{"id":3931,"date":"2021-01-18T22:20:29","date_gmt":"2021-01-18T21:20:29","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/upper-limb\/forearm\/neurovasculature\/"},"modified":"2023-05-23T17:00:42","modified_gmt":"2023-05-23T15:00:42","slug":"neurovasculature-of-the-hand","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/upper-limb\/hand\/neurovasculature-of-the-hand\/","title":{"rendered":"Neurovasculature of the hand"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><div class=\"intro\">The hand receives blood supply from the ulnar and radial arteries and drains into veins bearing the same name; it is innervated by branches of the ulnar, median, and radial nerve.<\/div><\/p>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Blood supply<\/h2>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">The blood vessels supplying the hand are the <strong>ulnar <\/strong>and <strong>radial arteries<\/strong>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These vessels form vascular arches that are connected to each other and provide blood supply to the muscles, joints and digits of the hand.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Ulnar artery<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">The ulnar artery is found medially in the forearm, supplying the medial aspect of the forearm.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Course<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">The ulnar artery enters the hand on its medial aspect, between the palmaris brevis muscle and the flexor retinaculum. It passes through the<strong> ulnar canal (Guyon canal)<\/strong> lateral to the pisiform and medial to the hook of the hamate.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Branches<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">The ulnar artery branches into <strong>two terminal branches<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The superficial palmar arch <\/strong>\u2013 A direct continuation of the ulnar artery, with the long flexor tendons of the digits found deep to it and the palmar aponeurosis located superficially.<\/li>\n\n\n\n<li><strong>The deep palmar branch<\/strong> \u2013 Branches off from the ulnar artery on its medial aspect, passes through the origin of the hypothenar muscles and around the hook of the hamate to reach the deep surface of the palm, and finally anastomoses with the deep palmar arch of the radial artery.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Additionally, the<strong> superficial palmar arch<\/strong> gives rise to the following branches:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The palmar digital artery<\/strong> \u2013 supplies the medial side of the little finger<\/li>\n\n\n\n<li><strong>The common palmar digital arteries<\/strong> \u2013 three branches supplying the little finger on its lateral aspect, the ring and middle fingers, and the index finger on its medial aspect. They ultimately <strong>anastomose with the palmar metacarpal arteries<\/strong> from the deep palmar arch. Each of these arteries <strong>give rise to proper palmar digital arteries<\/strong>, supplying the previously mentioned fingers.<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Radial artery<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">The ulnar artery found laterally in the forearm, supplying the lateral aspect of the forearm.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Course<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">The radial artery reaches the hand on its lateral aspect, curving around the trapezoid and scaphoid to cross the floor of the<strong> anatomical snuffbox<\/strong>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It reaches the deep aspect of the palm by passing between the heads of the first dorsal interosseous muscle, and then between the two heads of the adductor pollicis muscle.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Branches<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">The radial artery gives rise to the following branches:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The dorsal carpal branch<\/strong> \u2013 forms the <strong>dorsal carpal arch<\/strong> over the dorsal aspect of the wrist and further branches into <strong>three dorsal metacarpal arteries<\/strong>, which eventually give off the dorsal digital arteries, supplying the fingers<\/li>\n\n\n\n<li><strong>The first dorsal metacarpal artery<\/strong> \u2013 supplies the medial side of the thumb and the lateral side of the index finger<\/li>\n\n\n\n<li><strong>The principes pollicis artery<\/strong> \u2013 responsible for the majority of blood supply to the thumb<\/li>\n\n\n\n<li><strong>The radialis indices artery<\/strong> \u2013 Supplies the index finger laterally<\/li>\n\n\n\n<li><strong>The deep palmar arch<\/strong> \u2013 The termination of the radial artery. It is located distal to the bases of the metacarpal bones.\n<ul class=\"wp-block-list\">\n<li>The arch anastomoses medially with the deep palmar branch from the ulnar artery. <\/li>\n\n\n\n<li>The arch also gives rise to the <strong>palmar metacarpal arteries<\/strong>, which communicate with the common palmar digital arteries, and to <strong>three perforating branches<\/strong> which anastomose with the dorsal carpal arch.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Venous drainage<\/h2>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n\n<p class=\"wp-block-paragraph\">Deep and superficial veins drain the hand in the following manner:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Deep and superficial venous palmar arches<\/strong> \u2013 follow the arterial arches and drain into the deep veins of the forearm (<strong>ulnar<\/strong> and <strong>radial veins<\/strong>).<\/li>\n\n\n\n<li><strong>The dorsal digital veins<\/strong> \u2013 drain into the dorsal metacarpal veins, which unite and <strong>form the dorsal venous network<\/strong>.<\/li>\n\n\n\n<li><strong>The dorsal venous network<\/strong> \u2013 drains on the lateral side of the hand to the <strong>cephalic vein<\/strong>, and on the medial side to the <strong>basilic vein<\/strong>.<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h2 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Innervation<\/h2>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<p class=\"wp-block-paragraph\">The nerves supplying the hand are the ulnar, radial and median nerves.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Ulnar nerve<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<p class=\"wp-block-paragraph\">The ulnar nerve reaches the hand on its medial surface through the <strong>ulnar (Guyon) canal<\/strong>. It branches into a <strong>deep (predominantly motor)<\/strong> branch and a <strong>superficial (predominantly sensory)<\/strong> branch just distal to the pisiform.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Branches<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The deep branch<\/strong> &#8211; supplies the <strong>hypothenar muscles<\/strong> as well as penetrates them to reach and supply the <strong>interossei, adductor pollicis<\/strong>, and the <strong>two medial lumbrical muscles<\/strong>.<\/li>\n\n\n\n<li><strong>The superficial branch &#8211;<\/strong> supplies the <strong>palmaris brevis<\/strong> muscle and provides <strong>sensory innervation<\/strong> to the palmar aspect of the little finger and the medial half of the ring finger.<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_12\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Median nerve<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_12\">\n\n\n<p class=\"wp-block-paragraph\">The median nerve reaches the hand via the<strong> carpal tunnel<\/strong>, later branching into a recurrent and palmar digital branches.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_13\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title3\">Branches<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_13\">\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The recurrent median nerve<\/strong>&#8211; a motor nerve, arising from the lateral aspect of the median nerve. It passes around the flexor retinaculum, between the <strong>flexor pollicis brevis and abductor pollicis<\/strong> muscles to reach the <strong>opponens pollicis<\/strong>, and supplies those muscles.<\/li>\n\n\n\n<li><strong>The palmar digital nerves <\/strong>&#8211; reach the digits by crossing the palmar aponeurosis and superficial palmar arch.\n<ul class=\"wp-block-list\">\n<li>These nerves provide <strong>sensory innervation<\/strong> to the skin over the palmar surfaces of the <strong>lateral three and a half digits<\/strong> and the dorsal aspects of the skin over their distal phalanges. <\/li>\n\n\n\n<li>Additionally, these nerves provide <strong>motor innervation<\/strong> to the <strong>lateral two lumbrical<\/strong> muscles.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In addition, the median nerve gives rise to the <strong>palmar cutaneous branch<\/strong>, which supplies skin over the <strong>central aspect of the palm<\/strong>.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_14\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Radial nerve<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_14\">\n\n\n<p class=\"wp-block-paragraph\">The radial nerve only participates in <strong>sensory innervation<\/strong> of the hand and therefore, the only branch entering the hand is the <strong>superficial branch<\/strong>. It <strong>passes through the anatomical snuffbox<\/strong> and innervates the skin over the <strong>dorsolateral aspect of the palm<\/strong>, as well as the skin over the <strong>dorsal aspect of the lateral three and a half digits<\/strong>, not including the skin over the distal phalanges.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_15\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Clinical information<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_15\">\n\n\n<p class=\"wp-block-paragraph\">Injury to the ulnar nerve can result in a &#8220;claw&#8221; appearing hand, in which the metacarpophalangeal joints are permanently overextended and the interphalangeal joints are flexed due to loss of function of most of the intrinsic muscles of the hand, innervated by this nerve.<\/p>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h2 class=\"wp-block-heading\" class=\"wp-block-heading\">Blood supply<\/h2><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Ulnar artery<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Course<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Branches<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Radial artery<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Course<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Branches<\/h4><h2 class=\"wp-block-heading\" class=\"wp-block-heading\">Venous drainage<\/h2><h2 class=\"wp-block-heading\" class=\"wp-block-heading\">Innervation<\/h2><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Ulnar nerve<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Branches<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Median nerve<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Branches<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Radial nerve<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Clinical information<\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>Blood supply The blood vessels supplying the hand are the ulnar and radial arteries. These vessels form vascular arches that are connected to each other and provide blood supply to the muscles, joints and digits of the hand. Ulnar artery The ulnar artery is found medially in the forearm, supplying the medial aspect of the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3468,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3931","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Neurovasculature of the hand &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/upper-limb\/hand\/neurovasculature-of-the-hand\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/upper-limb\\\/hand\\\/neurovasculature-of-the-hand\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/upper-limb\\\/hand\\\/neurovasculature-of-the-hand\\\/\",\"name\":\"Neurovasculature of the hand &#8211; 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