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Radial Artery


The radial artery is the smaller of the terminal branches of the brachial artery. It begins in the cubital fossa at the level of the neck of the radius. It passes downward and laterally, beneath the brachioradialis muscle and resting on the deep muscles of the forearm. In the middle third of its course, the superficial branch of the radial nerve lies on its lateral side. In the distal part of the forearm, the radial artery lies on the anterior surface of the radius and is covered only by skin and fascia. Here, the artery has the tendon of brachioradialis on its lateral side and the tendon of flexor carpi radialis on its medial side (site for taking the radial pulse). The radial artery leaves the forearm by winding around the lateral aspect of the wrist to reach the posterior surface of the hand.

Branches in the Forearm

1. Muscular branches to neighboring muscles.

2. Recurrent branch, which takes part in the arterial anastomosis around the elbow joint.

^ 3. Superficial palmar branch, which arises just above the wrist, enters the palm of the hand, and frequently joins the ulnar artery to form the superficial palmar arch.

Nerves of the Anterior Fascial Compartment of the Forearm

Median Nerve The median nerve leaves the cubital fossa by passing between the two heads of the pronator teres. It continues downward behind the flexor digitorum superficialis and rests posteriorly on the flexor digitorum profundus. At the wrist, the median nerve emerges from the lateral border of the flexor digitorum superficialis muscle and lies behind the tendon of the palmaris longus. It enters the palm by passing behind the flexor retinaculum.

Branches

^ 1. Muscular branches in the cubital fossa to the pronator teres, the flexor carpi radialis, the palmaris longus, and the flexor digitorum superficialis.

2. Articular branches to the elbow joint.

3. Anterior interosseous nerve.

4. Palmar cutaneous branch. This arises in the lower part of the forearm and is distributed to the skin over the lateral part of the palm.

Anterior Interosseous Nerve The anterior interosseous nerve arises from the median nerve as it emerges from between the two heads of the pronator teres. It passes downward on the anterior surface of the interosseous membrane, between the flexor pollicis longus and the flexor digitorum profundus. It ends on the anterior surface of the carpus.

Branches

^ 1. Muscular branches to the flexor pollicis longus, the pronator quadratus, and the lateral half of the flexor digitorum profundus.

2. Articular branches to the wrist and distal radioulnar joints. It also supplies the joints of the hand. Ulnar Nerve The ulnar nerve passes from behind the medial epicondyle of the humerus, crosses the medial ligament of the elbow joint, and enters the front of the forearm by passing between the two heads of the flexor carpi ulnaris. It then runs down the forearm between the flexor carpi ulnaris and the flexor digitorum profundus muscles. In the distal two-thirds of the forearm, the ulnar artery lies on the lateral side of the ulnar nerve. At the wrist, the ulnar nerve becomes superficial and lies between the tendons of the flexor carpi ulnaris and flexor digitorum superficialis muscles. The ulnar nerve enters the palm of the hand by passing in front of the flexor retinaculum and lateral to the pisiform bone; here it has the ulnar artery lateral to it.

Branches

^ 1. Muscular branches to the flexor carpi ulnaris and to the medial half of the flexor digitorum profundus.

2. Articular branches to the elbow joint.

3. Palmar cutaneous branch. This is a small branch that arises in the middle of the forearm and supplies the skin over the hypothenar eminence.

^ 4. Dorsal, or posterior cutaneous branch. This is a large branch that arises in the distal third of the forearm. It passes medially between the tendon of the flexor carpi ulnaris and the ulna and is distributed on the posterior surface of the hand and fingers.

Contents of the Lateral Fascial Compartment of the Forearm

This may be regarded as part of the posterior fascial compartment.

^ Arteries of the Lateral Compartment of the Forearm

The arterial supply is derived from branches of the radial and brachial arteries.

Nerve of the Lateral Compartment of the Forearm

Radial Nerve

The radial nerve pierces the lateral intermuscular septum in the lower part of the arm and passes forward into the cubital fossa. It then passes downward in front of the lateral epicondyle of the humerus, lying between the brachialis on the medial side and the brachioradialis and extensor carpi radialis longus on the lateral side. At the level of the lateral epicondyle it divides into superficial and deep branches.

Branches

^ 1. Muscular branches to the brachioradialis, to the extensor carpi radialis longus, and a small branch to the lateral part of the brachialis muscle.

2. Articular branches to the elbow joint.

3. Deep branch of the radial nerve. This winds around the neck of the radius, within the supinator muscle, and enters the posterior compartment of the forearm.

^ 4. Superficial branch of the radial nerve.

Superficial Branch of the Radial Nerve

The superficial branch of the radial nerve is the direct continuation of the nerve after its main stem has given off its deep branch in front of the lateral epicondyle of the humerus. It runs down under cover of the brachioradialis muscle on the lateral side of the radial artery. In the distal part of the forearm, it leaves the artery and passes backward under the tendon of the brachioradialis. It reaches the posterior surface of the wrist, where it divides into terminal branches that supply the skin on the lateral two-thirds of the posterior surface of the hand and the posterior surface over the proximal phalanges of the lateral three and one-half fingers. The area of skin supplied by the nerve on the dorsum of the hand is variable.

Contents of the Posterior Fascial Compartment of the Forearm

Muscles:

Superficial group: Extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, and anconeus. These muscles possess a common tendon of origin, which is attached to the lateral epicondyle of the humerus.

^ Deep group: Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, and extensor indicis.

Blood supply: Posterior and anterior interosseous arteries.

Nerve supply to the muscles: Deep branch of the radial nerve.

"Anatomic Snuffbox" The anatomic snuffbox is a term commonly used to describe a triangular skin depression on the lateral side of the wrist that is bounded medially by the tendon of the extensor pollicis longus and laterally by the tendons of the abductor pollicis longus and extensor pollicis brevis. Its clinical importance lies in the fact that the scaphoid bone is most easily palpated here and that the pulsations of the radial artery can be felt here.


^ Arteries of the Posterior Fascial Compartment of the

Forearm

The anterior and posterior interosseous arteries arise from the common interosseous artery, a branch of the ulnar artery. They pass downward on the anterior and posterior surfaces of the interosseous membrane, respectively, and supply the adjoining muscles and bones. They end by taking part in the anastomosis around the wrist joint.

^ Nerve of the Posterior Fascial Compartment of the Forearm

Deep Branch of the Radial Nerve

There deep branch arises from the radial nerve in front of the lateral epicondyle of the humerus in the cubital fossa. It pierces the supinator and winds around the lateral aspect of the neck of the radius in the substance of the muscle to reach the posterior compartment of the forearm. The nerve descends in the interval between the superficial and deep groups of muscles. It eventually reaches the posterior surface of the wrist joint.

Branches

^ 1. Muscular branches to the extensor carpi radialis brevis and the supinator, the extensor digitorum, the extensor digiti minimi, the extensor carpi ulnaris, the abductor pollicis longus, the extensor pollicis brevis, the extensor pollicis longus, and the extensor indicis.

2. Articular branches to the wrist and carpal joints.


The Region of the Wrist


^ STRUCTURES ON THE ANTERIOR ASPECT OF THE WRIST

The following structures pass superficial to the flexor retinaculum from medial to lateral.

1. Flexor carpi ulnaris tendon, ending on the pisiform bone. (This tendon does not actually cross the flexor retinaculum but is included for the sake of completeness.)

^ 2. Ulnar nerve lies lateral to the pisiform bone.

3. Ulnar artery lies lateral to the ulnar nerve.

4. Palmar cutaneous branch of the ulnar nerve.

5. Palmaris longus tendon (if present), passing to its insertion into the flexor retinaculum and the palmar aponeurosis.

^ 6. Palmar cutaneous branch of the median nerve.

The following structures pass beneath the flexor retinaculum from medial to lateral.

1. Flexor digitorum superficialis tendons and, posterior to these, the tendons of the flexor digitorum profundus; both groups of tendons share a common synovial sheath.

2. Median nerve.

3. Flexor pollicis longus tendon surrounded by a synovial sheath.

4. Flexor carpi radialis tendon going through a split in the flexor retinaculum. The tendon is surrounded by a synovial sheath.


^ STRUCTURES ON THE POSTERIOR ASPECT OF THE WRIST

The following structures pass superficial to the extensor retinaculum from medial to lateral.

1. Dorsal (posterior) cutaneous branch of the ulnar nerve.

2. Basilic vein.

3. Cephalic vein.

^ 4. Superficial branch of the radial nerve.

The following structures pass beneath the extensor retinaculum from medial to lateral.

1. Extensor carpi ulnaris tendon, which grooves the posterior aspect of the head of the ulna.

2. Extensor digiti minimi tendon is situated posterior to the distal radiouinar joint.

^ 3. Extensor digitorum and extensor indicis tendons share a common synovial sheath and are situated on the lateral part of the posterior surface of the radius.

4. Extensor pollicis longus tendon winds around the medial side of the dorsal tubercle of the radius.

^ 5. Extensor carpi radialis longus and brevis tendons share a common synovial sheath and are situated on the lateral part of the posterior surface of the radius.

6. Abductor pollicis longus and the extensor pollicis brevis tendons have separate synovial sheaths but share a common compartment.

Beneath the extensor retinaculum, fibrous septa pass to the underlying radius and ulna and form six compartments that contain the tendons of the extensor muscles. Each compartment is provided with a synovial sheath, which extends above and below the retinaculum.

The radial artery reaches the back of the hand by passing between the lateral collateral ligament of the wrist joint and the tendons of the abductor pollicis longus and extensor pollicis brevis.


The Palm of the Hand

SKIN

The skin of the palm of the hand is thick and hairless. It is bound down to the underlying deep fascia by numerous fibrous fibrous bands. The skin shows many flexure creases at the sites of skin movement, which are not necessarily placed at the site of joints. Sweat glands are present in large numbers.

The palmaris brevis is a small muscle that arises from the flexor retinaculum and palmar aponeurosis and is inserted into the skin of the palm. It is supplied by the superficial branch of the ulnar nerve. Its function is to corrugate the skin at the base of the hypothenar eminence and so improve the grip of the palm in holding a rounded object.

The sensory nerve supply to the skin of the palm is derived from the palmar cutaneous branch of the median nerve, which crosses in front of the flexor retinaculum and supplies the lateral part of the palm, and the palmar cutaneous branch of the ulnar nerve; the latter nerve also crosses in front of the flexor retinaculum and supplies the medial part of the palm.

The skin over the base of the thenar eminence is supplied by the lateral cutaneous nerve of the forearm or the superficial branch of the radial nerve.

^ DEEP FASCIA

The deep fascia of the wrist and palm is thickened to form the flexor retinaculum and the palmar aponeurosis.

The Palmar Aponeurosis

The palmar aponeurosis is triangular and occupies the central area of the palm. The apex of the palmar aponeurosis is attached to the distal border of the flexor retinaculum and receives the insertion of the palmaris longus tendon. The base of the aponeurosis divides at the bases of the fingers into four slips. Each slip divides into two bands, one passing superficially to the skin and the other passing deeply to the root of the finger; here each deep band divides into two, which diverge around the flexor tendons and finally fuse with the fibrous flexor sheath and the deep transverse ligaments.

The medial and lateral borders of the palmar aponeurosis are continuous with the thinner deep fascia covering the hypothenar and thenar muscles. From each of these borders, borders, fibrous septa pass posteriorly into the palm and take part in the formation of the palmar fascial spaces.

The function of the palmar aponeurosis is to give firm attachment to the overlying skin and so improve the grip and to protect the underlying tendons.

^ THE CARPAL TUNNEL

The carpus is deeply concave on its anterior surface and forms a bony gutter. The gutter is converted into a tunnel by the flexor retinaculum.

The long flexor tendons to the fingers and thumb pass through the tunnel and are accompanied by the median nerve. The four separate tendons of the flexor digitorum superficialis muscle are arranged in anterior and posterior rows, those to the middle and ring fingers lying in front of those to the index and little fingers. At the lower border of the flexor retinaculum, the four tendons diverge and become arranged on the same plane. The tendons of the flexor digitorum profundus muscle are on the same plane and lie behind the superficialis tendons. All eight tendons of the flexor digitorum superficialis and profundus invaginate a common synovial sheath from the lateral side. This allows the arterial supply to the tendons to enter them from the lateral side.

The tendon of the flexor pollicis longus muscle runs through the lateral part of the tunnel in its own synovial sheath.

The median nerve passes beneath the flexor retinaculum in a restricted space between the flexor digitorum superficialis and the flexor carpi radialis muscles.


^ FIBROUS FLEXOR SHEATHS

The anterior surface of each finger, from the head of the metacarpal to the base of the distal phalanx, is provided with a strong fibrous sheath that is attached to the sides of the phalanges. The proximal end of the fibrous sheath is open, whereas the distal end of the sheath is closed and is attached to the base of the distal phalanx. The sheath, together with the anterior surfaces of the phalanges and the interphalangeal joints, forms a blind tunnel in which the flexor tendons of the finger lie.

In the thumb, the osteofibrous tunnel contains the tendon of the flexor pollicis longus. In the case of the four medial fingers, the tunnel is occupied by the tendons of the flexor digitorum superficialis and profundus. The fibrous sheath is thick over the phalanges but thin and lax over the joints.

^ SYNOVIAL FLEXOR SHEATHS

The crowded long flexor tendons emerge from the carpal tunnel and diverge as they pass down into the hand. The flexor pollicis longus tendon enters the osteofibrous tunnel of the thumb and is inserted into the base of the distal phalanx. The tendon is surrounded by a synovial sheath that extends into the forearm for a distance equal to about a fingersbreadth proximal to the flexor retinaculum; distally it extends to the insertion.

The eight tendons of the flexor digitorum superficialis and profundus invaginate a common synovial sheath from the lateral side. This common sheath extends proximally into the forearm for a distance equal to about a fingersbreadth proximal to the flexor retinaculum. Distally, the medial part of the sheath continues downward without interruption on the tendons of the little finger as far as the base of the distal phalanx. The remainder of the sheath ends blindly approximately at the level of the proximal transverse crease of the palm.

The distal ends of the flexor tendons of the index, middle, and ring fingers have digital synovial sheaths that commence at the level of the distal transverse crease of the palm and end at the bases of the distal phalanges. Thus, for a short length, the tendons for these fingers are devoid of a synovial covering.

The synovial sheath of the flexor pollicis longus (sometimes referred to as the radial bursa) communicates with the common synovial sheath of the superficialis and profundus tendons (sometimes referred to as the ulnar bursa) at the level of the wrist in about 50% of subjects.

The vincula longa and brevia are small vascular folds of synovial membrane that connect the tendons to the anterior surface of the phalanges. They resemble a mesentery and convey blood vessels to the tendons.

The function of these sheaths is to allow the long tendons to move smoothly, with the minimum of friction, beneath the flexor retinaculum and the fibrous flexor sheaths.

^ INSERTION OF THE LONG FLEXOR TENDONS

The flexor pollicis longus tendon is inserted simply onto the anterior surface of the base of the distal phalanx of the thumb.

Each tendon of the flexor digitorum superficialis enters the fibrous flexor sheath; opposite the proximal phalanx it divides into two halves, which pass around the profundus tendon and meet on its deep or posterior surface, where partial partial decussation of the fibers takes place. The superficialis tendon, having united again, divides almost at once into two further slips, which are attached to the borders of the middle phalanx.

Each tendon of the flexor digitorum profundus, having passed through the division of the superficialis tendon, continues downward, to be inserted into the anterior surface of the base of the distal phalanx.

^ SMALL MUSCLES OF THE HAND

Lumbrical Muscles

The lumbrical muscles are four in number.

The Interossei

There are eight interossei, consisting of four dorsal and four palmar muscles. They occupy the spaces between the metacarpal bones. The dorsal muscles arise by two heads and are larger than the palmar muscles, which have only one head.

Palmar Interossei

Dorsal Interossei

^ SHORT MUSCLES OF THE THUMB

The short muscles of the thumb are the abductor pollicis brevis, the flexor pollicis brevis, the opponens pollicis, and the adductor pollicis. The first three of these muscles form the thenar eminence.

Abductor Pollicis Brevis

Flexor Pollicis Brevis

Opponens Pollicis

Adductor Pollicis


^ ARTERIES OF THE PALM

Ulnar Artery

The ulnar artery enters the hand anterior to the flexor retinaculum on the lateral side of the ulnar nerve and the pisiform bone. The artery gives off a deep branch and then continues into the palm as the superficial palmar arch.

The superficial palmar arch is a direct continuation of the ulnar artery. On entering the palm it curves laterally behind the palmar aponeurosis and in front of the long flexor tendons. The arch is completed on the lateral side by one of the branches of the radial artery. The curve of the arch lies across the palm, level with the distal border of the fully extended thumb.

Four digital arteries arise from the convexity of the arch and pass to the fingers.

^ The deep branch of the ulnar artery arises in front of the flexor retinaculum, passes between the abductor digiti minimi and the flexor digiti minimi, and joins the radial artery to complete the deep palmar arch.

Radial Artery

The radial artery leaves the dorsum of the hand by turning forward between the proximal ends of the first and second metacarpal bones and the two heads of the first dorsal interosseous muscle. On entering the palm, it curves medially between the oblique and transverse heads of the adductor pollicis and continues as the deep palmar arch.

The deep palmar arch is a direct continuation of the radial artery. It curves medially beneath the long flexor tendons and in front of the metacarpal bones and the interosseous muscles. The arch is completed on the medial side by the deep branch of the ulnar artery. The curve of the arch lies at a level with the proximal border of the extended thumb.

The deep palmar arch sends branches superiorly, which take part in the anastomosis around the wrist joint, and inferiorly, to join the digital branches of the superficial palmar arch.

^ Branches of the Radial Artery in the Palm

Immediately on entering the palm, the radial artery gives off (a) the arteria radialis indicis, which supplies the lateral side of the index finger, and (b) the arteria princeps pollicis, which divides into two and supplies the lateral and medial sides of the thumb.

^ VEINS OF THE PALM

Superficial and deep palmar arterial arches are accompanied by superficial and deep palmar venous arches, receiving corresponding tributaries.

LYMPH DRAINAGE OF THE PALM

The lymph vessels of the fingers pass along their borders to reach the webs. From here the vessels ascend onto the dorsum of the hand. Lymph vessels on the palm form a plexus that is drained by vessels that ascend in front of the forearm or pass around the medial and lateral borders to join vessels on the dorsum of the hand.

The lymph from the medial side of the hand ascends in vessels that accompany the basilic vein; they drain into the supratrochlear nodes and then ascend to drain into the lateral axillary nodes. The lymph from the lateral side of the hand ascends in vessels that accompany the cephalic vein; they drain into the infraclavicular nodes, and some drain into the lateral axillary nodes.

^ NERVES OF THE PALM

Median Nerve

The median nerve enters the palm by passing behind the flexor retinaculum and through the carpal tunnel. It immediately divides into lateral and medial branches.

The muscular branch takes a recurrent course around the lower border of the flexor retinaculum and lies about fingersbreadth distal to the tubercle of the scaphoid; it supplies the muscles of the thenar eminence (the abductor pollicis brevis, the flexor pollicis brevis, and the opponens pollicis) and the first lumbrical muscle.

^ The cutaneous branches supply the palmar aspect of the lateral three and one-half fingers and the distal half of the dorsal aspect of each finger. One of these branches also supplies the second lumbrical muscle.

Note also that the palmar cutaneous branch of the median nerve given off in the front of the forearm crosses anterior to the flexor retinaculum and supplies the skin over the lateral part of the palm.

Ulnar Nerve

The ulnar nerve enters the palm anterior to the flexor retinaculum alongside the lateral border of the pisiform bone. As it crosses the retinaculum it divides into a superficial and a deep terminal branch.

^ Superficial Branch of the Ulnar Nerve

The superficial branch of the ulnar nerve descends into the palm, lying in the subcutaneous tissue between the pisiform bone and the hook of the hamate. The ulnar artery is on its lateral side. Here, the nerve and artery may lie in a fibro-osseous tunnel, the tunnel of Guyon, created by fibrous tissue derived from the superficial part of the flexor retinaculum. The nerve may be compressed at this site, giving rise to clinical signs and symptoms.

The nerve gives off the following branches: (a) a muscular branch to the palmaris brevis and (b) cutaneous branches to the palmar aspect of the medial side of the little finger and the adjacent sides of the little and ring fingers. It also supplies the distal half of the dorsal aspect of each finger.

^ Deep Branch of the Ulnar Nerve

The deep branch of the ulnar nerve runs backward between the abductor digiti minimi and the flexor digiti minimi. It pierces the opponens digiti minimi, winds around the lower border of the hook of the hamate, and passes laterally within the concavity of the deep palmar arch. The nerve lies behind the long flexor tendons and in front of the metacarpal bones and interosseous muscles. It gives off muscular branches to the three muscles of the hypothenar eminence, namely, the abductor digiti minimi, the flexor digiti minimi, and the opponens digiti minimi. It supplies all the palmar and dorsal interossei, the third and fourth lumbrical muscles, and both heads of the adductor pollicis muscle.

The palmar cutaneous branch of the ulnar nerve given off in the front of the forearm crosses anterior to the flexor retinaculum and supplies the skin over the medial part of the palm.

^ FASCIAL SPACES OF THE PALM

Normally, the fascial spaces of the palm are potential spaces filled with loose connective tissue. Their boundaries are important clinically because they may limit the spread of infection in the palm.

The triangular palmar aponeurosis fans out from the lower border of the flexor retinaculum. From its medial border a fibrous septum passes backward and is attached to the anterior border of the fifth metacarpal bone. Medial to this septum is a fascial compartment containing the three hypothenar muscles; this compartment is unimportant clinically. From the lateral border of the palmar aponeurosis, a second fibrous septum passes obliquely backward to the anterior border of the third metacarpal bone. Usually, the septum passes between the long flexor tendons of the index and middle fingers. This second septum divides the palm into the thenar space, which lies lateral to the septum (and must not be confused with the fascial compartment containing the thenar muscles), and the midpalmar space, which lies medial to the septum. Proximally, the thenar and midpalmar spaces are closed off from the forearm by the walls of the carpal tunnel. Distally, the two spaces are continuous with the appropriate lumbrical canals.

The thenar space contains the first lumbrical muscle and lies posterior to the long flexor tendons to the index finger and in front of the adductor policis muscle.

The midpalmar space contains the second, third, and fourth lumbrical muscles and lies posterior to the long flexor tendons to the middle, ring, and little fingers. It lies in front of the interossei and the third, fourth, and fifth metacarpal bones.

The lumbrical canal is a potential space surrounding the tendon of each lumbrical muscle and is normally filled with connective tissue. Proximally, it is continuous with one of the palmar spaces.

^ PULP SPACE OF THE FINGERS

The deep fascia of the pulp of each finger fuses with the periosteum of the terminal phalanx just distal to the insertion of the long flexor tendons and closes off a fascial compartment known as the pulp space. Each pulp space is subdivided by the presence of numerous septa, which pass from the deep fascia to the periosteum. Through the pulp space, which is filled with fat, runs the terminal branch of the digital artery that supplies the diaphysis of the terminal phalanx. Thrombosis of this vessel, caused by infection of the pulp space, will result in necrosis of the diaphysis of this bone. The epiphysis of the distal phalanx receives its blood supply proximal to the pulp space.

^ The Dorsum of the Hand

SKIN

The skin on the dorsum of the hand is thin, hairy, and freely mobile on the underlying tendons and bones.

The sensory nerve supply to the skin on the dorsum of the hand is derived from the superficial branch of the radial nerve and the posterior cutaneous branch of the ulnar nerve.

The superficial branch of the radial nerve winds around the radius deep to the brachioradialis tendon, descends over the extensor retinaculum, and supplies the lateral lateral two-thirds of the dorsum of the hand. It divides into several dorsal digital nerves that supply the thumb, the index and middle fingers, and the lateral side of the ring finger. The area of skin on the back of the hand and fingers supplied by the radial nerve is subject to variation. Frequently a dorsal digital nerve, a branch of the ulnar nerve, also supplies the lateral side of the ring finger.

The posterior cutaneous branch of the ulnar nerve winds around the ulna deep to the flexor carpi ulnaris tendon, descends over the extensor retinaculum, and supplies the medial third of the dorsum of the hand. It divides into several dorsal digital nerves that supply the medial side of the ring and the sides of the little fingers.

The dorsal digital branches of the radial and ulnar nerves do not extend far beyond the proximal phalanx. The remainder of the dorsum of each finger receives its nerve supply from palmar digital nerves.

^ DORSAL VENOUS ARCH (OR NETWORK)

The dorsal venous arch lies in the subcutaneous tissue proximal to the metacarpophalangeal joints and drains on the lateral side into the cephalic vein and, on the medial side, into the basilic vein. The greater part of the blood from the whole hand drains into the arch, which receives digital veins and freely communicates with the deep veins of the palm through the interosseous spaces.

^ THE RADIAL ARTERY ON THE DORSUM OF THE HAND

The radial artery winds around the lateral margin of the wrist joint, beneath the tendons of the abductor pollicis longus and extensor pollicis brevis, and lies on the lateral ligament.

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