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1 The carpal tunnel formed anteriorly at wrist by a deep arch formed by carpal bones & flexor retinaculum (transverse carpal ligament) Flexor digitorum/superficialis Flexor pollicis longus Median nerve Pass through the carpal tunnel 2 The extensor tendons pass into the hand in six compartments defined by an extensor retinaculum: extensor digitorum & extensor indicis posterior surface of the wrist extensor carpi ulnaris & extensor digiti minimi medial side of the wrist abductor pollicis longus & extensor pollicis brevis extensor carpi radialis longus & extensor carpi radialis brevis extensor pollicis longus through three compartments on the lateral surface of the wrist. 3 A triangular condensation of deep fascia that covers the palm and is anchored to the skin in distal regions. Continuous with the palmaris longus tendon, when present; otherwise, anchored to the flexor retinaculum. 4 Tendons of the extensor digitorum extensor pollicis longus muscles expand over the proximal phalanges to form "extensor hoods" or "dorsal digital expansions". Tendons of the extensor digiti minimi, extensor indicis, extensor pollicis brevis join these hoods. 5 Palmaris brevis Thenar muscles Hypothenar muscles Adductor pollicis Lumbrical Abductor digiti minimi Flexor digiti minimi Abductor pollicis brevis Opponens pollicis Flexor pollicis brevis Interossei 6 Superficial Deep palmar arch palmar arch 7 Cephalic vein originates from lateral side of dorsal venous network. Basilic vein originates from medial side of dorsal venous network. 8 Homework: 1. Which structures pass through the carpal tunnel and their anatomical relationships with each other in the tunnel? 2. The incidence of carpal tunnel syndrome in the world and/or in Turkey? 3. The risk factors, higher in whom? Any gender disperancies in its incidence? Please send answers to [email protected] 9 10