Arteries & Nerves of the Hand

This presentations describes specifically the Arteries & Nerves of the Hand

Transcript

1. Arteries of the Hand
2. Orientation
3. Pisiform bone Hook of hamate Lower end of radius Base of 5th metacarpal bone 1st intermetacarpal space
4. Deep palmar arch Superficial palmar arch Ulnar artery Radial artery
5. Palmar aponeurosis Adductor pollicis m. Palmaris brevis m. Abductor pollicis brevis m. Abductor digiti minimi m. Flexor digiti minimi brevis m. Flexor pollicis brevis m.
6. Adductor pollicis 1st dorsal interosseous m.
7. Ulnar artery Flexor retinaculum Superficial palmar arch Radial artery Ulnar nerve Median nerve
8. Arterial Arches in the Hand 1- Anterior carpal arch: gives articular blood supply to wrist joint. 2- Superficial palmar arch: gives 3 common palmar digital arteries. 3- Posterior carpal arch: gives 2nd, 3rd and 4th dorsal metacarpal arteries. 4- Deep palmar arch: gives 3 palmar metacarpal arteries.
9. Anterior carpal arch Posterior carpal arch Superficial palmar arch Deep palmar arch Site of arterial arches in the hand
10. Arteries of the Hand 1- Ulnar artery. 2- Radial artery.
11. Ulnar Artery
12. Course of Ulnar Artery in the Hand
13. Ulnar artery Flexor retinaculum Deep br. of ulnar artery Thenar eminence Superficial palmar arch Superficial palmar branch from radial artery Pisiform bone Superficial branch of ulnar artery Hook of hamate Ulnar nerve
14. Surface Anatomy of Superficial Palmar Arch
15. Lateral to pisiform bone Medial to hook of hamate A curved line at level of distal margin of outstretched thumb
16. Relations of Superficial Palmar Arch Superficial: Skin, superficial fascia and palmar aponeurosis. Deep: Terminal branches of median nerve, flexor digitorum tendons, common synovial sheath and lumbricals.
17. Palmar aponeurosis
18. Superficial palmar arch Terminal branches of median nerve Tendons of flexor digitorum muscles & lumbricals Common synovial sheath
19. Branches of Superficial Palmar Arch 1- Palmar digital branch of little finger. 2- Three common palmar digital branches.
20. Palmar digital branch Three common palmar digital branches Two proper digital branches
21. Palmar metacarpal branch Communication between Branches of Deep Palmar Arch and branches of superficial palmar arch Deep palmar arch Common palmar digital branches
22. Radial Artery
23. Course of Radial Artery
24. Radial artery in the forearm Radial artery in anatomical snuff box Radial artery passes between 2 heads of 1st dorsal interosseous muscle Abductor pollicis longus tendon Extensor pollicis brevis tendon Extensor pollicis longus tendon
25. Radial artery 1st dorsal interosseous m
26. Transverse head of adductor pollicis m Oblique head of adductor pollicis Deep palmar arch Base of 5th metacarpal bone Deep branch of ulnar artery Radial artery in the palm Radial artery 1st dorsal interosseous m Deep branch of ulnar nerve
27. Surface Anatomy of Deep Palmar Arch
28. Curved line 1/2 inch proximal to superficial palmar arch A curved line at level of distal margin of outstretched thumb
29. Relations of Deep Palmar Arch Superficial: -Flexor digitorum tendons and lumbricals. Deep: Metacarpal bones (just distal to their bases) and interossei muscles. Concavity: Deep branch of ulnar nerve.
30. Branches of Radial Artery in the Hand Dorsum of hand: 1- Dorsal (posterior) carpal branch. 2- Dorsal digital branch. 3- First dorsal metacarpal branch. In the 1st intermetacarpal space: 1- Radialis indices. 2- Princips pollicis. In the palm (Deep palmar arch): 1- Three palmar metacarpal branches. 2- Proximal perforating arteries. 3- Recurrent branch to anterior carpal arch.
31. 2- Dorsal digital branch 3-1st dorsal metacarpal br. 1-Posterior carpal branch Radial artery Branches of Radial Artery on the Dorsum Dorsal (posterior) branch of ulnar artery Dorsal (posterior) carpal arch 2nd, 3rd and 4th dorsal metacarpal arteries
32. Perforating arteries: A- Proximal perforating arteries: Between dorsal metacarpal arteries and deep palmar arch. B- Distal perforating arteries: Between dorsal metacarpal arteries and palmar metacarpal arteries.
33. 2- Priceps pollicis artery 1- Radialis indices Branches of Radial Artery in the 1st Intermetacarpal Space (Between 1st dorsal interosseous and adductor pollicis muscles) Radial artery passing through proximal part of 1st intermetacarpal space
34. Palmar metacarpal branches Branches of Deep Palmar Arch Deep palmar arch Common palmar digital branches
35. Palmar metacarpal arteries Recurrent branch Anterior carpal arch
36. Arterial Arches in the Hand Superficial to flexor digitorum tendons. At the level of middle of shaft of metacarpal bones. Deep to flexor digitorum tendons. At level just distal to bases of metacarpal bones. Anterior to carpal bones, deep to flexor tendons. Posterior to carpal bones, deep to extensor tendons. -Mainly superficial branch of ulnar artery. -Superficial palmar branch of radial a. -Mainly radial artery. -Deep branch of ulnar artery. -Anterior carpal branches of radial& ulnar arteries. -Descending branch of anterior interosseous artery. -Recurrent branch from deep palmar arch. It is a cruciate anastomosis. -Posterior carpal branches of radial& ulnar arteries. -Anterior & posterior interosseous artery. -3 common palmar digital arteries. -Palmar digital artery. -3 palmar metacarpal arteries. -Proximal perforating arteries. -Recurrent branch. -Articular branches to wrist joint. -2nd, 3rd and 4th dorsal metacarpal arteries. Site Formation Branches Superficial palmar Deep palmar Anterior carpal Posterior carpal Dr. Sherif Fahmy
37. Nerves in the Hand
38. Nerves of the Hand 1- Median Nerve and its palmar cutaneous branch of Median nerve. 2- Ulnar Nerve and its palmar & dorsal cutaneous branches of ulnar nerve. 3- Termination of superficial Radial Nerve. 4- Termination of lateral cutaneous nerve of forearm.
39. Median Nerve & Its Palmar Cutaneous Branch
40. Median nerve Palmar cutaneous branch of median nerve Flexor retinaculum Lateral division of median nerve Recurrent branch Medial division
41. Ulnar Nerve & its Palmar Cutaneous Branch
42. Ulnar nerve Palmar cutaneous br. Of ulnar nerve Superficial terminal branch Deep terminal branch Palmaris brevis Pisiform bone Digital branches of superficial division Flexor retinaculum Deep branch of ulnar nerve
43. Ulnar nerve Deep branch of ulnar nerve
44. Dorsal Cutaneous Branch of Ulnar Nerve & Superficial Radial Nerve
46. Superficial radial nerve Dorsal cutaneous branch of ulnar nerve