1452 



SUEFACE AND SUKGICAL ANATOMY. 



The prominences of the knuckles are formed entirely by the heads of the 

 metacarpal bones. Anteriorly, the metacarpo-phalangeal articulations are situated 

 | in. proximal to the level of the web of the fingers ; posteriorly, the joints may be 

 felt as a groove immediately proximal to the projecting ridge at the base of the first 

 phalanges. A well-marked crease crosses obliquely over the anterior aspect of the 

 metacarpo-phalangeal joint of the thumb. To cut into the first interphalangeal joints 

 from the front, incise along the most proximal of the creases in front of the joints ; 

 whereas to cut into the terminal joints, incise along the most distal of the creases in 



Superficial volar arch 



Deep branch of ulnar 

 artery 



Hamulus of os hamatum 

 Deep branch of ulnar nerve- 



Ulnar. nerve 

 Pisiform bone 



Palmaris longus 

 Styloid process of ulna 



Ulnar artery 



Deep volar arch 



Transverse carpal ligament 

 Ridge of greater multangular bone 

 Radial artery 



Median nerve 

 Styloid process of radius 

 Radial artery 



Flexor carpi radialis 



FIG. 1116. PALM OF HAND. 



front of the joints. Dorsally, the first and the terminal interphalangeal articu- 

 lations are opposite the most distal of the various creases overlying the joints. 



The most important muscular landmarks upon the front of the forearm are the 

 brachio-radialis, the flexor carpi radialis, and the pronator teres. The brachio- 

 radialis is thrown into prominence by flexing the semi-prone forearm against 

 resistance. At the junction of the proximal and middle thirds of the forearm the 

 pronator teres passes under cover of the brachio -radian's ; between the two is the radial 

 artery. The tendon of the flexor carpi radialis forms a prominent landmark 

 descending along the middle of the volar aspect of the forearm towards the 

 ridge of the multangulum majus ; the tendon of the palmaris longus, when 

 present, is seen to its medial side. 



