Henry Gray (18251861). Anatomy of the Human Body. 1918.
digitorum sublimis. Opposite the first phalanges the tendons pass through the openings in the tendons of the Flexor digitorum sublimis, and are finally inserted into the bases of the last phalanges. The portion of the muscle for the index finger is usually distinct throughout, but the tendons for the middle, ring, and little fingers are connected together by areolar tissue and tendinous slips, as far as the palm of the hand.
Fibrous Sheaths of the Flexor Tendons.After leaving the palm, the tendons of the Flexores digitorum sublimis and profundus lie in osseo-aponeurotic canals (Fig. 427), formed behind by the phalanges and in front by strong fibrous bands, which arch across the tendons, and are attached on either side to the margins of the phalanges. Opposite the middle of the proximal and second phalanges the bands (digital vaginal ligaments) are very strong, and the fibers are transverse; but opposite the joints they are much thinner, and consist of annular and cruciate ligamentous fibers. Each canal contains a mucous sheath, which is reflected on the contained tendons.
Within each canal the tendons of the Flexores digitorum sublimis and profundus are connected to each other, and to the phalanges, by slender, tendinous bands, called vincula tendina(Fig. 416). There are two sets of these; (a) the vincula brevia, which are two in number in each finger, and consist of triangular bands of fibers, one connecting the tendon of the Flexor digitorum sublimis to the front of the first interphalangeal joint and head of the first phalanx, and the other the tendon of the Flexor digitorum profundus to the front of the second interphalangeal joint and head of the second phalanx; (b) the vincula longa, which connect the under surfaces of the tendons of the Flexor digitorum profundus to those of the subjacent Flexor sublimis after the tendons of the former have passed through the latter.
Variations.The index finger portion may arise partly from the upper part of the radius. Slips from the inner head of the Flexor sublimis, medial epicondyle, or the coronoid are found. Connection with the Flexor pollicis longus.
Four small muscles, the Lumbricales, are connected with the tendons of the Flexor profundus in the palm. They will be described with the muscles of the hand (page 464).
The Flexor pollicis longus is situated on the radial side of the forearm, lying in the same plane as the preceding. It arises from the grooved volar surface of the body of the radius, extending from immediately below the tuberosity and oblique line to within a short distance of the Pronator quadratus. It arises also from the adjacent part of the interosseous membrane, and generally by a fleshy slip from the medial border of the coronoid process, or from the medial epicondyle of the humerus. The fibers end in a flattened tendon, which passes beneath the transverse carpal ligament, is then lodged between the lateral head of the Flexor pollicis brevis and the oblique part of the Adductor pollicis, and, entering an osseoaponeurotic canal similar to those for the Flexor tendons of the fingers, is inserted into the base of the distal phalanx of the thumb. The volar interosseous nerve and vessels pass downward on the front of the interosseous membrane between the Flexor pollicis longus and Flexor digitorum profundus.
Variations.Slips may connect with Flexor sublimis, or Profundus, or Pronator teres. An additional tendon to the index finger is sometimes found.
The Pronator quadratus is a small, flat, quadrilateral muscle, extending across the front of the lower parts of the radius and ulna. It arises from the pronator ridge on the lower part of the volar surface of the body of the ulna; from the medial part of the volar surface of the lower fourth of the ulna; and from a strong aponeurosis which covers the medial third of the muscle. The fibers pass lateralward