FASCIA OF WRIST & HAND

FLEXOR RETINACULUMStrong fibrous band- carpal tunnelAttachment- medially- pisiform

hook hamatelaterally- 2 laminaesuperficial-tubercles of scaphoid,

trapeziumdeep- groove on trapezium

superiorly- fascia of forearminferiorly- palmar aponeurosis

Relations- crossed superficially ulnar vessels &nerve

palmar cutaneous branches of radial & ulnar nerves

palmaris longusintrinsic muscles hand

CONTENTS OF CARPAL TUNNEL1- flexor digitorum superficialis2- flexor digitorum profundus3- flexor pollicis longus4- median nerve5- ulnar bursa6- radial bursa

Arrangement of structures

CARPAL TUNNEL SYNDROMECompression median nerve at wristCauses-

oedema, myxedema,osteo arthritis,rheumatoid arthritisSymptoms-

pain, numbness- radial three & half digits especially at nightExamination-

wasting thenar muscleshypo-aesthesiaskin over thenar eminence normal

Treatment-analgesic, splinting

EXTENSOR RETINACULUMOblique bandBorders- superior & inferior continuous deep fascia

medial –attached triquetrallateral- attached anterior border radius

Compartments abductor pollicis longus, extensor pollicis brevisextensor carpi radialis longus, brevisextensor pollicis longusextensor digitorum, indicis, posterior interosseous nerves & vesselsextensor digiti minimiextensor carpi ulnaris

FASCIA OF HANDFunctions-

chaneling of structures transmission of loadanchoragebindinglubricationframework muscle attachments

PALMAR APONEUROSISParts- central, medial, lateralCentral part- thick, protects vessels, nerves

prevents tendons from bow- stringingLateral, medially- thinFeatures- triangular

apex proximaldistally- thick, four slips(superficial, deep)intervals traversed- digital vessels,nerves,lumbricals

Medial, lateral palmar septaFunctions- improves grip

protectionorigin- palmaris brevispotential spaces

Morphology- degenerated tendon

FIBROUS FLEXOR SHEATHS

Extent- MP joint-base distal phalanxContentsEach crosses three jointsThick, thin zones

Digital synovial sheaths- vincula longa, brevia