Objectives- Palm of the Hand

1. Describe the function of the hand

Numerous movements of the hand allow manual dexterity
during occupational and recreational activites
2. Discuss attachments, function, and pathologies of the palmar
aponeurosis and flexor retinaculum
Palmar Aponeurosis
Palmar aponeurosis: strong part of the deep fascia of the
palm, covers soft tissue and overlies the long flexor tendons
Proximal end of the palmar aponeurosis is continuous with the
flexor retinaculum and the palamaris longus tendon
Palmar aponeurosis is basically an extension of the palmar
longus if it is present
Palmar aponeurosis forms 4 longitudinal bands that radiate
from the apex and attach to the bases of the proximal
phalanges and continue on to form the fibrous digital sheaths
Disease of aponeurosis: Dupuytren Contracture
o Shortening, thickening, fibrosis of the palmar fascia and
aponeurosis
o Degeneration on medial side pulls 4th/5th fingers into
partial flexion
o Treatment: surgical excision of fibrotic parts of palmar
fascia
Flexor Retinaculum
Origin for muscles of thenar eminence
Forms the carpal tunnel on the anterior aspect of wrist
Attached medially to triquetrum, psiform, and hamate, and
laterally to scaphoid and trapezium
Crossed superficially by
o Ulnar nerve and artery
o Palmar longus tendon
o Palmar cutaneous branch of the median nerve
3. List the contents of the carpal tunnel
Formed anteriorly by flexor retinaculum and posteriorly by the
carpal bones
Contains:
o Median Nerve
o FDS (flexor digitorum superficialis)
o FDP (flexor digitorum profundus)
o FPL (flexor pollicis longus)
4. Identify muscles, blood vessels, and nerves of the palm
On sheet
5. Describe the origins and destinations of nerves and vessels