The human hand is an important feature of the human body which allows individuals to manipulate their surroundings and also to gather large amounts of data from the environment that the individual is situated within. A hand is generally defined as the terminal aspect of the human arm, which consists of prehensile digits, an opposable thumb, and a wrist and palm. Although many other animals have similar structures, only primates and a limited number of other vertebrates can be said to have a ‘hand’ due to the need for an opposable thumb to be present and the degree of extra articulation that the human hand can achieve. Due to this extra articulation, humans have developed fine motor skills allowing for much increased control in this limb. Consequently we see improved ability to grasp and grip items and development of skills such as writing.
A hand is made up of five digits, the palm and wrist. It consists of 27 bones, tendons, muscles and nerves, with each fingertip of each digit containing numerous nerve endings making the hand a crucial area for gathering information from the environment using one of man’s most crucial five senses: touch. Muscles interact together with tendons to allow fingers to bend, straighten, point and, in the case of the thumb, rotate. However, the hand is an area that sees many injuries due to the number of ways we use it, one in ten injuries in A&E being hand related, and there are also several disorders that can affect the hand development in the womb, such as polydactyly, where an individual is born with extra digits, which are often in perfect working order.
The human hand contains 27 bones, and these divide up into three distinct groups: the carpals, metacarpals and phalanges. These also then further break down into three: the proximal phalanges, intermediate phalanges and distal phalanges. Eight bones are situated in the wrist and these are collectively called the carpals. The metacarpals, which are situated in the palm of the hand account for a further five out of the 27, and each finger has three phalanges, the thumb has two. Intrinsic muscles and tendons interact to control movement of the digits and hand, and attach to extrinsic muscles that extend further up into the arm, which fl ex the digits.
Muscles and other structures
The movements and articulations of the hand and by the digits are controlled by tendons and two muscle groups situated within the hand and wrist. These are the extrinsic and intrinsic muscle groups, so named as the extrinsics are attached to muscles which extend into the forearm, whereas the intrinsics are situated within the hand and wrist. The flexors and extensors, which make up the extrinsic muscles, use either exclusively tendons to attach to digits they control (flexors) or a more complex mix of tendons and intrinsic muscles to operate (extensors). These muscles will contract in order to cause digit movement, and flexors and extensors work in a pair to complement each to straighten and bend digits. The intrinsic muscles are responsible for aiding extrinsic muscle action and other movements in the digits and have three distinct groups; the thenar and hypothenar (referring to the thumb and little finger respectively), the interossei and the lumbrical.
Extrinsic muscles are so called because they are primarily situated outside the hand, the body of the muscles situated along the underside or front of the forearm. This body of muscles actually breaks down into two quite distinct groups: the flexors and the extensors. The flexors run alongside the underside of the arm and allow for the bending of the digits, whereas the extensor muscles’ main purpose is the reverse of this action, to straighten the digits. There are both deep and superficial flexors and extensors, and which are used at any one time depends on the digit to be moved.