Human Anatomy Vol 1

UPPER LIMB

Fig. 9.49: Complete claw-hand

digital branches which supply the skin of the digits as

follows (see Fig.7.1).

1st

2nd

3rd

Lateral side of thumb

Medial side of thumb

Lateral side of index finger

tt
E

=f,
n
EL
f

Eo
o(l,
a

4th : Contiguous sides of index and middle fingers

Note that skin over the dorsum of the distal phalanges,

is supplied by the median nerve (not radial) (Fig.9.50).

Sensory loss is less because of overlapping of nerves.

SPACES OF THE HAND

Having learnt the anatomy of the whole hand, the

clinically significant spaces of the hand need to be

understood and their boundaries to be identified from

the following text.

The arrangement of fasciae and the fascial septa in

the hand is such that many spaces are formed. These

spaces are of surgical importance because they may

become infected and distended with pus. The important

spaces are as follows.

Fig. 9.50: Sensory loss in

nerve

Fig.9.46: Vasomotor and trophic changes in right hand

Lagging in making fist

Flattened thenar

emtnence

Fig. 9.47: Partial claw-hand and lagging behind of index and

middle fingers in making the fist due to paralysis of first and

second lumbrical muscles in median nerue paralysis

Fig. 9.48: Phalen's test: Acutely flexed wrist causes pain in

carpal tunnel syndrome

Phalen's test

Palmar aspect Dorsal aspect

injury to superficial branch of radial