The Grasping Hand: Structural and Functional Anatomy of the Hand and Upper Extremity

The Grasping Hand: Structural and Functional Anatomy of the Hand and Upper Extremity
Title Page
Copyright
Dedication
Contents
Foreword
Preface
Preface
Contributors
Section I Prolegomena
	1 The Story of Hand Anatomy
Section II Structural and Functional Fundamentals
	2 Structural and Functional Anatomy of the Hand
		2.1 Introduction
		2.2 Prehension
		2.3 Surface Anatomy
		2.4 Structure
			2.4.1 The Rays of the Hand
			2.4.2 The Fixed and Mobile Elements
			2.4.3 The Arches of the Hand
			2.4.4 The Fibrous Skeleton
		2.5 Muscles and Tendons
			2.5.1 Extensor Tendons
			2.5.2 Flexor Tendons
			2.5.3 Interosseous Muscles
			2.5.4 Lumbrical Muscles
			2.5.5 The Intrinsic Muscles of the Thumb
			2.5.6 Hypothenar Muscles
		2.6 Movements of the Hand
		2.7 Sensation and Proprioception
		2.8 Control of Digital Motion
		2.9 Grasp
		2.10 Conclusion
	3 Sense and Proprioception
		3.1 Sensations
			3.1.1 The Somatosensory Unit
		3.2 Biomechanics of Proprioception
	4 Joint Senses and Proprioception
		4.1 Introduction
		4.2 Innervation of Joints in the Human Hand
			4.2.1 Wrist
			4.2.2 Finger Joints
			4.2.3 Thumb Trapeziometacarpal Joint
		4.3 The Joint Senses and Proprioception
		4.4 Conscious Joint Senses
		4.5 Unconscious Joint Sense
	5 The Hand and the Brain
		5.1 Introduction
		5.2 Motor System
		5.3 Somatosensory System
		5.4 Plasticity in the Somatosensory and Motor Systems
	6 Structure and Function of Muscles
		6.1 Overview
		6.2 Muscle Architecture
			6.2.1 PCSA and Fiber Length
			6.2.2 Mechanics of Joint Motion
		6.3 Molecular Anatomy
			6.3.1 Active Tension
			6.3.2 Passive Tension
	7 Ultrastructure of Bones and Joints
		7.1 Bone
			7.1.1 Subchondral Bone Plate
			7.1.2 Corner Zones
			7.1.3 Physeal Scar
			7.1.4 Trabecular Vault
			7.1.5 Pillars
			7.1.6 Diaphysis
			7.1.7 Capsule
	8 The Blood Vessels and Microcirculation
		8.1 Vascular Supply to the Hand from the Base to the Fingertips
		8.2 Differences between Large, Medium-Sized, and Small Arteries and Veins and the Vascular Network of the Microcirculation
		8.3 Outline of Anatomy and Physiology of Microcirculation for Metabolite Exchange
Section III General Anatomy and Function
	9 Nerves of the Upper Extremity
		9.1 Supraclavicular Branches of the Brachial Plexus
			9.1.1 The Median Nerve
	10 The Brachial Plexus
		10.1 Introduction
		10.2 Neural Anatomy
		10.3 Vascular Anatomy
		10.4 Lymphatic Anatomy
		10.5 Posterior Triangle of the Neck
		10.6 Exposure of the Brachial Plexus
		10.7 Case Example 1: Adult Injury
		10.8 Case Example 2: Obstetrical Injury
	11 Vascular Anatomy of the Upper Extremity
		11.1 Vascular Anatomy of the Upper Extremity
		11.2 Axillary Artery
		11.3 Brachial Artery
		11.4 Ulnar Artery
		11.5 Radial Artery
		11.6 Veins of the Upper Extremity
			11.6.1 The Superficial Veins of the Upper Extremity
		11.7 The Deep Veins of the Upper Extremity
		11.8 Lymphatic Vessels of the Upper Extremity
Section IV Regional Anatomy and Function
	12 The Shoulder Joint
		12.1 Introduction
			12.1.1 Clavicle and Sternoclavicular Joint
		12.2 Acromioclavicular Joint
		12.3 Glenohumeral Joint
		12.4 Glenoid, Labrum, and Capsule
		12.5 Rotator Cuff
	13 The Anatomy of the Arm
		13.1 Humerus
		13.2 Cutaneous Innervations of the Arm
		13.3 Muscles of the Arm
		13.4 Nerves of the Arm
		13.5 Musculocutaneous Nerve (C5–C6)
		13.6 Median Nerve in the Arm (C6–T1)
		13.7 Ulnar Nerve in the Arm (C8–T1)
		13.8 Radial Nerve in the Arm (C5–T1)
		13.9 Arteries of the Arm
			13.9.1 The Brachial Artery
		13.10 Superficial Veins of the Arm
		13.11 Summary
		13.12 Surgical Approaches
		13.13 Anterior Approach to the Humerus
		13.14 Anterolateral Approach to the Humerus
		13.15 Posterior Approaches to the Humerus
		13.16 Extended Posterolateral Approach
	14 The Elbow Joint
		14.1 The Confluent Layered Anatomy of the Elbow
		14.2 Articular Anatomy
		14.3 Effect of Elbow Joint Morphology on Elbow Alignment
		14.4 Structures That Provide for Varus/Valgus Stability
		14.5 Structures That Resist Posterolateral Elbow Dislocation
			14.5.1 Posteromedial Anatomy
			14.5.2 Medial Anatomy
		14.6 Deep Medial Anatomy
			14.6.1 Anterior Anatomy
		14.7 Distal Biceps Tendon
			14.7.1 Lateral Anatomy
		14.8 Lateral Collateral Ligament Complex
			14.8.1 Posterior Anatomy
	15 The Forearm Fascia and Retinacula
		15.1 General Considerations for Fascia
		15.2 The Fascial System of the Forearm
			15.2.1 Retinacula System
			15.2.2 Lacertus Fibrosus
		15.3 Conclusion
	16 Anatomy of the Forearm
		16.1 Osteology
		16.2 Myology
			16.2.1 Volar
			16.2.2 Dorsal
		16.3 Arteries
		16.4 Veins
		16.5 Nerves
			16.5.1 Cutaneous Nerves of the Forearm
			16.5.2 Deep Nerves of the Forearm
		16.6 Lymphatics
	17 The Interosseous Membrane
		17.1 Interosseous Membrane Anatomy
		17.2 Kinematics
		17.3 Biochemistry and Biomechanics
	18 The Carpal Tunnel
		18.1 Introduction
		18.2 Anatomy
		18.3 Borders
		18.4 Contents
		18.5 Surgical Anatomy
	19 The Hypothenar Area: Anatomy of the Ulnar Carpal Tunnel
		19.1 Anatomy of the Ulnar Carpal Tunnel
			19.1.1 Guyon’s Canal
			19.1.2 The Pisohamate Tunnel
			19.1.3 The Opponens Tunnel
			19.1.4 Anatomical Zones of the Ulnar Carpal Tunnel
		19.2 Muscle Anatomy
			19.2.1 Palmaris Brevis
			19.2.2 Abductor Digiti Minimi
			19.2.3 Flexor Digiti Minimi Brevis
			19.2.4 Opponens Digiti Minimi
		19.3 Nerve Anatomy
			19.3.1 The Arborization of the Ulnar Nerve at the Hypothenar Area
			19.3.2 The Branching Patterns of the Motor Branch to the ADM
			19.3.3 The Deep Branch of the Ulnar Nerve
			19.3.4 The Superficial Branch of the Ulnar Nerve
			19.3.5 Other Communicating Branches
		19.4 Vascular Anatomy
			19.4.1 Anatomic Variations of the Ulnar Artery and Its Branches
	20 Anatomy of the Wrist Joint
		20.1 Bones of the Wrist
			20.1.1 Extensor Retinaculum
			20.1.2 Flexor Retinaculum
			20.1.3 Ligaments of the Wrist
		20.2 Extrinsic Ligaments
		20.3 Radioscaphocapitate Ligament
		20.4 Long Radiolunate Ligament
		20.5 Radioscapholunate Ligament
		20.6 Short Radiolunate Ligament
		20.7 Dorsal Radiocarpal Ligament
		20.8 Intrinsic Ligaments
		20.9 Dorsal Intercarpal Ligament
		20.10 Scapholunate Interosseous Ligament
		20.11 Lunotriquetral Interosseous Ligament
		20.12 Scaphotriquetral Ligament
		20.13 Scaphotrapeziotrapezoidal Ligament
		20.14 Soft-Tissue Attachments of the Pisiform
	21 Vascularity of the Distal Radius and Carpus
		21.1 Introduction
		21.2 Vascular Anatomy of the Distal Radius
			21.2.1 Extraosseous Vascularity
			21.2.2 Intraosseous Vascularity
		21.3 Vascular Anatomy of the Carpus
			21.3.1 Extraosseous Vascularity
			21.3.2 Intraosseous Vascularity
		21.4 Vascularized Bone Grafts
	22 Interosseous Vascularity of the Carpus
		22.1 Introduction
		22.2 The Lunate
		22.3 Capitate
		22.4 Scaphoid
	23 Function of the Wrist Joint
		23.1 Introduction
		23.2 Wrist Kinematics
			23.2.1 Flexion–Extension
			23.2.2 Radial–Ulnar Deviation
			23.2.3 “Dart-Throwing” Motion
		23.3 Wrist Kinetics
			23.3.1 Magnitude and Distribution of Forces across the Wrist
			23.3.2 Primary Ligament Stabilization of the Carpus
			23.3.3 Secondary Neuromuscular Stabilization of the Carpus
	24 Anatomy of the Distal Radioulnar Joint
		24.1 The Distal Radioulnar Joint (The MOBILE DRUJ)
		24.2 The Extensor Retinaculum
		24.3 The Triangular Fibrocartilage Complex (TFCC)
		24.4 Discussion
	25 Function of the Distal Radioulnar Joint
	26 Hand Fascia, Retinacula, and Microvacuoles
		26.1 Channelling of Structures in Transit Between Forearm and Digits
		26.2 Restraint of Unwanted Motion
		26.3 Transmission of Loads
		26.4 Anchorage
		26.5 Binding Role
		26.6 Limiting or Tethering Role
		26.7 Framework for Muscle Origins and Insertions
		26.8 Vascular Protection and Pumping Action
		26.9 Lubricating Role
			26.9.1 The Microvacuolar System
			26.9.2 Flexor Tendon Sheaths
	27 Thumb
		27.1 Osteology
		27.2 Myology
		27.3 Arteries
		27.4 Veins
		27.5 Nerves
	28 The Flexor Tendons and the Flexor Sheath
		28.1 Flexor Tendons
			28.1.1 Flexor Carpi Radialis
			28.1.2 Palmaris Longus
			28.1.3 Flexor Carpi Ulnaris
			28.1.4 Flexor Digitorum Superficialis/Sublimis
			28.1.5 Flexor Digitorum Profundus
			28.1.6 Flexor Pollicis Longus
		28.2 Flexor Sheath
			28.2.1 Synovial (Membranous) Component
			28.2.2 Retinacular (Pulley) Component
	29 The Extensor Tendons
		29.1 Introduction
		29.2 The Extensors Proximal to the Fingers
			29.2.1 Extensor Retinaculum
			29.2.2 Extensors of the Wrist
			29.2.3 Extensors of the Thumb
			29.2.4 Extensors of the Finger Metacarpophalangeal Joints
		29.3 Extensors of the Fingers
			29.3.1 Extrinsic Extensors of the Fingers and the Retinacular System
			29.3.2 Intrinsic Extensors of the Fingers
		29.4 Involvement of the Extensors in Control of Flexion of the Finger
		29.5 Involvement of the Extensors in Control of Extension of the Finger
		29.6 Conclusion
	30 The Interossei
		30.1 Anatomy and Biomechanics
		30.2 Function
		30.3 Summary
	31 Lumbricals
		31.1 Introduction
		31.2 Detailed Anatomy
			31.2.1 Origin
			31.2.2 Insertion
			31.2.3 Mechanics
		31.3 Nerve Supply
		31.4 Function
		31.5 Pathologic Manifestations
			31.5.1 Extensor Lacerations
			31.5.2 Lumbrical Plus
	32 Compartments of the Hand
		32.1 Introduction
			32.1.1 Thenar Compartment
			32.1.2 Adductor Compartment
			32.1.3 Interossei
			32.1.4 Hypothenar Compartment
			32.1.5 Carpal Tunnel
			32.1.6 Finger
		32.2 Compartment Monitoring
		32.3 Compartment Release
		32.4 Conclusion
	33 Hand Spaces
		33.1 Introduction
		33.2 Perionychium/Pulp Space
		33.3 Superficial Spaces
			33.3.1 Subcutaneous Dorsal and Palmar Digital Spaces
			33.3.2 Superficial Dorsal Hand Spaces
			33.3.3 Palmar Subcutaneous Space
			33.3.4 Interdigital Web Spaces
		33.4 Synovial Spaces
			33.4.1 Extensor Tendon Sheaths
			33.4.2 Flexor Tendon Sheaths
			33.4.3 Radial and Ulnar Bursae
		33.5 Deep Potential Spaces
			33.5.1 Space of Parona
			33.5.2 Thenar Space
			33.5.3 Midpalmar Space
			33.5.4 Lumbrical Spaces
			33.5.5 Hypothenar Space
	34 The Carpometacarpal Joints
		34.1 Introduction
		34.2 Thumb Carpometacarpal Joint
		34.3 Second Carpometacarpal Joint
		34.4 Third Carpometacarpal Joint
		34.5 Fourth Carpometacarpal Joint
		34.6 Fifth Carpometacarpal Joint
		34.7 Summary
	35 The Metacarpophalangeal Joints
		35.1 Surface Anatomy of Metacarpophalangeal Joint
			35.1.1 Skin and Integument
			35.1.2 Osteology
			35.1.3 Capsule, Collateral Ligaments, and Volar Plate
			35.1.4 Deep Transverse Metacarpal Ligament (Inter Palmar Plate Ligament) and the Metacarpal Transverse Arch
			35.1.5 Extensor Apparatus
			35.1.6 Flexor Tendons and Pulleys
		35.2 Neurovascular Anatomy
		35.3 Thumb Metacarpophalangeal Joint Surface Anatomy
			35.3.1 Osteology
			35.3.2 Capsule and Collateral Ligaments
			35.3.3 Volar Plate and Sesamoids
			35.3.4 Extensor Apparatus
			35.3.5 Flexor Tendons and Pulleys
		35.4 Neurovascular Anatomy
	36 The Interphalangeal Joint
		36.1 Introduction
		36.2 Proximal Interphalangeal Joint
			36.2.1 Bony Anatomy
			36.2.2 Stabilizing Restraints
			36.2.3 Vascular and Neurologic Structures
			36.2.4 Surface Anatomy
		36.3 The Distal Interphalangeal Joint
			36.3.1 Bony Anatomy
			36.3.2 Synovial Membrane
			36.3.3 Stabilizing Restraints
			36.3.4 Vascular and Neurologic Structures
			36.3.5 Surface Anatomy
		36.4 Biomechanics of Digital Motion
		36.5 Summary
	37 The Nail and Finger Pulp
		37.1 Introduction
		37.2 Embryology
		37.3 Anatomy
			37.3.1 Surface Anatomy
			37.2.2 Longitudinal and Cross-sections of the Fingertip
			37.2.3 Blood Supply to the Fingertip
			37.2.4 Nerve Supply
Section V Epilegomena
	38 Imaging and Anatomy
		38.1 Introduction
		38.2 Imaging Approach to Wrist Pathology
		38.3 Anatomical Considerations
Index