Flexor retinaculumAttachment: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 retinaculumFrom medial to lateral:1- ulnar nerve close to bisiform2- ulnar artery3- palmar cutaneous branch of ulnar nerve4- tendon of palmaris longus5- palmar cutaneous branch of median nerve

Structures deep to flexor retinaculum 1- median nerve most superficial2- 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 sheath4- recurrent branch from deep palmar archFunctions of flexor retinaculmProtection and maintining the tendons in position

carpal tunnel It is the space between the concave anterior surface of carpal bone and flexor retinaculumContents of the tunnel:1- median nerve2-tendon of flexor PL& its sheath3&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 tendonsb) Dislocation of lunate bone c) thickness of retinaculum by arthritis

Manifistations: Ape hand1- adducted thumb 2- wasting of thenar muscle 3- loss of opposition of thumb 4- loss 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 radius2nd 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

longusIndicis +Post.interos.N+ant interos.A

minimi

6

1 2 3 4

5 6

Anatomical snuff box:It is a triangular hollow situated on lat. Side of back of thumb near wrist jointBoundaries: Laterally: tendons of APL & EPBMedially: tendon of EBLFloor: back of scaphoid and trapezium

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