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The muscles of the palm can be divided into intrinsic and extrinsic groups. The intrinsic muscles are located within the hand and include the thenar muscles which act on the thumb, and the hypothenar muscles which act on the little finger. These muscles control fine motor movements. Other intrinsic muscles include the lumbricals, interossei, palmaris brevis and adductor pollicis. The extrinsic muscles are located in the forearm and produce forceful grip and crude hand movements.

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MUSCLES OF PALM Ms.Rutuja

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The muscles that act on the hand can be divided into two groups: Extrinsic muscles located in the anterior and posterior compartments of the forearm. They control crude movements and produce a forceful grip. Intrinsic muscles located within the hand itself. They are responsible for the fine motor functions of the hand.

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Thenar Muscles The thenar muscles are three short muscles located at the base of the thumb. The muscle bellies produce a bulge, known as the thenar eminence. They are responsible for the fine movements of the thumb.

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Thenar Muscles 1. Opponens Pollicis Origin Tubercle of trapezium bone, flexor retinaculum Insertion Radial border of metacarpal bone 1 Action Carpometacarpal joint 1: Thumb opposition Innervation Recurrent branch of median nerve(C8, T1) Blood supply Superficial palmar branch of radial artery Action

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Abductor pollicis brevis Origin Tubercles of scaphoid and trapezium bones, Flexor retinaculum Insertion Lateral aspect of base of proximal phalanx 1 (via radial sesamoid bone) Action Carpometacarpal joint 1: Thumb abduction Innervation Recurrent branch of median nerve (C8, T1) Blood supply Superficial palmar branch of radial artery

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Flexor pollicis brevis Origin Superficial head: Flexor retinaculum, tubercle of trapezium bone Deep head: Trapezoid and capitate bones Insertion Lateral aspect of base of proximal phalanx 1 (via radial sesamoid bone) Action Carpometacarpal and metacarpophalangeal joint 1: Thumb flexion Innervation Superficial head: Recurrent branch of median nerve Deep head: Deep branch of ulnar nerve (C8, T1) Blood supply Superficial palmar artery, princeps pollicis artery and radialis indicis artery

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Adductor pollicis muscle Origin Transverse head: Palmar base of metacarpal bone 3 Oblique head: Capitate bone, palmar bases of metacarpal bones 2 & 3 Insertion Medial base of proximal phalanx 1 (via ulnar sesamoid bone) Action Carpometacarpal joint 1: Thumb adduction Innervatio n Deep branch of ulnar nerve (C8, T1) Blood supply Deep palmar arch

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Hypothenar Muscles The hypothenar muscles form the hypothenar eminence – a muscular protrusion on the medial side of the palm, at the base of the little finger. These muscles are similar to the thenar muscles in both name and organisation. The ulnar nerve innervates the muscles of the hypothenar eminence.

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Opponens Digiti Minimi Origin Hook of hamate bone, flexor retinaculum Insertion Ulnar aspect of metacarpal bone 5 Action Carpometacarpal joint 5: Finger flexion, finger lateral rotation/opposition Innervation Deep branch of ulnar nerve (C8, T1) Blood supply Deep palmar branch of ulnar artery, deep palmar arch

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Abductor Digiti Minimi Origin Pisiform bone (Pisohamate ligament, Tendon of flexor carpi ulnaris) Insertion Ulnar side of base of proximal phalanx of digit 5, Extensor expansion of digit 5 Action Metacarpophalangeal joint 5: Finger abduction and flexion; Interphalangeal joints: Finger extension Innervation Deep branch of ulnar nerve (C8, T1) Blood supply Palmar branch of ulnar artery, palmar digital artery, superficial palmar arch

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Flexor digiti minimi brevis Origin Hook of hamate, flexor retinaculum Insertion Base of proximal phalanx of digit 5 Action Metacarpophalangeal joint 5: Finger flexion (+ finger lateral rotation/opposition) Innervation Deep branch of ulnar nerve (C8, T1) Blood supply Deep palmar branch of ulnar artery

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Lumbricals There are four lumbricals in the hand, each associated with a finger. They are very crucial to finger movement, linking the extensor tendons to the flexor tendons. Denervation of these muscles is the basis for the ulnar claw and hand of benediction. •Attachments: Each lumbrical originates from a tendon of the flexor digitorum profundus. They pass dorsally and laterally around each finger, and inserts into the extensor hood. •Actions: Flexion at the MCP joint and extension at the interphalangeal (IP) joints of each digit. •Innervation: The lateral two lumbricals (of the index and middle fingers) are innervated by the median nerve. The medial two lumbricals (of the little and ring fingers) are innervated by the ulnar nerve.

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INTEROSSEI The interossei muscles are located between the metacarpal bones of the hand. They can be divided into two groups – dorsal and palmar. In addition to their actions of abduction (dorsal interossei) and adduction (palmar interossei) of the fingers, the interossei also assist the lumbricals in flexion at the MCP joints and extension at the IP joints. Dorsal Interossei The most superficial of all dorsal muscles, these can be palpated on the dorsum of the hand. There are four dorsal interossei muscles. •Attachments: Each interossei originates from the lateral and medial surfaces of the metacarpals. They attach into the extensor hood and proximal phalanx of each finger. •Actions: Abduction of the digits. Assists in flexion at the metacarpophalangeal joints and extension at the interphalangeal joints. •Innervation: Ulnar nerve.

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PALMAR INTEROSSEI These are located anteriorly on the hand. There are three palmar interossei muscles (although some texts describe a fourth muscle at the base of the proximal phalanx of the thumb). •Attachments: Each interossei originates from a medial or lateral surface of a metacarpal, and attaches into the extensor hood and proximal phalanx of same finger. •Actions: Adduction of the digits. Assists in flexion at the metacarpophalangeal joints and extension at the interphalangeal joints. •Innervation: Ulnar nerve.

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Other Muscles in the Palm There are two other muscles in the palm that are not lumbricals or interossei and do not fit in the hypothenar or thenar compartments: Palmaris Brevis The palmaris brevis is a small, thin muscle, found superficially in the subcutaneous tissue of the hypothenar eminence. •Attachments: Originates from the palmar aponeurosis and flexor retinaculum, attaches to the dermis of the skin on the medial margin of the hand. •Actions: Wrinkles the skin of the hypothenar eminence and deepens the curvature of the hand, improving grip. •Innervation: Ulnar nerve.

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ADDUCTOR POLLICIS The adductor pollicis large triangular muscle with two heads. The radial artery passes anteriorly through the space between the two heads, forming the deep palmar arch. •Attachments: One head originates from metacarpal III. The other head originates from the capitate and adjacent areas of metacarpals II and III. Both attach into the base of the proximal phalanx of the thumb. •Actions: Adductor of the thumb. •Innervation: Ulnar nerve.

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  • 2. The muscles that act on the hand can be divided into two groups: Extrinsic muscles located in the anterior and posterior compartments of the forearm. They control crude movements and produce a forceful grip. Intrinsic muscles located within the hand itself. They are responsible for the fine motor functions of the hand.
  • 3. Thenar Muscles The thenar muscles are three short muscles located at the base of the thumb. The muscle bellies produce a bulge, known as the thenar eminence. They are responsible for the fine movements of the thumb.
  • 4. Thenar Muscles 1. Opponens Pollicis Origin Tubercle of trapezium bone, flexor retinaculum Insertion Radial border of metacarpal bone 1 Action Carpometacarpal joint 1: Thumb opposition Innervation Recurrent branch of median nerve(C8, T1) Blood supply Superficial palmar branch of radial artery Action
  • 5. Abductor pollicis brevis Origin Tubercles of scaphoid and trapezium bones, Flexor retinaculum Insertion Lateral aspect of base of proximal phalanx 1 (via radial sesamoid bone) Action Carpometacarpal joint 1: Thumb abduction Innervation Recurrent branch of median nerve (C8, T1) Blood supply Superficial palmar branch of radial artery
  • 6. Flexor pollicis brevis Origin Superficial head: Flexor retinaculum, tubercle of trapezium bone Deep head: Trapezoid and capitate bones Insertion Lateral aspect of base of proximal phalanx 1 (via radial sesamoid bone) Action Carpometacarpal and metacarpophalangeal joint 1: Thumb flexion Innervation Superficial head: Recurrent branch of median nerve Deep head: Deep branch of ulnar nerve (C8, T1) Blood supply Superficial palmar artery, princeps pollicis artery and radialis indicis artery
  • 7. Adductor pollicis muscle Origin Transverse head: Palmar base of metacarpal bone 3 Oblique head: Capitate bone, palmar bases of metacarpal bones 2 & 3 Insertion Medial base of proximal phalanx 1 (via ulnar sesamoid bone) Action Carpometacarpal joint 1: Thumb adduction Innervatio n Deep branch of ulnar nerve (C8, T1) Blood supply Deep palmar arch
  • 8. Hypothenar Muscles The hypothenar muscles form the hypothenar eminence – a muscular protrusion on the medial side of the palm, at the base of the little finger. These muscles are similar to the thenar muscles in both name and organisation. The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 9. Opponens Digiti Minimi Origin Hook of hamate bone, flexor retinaculum Insertion Ulnar aspect of metacarpal bone 5 Action Carpometacarpal joint 5: Finger flexion, finger lateral rotation/opposition Innervation Deep branch of ulnar nerve (C8, T1) Blood supply Deep palmar branch of ulnar artery, deep palmar arch
  • 10. Abductor Digiti Minimi Origin Pisiform bone (Pisohamate ligament, Tendon of flexor carpi ulnaris) Insertion Ulnar side of base of proximal phalanx of digit 5, Extensor expansion of digit 5 Action Metacarpophalangeal joint 5: Finger abduction and flexion; Interphalangeal joints: Finger extension Innervation Deep branch of ulnar nerve (C8, T1) Blood supply Palmar branch of ulnar artery, palmar digital artery, superficial palmar arch
  • 11. Flexor digiti minimi brevis Origin Hook of hamate, flexor retinaculum Insertion Base of proximal phalanx of digit 5 Action Metacarpophalangeal joint 5: Finger flexion (+ finger lateral rotation/opposition) Innervation Deep branch of ulnar nerve (C8, T1) Blood supply Deep palmar branch of ulnar artery
  • 12. Lumbricals There are four lumbricals in the hand, each associated with a finger. They are very crucial to finger movement, linking the extensor tendons to the flexor tendons. Denervation of these muscles is the basis for the ulnar claw and hand of benediction. •Attachments: Each lumbrical originates from a tendon of the flexor digitorum profundus. They pass dorsally and laterally around each finger, and inserts into the extensor hood. •Actions: Flexion at the MCP joint and extension at the interphalangeal (IP) joints of each digit. •Innervation: The lateral two lumbricals (of the index and middle fingers) are innervated by the median nerve. The medial two lumbricals (of the little and ring fingers) are innervated by the ulnar nerve.
  • 13. INTEROSSEI The interossei muscles are located between the metacarpal bones of the hand. They can be divided into two groups – dorsal and palmar. In addition to their actions of abduction (dorsal interossei) and adduction (palmar interossei) of the fingers, the interossei also assist the lumbricals in flexion at the MCP joints and extension at the IP joints. Dorsal Interossei The most superficial of all dorsal muscles, these can be palpated on the dorsum of the hand. There are four dorsal interossei muscles. •Attachments: Each interossei originates from the lateral and medial surfaces of the metacarpals. They attach into the extensor hood and proximal phalanx of each finger. •Actions: Abduction of the digits. Assists in flexion at the metacarpophalangeal joints and extension at the interphalangeal joints. •Innervation: Ulnar nerve.
  • 14. PALMAR INTEROSSEI These are located anteriorly on the hand. There are three palmar interossei muscles (although some texts describe a fourth muscle at the base of the proximal phalanx of the thumb). •Attachments: Each interossei originates from a medial or lateral surface of a metacarpal, and attaches into the extensor hood and proximal phalanx of same finger. •Actions: Adduction of the digits. Assists in flexion at the metacarpophalangeal joints and extension at the interphalangeal joints. •Innervation: Ulnar nerve.
  • 15. Other Muscles in the Palm There are two other muscles in the palm that are not lumbricals or interossei and do not fit in the hypothenar or thenar compartments: Palmaris Brevis The palmaris brevis is a small, thin muscle, found superficially in the subcutaneous tissue of the hypothenar eminence. •Attachments: Originates from the palmar aponeurosis and flexor retinaculum, attaches to the dermis of the skin on the medial margin of the hand. •Actions: Wrinkles the skin of the hypothenar eminence and deepens the curvature of the hand, improving grip. •Innervation: Ulnar nerve.
  • 16. ADDUCTOR POLLICIS The adductor pollicis large triangular muscle with two heads. The radial artery passes anteriorly through the space between the two heads, forming the deep palmar arch. •Attachments: One head originates from metacarpal III. The other head originates from the capitate and adjacent areas of metacarpals II and III. Both attach into the base of the proximal phalanx of the thumb. •Actions: Adductor of the thumb. •Innervation: Ulnar nerve.