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 4.35

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. First dorsal metacarpal a. 2. Tendon m. flexor pollicis longus 3. Digital a. and v., dorsalis pollicis a. 4. Proximal phalanx, pollex 5. Pollex, tendon m. extensor pollicis longus 6. First lumbrical m.	7. Tendon m. flexor digitorum superficialis 8. Tendon m. flexor digitorum profundus 9. Adductor pollicis m. 10. First dorsal interosseous m. 11. Palmar interosseous m. 12. Second metacarpal 13. Second lumbrical m. 14. Tendon m. extensor digitorum communis 15. Dorsal digital a. 16. Second dorsal interosseous m.	17. Tendon m. extensor digitorum communis 18. Third metacarpal 19. Third dorsal interosseous m. 20. Tendon m. flexor digitorum profundus 21. Tendon m. extensor digitorum communis 22. Tendon m. flexor digitorum superficialis 23. Fourth metacarpal 24. Fourth dorsal interosseous m. 25. Third lumbrical m. 26. Tendon m. flexor digitorum profundus 27. Digital a., ulnar a. br.28. Tendon m. extensor digiti minimi	29. Fourth lumbrical m. 30. Fourth lumbrical m. (var., accessory) 31. Fifth metacarpal 32. Tendons long digital flexor mm. 33. Palmar aponeurosis

This section is beyond the junction of the thumb with the hand. The thumb is cut through the first or proximal phalanx (4).

The fourth lumbrical (30) is doubled, but this is considered a normal variation. The third and fourth lumbricals frequently show anatomic variation.

The four lumbricals arise from the tendons of flexor digitorum profundus and insert into the extensor expansion on the radial side of the corresponding finger. In one study of 110 bodies (220 hands), it was reported that all four lumbricals were inserted on the radial side of the extensor tendon on the dorsum of their respective digits in 39% of hands. In 35%, the first, second, and fourth were inserted on the radial side, while the third was inserted on adjacent sides of both the middle and ring fingers. The remaining 25% of hands exhibited other types of anomalous origins and insertions. An accessory fascicle was found to arise from flexor pollicis longus to insert on the index finger.

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