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 4.34

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. Digital aa. and palmar digital nerve 2. Tendon m. flexor pollicis longus 3. Proximal phalanx 4. First lumbrical m. 5. First metacarpal 6. Sesamoid bone, pollex 7. Tendon m. extensor pollicis longus	8. Adductor pollicis, transverse head m. 9. Tendons long flexor digital mm., first digit 10. First dorsal interosseous m. 11. Palmar metacarpal a., radial a. 12. Second metacarpal 13. First palmar interosseous m. 14. Tendon m. extensor digitorum communis 15. Second dorsal interosseous m.	16. Tendon m. extensor digitorum communis 17. Third metacarpal 18. Adductor pollicis m., transverse head, origin 19. Third dorsal interosseous m. 20. Second lumbrical m. 21. Tendon m. extensor digiti minimi 22. Fourth metacarpal 23. Second palmar interosseous m. 24. Tendon m. flexor digitorum profundus 25. Tendon m. extensor digiti minimi 26. Fourth dorsal interosseous m.	27. Tendon m. extensor digiti minimi 28. Third lumbrical m. 29. Third palmar interosseous m. 30. Fifth metacarpal 31. Fourth lumbrical m. 32. Tendons long flexor digital mm., fourth digit 33. Opponens and abductor digiti minimi mm. 34. Tendon m. flexor digitorum profundus 35. Tendon m. flexor digitorum superficialis 36. Palmar aponeurosis

In this section, the four dorsal (10, 15, 19, 26) and three palmer (13, 23, 29) interosseous muscles are seen. When four palmer interosseous muscles are described the first palmer interosseous muscle is a division or part of flexor pollicis brevis or adductor pollicis. One origin of adductor pollicis (18) from the third metacarpal bone (17) can be seen. These muscles are all usually innervated by the deep palmer branch of the ulnar nerve. It is of some interest that flexor pollicis brevis is also supplied by the recurrent branch of the first palmer digital ramus of the median nerve as well as by the ulnar nerve. In one study, both nerves supplied the muscle in 19 of 29 cases, in five cases by the median alone, and in five cases by the ulnar alone.

All four lumbrical muscles are identified (4, 20, 28, 31). The first and second (4, 20) are usually median nerve innervated and the third and fourth (28, 31) are ulnar nerve innervated.

A sesamoid bone (6) of the thumb is seen.

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