Nerves and arteries of hand

By
Dr Asma Aijaz
MBBS, Mphil (Anatomy), CHPE
Assistant Professor
Department of Anatomy
KMDC
 Arteries of hand
• Ulnar artery: Enters hand by passing superficial to flexor retinaculum
and ends by dividing into superficial palmar branch and deep palmar
branch
• Superficial branch forms superficial palmar arch
• Deep branch join and complete deep palmar arch
• Superficial palmar arch: formed
as direct continuation of ulnar
artery beyond flexor retinaculum
by superficial palmar branch and
completed on its lateral side by
superficial palmar branch of
radial artery
• It is present deep to palamaris
brevis and palmar aponeurosis
and superficial to flexor tendons
of fingers, flexor digiti minimi,
lumbricals and digital branches of
median nerve
• Branches of superficial palmar arch:
• Four common palmar digital branches to supply medial 3 ½
fingers.
• The lateral three digital branches are joined by
corresponding three palmar metacrapal arteries from deep
palamar arch
 RADIAL ARTERY IN HAND
• It leaves forearm by winding
backward around the wrist to enter
anatomical snuff box where it passes
deep to tendons of abductor pollicis
longus, extensor pollicis brevis and
extensor pollicis longus
• It reaches proximal end of first
interosseous space , then passes
thru first dorsal interosseous muscle
to reach palm
• In palm it passes b/w two heads of
adductor pollicis to form deep
palmar arch
 Branches of radial artery
• DORSUM:
1. A branch to lateral side of dorsum
of thumb
2. First dorsal metacarpal artery
divides into two branches for
adjacent sides of thumb and index
finger
• PALM:
1. Princeps pollicis-----divides at the
base of proximal phalanx into two
branches for palmar surface of
thumb
2. Radialis indicis-------supply lateral
side of index finger
 DEEP PALMAR ARCH
• Form mainly by terminal part of
radial artery and completed
medially at the base of fifth
metacarpal bone by deep
palmar branch of ulnar artery
• It lies on proximal part of shafts
of metacarpal bones and on
interossei deep to oblique head
of adductor pollicis, lumbricals
and long flexor tendons
 Branches of deep palmar arch
1. From its convexity, it gives off three palmar metacarpal
arteries which supply medial four metacarpals and
terminate at finger clefts by joining lateral three common
palmar digital branches of superficial palmar arch
 Branches of Deep Palmar arch
2 .From the concavity of arch
Recurrent branch arises and it
passses proximally to and in
palmar carpal arch and supply
carpal bones and joints.
3 .Dorsally the arch gives off
three perforating arteries
which passes thru medial three
inteosseous spaces to
anastomose with dorsal
metacarpal arteries
 Ulnar nerve in hand
• Enters hand by passing superficial to flexor
retinaculum where it lies b/w pisiform bone
and ulnar vessels and then divides into
superficial and deep terminal branches
 BRANCHES OF ULNAR NERVE
• A. FROM SUPERFICIAL TERMINAL BRANCH:
• 1. MUSCULAR BRANCH: to Palmaris brevis
2. CUTANEOUS BRANCH: 2 palmar digital nerves
supply medial 1 ½ fingers
• B. FROM DEEP TERMINAL BRANCH:
• 1. MUSCULAR BRANCH: Three hypothenar
muscles, medial 2 lumbricals, eight interrosei and
ends by supplying adductor pollicis
• 2. ARTICULAR BRANCH: Wrist joint
 Median nerve in hand
• It enters hand by passing deep to flexor
retinaculum where it lies in front of ulnar
bursa closing flexor tendons , in the narrow
space of carpal tunnel
• Below flexor retinaculum, it divides into
medial and lateral divisions
BRANCHES OF MEDIAN NERVE IN HAND
• Lateral division:
• Muscular branches: thenar muscles
• Three digital branches: to lateral one and a half fingers including
thumb. The digital branch to index finger also supply first
lumbrical
• Medial division:
• Two digital branches: for second and third interdigital clefts
supplying adjoining sides of index , middle and ring fingers.
• The lateral digital branch also supply second lumbrical
• Digital branches also gives cutaneous branches to the dorsum of
distal phalanges and part of middle phalanges of lateral 3 ½ digits
 Radial nerve in hand
• The superficial terminal branch of radial nerve enters
dorsum of hand by winding around lateral side of radius,
then it passes over anatomical snuff box and divides into
4 or 5 digital branches which supply skin of proximal
phalanges of dorsum of digits as follows:
• 1st--------lateral side of thumb
• 2nd--------medial side of thumb
• 3rd----lateral side of index finger
• 4th------contiguous sides of index and middle finger
• 5th----contiguous sides of middle and ring finger