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Thumb Bones Thumb joints Thumb muscles Radial Digital Artery of Thumb Ulnar Digital Artery of Thumb Radial Digital Nerve of Thumb Ulnar Digital Nerve of Thumb Thumb extensor mechanism Thumb Ray skin Skin: Dorsal First Web Space Skin: Radial half of the thumb Skin: Ulnar half of the thumb Skin: Thenar area
Thumb Reconstruction
Bones: Thumb
Thumb Ulnar MCP Sesamoid Thumb Proximal Phalanx Thumb Distal Phalanx
Bones: Thumb
Thumb Metacarpal
Thumb Metacarpal
Articulations:
Thumb Carpometacarpal Joint
Bones:
Ligaments: Range of motion Palmar Adduction/Abduction Contact/45, Radial Adduction/Abduction Contact/60 Injuries: Arthritis Movement
palmar abduction radial abduction palmar adduction radial adduction opposition retropulsion
Ligaments:
Muscle Attachments:
Abductor Pollicis Longus
Tendons: Origin: Posterior surface of the Ulna, the radioulnar interosseous membrane and the middle third of posterior surface of theRadius Insertion: Radial dorsal base of the Thumb Metacarpal, Variably the dorsal Trapezium and the radial surface of the Abductor pollicis longus muscle Function: Abducts the thumb basal joint, along with other muscles which radially abduct the thumb. Also radially deviatesthewrist along with other mucles which produce wrist radial abduction Nerve: Posterior Interosseous Nerve
Tendons: Origin: transverse carpal ligament and the Trapezium Insertion: Volar radial aspect of the Thumb Metacarpal Function: flexes and pronates the basal joint along with other muscles which produce thumb opposition Nerve: Motor Branch of the Median Nerve Artery: Superficial Volar Branch of Radial artery
First Dorsal Interosseous
Tendons: Origin: the adjacent surfaces of the thumb and index metacarpals Insertion: the radial base of the index proximal phalanx and the index radial digital extensor mechanism Function: flexes, radially deviates (abducts) and pronates the index MCP joint and radially adducts the thumb basal joint along with other muscles which radially adduct the basal joint. Also (weakly) extends the index PIP and DIP joints Nerve: Motor Branch of Ulnar Nerve Artery: deep palmar arch
Fractures: Variations:
Thumb Radial MCP Sesamoid
Articulations: Thumb Metacarpophalangeal Joint Muscle Attachments: Flexor Pollicis Brevis Ligament Attachments: Epiphyses: Blood Supply: Fractures: Variations:
Thumb Ulnar MCP Sesamoid
Muscle Attachments: Adductor Pollicis Tendons: Origin: OBLIQUE HEAD: palmar surfaces of the Trapezoid, the Trapezium and Capitate as well as the bases of the Index and Middlemetacarpals TRANSVERSE HEAD: palmar surface of the shaft of the Middle metacarpal Insertion: The palmar ulnar base of the Thumb Proximal Phalanx, the Thumb Ulnar MCP Sesamoid, and the Thumb extensor mechanism Function: radially adducts the thumb basal joint along with other muscles which radially adduct the basal joint, and extends the thumb interphalangeal Joint Nerve: Motor Branch of Ulnar Nerve Artery: Deep Palmar Arch
Articulations:
Thumb Metacarpophalangeal Joint Thumb Interphalangeal Joint
Ligaments: Range of motion Injuries: Arthritis Movement Flexion Flexor Pollicis Longus Extension
Tendons: Origin: Posterior surface of the Radius and the radioulnar interosseous membrane Insertion: Dorsal base of the thumb proximal plalanx Function: Extends the thumb MCP joint and weakly abducts the thumb basal joint, along with other muscles which produceradial and palmar abduction Nerve: Posterior interosseous Artery: Posterior interosseous
Abductor Pollicis Brevis
Tendons: Origin: Transverse carpal ligament, the Scaphoid and Trapezium Insertion: Radial base of Thumb Proximal Phalanx and the thumb extensor mechanism Function: Abducts the Thumb basal (carpometacarpal) Joint along with other muscles which palmar abduct and radial abductthe basal joint, and extends the thumb interphalangeal Joint Nerve: Motor Branch of Median Nerve Artery: Superficial Volar Branch of Radial artery
Flexor Pollicis Brevis
Tendons: Origin: transverse carpal ligament and the Trapezium Insertion: radial proximal base of the Thumb Proximal Phalanx and
the thumb Radial MCP Sesamoid Function: Flexes the thumb MCP joint and flexes/pronates the basal joint along with other muscles which produce thumb opposition Nerve: DEEP head: Motor Branch of Ulnar Nerve SUPERFICIAL Head: Motor Branch of Median Nerve Artery: Superficial Volar Branch of Radial artery
Adductor Pollicis
Tendons:
Origin: Volar surface of the Radius, the adjacent interosseous membrane and the medial border of the coronoid process of theUlna Insertion: Palmar base of the thumb Thumb Distal Phalanx Function: Flexes the thumb Interphalangeal Joint (primary) and Metacarpophalangeal Joint (weak) Nerve: Anterior Interosseous branch of Median Nerve Artery: Anterior Interosseous artery
Extensor Pollicis Longus
Tendons: Origin: Middle third of posterior surface of the Ulna and the radioulnar interosseous membrane Insertion: Dorsal base of the thumb Distal Phalanx through the Thumb extensor mechanism Function: Extends the thumb Interphalangeal Joint Nerve: Posterior Interosseous Artery: Posterior Interosseous
Thumb joints
Thumb basal Carpometacarpal Joint Thumb Metacarpophalangeal Joint Thumb Interphalangeal Joint Scaphotrapeziotrapezoidal (STT) Joint
Bones:
Bones: Index
Index Metacarpal Index Proximal Phalanx Index Middle Phalanx Index Distal Phalanx
Index Metacarpal
Articulations:
Index Carpometacarpal Joint
Ligaments: Range of motion Injuries: Arthritis Movement Flexion Primary - the first dorsal interosseous, the first palmar interosseous and the index lumbrical Secondary (after flexion has been initiated) - the Flexor Digitorum Superficialis Index and Flexor Digitorum Profundus Index Extension - Extensor Digitorum Index Radial deviation / Pronation - First Dorsal Interosseous Ulnar deviation / Supination - first palmar interosseous (Tendons: Origin: ulnar shaft of the index metacarpal Insertion: ulnar base of the index proximal phalanx and index ulnar digital extensor mechanism Function: flexes, ulnarly deviates (adducts) and supinates the
index MCP joint and extends the index PIP and DIP joints Nerve: Motor Branch of Ulnar Nerve Artery: Deep Palmar Arch )
Muscle Attachments:
Flexor Carpi Radialis
Tendons: Origin: common forearm flexor origin from the medial epicondyle of the Humerus and the deep forearm fascia Insertion: Volar base of the Index Metacarpal and the Middle Metacarpal Function: flexion and radial deviation of the wrist, along with other muscles which flex the wrist and radially deviate the wrist,weak pronation of the forearm along with other muscles which pronate the forearm and weak flexion of the elbow along with other muscles which flex the elbow Nerve: Median Nerve Artery: Muscular Branches of Radial Artery
Extensor Carpi Radialis Longus
Tendons: Origin: Lower 1/3 of lateral supracondylar ridge of the Distal humerus and the lateral intermuscular septum Insertion: Dorsal base of the Index Metacarpal
Function: Extends, radially deviates the Wrist Nerve: Radial Artery: Muscular Branches of Radial Artery and the Radial Recurrent artery
Adductor Pollicis First Dorsal Interosseous First Palmar Interosseous Second Dorsal Interosseous
Tendons: Origin: Adjacent surfaces of the index and middle metacarpals Insertion: the radial base of the middle finger proximal phalanx and the middle finger radial digital extensor mechanism Function: flexes, radially deviates (abducts), and pronates the middle finger MCP joint, and extends the middle PIP and DIPjoints Nerve: Motor Branch of Ulnar Nerve Artery: Deep Palmar Arch
Articulations:
Index Metacarpophalangeal Joint Index Proximal Interphalangeal Joint
Articulations:
Index Proximal Interphalangeal Joint Index Distal Interphalangeal Joint
Muscle Attachments:
Finger extensor mechanism
phalanx by the Triangular ligament to form the Terminal tendon. This crosses the dorsal surface of the distal interphalangeal joint to attach to the dorsal base of the distal phalanx.
Flexor Digitorum Superficialis Index
Tendons: Origin: HUMERAL head from the common flexor tendon origin at the medial epicondyle ULNAR head from the coronoid process of the Ulna RADIAL head from the oblique line of the Radius and from the superficialis arch Insertion: radial and ulnar palmar margins of the index finger Middle Phalanx Function: flexion of the index PIP joint, index MCP joint (only after flexion has been initiated) and the Wrist, weakly, along with other muscles which flex the wrist Nerve: Median Nerve Artery: Muscular Branches of Radial Artery and Muscular Branches of Ulnar Artery
Extensor Digitorum Index
Extension
Extensor Digitorum Index First Dorsal Interosseous First Palmar Interosseous Index Lumbrical
Muscle Attachments:
Extensor Digitorum Index
Extensor Digitorum Shared Features Tendons: Insertion: dorsal base of the Index Middle Phalanx and the Digital extensor mechanism Function: Extends the index MCP and PIP joints
First Dorsal Interosseous
Ligaments: Range of motion Injuries: Arthritis Movement Flexion: Flexor Digitorum Profundus Index
Tendons: Origin (all profundi): Medial and anterior surface of the Ulna, the deep forearm fascia and the radioulnar interosseous membrane Insertion: Palmar base of the index distal phalanx Function: Flexes the index DIP joint, as well as the PIP joint, the MCP joint (only after flexion has been initiated) and the wristalong with other muscles which flex the wrist Nerve: Anterior Interosseous branch of Median Nerve Artery: the Anterior Interosseous artery and Muscular Branches of Ulnar Artery
First Dorsal Interosseous First Palmar Interosseous Index Lumbrical Extensor Digitorum Index Extensor Indicis
Muscle Attachments: Flexor Digitorum Profundus Index Ligament Attachments: Epiphyses: Blood Supply: Fractures: Variations:
Bones: Middle
Middle Metacarpal Middle Proximal Phalanx Middle Middle Phalanx Middle Distal Phalanx
Middle Metacarpal
Articulations:
Middle Carpometacarpal Joint
Ligaments: Range of motion Injuries: Arthritis Movement Flexion Primary - the Second Dorsal Interosseous Third Dorsal
Interosseous Middle Lumbrical Tendons: middle lumbrical Origin: the radial border of the middle flexor digitorum profundus middle tendon Insertion: the middle finger radial Digital extensor mechanism, along with the Second Dorsal Interosseous tendon Function: flexes the middle finger MCP joint and extends the PIP and DIP joints Nerve: Motor Branch of Median Nerve Artery: Deep Palmar Arch Superficial Palmar Arch
Secondary (after flexion has been initiated) - the Flexor Digitorum Superficialis Middle and the Flexor Digitorum Profundus Middle Extension Extensor Digitorum Middle Radial deviation / Pronation - Second Dorsal Interosseous Ulnar deviation / Supination - Third Dorsal Interosseous
Muscle Attachments:
Flexor Carpi Radialis Extensor Carpi Radialis Brevis
Tendons: Origin: Common extensor tendon of the lateral epicondyle the radial collateral ligament of the elbow and the deep forearm fascia
Insertion: Dorsal base of the Middle Metacarpal Function: Extends and radially deviates the Wrist. Weak elbow flexor. Nerve: Posterior Interosseous Nerve Artery:
Muscular Branches of Radial Artery Radial Recurrent artery Adductor Pollicis Second Dorsal Interosseous Third Dorsal Interosseous
Tendons: Origin: the adjacent surfaces of the middle and ring metacarpals Insertion: the ulnar base of the middle finger proximal phalanx and the middle finger ulnar digital extensor mechanism Function: flexes, ulnar deviates (abducts) and supinates the middle finger MCP joint and extends the middle finger PIP and DIPjoints Nerve: Motor Branch of Ulnar Nerve Artery: deep palmar arch
Articulations:
Middle Metacarpophalangeal Joint Middle Proximal Interphalangeal Joint
Extension
Second Dorsal Interosseous Third Dorsal Interosseous Extensor Digitorum Middle Middle Lumbrical
Muscle Attachments:
Extensor Digitorum Shared Features Tendons: Insertion: dorsal base of the middle finger Middle Phalanx and the Digital extensor mechanism Function: Extends the middle finger MCP and PIP joints
Second Dorsal Interosseous Third Dorsal Interosseous
Articulations:
Middle Proximal Interphalangeal Joint Middle Distal Interphalangeal Joint
Ligaments: Range of motion Injuries: Arthritis Movement Flexion Flexor Digitorum Profundus Middle Extension - (through the middle digital extensor mechanism)
Second Dorsal Interosseous Third Dorsal Interosseous Extensor Digitorum Middle Middle Lumbrical
Muscle Attachments:
Finger extensor mechanism Flexor Digitorum Superficialis Middle
Tendons: Origin: HUMERAL head from the common flexor tendon origin at the medial epicondyle ULNAR head from the coronoid process of the Ulna RADIAL head from the oblique line of the Radius and from
the superficialis arch Insertion: radial and ulnar palmar margins of the middle finger Middle Phalanx Function: flexion of middle finger PIP joint, middle MCP joint (only after flexion has been initiated) and the Wrist, weakly, along with other muscles which flex the wrist Nerve: Median Nerve Artery: Muscular Branches of the Radial Artery and Muscular Branches of the Ulnar Artery
Extensor Digitorum Middle
Articulations: Middle Distal Interphalangeal Joint Muscle Attachments: Flexor Digitorum Profundus Middle
Tendons: Origin (all profundi): Medial and anterior surface of the Ulna, the deep forearm fascia and the radioulnar interosseous membrane Insertion: Palmar base of the middle finger Middle Distal Phalanx Function: Flexes the middle finger DIP joint, the PIP joint, the MCP joint (only after flexion has been initiated) and the Wristalong with other muscles which flex the wrist Nerve: Anterior Interosseous branch of Median Nerve Artery: the Anterior Interosseous artery and Muscular Branches of the Ulnar Artery