Palm of the Hand

Gross Anatomy


Palm of the Hand


Anatomy Tables for Today's Topic

Bones of the Wrist and Hand
Intrinsic Muscles of the Hand
Flexor Muscles of the Forearm that Move the Fingers
Nerves of the Hand
Arteries of Hand
Joints of the Hand and Fingers
Fasciae of the Forearm and Hand

Bones of the Wrist and Hand

Bone Structure Description Notes
carpal bones   the bones of the wrist eight bones arranged in two rows; a pneumonic for memorizing the carpal bones is " some lovers try positions that they can't handle" - the first letters of these eight words are the first letters of the names of the eight carpal bones arranged from lateral to medial, proximal row first: scaphoid, lunate, triquitrum, pisiform/trapezium, trapezoid, capitate, hamate
proximal row lateral to medial: scaphoid, lunate, triquetrum, pisiform the scaphoid and lunate bones of the proximal row articulate with the distal end of the radius
distal row lateral to medial: trapezium, trapezoid, capitate, hamate the distal row of carpal bones articulates with the metacarpal bones of the hand
scaphoid   the most lateral carpal bone of the proximal row the scaphoid bone is located in the floor of the anatomical snuff box; it is frequently fractured by hyperextension and abduction of the wrist; scaphoid means "boat-shaped"
lunate   the carpal bone located between the scaphoid and triquetrum in the proximal row the lunate is so named because it is "moon-shaped" (crescent shaped) in longitudinal section; the head of the capitate sits within the crescent of the lunate
triquetrum   the carpal bone between the lunate and pisiform bones in the proximal row of carpal bones it articulates with the pisiform which sits anterior to it
pisiform   a sesamoid bone in the tendon of the flexor carpi ulnaris m. it articulates with the triquetrum; the pisiform bone provides a protective function for the flexor carpi ulnaris tendon by bearing the forces generated by the tendon riding across the triquitrum, especially during wrist extension; pisiform means "pea-shaped"
trapezium   the most lateral carpal bone of the distal row it forms a saddle joint with the metacarpal bone of the thumb; "the thumb swings on the trapezium"
trapezoid   the carpal bone located between the trapezium and the capitate in the distal row the trapezoid is named for its trapezoid shape
capitate   the carpal bone located between the trapezoid and the hamate in the distal carpal row the capitate is the largest carpal bone; it is named for its rounded head; forces generated in the hand (as during a punching blow with the fist) are transmitted through the third metacarpal bone to the capitate and proximally through the lunate to the radius
hamate   the most medial carpal bone in the distal row the hamulus (hook) of the hamate is its distinguishing characteristic; it is an attachment point of the flexor retinaculum
metacarpal bones   the bones located between the carpal bones (wrist) and the phalanges (fingers) of the hand there are a total of five metacarpal bones in the hand; the metacarpals of digits 2-5 are bound together by ligaments to form a firm foundation for finger movements; the metacarpal of the thumb is more independent in its range of motion
base the proximal end of the metacarpal it articulates with the distal row of carpal bones
body the slender shaft of the metacarpal it is also known as the diaphysis
head the rounded distal end of the metacarpal it articulates with the proximal phalanx of the corresponding digit
phalanx (phalanges)   the distal two or three bones in the digits of the hand there are a total of 14 phalanges in the hand; the thumb has two phalanges (proximal and distal) and each of the other digits has three phalanges (proximal, middle and distal); phalanx means "line of soldiers"
base the proximal end of the phalanx the base of the proximal phalanx articulates with the head of the corresponding metacarpal bone; the base of the middle or distal phalanx articulates with the head of the next proximal phalanx
body the slender shaft of the phalanx also known as the diaphysis; the body of the distal phalanx is very short
head the distal end of the phalanx the proximal, middle and distal phalanges each have a head; the head of a proximal or middle phalanx articulates with the base of the next distal phalanx

Intrinsic Muscles of the Hand

Muscle Origin Insertion Action Innervation Artery Notes
abductor digiti minimi (hand) pisiform base of the proximal phalanx of the 5th digit on its ulnar side abducts the 5th digit deep branch of the ulnar nerve ulnar a. abductor digiti minimi, flexor digiti minimi brevis, and opponens digiti minimi are located in the hypothenar compartment of the hand
abductor pollicis brevis flexor retinaculum, scaphoid, trapezium base of the proximal phalanx of the first digit abducts the thumb recurrent branch of median nerve superficial palmar br. of the radial a. abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis are located in the thenar compartment of the hand
adductor pollicis oblique head: capitate and base of the 2nd and 3rd metacarpals; transverse head: shaft of the 3rd metacarpal base of the proximal phalanx of the thumb adducts the thumb ulnar nerve, deep branch deep palmar arterial arch deep palmar arch and deep ulnar nerve pass between the two heads of adductor pollicis, which is in the adductor-interosseous compartment
dorsal interosseous (hand) four muscles, each arising from two adjacent metacarpal shafts base of proximal phalanx and extensor expansion on lateral side of 2nd digit, lateral & medial sides of 3rd digit, and medial side of 4th digit flex metacarpophalangeal, extend proximal and distal interphalangeal joints of digits 2-4, abduct digits 2-4 (abduction of digits of hand is defined as movement away from midline of 3rd digit)ulnar nerve, deep branch dorsal metacarpal aa. bipennate muscles; remember DAB & PAD: meaning Dorsal interossei ABduct and Palmar interossei ADduct, then you can figure out where they must insert
flexor digiti minimi brevis (hand) hook of hamate & the flexor retinaculum proximal phalanx of the 5th digit flexes the carpometacarpal and metacarpophalangeal joints of the 5th digit ulnar nerve, deep branch ulnar a. flexor digiti minimi brevis, abductor digiti minimi, and opponens digiti minimi are in the hypothenar compartment of the hand
flexor pollicis brevis flexor retinaculum, trapezium proximal phalanx of the 1st digit flexes the carpometacarpal and metacarpophalangeal joints of the thumb recurrent branch of the median nerve superficial palmar br. of the radial a. flexor pollicis brevis, abductor pollicis brevis, and opponens pollicis are the three muscles of the thenar compartment of the hand
lumbrical (hand) flexor digitorum profundus tendons of digits 2-5 extensor expansion on the radial side of the proximal phalanx of digits 2-5 flex the metacarpophalangeal joints, extend the proximal and distal interphalangeal joints of digits 2-5 median nerve (radial 2) via palmar digital nerves & ulnar nerve (ulnar 2) via deep branch superficial palmar arterial arch lumbricals, (lumbricus is Latin for "worm") arise from the profundus tendons and have the same pattern of innervation as does the profundus muscle (ulnar and median nn. split the task equally)
opponens digiti minimi hook of hamate and flexor retinaculum shaft of 5th metacarpal opposes the 5th digit ulnar nerve, deep branch ulnar a. opposition is a rotational movement of the 5th metacarpal around the long axis of its shaft; opponens digiti minimi, abductor digiti minimi, and flexor digiti minimi brevis are in the hypothenar compartment of the hand
opponens pollicis flexor retinaculum, trapezium shaft of 1st metacarpal opposes the thumb recurrent branch of median nerve superficial palmar branch of the radial a. opposition is a rotational movement of the 1st metacarpal around the long axis of its shaft; opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis are in the thenar compartment of the hand
palmar interosseous three muscles, arising from the palmar surface of the shafts of metacarpals 2, 4, & 5 base of the proximal phalanx and extensor expansion of the medial side of digit 2, and lateral side of digits 4 & 5 flexes the metacarpophalangeal, extends proximal and distal interphalangeal joints and adducts digits 2, 4, & 5 (adduction of the digits of the hand is in reference to the midline of the 3rd digit) ulnar nerve, deep branch palmar metacarpal aa. unipennate muscles; remember PAD & DAB: Palmar interossei ADduct and Dorsal interossei ABduct, and you will be able to figure out where they must insert


Flexor Muscles of the Forearm That Move the Fingers

Muscle Origin Insertion Action Innervation Artery Notes
flexor digitorum profundus posterior border of the ulna, proximal two-thirds of medial border of ulna, interosseous membrane base of the distal phalanx of digits 2-5 flexes the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints median nerve (radial one-half); ulnar nerve (ulnar one-half) ulnar a., anterior interosseous a. ulnar nerve innervates the portion of profundus that acts on digits 4 & 5 (the ulnar 2 digits)
flexor digitorum superficialis humeroulnar head: common flexor tendon; radial head: middle 1/3 of radius shafts of the middle phalanges of digits 2-5 flexes the metacarpophalangeal and proximal interphalangeal joints median nerve ulnar a. median nerve travels distally in the forearm on the deep surface of the flexor digitorum superficialis m.
flexor pollicis longus anterior surface of radius and interosseous membrane base of the distal phalanx of the thumb flexes the metacarpophalangeal and interphalangeal joints of the thumb median nerve anterior interosseous a. the tendon of flexor pollicis longus passes through the carpal tunnel with the other long digital flexor tendons and the median nerve

Nerves of the Hand

Nerve Source Branches Motor Sensory Notes
common palmar digital nn. median n.; superficial br. of the ulnar n. proper palmar digital nn. sympathetic motor to the skin; motor nn. to the 1st & 2nd lumbrical mm. are carried on common palmar digital brs. of the median n. skin of the palmar surfaces of the adjacent sides of two digits the proper branches of these nerves also supply the dorsum of the tip of the digit (nail bed)
dorsal digital n. radial n. no named branches sympathetic motor innervation to skin dorsal skin of the lateral 3 1/2 digits, except the nail bed the nail bed is supplied by palmar digital nn.
median n. lateral and medial cords of the brachial plexus unnamed muscular branches, anterior interosseous n., palmar br., recurrent (motor) br., common palmar digital nn. (for digits 1-3) pronator teres m., flexor carpi radialis m., palmaris longus m., flexor digitorum superficialis m., flexor digitorum profundus m. (radial half), flexor pollicis longus m., pronator quadratus m., abductor pollicis brevis m., flexor pollicis brevis m., opponens pollicis m., lateral 2 lumbrical mm. skin of the radial half of the palm and palmar side of the lateral 3 1/2 digits (and nail bed for these digits) the median n. is motor to the flexor muscles of the forearm (except flexor carpi ulnaris and the medial 1/2 of the flexor digitorum profundus),the muscles of the thenar compartment and the lateral 2 lumbricals
proper palmar digital nn. common palmar digital branches of the median n.; common palmar digital branches of the superficial br. of the ulnar n. no named branches sympathetic motor to the skin median: palmar skin and nail bed of digits 1-3 and the lateral side of 4th digit; ulnar: palmar and dorsal skin on medial side of the 4th digit and all of the 5th digit proper palmar digital nn. supply the dorsum of the tip of the digit (nail bed)
ulnar n. medial cord of the brachial plexus (C8, T1) palmar cutaneous br., dorsal br., superficial and deep brs. flexor carpi ulnaris m., flexor digitorum profundus m. (ulnar half), abductor digiti minimi m., flexor digiti minimi brevis m., opponens digiti minimi m., ulnar 2 lumbrical mm., palmar and dorsal interosseous mm. skin of the medial side of the wrist and hand; skin of the medial 1 1/2 digits ulnar n. is motor to most of the muscles of the hand


Arteries of the Hand

Artery Source Branches Supply to Notes
common palmar digital superficial palmar arterial arch proper palmar digital aa. (2) palmar aspect two adjacent digits common palmar digital aa. anastomose with palmar metacarpal aa.
deep palmar arch radial a., deep br. of ulnar a. palmar metacarpal aa. (2nd-4th), perforating brs. deep palm, digits including the dorsum of the distal phalangeal segment deep palmar arterial arch receives its major blood supply from the radial a.
digital, common palmar superficial palmar arterial arch proper palmar digital aa. (2) palmar aspect two adjacent digits common palmar digital aa. anastomose with palmar metacarpal aa.
digital, proper palmar common palmar digital a. no named branches palmar aspect of each digit proper palmar digital aa. supply the dorsum of the distal phalangeal segment and nail bed
dorsal carpal arterial arch radial a., ulnar a. dorsal metacarpal aa. dorsum of the hand and digits, excluding the distal phalangeal segment dorsal carpal arterial arch receives the majority of its blood supply from the radial a.
dorsal digital, of hand dorsal metacarpal a. no named branches dorsal aspect of 1/2 digit, excluding the distal phalangeal segment dorsal digital aa. do not supply the nail bed
dorsal metacarpal 1st: radial a.; 2-4: dorsal carpal arterial arch dorsal digital aa. (2) dorsum of 2 adjacent digits, excluding the distal phalangeal segment each dorsal metacarpal a. gives off a perforating br. that anastomoses with the deep palmar arterial arch
palmar metacarpal deep palmar arch proper palmar digital aa. interosseous mm., deep hand palmar metacarpal aa. join with the common palmar digital aa.
superficial palmar arch ulnar a., superficial palmar br. of the radial a. common palmar digital aa. (3) superficial palm, palmar surface of the digits excluding thumb, dorsum of the distal phalangeal segments of digits 2-5 superficial palmar arterial arch receives its major blood supply from the ulnar a.

Joints of the Hand and Fingers

Joint or ligament Description Notes
carpometacarpal joint, finger the articulation between the distal carpal bones and the proximal ends of the metacarpal bones of the hand a synovial plane joint; limited motion is permitted at the carpometacarpal joint; the carpometacarpal joint is reinforced by dorsal and palmar ligaments
carpometacarpal joint, thumb the articulation between the trapezium and the proximal end of the metacarpal bone of the thumb a synovial saddle (sellar) joint; this articulation permits two planes of motion: flexion/extension and abduction/adduction which may be combined to produce circumduction
intermetacarpal joint the articulation between the adjacent sides of the proximal ends of metacarpal bones 2-5 a synovial plane joint; limited motion is possible between at the carpometacarpal joints or between adjacent metacarpal bones
intercarpal joint joints between adjacent carpal bones synovial plane joints; small gliding movements are permitted between adjacent carpal bones
interphalangeal joints the articulations between the proximal and middle phalanges (proximal interphalangeal joint, abbreviated PIP) or the middle and distal phalanges (distal interphalangeal joint, abbreviated DIP) a synovial hinge joint; these joints are strengthened by medial and lateral collateral ligaments
metacarpophalangeal joint the articulation between the head of a metacarpal and the base of a proximal phalanx a synovial condyloid (or ellipsoid) joint; it is strengthened by medial and lateral collateral ligaments; the joint has two planes of motion: flexion/extension and abduction/adduction which may be combined to yield circumduction

Fasciae of the Forearm and Hand

Structure Location/Description Notes
fascia, hypothenar fascia covering the hypothenar muscle group hypothenar fascia blends with the palmar aponeurosis and attaches to the fifth metacarpal bone; it defines the hypothenar compartment of the hand
fascia, thenar fascia covering the thenar muscle group thenar fascia blends with the palmar aponeurosis and attaches to the first metacarpal bone it defines the thenar compartment of the hand
flexor retinaculum a thickening of the deep fascia on the ventral surface of the wrist flexor retinaculum spans the ventral surfaces of the carpal bones (medially - scaphoid and trapezium; laterally - hamate and pisiform) to complete an osseofibrous tunnel for passage of the flexor tendons; tendons are surrounded by synovial tendon sheathes where they pass deep to retinacula
palmar aponeurosis a thickening of the deep fascia covering the palm of the hand palmar aponeurosis is composed of very dense connective tissue that extends out into each of the fingers



Other Tables of Interest:


Back Region


Upper Limb

All Anatomy Tables

Tables Organized by System Tables Organized by Region


Some of the material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest and Jaye Schlesinger
Published by ILOC, Inc., New York. Copyright 1995.

Content of tables edited for use in this course by Patrick W. Tank, Ph.D.
Copyright 2005, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences.

Unauthorized use is prohibited.