Anatomy Atlases: Atlas of Human Anatomy in Cross Section: Section 4. Upper Limb

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Atlas of Human Anatomy in Cross Section: Section 4. Upper Limb

Plate 4.29

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed

Upper Left Quadrant	Lower Left Quadrant	Lower Right Quadrant	Upper Right Quadrant
1. Tendon m. palmaris longus 2. Median nerve, in carpal canal 3. Flexor pollicis brevis m. 4. Abductor pollicis brevis m. 5. Tendon m. flexor pollicis longus 6. Opponens pollicis m. 7. Carpal bone, trapezium tubercle 8. Radial a.	9. First metacarpal base 10. Tendon m. extensor pollicis brevis 11. Carpal bone, trapezium 12. Tendons m. flexor carpi radialis 13. Hematoma 14. Tendon m. extensor carpi radialis longus 15. Second metacarpal base 16. Tendon m. extensor carpi radialis brevis 17. Carpal bone, trapezoid 18. Third metacarpal base 19. Tendon m. extensor digitorum	20. Carpal bone, capitate 21. Tendon m. extensor digitorum 22. Fourth metacarpal base 23. Dorsal venous plexus, manus 24. Tendon m. extensor digiti minimi proprius 25. Tendon m. extensor carpi ulnaris 26. Tendons m. flexor digitorum profundus 27. Fifth metacarpal base 28. Palmar interosseous m.	29. Flexor digiti minimi brevis m. 30. Ulnar nerve, deep br. in canal of Guyon, and ulnar a. 31. Abductor digiti minimi m. 32. Carpal bone, hook of hamate 33. Opponens digiti minimi m. 34. Palmaris brevis m. 35. Tendons m. flexor digitorum superficialis 36. Carpal canal (tunnel), transverse carpal ligament

This is the last section through the carpal canal and the dense flexor retinaculum (36). The retinaculum passes between the hook of the hamate (32) and the crest or tubercle of the trapezium (7).

The ulnar nerve (30) is seen passing medial to the hook of the hamate (32) to enter the hand. The deep branch of the ulnar nerve usually, but not always, supplies the three hypothenar muscles (31, 33), all seven interossei, the third and fourth lumbricals, the adductor pollicis muscle, and several joints. The superficial branch supplies the palmaris

brevis muscle (34) and is sensory for the little finger and the medial side of the ring finger and the medial side of the palm of the hand.

The passage of the ulnar nerve, deep branch (30), into the hand is via a canal (of Guyon) whose sides (with the hand in the anatomic position) include the pisohamate ligament above, the pisiform bone medially, the hook of the hamate laterally, and the transverse carpal ligament below.

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