ABSTRACT
The metacarpals have expanded bases which articulate with the distal row of carpal bones (Figs 14.1 and 14.2) and the medial four also articulate with each other. Their slender bodies give attachment to the interossei, opponens pollicis
The carpus (Figs 14.1 and 14.2) has eight carpal bones arranged as a proximal row of three, from lateral to medial the scaphoid, lunate and triquetral; a distal row of four, from lateral to medial the trapezium, trapezoid, capitate and
The bones of the hand 203 The palm 208 Blood supply 211 Nerves 211
MCQs 213 EMQs 214 Applied questions 215
9 10 Flexor carpi ulnaris and abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Palmar interossei
Abductor digiti minimi and flexor digiti minimi brevis
Flexor digitorum superficialis Flexor digitorum
superficialis
Flexor digitorum profundus
Flexor carpi radialis
Oblique head / adductor pollicis
Flexor pollicis brevis
Abductor pollicis brevis
Opponens pollicis
Abductor pollicis longus
Flexor pollicis brevis
Figure 14.1 Hand. (a) Palmar surface surface anatomy: 1, proximal, middle and distal phalanges; 2, metacarpals; 3, hamate; 4, triquetral; 5, pisiform; 6, lunate; 7, capitate; 8, scaphoid; 9, trapezoid; 10, trapezium. (b) X-ray, dorsopalmar view. (c) Bones and muscle attachments, palmar aspect
(b)
(c)
(a)
and adductor pollicis muscles, and their heads articulate with the proximal phalanges. The first metacarpal is the shortest, strongest and most mobile; its axis is rotated to lie almost at a right-angle to that of the other metacarpals. It articulates proximally with the trapezium.
