The dissection of the hand is reasonably straight forward if you keep in mind the distinction between extrinsic and intrinsic muscles and the axis through the middle finger. It is helpful to approach the dissection in layers.

Basic concepts:
You may wish to review the basic concepts for the upper limb at this time. The link opens a new window which you will need to close to return to this page.

Specific Learning Objectives:

1. Recall the cutaneous innervation of the hand. Compare and contrast a dermatome with the cutaneous innervation of specific nerves.
2. Summarize the functions of muscles in each of the compartments. Knowing the functions helps you learn the attachments (origins and insertions) of individual muscles.
3. Describe the innervation of each compartment and the specific deficits that occur with lesions of individual nerves at different parts along the course of each nerve. Where can the above nerves be checked for sensory loss? What is the significance of wrist drop, claw hand, carpal tunnel syndrome?
4. Define the bony components of the wrist and carpal tunnel.
5. Compare and contrast intrinsic and extrinsic muscles of the hand.
6. Identify anatomic structures in radiographic studies including X-ray, CT scans and MRI films.

Difficult parts of the dissection:

1. Be very careful removing the palmar aponeurosis. Do not do so until you have isolated the ulnar artery, the superficial palmar arch, and the recurrent median nerve. See Step 1.
2. To view how the tendons of the lumbicals, dorsal and palmar interossei insert onto the extensor expansion it is recommended that you dissect the muscles between the 3rd and 4th digits as described Step 3.