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Intrinsic muscles of the hand

Intrinsic muscles of the hand
Muscle Proximal attachment Distal attachment Innervation* Main action
Thenar muscles
Opponens pollicis Flexor retinaculum and tubercles of scaphoid and trapezium Lateral side of first metacarpal Recurrent branch of median nerve (C8, T1) To oppose thumb, it draws first metacarpal medially to center of palm and rotates it medially
Abductor pollicis brevis Lateral side of base of proximal phalanx of thumb Abducts thumb; helps oppose it
Flexor pollicis brevis Flexes thumb
Superficial head Adducts thumb toward lateral border of palm
Deep head Deep branch of ulnar nerve (C8, T1)
Adductor pollicis Bases of second and third metacarpals, capitate, adjacent carpals Medial side of base of proximal phalanx of thumb
Oblique head
Transverse head Anterior surface of shaft of third metacarpal
Hypothenar muscles
Abductor digiti minimi Pisiform Medial side of base of proximal phalanx of fifth finger Deep branch of ulnar nerve (C8, T1) Abducts fifth finger; assists in flexion of its proximal phalanx
Flexor digiti minimi brevis Hook of hamate and flexor retinaculum Flexes proximal phalanx of fifth finger
Opponens digiti minimi Medial border of fifth metacarpal Draws fifth metacarpal anterior and rotates it, bringing fifth finger into opposition with thumb
Short muscles
Lumbricals Lateral two tendons of flexor digitorum profundus (as unipennate muscles) Lateral sides of extensor expansions of second through fifth fingers Median nerve (C8, T1) Flex metacarpophalangeal joints; extend interphalangeal joints of second through fifth fingers
First and second
Third and fourth Medial three tendons of flexor digitorum profundus (as bipennate muscles) Deep branch of ulnar nerve (C8, T1)
Dorsal interossei, first through fourth Adjacent sides of two metacarpals (as bipennate muscles) Bases of proximal phalanges; extensor expansions of second through fourth fingers Abduct second through fourth fingers from axial line; act with lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints
Palmar interossei, first through third Palmar surfaces of second, fourth, and fifth metacarpals (as unipennate muscles) Bases of proximal phalanges; extensor expansions of second, fourth, and fifth fingers Adduct second, fourth, and fifth fingers toward axial line; assist lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints; extensor expansions of second-fourth fingers
* The spinal cord segmental innervation is indicated (eg, "C8, T1" means that the nerves supplying the opponens pollicis are derived from the eighth cervical segment and first thoracic segment of the spinal cord). Numbers in boldface (C8) indicate the main segmental innervation. Damage to one or more of the listed spinal cord segments or to the motor nerve roots arising from them results in paralysis of the muscles concerned.
Reproduced with permission from: Moore KL, Dalley AR. Clinically Oriented Anatomy, 5th ed, Lippincott Williams & Wilkins, Philadelphia 2006. Copyright © 2006 Lippincott Williams & Wilkins. www.lww.com.
Graphic 66991 Version 15.0

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