Thenar eminence
| Thenar eminence | |
|---|---|
 | |
| The mucous sheaths of the tendons on the anterior surface of the wrist and digits | |
 | |
| Transverse section across the wrist and digits (muscles of thumb labeled at upper left) | |
| Latin | Eminentia thenaris |
| Gray's | p.546 |
| Origin | |
| Insertion | |
| Artery | Superficial palmar arch |
| Nerve | Median nerve |
| Actions | Control movement of the thumb |
The thenar eminence (from the Greek "θέναρ" - thenar, "palm of the hand"[1] and the Latin word "eminentia", meaning projection,[2]) refers to the group of muscles on the palm of the human hand at the base of the thumb. The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex.
Muscles
The following three muscles are considered part of the thenar eminence:[3]
- Abductor pollicis brevis abducts the thumb. This muscle is the most superficial of the thenar group.
- Flexor pollicis brevis, which lies next to the abductor, will flex the thumb, curling it up in the palm.
- Opponens pollicis lies deep to abductor pollicis brevis. As its name suggests it opposes the thumb, bringing it against the fingers. This is a very important movement, as most of our dexterity comes from this action.
Another muscle that controls movement of the thumb is adductor pollicis. It lies deeper and more distal to flexor pollicis brevis. Despite its name, its main action is mainly rotation and opposition. It is not in the thenar group of muscles, so is supplied by the ulnar nerve.[4]
Innervation
The Opponens pollicis and Abductor pollicis brevis are normally innervated by the median nerve. The Flexor pollicis brevis can be innervated by the median or ulnar nerve. The adductor pollicis is typically innervated by the ulnar nerve. There are normal variations. In a Cannieu-Riche anastomasis, fibers from the deep palmar branch of the ulnar nerve innervate the opponens pollicis and/or abductor pollicis brevis. Regardless of their final innervation, the nerves that reach the thenar muscles arise from the C8 and T1 roots, pass through the lower trunk of the plexus, and then through the medial cord of the plexus.
The ulnar nerve is exclusively responsible for the innervations of the hypothenar eminence. Both nerves contribute to the innervations of the midpalmar group.[5]
Flexor Pollicis Brevis (FPB) is typically an ulnar-innervated muscle. Due to a common interconnection between the Median and Ulnar nerves in the hand (Riche-Cannieu interconnection), the Median nerve may innervate the FPB in 35% of people. It is innervated by the Ulnar nerve in 50% of people and by both the Median and Ulnar nerves in 15%.
The muscles in this location are usually innervated by the recurrent branch of the median nerve. They all control movement of the thumb.
The innervation of these muscles by the median nerve is unusual, as most of the intrinsic muscles on the palm of the hand are supplied by the ulnar nerve. The lateral two lumbrical muscles are the other exception.
Mnemonics
The muscles of the hand can be remembered using the mnemonic, "A OF A OF A" for, Abductor pollicis brevis, Opponens pollicis, Flexor pollicis brevis (these 3 are the thenar muscles), Adductor pollicis and Opponens digiti minimi, Flexor digiti minimi, Abductor digiti minimi (hypothenar muscles).[6]
A good way to remember what muscles are in the thenar eminence is "OAF"; oafs have big thenar eminences. 'O' = opponens, 'A' = abductor, 'F' = flexor. There is only one opponens. The other two muscles each have a long partner and thus are called "brevis."
Meat-LOAF: the "M" in the word "Meat" helps you remember that the LOAF muscles of the hand (2 Lateral Lumbricals, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis) are innervated by the Median Nerve
ABOF (pronounced "above") the Law muscles. The law states muscles of the hand are supplied by ulnar nerve. However, ABOF the Law muscles are supplied by MEDIAN nerve. 'AB' = abductor, 'O' = Opponens, 'F' = Flexor, Law 'L' = Lateral Lumbricals (2).
MAINTAINER—Main(Median nerve) --Tainer(thenar muscles)
Additional Images
-
Thenar muscle
-
Thenar muscle
-
Thenar eminence
See also
References
- ↑ θέναρ, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital library
- ↑ Mosby's Medical Dictionary (8th ed.). Elsevier. 2009. ISBN 978-0-323-05290-0.
- ↑ "Intrinsic Muscles of the Hand — Wheeless' Textbook of Orthopaedics". Retrieved 2008-01-16.
- ↑ "Applied MSK anatomy of the hand". Archived from the original on 2008-01-01. Retrieved 2008-01-16.
- ↑ Van De Graaff, Kent M. (1992). Human Anatomy (3rd ed.). Dubuque: Wm C Brown. ISBN 0-697-09716-1. Print.
- ↑ "Medical mnemonics". LifeHugger. Retrieved 2009-12-19.
External links
- lesson5mus&tendonsofhand at The Anatomy Lesson by Wesley Norman (Georgetown University)
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||