Lumbricals of the hand

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Lumbricals of the hand
Lumbricales (hand).png
The muscles of the left hand. Palmar surface. (first lumbricalis labeled at bottom right of muscular group)
Details
Origin flexor digitorum profundus
Insertion extensor expansion
Artery superficial palmar arch, common palmar digital arteries, deep palmar arch, dorsal digital artery
Nerve Third and fourth deep branch of ulnar nerve, first and second median nerve
Actions flex metacarpophalangeal joints, extend interphalangeal joints
Identifiers
Latin musculi lumbricales manus
TA A04.6.02.065
FMA 37385
Anatomical terms of muscle
[edit on Wikidata]

The lumbricals are intrinsic muscles of the hand that flex the metacarpophalangeal joints and extend the interphalangeal joints.[1]

The lumbrical muscles of the foot also have a similar action, though they are of less clinical concern.

Structure

The lumbricals are four, small, worm-like muscles on each hand. These muscles are unusual in that they do not attach to bone. Instead, they attach proximally to the tendons of flexor digitorum profundus and distally to the extensor expansions.[1]

# Form Origin Insertion
First unipennate It originates from the radial side of the most radial tendon of the flexor digitorum profundus (corresponding to the index finger). It passes posteriorly along the radial side of the index finger to insert on the extensor expansion near the metacarpophalangeal joint.
Second unipennate It originates from the radial side of the second most radial tendon of the flexor digitorum profundus (which corresponds to the middle finger). It passes posteriorly along the radial side of the middle finger and inserts on the extensor expansion near the metacarpophalangeal joint.
Third bipennate One head originates on the radial side of the flexor digitorum profundus tendon corresponding to the ring finger, while the other originates on the ulnar side of the tendon for the middle finger. The muscle passes posteriorly along the radial side of the ring finger to insert on its extensor expansion.
Fourth bipennate One head originates on the radial side of the flexor digitorum profundus tendon corresponding to the little finger, while the other originates on the ulnar side of the tendon for the ring finger. The muscle passes posteriorly along the radial side of the little finger to insert on its extensor expansion.
Lumbricals labeled at bottom left. Left hand, palmar view.

Nerve supply

The first and second lumbricals (the most radial two) are innervated by the median nerve. The third and fourth lumbricals (most ulnar two) are innervated by the ulnar nerve.

This is the usual innervation of the lumbricals (occurring in 60% of individuals). However 1:3 (median:ulnar - 20% of individuals) and 3:1 (median:ulnar - 20% of individuals) also exist. The lumbrical innervation always follows the innervation pattern of the associated muscle unit of flexor digitorum profundus (i.e. if the muscle units supplying the tendon to the middle finger are innervated by the median nerve, the second lumbrical will also be innervated by the median nerve).[2]

Blood supply

Four separate sources supply blood to these muscles: the superficial palmar arch, the common palmar digital artery, the deep palmar arch, and the dorsal digital artery.

Function

The lumbrical muscles, with the help of the interosseous muscles, simultaneously flex the metacarpophalangeal joints while extending both interphalangeal joints of the digit on which it inserts. The lumbricals are used during an upstroke in writing.

Additional images

References

  1. ^ a b Gosling, J.A.; Harris, P.F.; Humpherson, J.R.; Whitmore, I.; Willan, P.L.T. (2008). Human Anatomy: Color Atlas and Textbook. phot. by A.L. Bentley (5th ed.). Philadelphia: Mosby. ISBN 978-0-7234-3451-1. p. 97
  2. ^ Last's Anatomy - Regional and Applied, 10th ed. Chummy S. Sinnatamby, pg. 64 and pg. 82.
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