Hand: Anterior Region

Right hand, superficial layer (palmar aspect).

Dissection of the superficial palmar arch.

Arteries and nerves of the right hand

(palmar aspect, schematic drawing).

Longitudinal section through the hand

at the level of the third finger.

Longitudinal section through the hand

at the level of the third finger (MRI scan,

courtesy of Prof. Heuck, Munich).


Hand: Anterior Region 427

Right hand, middle layer (palmar aspect). The flexor retinaculum

has been removed.

1 Superficial branch of radial nerve

2 Tendon of flexor carpi radialis muscle

3 Radial artery

4 Median nerve

5 Tendon of flexor digitorum superficialis muscle

6 Tendon of abductor pollicis longus muscle

7 Tendon of extensor pollicis brevis muscle

8 Superficial palmar branch of radial artery

9 Abductor pollicis brevis muscle

10 Superficial head of flexor pollicis brevis muscle

11 Terminal branches of superficial branch of radial nerve

12 Common palmar digital nerves (median nerve)

13 Proper palmar digital arteries of thumb

14 Proper palmar digital nerves (median nerve)

15 Tendon of flexor carpi ulnaris muscle

16 Ulnar artery

17 Position of pisiform bone

18 Superficial branch of ulnar nerve

19 Flexor retinaculum

20 Deep branch of ulnar nerve

21 Abductor digiti minimi muscle

22 Common palmar digital nerves (ulnar nerve)

Arteriogram of the right hand (palmar aspect).

23 Superficial palmar arch

24 Tendons of flexor digitorum muscles

25 Common palmar digital arteries

26 Palmar digital nerves (ulnar nerve)

27 Proper palmar digital arteries

28 Carpal tunnel

29 Fibrous sheaths for the tendons of flexor digitorum

muscles

30 Deep palmar arch

31 Princeps pollicis artery

32 Palmar branch of median nerve

33 Common digital palmar artery

34 Ulnar nerve

35 Capillary network of finger

36 Radius

37 Carpal bones

38 Metacarpal bone

39 Interosseous muscles

40 Proximal phalanx

41 Middle phalanx

42 Distal phalanx

43 Dorsal branch of ulnar nerve

44 Tendons of flexor digitorum profundus (upper)

and superficialis (lower) muscles


428

15

Hand: Anterior Region

Right hand, superficial layer (palmar aspect). Dissection of

vessels and nerves.

Right hand, superficial layer (palmar aspect). Dissection of

vessels and nerves. The palmar aponeurosis has been removed to

display the superficial palmar arch.

1 Tendon of palmaris longus muscle

2 Radial artery

3 Tendon of flexor carpi radialis muscle and median nerve

4 Distal part of antebrachial fascia

5 Radial artery passing into the anatomical snuffbox

6 Abductor pollicis brevis muscle

7 Superficial head of flexor pollicis brevis muscle

8 Palmar digital artery of thumb

9 Common palmar digital arteries

10 Proper palmar digital nerves (median nerve)

11 Ulnar nerve

12 Tendon of flexor carpi ulnaris muscle

13 Ulnar artery

14 Superficial branch of ulnar nerve

15 Palmaris brevis muscle

16 Palmar aponeurosis

17 Palmar digital nerves (ulnar nerve)

18 Superficial transverse metacarpal ligament

19 Proper palmar digital arteries

20 Superficial palmar branch of radial artery

(contributing to the superficial palmar arch)

21 Flexor retinaculum

22 Median nerve

23 Abductor digiti minimi muscle

24 Flexor digiti minimi brevis muscle

25 Opponens digiti minimi muscle

26 Superficial palmar arch

27 Tendons of flexor digitorum superficialis muscle

28 Common palmar digital branch of ulnar nerve

29 Common palmar digital branch of median nerve

30 Fibrous sheath of flexor tendons


Hand: Anterior Region 429

1 Tendon of flexor carpi radialis muscle

2 Radial artery

3 Tendon of abductor pollicis longus muscle

4 Abductor pollicis brevis muscle

5 Superficial and deep heads of flexor pollicis

brevis muscle

6 Oblique and transverse heads of adductor

pollicis muscle

7 Median nerve

8 Tendons of flexor digitorum superficialis and

profundus muscles

9 Tendon of flexor pollicis longus muscle

10 Pronator quadratus muscle

11 Tendon of flexor carpi ulnaris muscle

Right hand, deep layer (palmar aspect). The carpal tunnel has

been opened, the tendons of the flexor muscles have been

removed, and the superficial palmar arch has been cut. Right hand, deep layer (palmar aspect). Dissection of the deep

palmar arch.

12 Ulnar artery

13 Superficial branch of ulnar nerve

14 Deep branch of ulnar nerve

15 Abductor digiti minimi muscle

16 Superficial palmar arch (cut end)

17 Common palmar digital nerves (ulnar nerve)

18 Palmar metacarpal arteries of deep palmar arch

19 Palmar digital artery of the fifth finger

20 Fibrous sheaths of tendons of flexor muscles

21 Palmar interosseous muscles

22 Opponens pollicis muscle (cut)

23 Deep palmar arch

24 First dorsal interosseous muscle

25 First lumbrical muscle


430 Sections through the Upper Limb

Horizontal section through the right shoulder joint (section 1; MRI scan;

inferior aspect).

Upper limb,

location of sections 1–5

(MRI scans, p. 430:

courtesy of Prof. Heuck,

Munich, Germany;

MRI scans, p. 431:

courtesy of Prof. Bautz and

R. Janka, M. D., University

of Erlangen, Germany).

1 Pectoralis major muscle

2 Greater tubercle and tendon of biceps muscle

3 Lesser tubercle

4 Head of humerus and articular cavity of

shoulder joint

5 Deltoid muscle

6 Scapula

7 Infraspinatus muscle

8 Serratus anterior muscle

9 Sternum

10 Infrahyoid muscles

11 Trachea

12 Body of thoracic vertebra

13 Vertebral canal and spinal cord

14 Deep muscles of the back

15 Trapezius muscle

16 Brachialis muscle

17 Radial nerve and profunda brachii vessels

Horizontal section through the right shoulder joint (section 1; inferior aspect).

* = Upper lobe of lung.

Axial section through the middle of the

right arm (section 2; MRI scan; inferior aspect).

Axial section through the middle of the

right arm (section 2; inferior aspect).

1

2

3

4

5


Sections through the Upper Limb 431

18 Triceps brachii muscle

19 Cephalic vein

20 Biceps brachii muscle

21 Musculocutaneous nerve

22 Ulnar nerve

23 Medianus nerve

24 Brachial artery and vein

25 Shaft of humerus

26 Brachioradialis muscle

27 Radial nerve

28 Olecranon and articular cavity

of elbow joint

29 Basilic vein

30 Humerus

31 Pronator teres muscle

32 Extensor muscles of forearm

33 Ramus profundus of

radialis nerve

34 Anterior interosseus

vessels and nerve

35 Interosseous membrane

36 Ulna

37 Radius

38 Radial artery and superficial

branch of radial nerve

39 Flexor pollicis longus muscle

40 Flexor digitorum

superficialis and profundus

muscles

41 Ulnar nerve, ulnar artery, and

vein

42 Flexor carpi ulnaris muscle

43 Radial artery

44 Metacarpal bones III and IV

45 Carpal canal with tendons of

flexor digitorum muscles

46 Hypothenar muscle

47 Median nerve

48 Interosseous muscles

49 First metacarpal bone

50 Thenar muscles

51 Articular cavity of

humeroradial joint

Axial section through the right hand at the level of the

metacarpus (section 5; MRI scan; inferior aspect).

Axial section through the right hand at the level of the

metacarpus (section 5; inferior aspect).

Axial section through the right elbow

joint (section 3; MRI scan; inferior aspect).

Axial section through the middle of the

right forearm (section 4; MRI scan; inferior

aspect).

Axial section through the middle of the

right forearm (section 4; inferior aspect).

Axial section through the right elbow joint

(section 3; inferior aspect).


432

1 Right hip bone

2 Sacrum

3 Femur

4 Patella

5 Fibula

6 Tibia

7 Tarsal bones

8 Metatarsal bones

9 Phalanges

10 Sacro-iliac joint

11 Pubic symphysis

12 Hip joint

13 Knee joint

14 Proximal tibiofibular joint

15 Distal tibiofibular joint

16 Ankle joint

17 Talocalcaneonavicular joint

18 Tarsometatarsal joints

19 Metatarsophalangeal joints

20 Interphalangeal joints

Skeleton of pelvic girdle and lower limb (anterior

aspect). The ankle joint has been dislocated.

Organization of pelvic girdle and lower limb.

8 Lower Limb

The lower limb (extremity) is specialized for support of the upright posture, locomotion, and maintaining balance. In

contrast to the upper limb, the lower limb is more restricted in

its movements, and the joints are tighter and fixed by strong

ligaments. The hip joint is a ball-and-socket type of synovial

joint between the head of the femur and acetabulum. The knee

joint is a hinge type of synovial joint that permits only limited

rotation. The talocrural joint is a hinge joint between the talus,

fibula, and tibia, only allow ing movements of flexion and

extension.

The long axis of the foot is at a right angle to that of the leg,

thus forming an effective arch for the upright stance of the

body.

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19

20

1

2

3

4

5

6

7

8

9

1

2

3

4

5

6

7

8

9

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B

C

D

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