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

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

Plate 4.29

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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