Flexor retinaculum Attachment: Medially: besiform& hook of hamate. Laterally: split into two laminae;the superficial attached to tubercle of scaphoid and crest of trapezium. Deep lamina: attached to med. Lip of groove of trapezium. (The tendon of flexor carpi radialis lies between the 2 lamina). Proximally: continuous with antebrachial fascia. Distally: continuous with palmar aponeurosis

Structures superficial to flexor retinaculum From medial to lateral: 1- ulnar nerve close to bisiform 2- ulnar artery 3- palmar cutaneous branch of ulnar nerve 4- tendon of palmaris longus 5- palmar cutaneous branch of median nerve

Structures deep to flexor retinaculum 1- median nerve most superficial 2- 4 tendons of flexor digitorum superficialis and 4 tendons of flexor digitorum profundus ( in common synovial sheath) 3- 1 tendon of flexor pollicis longus in its synovial sheath 4- recurrent branch from deep palmar arch Functions of flexor retinaculm Protection and maintining the tendons in position

carpal tunnel

It is the space between the concave anterior surface of carpal bone and flexor retinaculum

Contents of the tunnel:

1- median nerve 2-tendon of flexor PL& its sheath 3&4- tendons of FDS & FDP in the common sheath.

Carpal tunnel syndrome: it is compression of median nerve within the tunnel by: a) Inflammation of synovial sheaths of flexor tendons b) Dislocation of lunate bone c) thickness of retinaculum by arthritis Manifistations: Ape hand 1- adducted thumb 2- wasting of thenar muscle 3- loss of opposition of thumb 4loss of sensation over lat. 3.5 fingers

Extensor retinaculum Attachment: Laterally: ant. border of radius above styloid process. Medially triquetral and pisiform bones. The space deep to it is divided into 6 tunnels by 5 septa.

1

Contents: 1st compatment: on lat. Side of styloid process of radius 2nd compartment: on back of radius lat. To dorsal tubercle. 3rd compartment back of radius just med. To dorsal tubercle. 4th compartment: on back of radius med. To later one. 5th compartment: between radius and ulna. 6th compartment: back of ulna between head of and styloid process

56 12 34

Indicis + Post.interos.N+ant interos.A minimi

6

longus

Anatomical snuff box: It is a triangular hollow situated on lat. Side of back of thumb near wrist t Boundaries: Laterally: tendons of APL & EPB Medially: tendon of EBL Floor: back of scaphoid and trapezium

Roof: skin, superficial fascia containing cephalic vein, dorsal digital brs of superficial branch of radial nerve Contents: radial A & tendons of Extensor carpi radialis longus and brevis