THE HAND. 



491 



great strength and thickness, and binds down the tendons in this situation. It is 

 narrow above, being attached to the lower margin of the annular ligament, and 

 receives the expanded tendon of the Palmaris longus muscle. Below, it is broad 

 and expanded, and divides into four slips, for the four fingers. Each slip gives off 

 superficial fibres, which are inserted into the skin of the palm and finger, those to 

 the palin joining the skin at the furrow corresponding to the metacarpo-phalangeal 

 articulation, and those to the fingers passing into the skin at the transverse fold 

 at the base of the fingers. The deeper part of each slip subdivides into two pro- 

 cesses, which are inserted into the lateral margins of the anterior (glenoid) liga- 

 ment of the metacarpo-phalangeal joint. From the sides of these processes 



Digital artery. 

 Digital nerce. 



...EXTENSOR METACARPI AND 

 EXTENSOR BREVIS POLLICIS. 



FLEXOR LONGUS POLLICIS. 



FIG. 314. Palmar fascia. 

 England.) 



(Altered from a dissection in the Museum of the Royal College of Surgeons of 



offsets are sent backward, to be attached to the borders of the lateral surfaces of 

 the metacarpal bones at their distal extremities. By this arrangement short 

 channels are formed on the front of the lower ends of the metacarpal bones, 

 through which the flexor tendons pass. Dr. W. W. Keen describes a fifth slip as 

 frequently found passing to the thumb. The intervals left in the fascia between 

 the four fibrous slips transmit the digital vessels and nerves and the tendons of 

 the Lumbricales. At the points of division of the palmar fascia into the slips 

 above mentioned numerous strong, transverse fibres bind the separate processes 

 together. The palmar fascia is intimately adherent to the integument by dense 

 fibro-areolar tissue, forming the superficial palmar fascia, and gives origin by its 

 inner margin to the Palmaris brevis : it covers the superficial palmar arch, the 



