UPPER EXTREMITIES. 413 



the continuity of ligamentous with cellular tissue, and conse- 

 quently of the affinity of the two. 



The flexor tendons of the hand and fingers are held down, 

 by the Ligamentum Carpi Volare or the Anterior Annular Li- 

 gament of the Wrist. It is a very strong fasciculus of liga- 

 mentous fibres, which subtends the concavity of the carpal bones 

 in front, and converts it into the large oval foramen which con- 

 tains the tendons. It is attached by one end at the ulnar side 

 of the wrist, to the hook-like process of the unciforme, to the 

 cuneiforme, and to the pisiforme. Its fibres go straightly across 

 the wrist to be attached by their other extremities to the radial 

 end of the trapezium, and of the scaphoides ; and may be readi- 

 ly distinguished from the fascia brachialis by their uniformly 

 transverse course; by their superior whiteness; by their in- 

 creased thickness ; and by their great strength and unyielding 

 nature. Yet the superior margin of this ligament is partially 

 continuous with the fascia brachialis, and the inferior margin 

 with the aponeurosis palmaris. Several of the little muscles of 

 the hand arise from its front surface, while the posterior is in 

 contact with the flexor tendons. 



The Aponeurosis Palmaris is placed just below the skin, and 

 covers the middle of the palm of the hand. It is triangular, 

 and has its apex above, where it arises from the inferior margin 

 of the volar or anterior annular ligament of the wrist, and from 

 the tendon of the palmaris longus; it spreads out in its descent, 

 and reaches the lower ends of the metacarpal bones, where it 

 is divided into four portions. Each of these portions bifurcates 

 and passes to the head of its appropriate metacarpal bone, to 

 be fixed to it just in advance of the inferior palmar ligaments. 

 The vacuity of the bifurcation permits the flexor tendons to pass 

 on to the finger, and its branches are held together by transverse 

 arid reticulated fibres, the interstices of which are filled with 

 fat. The lateral margins of this aponeurosis send off a thin 

 membrane, for the purpose of covering the muscles of the thumb 

 and of the little finger; or, in other words, the thenar and the 

 hypothenar eminences in the palm of the hand. 



35* 



