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Home » Hand Anatomy:Bones ,Joints and muscles

Hand Anatomy:Bones ,Joints and muscles

Bones Of the Hand

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The hand is composed of many different bones, muscles, and ligaments that allow for a large amount of movement and dexterity.

There are 3 major types of bones in the hand itself, including:

  • Phalanges: The 14 bones that are found in the fingers of each hand and also in the toes of each foot. Each finger has 3 phalanges (the distal, middle, and proximal); the thumb only has 2.
  • Metacarpal bones. The 5 bones that compose the middle part of the hand.
  • Carpal bones. The 8 bones that create the wrist. The 2 rows of carpal bones are connected to 2 bones of the arm–the ulna bone and the radius bone.
hand bones

The carpus is formed from eight small bones collectively referred to as the carpal bones. The carpal bones are bound in two groups of four bones:

  • the pisiform, triquetrum, lunate and scaphoid on the upper end of the wrist
  • the hamate, capitate, trapezoid and trapezium on the lower side of the hand.

Other bones of the hand are:

  • the metacarpals – the five bones that comprise the middle part of the hand
  • the phalanges (singular phalanx) – the 14 narrow bones that make up the fingers of each hand. Each finger has three phalanges (the distal, middle, and proximal); the thumb has two.

The hand is divided into three regions:

  • Proximal region of the hand is the carpus (wrist)
  • The middle region the metacarpus (palm)
  • The distal region the phalanges (fingers).

 Carpus

  •  The carpus controls length-tension relationships in the multiarticular hand muscles and to allow fine adjustment of grip.
  • Three of the bones in the proximal row articulate with the radius forming the radiocarpal joint and distally with the distal carpal forming the midcarpal joint.    
  • The four carpal bones in the distal row articulate with the bases of the five metacarpal bones forming the carpometacarpal joints.     
  • The joints formed between the carpal bones are known as the intercarpal joints and most are of the plane synovial type, as the bones interlock with each other the rows are sometimes referred to as two single synovial joints.   

The arrangement of the bones and ligaments allows very little movement between bones, but they do slide contributing to the finer movements of the wrist. 

Carbal Bones
Carbal Bones

The exception to this is the capitate which has a larger range of movement .  

Proximal Row

  • Scaphoid – (boat like)– anterior surface palpable tubercle. Articulates proximally with radius, medially with lunate and distally with the head of the capitate.  It is a common site of fracture- 70% of all carpal fractures[8], often injured by a fall onto an outstretched limb
  • Lunate – (moon shaped) – Its palmar surface is smooth and convex and is larger than its dorsal surface.  Proximally it articulates with the radius and articular disc, medially with the triquetrum, laterally with the scaphoid and distally with the head of the capitate
  • Triquetrum – (three cornered) – Nestles in the space between the lunate and hamate.  When the hand is adducted it enters the radiocarpal joint.
  • Pisiform – (pea shaped) = a small round bone found in the tendon of flexor carpi ulnaris.  It articulates with the palmar surface of the triquetrum.   The anterior surface projects distally and laterally forming the medial part of the carpal tunnel. 

Distal Row

  • Trapezium – four sided figures with no two sides parallel – the most irregular, with a palpable tubercle and groove anterior medially. It articulates proximally with the scaphoid and medially with the trapezoid.  Its articular surface is saddle-shaped and contributes to the mobility of the carpometacarpal joint of the thumb
  • Trapezoid – four sided figure with two parallel sides – Articulates distally with the second metacarpal, laterally with the trapezium, proximally with the scaphoid and medially with the capitate
  • Capitate – head shaped – The largest of all the carpal bones sitting centrally and articulating with the lunate and scaphoid, medially with the hamate and laterally with the trapezoid.  The distal surface articulates mainly with the base of the third metacarpal but also by narrow surfaces with the bases of the second and fourth metacarpals.
  • Hamate – hooked – This is wedge shaped with a curved palpable hook projecting from the palmar surface near the base of the fifth metacarpal.

The Carpal Tunnel – formed by the anterior concave space formed by the pisiform and hamate – on the ulnar side and the scaphoid and trapezium – on the radial side, with a roof-like covering of the flexor retinaculum (strong fibrous bands of connective tissue).  The long flexor tendons of the digits and thumb and the median nerve pass through the carpal tunne.

The Metacarpus

The metacarpus, the palm of the hand, which is made up of five bones – the metacarpals.  The bones are numbered laterally, from the thumb, 1 – 5.  Each bone is long with a proximal quadrilateral base, a shaft (body) and a distal rounded head.  The base of the first metacarpal is saddle-shaped and articulates with the trapezium.  The base of the second metacarpal articulates with the trapezium, trapezoid and capitate. The base of the third metacarpal articulates with the capitate.  The bases of the fourth and fifth metacarpal articulate with the hamate.  The bases of the second to fifth metacarpals also articulate with each other.

The heads of the metacarpals, commonly known as knuckles, are smooth and rounded and extend onto the palmar surface – these become visible when the fist is clenched[6].  The head of the first metacarpal is wider than the others, having two sesamoid bones, usually found in the short tendons crossing the joint, which articulate with the palmar part of the joint surface.  The heads fit into a concavity on the base of the proximal phalanx at the metacarpophlangeal joints.

The Phalanges

The phalanges, the fingers, consist of 14 long bones.  Apart from the thumb (the pollex) each phalanx has three bones, the distal, middle and proximal phalanx – the thumb has only two distal and proximal.  As with the metacarpals, the phalanges are numbered 1-5 starting at the thumb.  The proximal phalanx is large and is concave for articulation with the head of the metacarpal.  The shaft is curved along its length being convex dorsally.  It is convex from side to side on its dorsal surface and flat on the palmar surface.  The distal end, the head, is smaller and convex to articulate with the next bone in sequence.  In order from the thumb, digits are also known as the index finger, middle finger, ring finger and little finger.

Joints Of The Wrist and Hand

The wrist has two degrees of freedom , although some say three degrees of freedom because they include the movements of pronation and supination , which occur at the the radioulnar joint. The radioulnar joint is often referred to as a joint of the forearm but it is this articulation that gives the wrist more freedom of movement.  The true joints of the wrist and hand are listed in the table below .

JointProximal articulationDistal ArticulationTypeMovement
Radiocarpal jointRadius and articular disc/ concaveScaphoid, lunate, triquetrum / – convexEllipsoidFlexion-extension; Abduction-adduction
Midcarpal jointScaphoid. Lunate, TriquetrumTrapezium, Trapezoid, Capitate, HamateGlidingFlexion-extension; Abduction-adduction
Carpometacarpal joint (thumb)trapezium1st metacarpalSaddleFlexion-extension; Abduction-adduction; circumduction; opposition
Carpometacarpal joint (fingers)trapezoid, trapeziumcapitatecapitate, hamatehamate2nd metacarpal3rd metacarpal4th metacarpal5th metacarpalEllipsoidalFlexion-extension
Metacarpophalangeal jointsMetacarpalsphalangealEllipsoidalFlexion, extension, abduction, adduction, circumduction
InterphalangealProximal phalangealDistal phalangealHingeFlexion (lots) Extension (minimal)

Ligaments Of The Wrist and Hand

Important ligaments of the hand are:

  • Collateral ligaments – strong ligaments on either side of the finger and thumb joints, which prevent sideways movement of the joint
  • Volar plate – a ligament that connects the proximal phalanx to the middle phalanx on the palm side of the joint. As the joint in the finger is straightened, this ligament tightens to keep the PIP joint from bending backward.
  • Radial and ulnar collateral ligaments – a pair of ligaments which bind the bones of the wrist and provide stability
  • Volar radiocarpal ligaments – a complex web of ligaments that support the palm side of the wrist
  • Dorsal radiocarpal ligaments – ligaments that support the back of the wrist
  • Ulnocarpal and radioulnar ligaments – two sets of ligaments that provide the main support for the wrist.

The stability of the wrist is provided by ligaments (see table); on the palmar aspect is the flexor retinaculum which together with the carpal bones forms a canal – the carpal tunnel – which nerves, muscles and blood vessels run through, it is this area that is involved in carpal tunnel syndrome.

LigamentLocationFunction
Posterior radiocarpal ligamentruns diagonally across the posterior aspect of the wrist from the distal end of the radius to the triquetral and hamate carpal bones (on the ulnar side of the wristlimits flexion of the wrist
Anterior radiocarpal ligamentruns from the anterior aspect of the distal end of the radius to the scaphoid, lunate and capitate bones of the wristLimits extension of the wrist
Radial collateral ligamentfrom the styloid process of radius to the scaphoid bonelimits adduction of wrist (frontal plane)
Ulnar collateral ligamentfrom the styloid process of the ulna to the triquetrallimits abduction (front plane)
Anterior, posterior and interosseous carpal ligamentsBetween the carpal bonesholds carpal bones together – reinforced by the shape and interlocking structure of the bones
Transverse carpal ligamentflexor retinaculumThe roof of the carpal tunnel which the median nerve and flexor tendons pass through

Muscles Of The Hand

Muscles acting on the hand can be divided into two groups: extrinsic and intrinsic muscles.

1. Extrensic muscles

The extrinsic muscles are located in the anterior and posterior compartments of the forearm. They control crude movements and produce a forceful grip.

  • The muscles in the anterior compartment of the forearm are organised into three layers:
  • Superficial: flexor carpi ulnaris, palmaris longus, flexor carpi radialis, pronator teres.
  • Intermediate: flexor digitorum superficialis.
  • Deep: flexor pollicis longus, flexor digitorum profundus and pronator quadratus.

This muscle group is associated with pronation of the forearm, flexion of the wrist and flexion of the fingers.

They are mostly innervated by the median nerve (except for the flexor carpi ulnaris and medial half of flexor digitorum profundus, which are innervated by the ulnar nerve), and they recieve arterial supply from the ulnar artery and radial artery

Anterior Compartment: Extrinsic Hand Muscles

Superficial Compartment

The superficial muscles in the anterior compartment are the flexor carpi ulnaris, palmaris longus, flexor carpi radialis and pronator teres.

They all originate from a common tendon, which arises from the medial epicondyle of the humerus.

1.Flexor Carpi Ulnaris

Attachments: The flexor carpi ulnaris has two origins. The humeral head originates from the medial epicondyle of the humerus with the other superficial flexors, whilst the ulnar head originates from the olecranon of the ulnar.

The muscle tendon passes into the wrist and attaches to the pisiform bone, hook of hamate, and base of the 5th metacarpal

Actions: Flexion and adduction at the wrist.

Innervation: Ulnar nerve.

2.Palmaris Longus

This muscle is absent in about 15% of the population.

Attachments: Originates from the medial epicondyle, attaches to the flexor retinaculum of the wrist.

Actions: Flexion at the wrist.

Innervation: Median nerve.

3.Flexor Carpi Radialis

Attachments: Originates from the medial epicondyle, attaches to the base of metacarpals II and III.

Actions: Flexion and abduction at the wrist.

Innervation: Median nerve.

4.Pronator Teres

The lateral border of the pronator teres forms the medial border of the cubital fossa, an anatomical triangle located over the elbow.

Attachments: It has two origins, one from the medial epicondyle, and the other from the coronoid process of the ulna. It attaches laterally to the mid-shaft of the radius.

Actions: Pronation of the forearm.

Innervation: Median nerve.

The Superficial muscles in the anterior compartment of the hand
The Superficial muscles in the anterior compartment of the hand

Intermediate Compartment

The flexor digitorum superficialis is the only muscle of the intermediate compartment. It can sometimes be classed as a superficial muscle, but in most individuals, it lies between the deep and superficial muscle layers.

The muscle is a good anatomical landmark in the forearm – the median nerve and ulnar artery pass between its two heads, and then travel posteriorly.

Attachments: It has two heads – one originates from the medial epicondyle of the humerus, the other from the radius. The muscle splits into four tendons at the wrist, which travel through the carpal tunnel, and attaches to the middle phalanges of the four fingers.

Actions: Flexes the metacarpophalangeal joints and proximal interphalangeal joints at the 4 fingers, and flexes at the wrist.

Innervation: Median nerve.

Deep Compartment

There are three muscles in the deep anterior forearm: flexor digitorum profundus, flexor pollicis longus, and pronator quadratus.

1.Flexor Digitorum Profundus

Attachments: Originates from the ulna and associated interosseous membrane. At the wrist, it splits into four tendons, that pass through the carpal tunnel and attach to the distal phalanges of the four fingers.

Actions: It is the only muscle that can flex the distal interphalangeal joints of the fingers. It also flexes at metacarpophalangeal joints and at the wrist.

Innervation: The medial half (acts on the little and ring fingers) is innervated by the ulnar nerve. The lateral half (acts on the middle and index fingers) is innervated by the anterior interosseous branch of the median nerve.

2.Flexor Pollicis Longus

This muscle lies laterally to the FDP.

Attachments: Originates from the anterior surface of the radius and surrounding interosseous membrane. Attaches to the base of the distal phalanx of the thumb.

Actions:  Flexes the interphalangeal joint and metacarpophalangeal joint of the thumb.

Innervation: Median nerve (anterior interosseous branch).

3.Pronator Quadratus

A square shaped muscle found deep to the tendons of the FDP and FPL.

Attachments: Originates from the anterior surface of the ulna and attaches to the anterior surface of the radius.

Actions: Pronates the forearm.

Innervation: Median nerve (anterior interosseous branch).

The Deep muscles in the anterior compartment of the hand
The Deep muscles in the anterior compartment of the hand

Posterior Compartment Of Extrinsic Hand Muscles

  • The muscles in the posterior compartment of the forearm are commonly known as the extensor muscles.

The general function of these muscles is to produce extension at the wrist and fingers. They are all innervated by the radial nerve.

Anatomically, the muscles in this compartment can be divided into two layers; deep and superficial. These two layers are separated by a layer of fascia.

Superficial Muscles

The superficial layer of the posterior forearm contains seven muscles. Four of these muscles – extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris and extensor digiti minimi share a common tendinous origin at the lateral epicondyle.

1.Brachioradialis

The brachioradialis is a paradoxical muscle. Its origin and innervation are characteristic of an extensor muscle, but it is actually a flexor at the elbow.

The muscle is most visible when the forearm is half pronated, and flexing at the elbow against resistance.

In the distal forearm, the radial artery and nerve are sandwiched between the brachioradialis and the deep flexor muscles.

Attachments: Originates from the proximal aspect of the lateral supracondylar ridge of humerus, and attaches to the distal end of the radius, just before the radial styloid process.

Actions: Flexes at the elbow.

Innervation: Radial nerve.

2.Extensor Carpi Radialis Longus and Brevis

The extensor carpi radialis muscles are situated on the lateral aspect of the posterior forearm. Due to their position, they are able to produce abduction as well as extension at the wrist.

Attachments: The ECRL originates from the supracondylar ridge, while the ECRB originates from the lateral epicondyle. Their tendons attach to metacarpal bones II and III.

Actions: Extends and abducts the wrist.

Innervation: Radial nerve.

3.Extensor Digitorum Communis

The extensor digitorum is the main extensor of the fingers. To test the function of the muscle, the forearm is pronated, and the fingers extended against resistance.

Attachments: Originates from the lateral epicondyle. The tendon continues into in the distal part of the forearm, where it splits into four, and inserts into the extensor hood of each finger.

Actions: Extends medial four fingers at the MCP and IP joints.

Innervation: Radial nerve (deep branch).

4.Extensor Digiti Minimi

The extensor digiti minimi is thought to originate from the extensor digitorum muscle. In some people, these two muscles are fused together. Anatomically, the extensor digiti minimi lies medially to the extensor digitorum.

Attachments: Originates from the lateral epicondyle of the humerus. It attaches, with the extensor digitorum tendon, into the extensor hood of the little finger.

Actions: Extends the little finger, and contributes to extension at the wrist.

Innervation: Radial nerve (deep branch).

5.Extensor Carpi Ulnaris

The extensor carpi ulnaris is located on the medial aspect of the posterior forearm. Due to its position, it is able to produce adduction as well as extension at the wrist.

Attachments: Originates from the lateral epicondyle of the humerus,and attaches to the base of metacarpal V.

Actions: Extension and adduction of wrist.

Innervation: Radial nerve (deep branch).

6.Anconeus

The anconeus is situated medially and superiorly in the extensor compartment of the forearm. It is blended with the fibres of the triceps brachii, and the two muscles can be indistinguishable.

Attachments: Originates from the lateral epicondyle, and attaches to the posterior and lateral part of the olecranon.

Actions: Extends and stablises the elbow joint. Abducts the ulna during pronation of the forearm.

Innervation: Radial nerve.

The superficial muscles in the  posterior compartment of the hand

Deep Muscles

There are five muscles in the deep compartment of the posterior forearm – the supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus and extensor indicis.

With the exception of the supinator, these muscles act on the thumb and the index finger.

1.Supinator

 The supinator lies in the floor of the cubital fossa. It has two heads, which the deep branch of the radial nerve passes between.

Attachments: It has two heads of origin. One originates from the lateral epicondyle of the humerus, the other from the posterior surface of the ulna. They insert together into the posterior surface of the radius.

Actions: Supinates the forearm.

Innervation: Radial nerve (deep branch).

2.Abductor Pollicis Longus

The abductor pollicis longus is situated immediately distal to the supinator muscle. In the hand, its tendon contributes to the lateral border of the anatomical snuffbox.

Attachments: Originates from the interosseous membrane and the adjacent posterior surfaces of the radius and ulna. It attaches to the lateral side of the base of metacarpal I.

Actions: Abducts the thumb.

Innervation: Radial nerve (posterior interosseous branch).

3.Extensor Pollicis Brevis

The extensor pollicis brevis can be found medially and deep to the abductor pollicis longus. In the hand, its tendon contributes to the lateral border of the anatomical snuffbox.

Attachments: Originates from the posterior surface of the radius and interosseous membrane. It attaches to the base of the proximal phalanx of the thumb.

Actions: Extends at the metacarpophalangeal and carpometacarpal joints of the thumb.

Innervation: Radial nerve (posterior interosseous branch).

4.Extensor Pollicis Longus

The extensor pollicis longus muscle has a larger muscle belly than the EPB. Its tendon travels medially to the dorsal tubercle at the wrist, using the tubercle as a ‘pulley’ to increase the force exerted.

The tendon of the extensor pollicis longus forms the medial border of the anatomical snuffbox in the hand.

Attachments: Originates from the posterior surface of the ulna and interosseous membrane. It attaches to the distal phalanx of the thumb.

Actions: Extends all joints of the thumb: carpometacarpal, metacarpophalangeal and interphalangeal.

Innervation: Radial nerve (posterior interosseous branch).

5.Extensor Indicis Proprius

This muscle allows the index finger to be independent of the other fingers during extension.

Attachments: Originates from the posterior surface of the ulna and interosseous membrane, distal to the extensor pollicis longus. Attaches to the extensor hood of the index finger.

Actions: Extends the index finger.

Innervation: Radial nerve (posterior interosseous branch).

The Deep muscles in the  posterior compartment of the hand
The Deep muscles in the  posterior compartment of the hand

2. Intrinsic muscles

The intrinsic muscles of the hand are located within the hand itself. They are responsible for the fine motor functions of the hand.

Thenar Muscles

The thenar muscles are three short muscles located at the base of the thumb. The muscle bellies produce a bulge, known as the thenar eminence. They are responsible for the fine movements of the thumb.

The median nerve innervates all the thenar muscles.

  • Opponens Pollicis

The opponens pollicis is the largest of the thenar muscles, and lies underneath the other two.

Attachments: Originates from the tubercle of the trapezium, and the associated flexor retinaculum. It inserts into the lateral margin of the metacarpal of the thumb (i.e. the first metacarpal).

Actions: Opposes the thumb, by medially rotating and flexing the metacarpal on the trapezium.

Innervation: Median nerve.

  • Abductor Pollicis Brevis

This muscle is found anteriorly to the opponens pollicis and proximal to the flexor pollicis brevis.

Attachments: Originates from the tubercles of the scaphoid and trapezium, and from the associated flexor retinaculum. Attaches to lateral side of proximal phalanx of the thumb.

Actions: Abducts the thumb.

Innervation: Median nerve.

  • Flexor Pollicis Brevis

The most distal of the thenar muscles.

Attachments: Originates from the tubercle of the trapezium and from the associated flexor retinaculum. Attaches to the base of the proximal phalanx of the thumb.

Actions: Flexes the metacarpophalangeal (MCP) joint of the thumb.

Innervation: Median nerve. The deep head is innervated by the deep branch of the ulnar nerve.

Thenar Muscles
Thenar Muscles

Hypothenar Muscles

The hypothenar muscles produce the hypothenar eminence – a muscular protrusion on the medial side of the palm, at the base of the little finger. These muscles are similar to the thenar muscles in both name and organisation.

The ulnar nerve innervates the muscles of the hypothenar eminence.

  • Opponens Digiti Minimi

The opponens digit minimi lies deep to the other hypothenar muscles.

Attachments: Originates from the hook of hamate and associated flexor retinaculum, inserts into the medial margin of metacarpal V.

Actions: It rotates the metacarpal of the little finger towards the palm, producing opposition.

Innervation: Ulnar nerve.

  • Abductor Digiti Minimi

The most superficial of the hypothenar muscles.

Attachments: Originates from the pisiform and the tendon of the flexor carpi ulnaris. It attaches to the base of the proximal phalanx of the little finger.

Actions: Abducts the little finger.

Innervation: Ulnar nerve.

  • Flexor Digiti Minimi Brevis

This muscle lies laterally to the abductor digiti minimi.

Attachments: Originates from the hook of hamate and adjacent flexor retinaculum, and inserts into the base of the proximal phalanx of the little finger.

Actions: Flexes the MCP joint of the little finger.

Innervation: Ulnar nerve.

The hypothenar muscles
The hypothenar muscles

Lumbricals

These are four lumbricals in the hand, each associated with a finger. They are very crucial to finger movement, linking the extensor tendons to the flexor tendons.

Denervation of these muscles is the basis for the ulnar claw and hand of benediction.

Attachments: Each lumbrical originates from a tendon of the flexor digitorum profundus. They pass dorsally and laterally around each finger, and inserts into the extensor hood.

Actions: Flexion at the MCP joint and extension at the interphalangeal (IP) joints of each digit.

Innervation: The lateral two lumbricals (of the index and middle fingers) are innervated by the median nerve.

 The medial two lumbricals (of the little and ring fingers) are innervated by the ulnar nerve.

Four lumbricals in the hand
Four lumbricals in the hand

Interossei

The interossei muscles are located between the metacarpals. They can be divided into two groups: the dorsal and palmar interossei.  

In addition to their actions of abduction (dorsal interossei) and adduction (palmar interossei) of the fingers, the interossei also assist the lumbricals in flexion at the MCP joints and extension at the IP joints.

  • Dorsal Interossei

The most superficial of all dorsal muscles, these can be palpated on the dorsum of the hand. There are four dorsal interossei muscles.

Attachments: Each interossei originates from the lateral and medial surfaces of the metacarpals. They attach into the extensor hood and proximal phalanx of each finger.

Actions: Abduct the fingers at the MCP joint.

Innervation: Ulnar nerve.

  • Palmar Interossei

These are located anteriorly on the hand. There are three palmar interossei muscles – although some texts report a fourth muscle at the base of the proximal phalanx of the thumb.

Attachments: Each interossei originates from a medial or lateral surface of a metacarpal, and attaches into the extensor hood and proximal phalanx of same finger.

Actions: Adducts the fingers at the MCP joint.

Innervation: Ulnar nerve.

Dorsal and Palmar Interossei Muscles
Dorsal and Palmar Interossei Muscles

Other Muscles in the Palm

There are two other muscles in the palm that are not lumbricals or interossei and do not fit in the hypothenar or thenar compartments:

  • Palmaris Brevis

This is a small, thin muscle, found very superficially in the subcutaneous tissue of the hypothenar eminence.

Attachments: Originates from the palmar aponeurosis and flexor retinaculum, attaches to the dermis of the skin on the medial margin of the hand.

Actions: Wrinkles the skin of the hypothenar eminence and deepens the curvature of the hand, improving grip.

Innervation: Ulnar nerve.

  • Adductor Pollicis

This is large triangular muscle with two heads. The radial artery passes anteriorly through the space between the two heads, forming the deep palmar arch.

Attachments: One head originates from metacarpal III. The other head originates from the capitate and adjacent areas of metacarpals II and III. Both attach into the base of the proximal phalanx of the thumb.

Actions: Adductor of the thumb.

Innervation: Ulnar nerve.

Adductor Pollicis
Adductor Pollicis

References

1.Apaydin N, Tubbs S, Loukas M, Duparc F. Review of the surgical anatomy of the axillary nerve and the anatomic basis of its iatrogenic and traumatic injury. Springer. 2010;32:193-201.

2. Health. (2021). Johns Hopkins Medicine.  https://www.hopkinsmedicine.org/health/treatment- tests-and therapies/anatomy-of-the-hand 

3.Manske R, Sumler A, Runge J. Quadrilateral space syndrome. Humen Kinetics- ATTI.2009;14(2):45-47.

4.Miller T. Peripheral nerve injuries at the shoulder. The Journal of Manipulative Therapy. 1998;6(4)170-183.

5.Miller T. Axillary neuropathy following traumatic dislocation of the shoulder: a case study. The Journal of Manual & Manipulative Therapy. 1998;6(4):184-185.

6.Muscles of the Hand. (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper- limb/muscles/hand/

7.Muscles in the Posterior Compartment of the Forearm.  (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper-limb/muscles/posterior-forearm/

8. Nerve Supply to the Upper Limb. (22 October 2021). https://geekymedics.com/nerve-supply-to- the-upper-limb/#Musculocutaneous_nerve_C5C6C7 

9.Palastanga, N. P., Soames, R. W., & Nigel Palastanga MA BA FCSP DMS DipTP (2011). Anatomy and human movement: Structure and function (Physiotherapy essentials) (6th ed.). Edinburgh: Churchill Livingstone.

10.Radial nerve. (2021). Physiopediahttps://www.physio-pedia.com/Radial_nerve

 11.The Axillary Nerve. (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper- limb/nerves/axillary-nerve/

12.The Brachial Plexus. (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper- limb/nerves/brachial-plexus/

13.The Median Nerve. (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper- limb/nerves/median-nerve/

14.The Musculocutaneous Nerve. (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper- limb/nerves/musculocutaneous-nerve/

15.The Radial Nerve. (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper- limb/nerves/radial-nerve/

16.The Ulnar Nerve. (2021). Teach Me Anatomy. https://teachmeanatomy.info/upper- limb/nerves/ulnar-nerve/

7 thoughts on “Hand Anatomy:Bones ,Joints and muscles”

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