Muscles of the Hand

 Thenar Muscles
 Hypothenar Muscles
 Lumbricals
 Interossei
 Other Muscles in the Palm
The muscles that act on the hand can be divided into two groups:
 Extrinsic muscles – located in the anterior and posterior compartments of
the forearm. They control crude movements and produce a forceful grip.
 Intrinsic muscles – located within the hand itself. They are responsible for
the fine motor functions of the hand.

Thenar Muscles
The thenar muscles are three short muscles located at the base of the thumb. The
muscle bellies produce a bulge, known as the thenar eminence. They are
responsible for the fine movements of the thumb.
The median nerve innervates all the thenar muscles.
Opponens Pollicis
The opponens pollicis is the largest of the thenar muscles, and lies underneath the
other two.
 Attachments: Originates from the tubercle of the trapezium and the
associated flexor retinaculum. It inserts onto the lateral margin of the first
metacarpal.
  Actions: Opposes the thumb, by medially rotating and flexing the
metacarpal on the trapezium.
 Innervation: Median nerve (recurrent branch).
Abductor Pollicis Brevis
The abductor pollicis brevis forms the anterolateral aspect of the thenar
eminence, overlying the opponens pollicis.
 Attachments: Originates from the tubercles of the scaphoid and trapezium,
and from the associated flexor retinaculum. Attaches to lateral side of
proximal phalanx of the thumb.
 Actions: Abducts the thumb.
 Innervation: Median nerve (recurrent branch).
Flexor Pollicis Brevis
The flexor pollicis brevis forms the medial aspect of the thenar eminence. It is
described as having a superficial and deep part – although the deep component is
variable in size.
 Attachments: Originates from the tubercle of the trapezium and from the
associated flexor retinaculum. Attaches to the base of the proximal phalanx
of the thumb.
 Actions: Flexes the metacarpophalangeal joint of the thumb.
 Innervation: Median nerve (recurrent branch). The deep head is innervated
by the deep branch of the ulnar nerve.
Palmar view of the thenar muscles.
Prosection of the superficial muscles and tendons of the hand. The tendons of the flexor
digitorum superficialis can be seen as they pass through the carpal tunnel to insert onto each
digit.
Prosection of the superficial muscles and tendons of the hand. The tendons of the flexor
digitorum superficialis can be seen as they pass through the carpal tunnel to insert onto each
digit.
Prosection of the superficial muscles and tendons of the hand. The tendons of the flexor
digitorum superficialis can be seen as they pass through the carpal tunnel to insert onto each
digit.

Hypothenar Muscles
The hypothenar muscles form the hypothenar eminence – a muscular protrusion
on the medial side of the palm, at the base of the little finger. These muscles are
similar to the thenar muscles in both name and organisation.
The ulnar nerve innervates the muscles of the hypothenar eminence.
Opponens Digiti Minimi
The opponens digit minimi lies deep to the other hypothenar muscles.
 Attachments: Originates from the hook of hamate and associated flexor
retinaculum, inserts into the medial margin of metacarpal V.
 Actions: It rotates the metacarpal of the little finger towards the palm,
producing opposition.
 Innervation: Ulnar nerve.
Abductor Digiti Minimi
The abductor digiti minimi is the most superficial of the hypothenar muscle group.
 Attachments: Originates from the pisiform and the tendon of the flexor
carpi ulnaris. It attaches to the base of the proximal phalanx of the little
finger.
 Actions: Abducts the little finger.
 Innervation: Ulnar nerve.
Flexor Digiti Minimi Brevis
The flexor digiti minimi brevis lies laterally to the abductor digiti minimi in the
hand.
 Attachments: Originates from the hook of hamate and adjacent flexor
retinaculum, and inserts into the base of the proximal phalanx of the little
finger.
 Actions: Flexes the metacarpophalangeal joint of the little finger.
 Innervation: Ulnar nerve.
Superficial and deep layers of the hypothenar muscles

Lumbricals
There are four lumbricals in the hand, each associated with a finger. They are very
crucial to finger movement, linking the extensor tendons to the flexor tendons.
Denervation of these muscles is the basis for the ulnar claw and hand of
benediction.
 Attachments: Each lumbrical originates from a tendon of the flexor
digitorum profundus. They pass dorsally and laterally around each finger,
and inserts into the extensor hood.
 Actions: Flexion at the MCP joint and extension at the interphalangeal (IP)
joints of each digit.
 Innervation: The lateral two lumbricals (of the index and middle fingers) are
innervated by the median nerve. The medial two lumbricals (of the little
and ring fingers) are innervated by the ulnar nerve.
The lumbricals of the hand. Note the differing unipennate and bipennate structure.

Interossei
The interossei muscles are located between the metacarpal bones of the hand.
They can be divided into two groups – dorsal and palmar.
In addition to their actions of abduction (dorsal interossei) and adduction (palmar
interossei) of the fingers, the interossei also assist the lumbricals in flexion at the
MCP joints and extension at the IP joints.
Dorsal Interossei
The most superficial of all dorsal muscles, these can be palpated on the dorsum of
the hand. There are four dorsal interossei muscles.
 Attachments: Each interossei originates from the lateral and medial
surfaces of the metacarpals. They attach into the extensor hood and
proximal phalanx of each finger.
 Actions: Abduction of the digits. Assists in flexion at the
metacarpophalangeal joints and extension at the interphalangeal joints.
 Innervation: Ulnar nerve.
Palmar Interossei
These are located anteriorly on the hand. There are three palmar interossei
muscles (although some texts describe a fourth muscle at the base of the proximal
phalanx of the thumb).
 Attachments: Each interossei originates from a medial or lateral surface of a
metacarpal, and attaches into the extensor hood and proximal phalanx of
same finger.
 Actions: Adduction of the digits. Assists in flexion at the
metacarpophalangeal joints and extension at the interphalangeal joints.
 Innervation: Ulnar nerve.

The dorsal and palmar interossei of the hand.

Other Muscles in the Palm
There are two other muscles in the palm that are not lumbricals or interossei and
do not fit in the hypothenar or thenar compartments:
Palmaris Brevis
The palmaris brevis is a small, thin muscle, found superficially in the subcutaneous
tissue of the hypothenar eminence.
 Attachments: Originates from the palmar aponeurosis and flexor
retinaculum, attaches to the dermis of the skin on the medial margin of the
hand.
 Actions: Wrinkles the skin of the hypothenar eminence and deepens the
curvature of the hand, improving grip.
 Innervation: Ulnar nerve.
Adductor Pollicis
The adductor pollicis large triangular muscle with two heads. The radial artery
passes anteriorly through the space between the two heads, forming the deep
palmar arch.
 Attachments: One head originates from metacarpal III. The other head
originates from the capitate and adjacent areas of metacarpals II and
III. Both attach into the base of the proximal phalanx of the thumb.
 Actions: Adductor of the thumb.
 Innervation: Ulnar nerve.
The adductor pollicis. Note the two heads of the muscle.