biceps brachii
 Forearm － between elbow and hand
 Hand － styloid process, dorsal tubercle
Anatomical snuff box
鼻烟壶
 When the thumb is abducte
d and extended, a triangular
hollow appears between the
tendon of the extensor pollic
is longs medially and the te
ndons of the extensor pollici
s brevis and abductor pollici
s longus laterally.
 The floor of the snuff box is
the scaphoid and trapezium
bones and crossed by the r
adial a..
Carring angle 提携
角

1650 ～ 1700
 Mamma 乳房

Position
 Lie in superficial fascia
over the pectorals majo
r and pectoral fascia
 Extend from 3rd to 7th r
ibs vertically, and from
parasternal line to mida
xillary line transversally
Structures － contains ski
n, mammary glands and a
dipose tissue
 Each brest has about 1
5 ～ 20 lobes of mammary
gland
 Each lobe radiates out fro
m the nipple and has a lac
tiferous duct 输乳管 whic
h opens separately on the
summit of the nipple and p
ossesses a dilated lactifer
ous sinuses 输乳管窦 just
prior to its termination
 Suspensory ligaments of
breast 乳房悬韧带 (coope
r’s ligaments ) － strand
s of connective tissue r
uns between skin and d
eep fascia and serve to
support the mammary g
lands
Axillary fossa 腋窝
 The axillary fossa is a pyr
amid-shaped space throu
gh which major neurovas
cular structures pass bet
ween the thorax and upp
er extremity
Boundaries
 The apex is a triangular
space limited by the firs
t rib, the scapula, and t
he middle third of clavic
le.
 The base － skin and f
ascia of the axillary foss
a
 The anterior wall
 Pectoralis major, pectoralis minor and subclavius muscles
 Clavipectoral fascia 锁胸筋膜
 The deep faxcia which extends between subclavius, coracoid proces
s and pectoralis minor muscles
 The structures pass through the clavipectoral faxcia
 Cephalic v.
 Thoracoacromial a.
 Lateral pectoral n.
 The posterior wall － teres major,
latissimus dorsi, subscapularis and
scapula
Trilateral and quadrilateral foramina
三边孔和四边孔
 Between the subscapularis and teres
major, there is a long triangular space
whose lateral side is surgical neck of h
umerus. The long head of triceps brac
hii subdivides this space into a medial t
rilateral foramen and a lateral quadrilat
eral foramen.
 The posterior humeral circumflex a.
and axillary n. pass through the quadri
lateral foramen.
 The circumflex scapular a. passes th
rough the triangular space to reach the
dorsum of the scapula.
 The broad medial wall － serratus anterior ， intercostal m
uscles and upper four ribs
 The narrow lateral wall － coracobrachialis, biceps brachii
and intertubercular groove
Contents
Brachial plexus, axillary a. and principal branches, axillary v. a
nd tributaries, axillary lymph nodes and loose connective tissu
e
Brachial plexus 臂丛
Formation:
 Five roots: formed by anterior rami of C5-C
8 and T1 spinal nerves, roots C5 ～ C7giv
e rise to long thoracic n. 胸长神经
 Three trunks
 The upper trunk is formed by the joining of r
oot C4,C5,C6.
 The middle trunk is the continuation of root
C7.
 The lower trunk is formed by the joining of r
oot C8 and T1.
 Six divisions: above clavicle, trunks form a
nterior and posterior divisions
 Three cords: below clavicle, divisions form
three cords that surround the second porti
on of axillary a.
Position:
passes through the scalene fissure to post
erosuperior of subclavian artery, then ente
rs the axilla to form lateral, medial and post
erior cords
Main branches
 Lateral cord
 Musculocutaneous n. 肌皮神经
 Lateral root to median n. 正中神经外侧根
 Medial cord
 Medial root to median n. 正中神经内侧根
 Ulnar n. 尺神经
 Medial brachial cutaneous n. 臂内侧皮神经
 Medial antebrachial cutaneous n.
前臂内侧皮神经
 Posterior cord
 radial n. 桡神经
 axillary n. 腋神经
 thoracodorsal n. 胸背神经
 Axillary sheath 腋鞘
－ extension of deep ce
rvical fascia of the neck
, forming a tubular shea
th that surrounds axillar
y a. and v., and brachia
l plexus
Axillary artery
 Continuation of subclavian artery at lat
eral border of first rib
 Becomes brachial artery at lower borde
r of teres major
 Divided into three parts by overlying pe
ctoralis minor
 First portion, above muscle － gives rise t
o thoracoacromial a. 胸肩峰动脉
 Second portion, behind muscle － gives r
ise to lateral thoracic a. 胸外侧动脉
 Third portion, below muscle － gives rise
to subscapular a. 肩胛下动脉 , anterior
and posterior humeral circumflex a. 旋
肱前、后动脉 ; the former then divides into
throcodorsal a. 胸背动脉 and circumfle
x scapular a. 旋肩胛动脉
Axillary lymph node － arranged in five groups
 Lateral lymph nodes － lie around the distal end
of axillary artery vein , receive afferent vessels fro
m upper limb.
 Pectoral lymph nodes － lie along lateral thoraci
c vessels, receive afferents from anterior thoracic
wall including central and lateral portion of mam
ma
 Subscapular lymph node － along subscapular
vessels, receive lymph from nape and scapular r
egion
 Efferents above three groups pass to central lym
ph node
 Central lymph node － lie in fat of axillary fossa,
receive lymph from all the above nodes, efferents
pass to apical lymph node
 Apical lymph node － lie in the apex of the axilla
, along the proximal end of axillary vessels, recei
ve afferents chiefly from central lymph node , upp
er portion of mamma; efferents form subclavian tr
unk, the right subclavian trunk joints the right lym
phatic duct; left usually drains directly into thoraci
c duct
Cubiral fossa 肘窝
Boundaries
 Base － line drawn through
epicondyles of humerus
 Apex － brachioradialis later
ally and pronator teres medi
ally
 Roof － skin, superficial faxc
ia, deep faxcia and aponeur
osis of biceps
 Floor － brachialis, supinato
r and capsule of elbow joint
Contents － from lateral to
medial
 Biceps brachii tendon

 Brachial a. － divides into r

adial and ulnar a.,usually a

t apex of fossa
 Median n.

Lateral to the biceps brachii t

endon － radial n. and late
ral antebrachial cutaneous
n.
Carpal tunnel 腕管
Flexor retinaculum
 Thickening of deep fascia in
the hand
 Attached laterally to scaphoi
d and trapeziun and mediall
y to pisiform and hamate
 Form an osseofibrous tunne
l (carpal tunnel) with carpal
groove － transmits median
n., flexor digitorum supericia
lis, flexor digitorum profundu
s, and flexor pollicus longus
from forearm into hand
Teninous sheath of flexor pollicis longus

Common flexor
sheath
Skin incisions
Superficial fascia

Cephalic v.

Lateral cutaneous branch

Anterior cutaneous branch

 Clavipectoral fascia
锁胸筋膜
 The deep faxcia which
extends between sub
clavius, coracoid proc
ess and pectoralis mi
nor muscles
 The structures pass t
hrough the clavipecto
ral faxcia
 Cephalic v.
 Thoracoacromial a.
 Lateral pectoral n.
 Axillary a.
Thoracoacromial a.
Lateral pectoral n.
Musculocutaneous n.

Medial antebrachial cutaneous n.

Median n.

Ulnar n.
Medial brachial cutaneous n.

Intercostobrachial n.
Thoracodorsal n. & a.
Long thoracic n. & lateral thoracic a.
Posterior humeral circumflex
a. & axillary n.

Circumflex scapular a.

Radial
n.
Musculocutaneous n
.

Median n.
Medial brachial cutan
eous n.
Deep brachial a.
Ulnar n.

Superior ulnar coleteral a.

Medial antebrachial cutan

eous n.
Musculocutaneous n.

Median n.
Medial antebrachial c
Axillary a. utaneous n.
Medial brachial cutaneous n.

Brachial a. Deep brachial a.

Superior ulnar coleteral a.

& Ulnar n.

Inferior ulnar coleteral a.

Lateral anterachial cutaneous n.
& cephelic v. Medial interracial cutaneous n.
& basiic v.

Median cubital v
.
 Ulnar n.
Brachial a.
Median n.
Radial a.

Radial recurrent a. Ulnar a.

Radial n. Ulnar recurrent a.

Ulnar n.
Muscolocutaneous n.

Brachial a.

Radial n.

Radial recurrent a. Ulnar recurrent a.

Radial a. Common interosseous a.

Median n.
Ulnar a., v. & n.
Palmar aponeurosis
Superficial palmar a.

Ulnar a.

recurrent n.
Posterior region of upper limb

山东大学医学院 解剖教研室
李振华
Skin incisions
Cutaneous n. and
superificial v.
 Trapezium Levator scapular

Deltoid
Rhomboideus

Triangle of ausculation

Latissimus dorsi

Thoracolumbar fascia
 Suprascapular n.& a.

Supraspinatus

Teres minor

Axillary n.
Infraspinatus
Posterio humeral
circumflex a.
Deep brachial a.
Radial n.
Teres major
Radial n. Deep brac
hial a.
Posterior interosseousa.

Posterior interosseous n.
 Hand

山东大学医学院 解剖教研室
李振华
Palm of hand 手掌
Flexor retinaculum 屈肌支持带
 Thickening of deep fascia in the han
d
 Attached laterally to scaphoid and tr
apeziun and medially to pisiform and
hamate
Carpal tunnel 腕管
 Formed by flexor retinaculum and ca
rpal groove
 Transmits
 Median n.
 Flexor digitorum superficialis and flex
or digitorum profundus enclosed by c
ommon flexor sheath
 Flexor pollicus longus enclosed by te
ndinous sheath of flexor pollicus long
us
Tendinous sheath of flexor pollicis longus

Common flexor
sheath
 Deep palmar fascia
掌部深筋膜
Superficial layer
 Thenar fascia 鱼际筋膜

 Hypothenar fascia 小鱼际筋膜

 Palmar aponeurosis 掌腱膜

thick triangular membrane
Deep layer － palmar interosseo
us fascia 骨间掌侧筋
膜
 Osseofascial compartments of palm
手掌骨筋膜鞘
 Lateral compartment 外侧鞘
 Medial compartment 内侧鞘
 Intermediate compartment 中间鞘
Medial intermuscular septum Laeral intermuscular septum
Palmar aponeurosis
Thenar fascia
Hypothenar fascia

Adductor pollicis

Palmar interosseous fascia

Intermediate compartment 中间鞘
 Formed by palmar aponeurosis, Laeral and medial intermuscul
ar septum, palmar interosseous fascia
 Contents: superficial palmar arch, a., v.,n., tendons of flexor di
gitorum superficialis and profundus, lumbricales, common flexo
r sheath
 Fascia spaces 筋膜间隙
 Thenar space 鱼际间隙
 Midpalmar space 掌中间隙

Midplmar septum
掌中隔

Thenar space

Midpalmar space
Dorsum of hand 手背
Extensor retinaculum
伸肌支持带
 Thickening of deep faxcia of fore
arm a wrist
 Attached laterally to radius and
medially to styloid process of uln
a and triquetrum
 Forms six fibrous compartments
for extensor tendons passing fro
m forearm into hand:
 ① tendons of abductor pollicis longus and extensor pollicis
brevis and their synovial sheaths;
 ② tendons of extensor carpi radialis longus and brevis and
their synovial sheaths;
 ③ tendon of pollicis longus and its synovial sheath;
 ④ tendons of extensor digitorum, extensor indicis and their
synovial sheaths;
 ⑤ tendon of extensor digiti minimi and its synovial sheaths
;
 ⑥ tendon of extensor carpi ulnaris and its synovial sheaths
Fascia of the dorsal han
d
 The superficial fascia
 Deep fascia － the dorsal
fascia of hand
 Superficial layer (dorsal a
poneurosis) 手背腱膜
 Deep layer (dorsal intero
sseous fascia)
骨间背侧筋膜
 Two spaces
 The dorsal subcutaneous space 手背皮下间隙
 The dorsal subaponeurotic space 手背腱膜下间隙

Dorsal subaponeurotic
Superficial fascia space

Dorsal aponeurosis Dorsal subcutaneous space

Dorsal interosseous fascia

 Nerves of hand
 Median n. － thenar except adductor pollicis, first two lumbricals;
skin of thenar, central part of palm, palmar aspect of radial three a
nd one-half fingers, including middle and distal fingers on dorsum
 Ulnar n. － hypothenar muscles, interossei, 3rd and 4th lumbrical
s and adductor pollicis; skin of hypothenar, palmar surface of ulna
r one and one-half fingers
 Radial n. － skin of radial side of dorsum of hand an
d radial two and one-half fingers
Fingers 手指
 Pulp space 指髓间隙
On the palmar side of the tips of
the fingers and thumb. They contain fatty ti
ssue that is divided into numerous compart
ments by fibrous septa that pass between t
he distal phalanx and the skin. The pulp sp
ace is limited proximally by the firm adhere
nce of skin and the distal flexion crease to
the underlying tissue; this prevents pulp inf
ection from spreading proximally along the
finger.
 vessels :
有 2 条指掌侧固有动脉和 2 条指背动脉，分别走行于手指的两侧。
 Nerves ：
神经与同名动脉伴行。