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Wrist/Carpus 2

Carpal Tunnel
by

Michael Hellawell

on 25 February 2014

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Transcript of Wrist/Carpus 2

Lateral (radial):
Medial (ulnar):
Superficial lamina and deep lamina . Attaching to the scaphoid and trapezium.
Flexor Carpi Radialis
Flexor Pollicis Longus
median nerve
Common tendinous sheath
of the digital flexors
Pisiform and hook of hamate.
Flexor Retinaculum and Carpal Tunnel
The flexor retinaculum is a strong fibrous band, approximately 3 cm wide, which spans the carpal bones, forming a roof over their palmar concavity, the carpal sulcus.

The space between the flexor retinaculum and anterior aspect of the carpus is called the carpal tunnel and houses
the four tendons of flexor digitorum profundus,
the four tendons of the flexor digitorum superficialis,
the tendon of the flexor pollicis longus
the median nerve.
Extensor Retinaculum
Tendinous sheath of extensor digitorum and extensor indicis
Tendinous sheath of extensor carpi radialis longus and brevis
Tendinous sheath of extensor digiti minimi
Extensor carpi ulnaris
Tendinous sheath of extensor pollicis brevis and abductor pollicis longus
From the deep surface of the retinaculum fibrous septa reach deeper bones and ligaments. These septa divide the extensor tunnel into six compartments. From radial to ulnar they contain:

1) Tendons and synovial sheaths of abductor pollicis longus and extensor pollicis brevis

2) Tendons and synovial sheaths of extensors carpi radialis longus and brevis

3) Tendon and synovial sheath of extensor pollicis longus

4) Tendon and synovial sheath of extensor pollicis longus

5) Tendons of extensor digitorum and tendon of extensor indicis and their common synovial sheath

6) Extensor digiti minimi tendons and synovial sheath

7) Tendon and synovial sheath of extensor carpi ulnaris.
Laterally (radically) it is attached to the anterolateral border of the radius immediately proximal to the styloid process.
Medially (ulnarly) it attaches to the pisiform and triquetrum.
The extensor retinaculum is a 2cm wide thickening of the dorsal deep fascia of the forearm strengthened by transverse fibers.
Extensor pollicis longus
blood supply
Ulnar artery
radial artery
Superficial palmar arch
Common palmar digital arteries
Proper palmar digital arteries
median artery
Dorsal carpal arch
dorsal metacarpal arteries
Dorsal digital arteries
Proper palmar digital arteries
nerves
The dorsal digital nerves arise from the superficial branch of the radial nerve and the dorsal branch of the ulnar nerve.
Branches from ulnar nerve: dorsal digital nerves from the dorsal branch of the ulnar nerve supply the skin of the radial and ulnar sides of the little finger and the ulnar side of the ring finger.
These arise from the division of the common palmar digital nerves.
ulnar nerve
Ulnar nerve: proper palmar digital nerves
median nerve proper palmar digital nerves
median nerve
radial nerve
The wrist/carpus 2
MH Feb 2012
Full transcript