Human Anatomy Vol 1

8 The hook of the hamate lies one finger breadth below
the pisiform bone, in line with the ulnar border of
the ring finger. It canbe felt only on deep palpation
through the hypothenar muscles.
9 The tubercle of the scaphoid lies beneath the lateral
part of the distal transverse crease in an extended
wrist. It can be felt at the base of the thenar eminence
in a depression just lateral to the tendon of the flexor
carpi radialis (Fig. 9.2).
10 The tubercle (crest) of the trapezium may be felt on deep
palpation inferolateral to the tubercle of the scaphoid.
11 The brachioradialls becomes prominent along the
lateral border of the forearm when the elbow is
flexed against resistance in the midprone position
of the hand.
L2 The tendons of the flexor carpi radialis, palmaris longus ,
andflexor carpi ulnaris can be identified on the front
of the wrist when the hand is flexed against
resistance. The tendons lie in the order stated, from
lateral to medial side (Fig. 9.3).
13 The pulsation of the radial artery can be felt in front
of the lower end of the radius just lateral to the
tendon of the flexor carpi radialis.
14 The pulsations of the ulnar artery can be felt by
careful palpation just lateral to the tendon of the
flexor carpi ulnaris. Here the ul:rar nerve lies medial
to the artery.
15 The transaerse creases in front of the wrist are
important landmarks. The proximal transverse
crease lies at the level of the wrist joint, and distal
crease corresponds to the proximal border of the
flexor retinaculum.
16 The median nerae is very superficial in position at
and above the wrist. It lies along the lateral edge of
the tendon of the palmaris longus at the middle of
the wrist.

Crest of trapezium

Tubercle of scaphoid

Styloid process of

radius

Fig.9.2: Sudace landmarks: Wrist and palm

FOREARM AND HAND

Common flexor origin

Pronator teres

Flexor carpi ulnaris

Palmaris longus

Flexor carpi radialis

Flexor digitorum superfi cialis

Flexor retinaculum

Palmar aponeurosis

Fig. 9.3: The superficial muscles of the front of the right forearm

Dissection

The skin of the forearm has already been reflected on

each side. Cut through the superficial and deep fasciae

to expose the superficial muscles of the forearm.

ldentify these five superficial muscles. These are from

lateral to medial side, pronator teres getting inserted into

middle of radius, flexor carpi radialis reaching till the wrist,

palmaris longus continuing with palmar aponeurosis,

flexor digitorum superficialis passing through the palm

and most medially the flexor carpi ulnaris getting inserted

into the pisiform bone (Fig. 9.3).

Deep muscles

Cut through the origin of superficial muscles of forearm

at the level of medial epicondyle of humerus and reflect

them distally. This will expose the three deep muscles,

e.g. flexor pollicis longus, flexor digitorum profundus

and pronator quadratus (refer the S).

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