OF 
22 THE MUSCULAR SYSTEM. 
attachment to the flexor and extensor carpi ulnaris and the flexor profundus 
digitorum. Above the wrist the fascia is pierced anteriorly by the tendon of the 
palmaris longus and by the ulnar artery and nerve. At the wrist it gains attach- 
ment to the bones of the forearm and carpus, is greatly strengthened by addition 
of transverse fibres, and constitutes the annular ligaments. 
The anterior annular ligament of the wrist is a band about an inch anda 
half in depth, continuous above and below with the deep fascia of the forearm and 
hand. It is attached to the scaphoid and trapezium externally; to the pisiform 
and unciform bones internally ; and it forms a membranous arch binding down in 
the hollow of the carpus the flexor tendons of the wrist, and the median nerve. 
It is divided into two compartments, the larger accommodating the tendons of the 
FLEXOR PROFUNDUS 
= si \. KS -Ligamenta vaginalia 
_DIGITORUM i } | g 
FLEXOR SUBLIMIS _ 
DIGITORUM 
TENDON OF FLEXOR 
LONGUS POLLICIS 
FLEXOR PROFUNDUS_=—— non 
DIGITORUM TENDONS AN Hi; iy DDUCTOR TRANSVERSUS 
FLEXOR SUBLIMIS ———W\ . ] / POLLICIS 
DIGITORUM TENDONS ’ 
OPPONENS MINIMI- 
DIGITI i 3 y 
FLEXOR BREVIS MINIMI DIGITI | LM, i y FLEXOR BREVIS POLLICIS 
ABDUCTOR MINIMI DIGITI 
Origin of palmar fascia (cut) 
Anterior annular ligament—— 
EXTENSOR OSSIS METACARPI POLLICIS 
PALMARIS LONGUS 
FLEXOR CARPI ULNARIS ——FLEXOR CARPI RADIALIS 
FLEXOR SUBLIMIS DIGITORUM—— Posterior annular ligament 
o 
Fig. 239.—THE MUSCLES AND TENDONS IN THE PALM OF THE HAND. 
flexors of the digits and the median nerve, the smaller (placed externally) contain- 
ing the tendon of the flexor carpi radialis. There are three synovial membranes in 
these compartments: one for the flexor carpi radialis tendon, the other two, which 
may communicate together, enveloping the tendons of the flexor longus pollicis and 
the flexor tendons of the fingers respectively. The surface of the ligament is crossed 
by the palmar branches of the median and ulnar nerves; by the tendon of the 
palmaris longus muscle, which is attached to its surface; and by the ulnar artery 
and nerve, which are again bridged over and protected by a band of fibrous tissue 
passing from the pisiform bone and the superficial fascia to the surface of the 
ligament. To the lower border of the ligament are attached the palmar fascia in 
the centre, and the superficial muscles of the thumb and the muscles of the little 
finger on each side. 
The posterior annular ligament of the wrist is placed at a higher level 
