DEPARTMENT OF ANATOMY FASCIAL SPACES OF FOREARM AND HAND Arrangement of the fascia and fascial septae in the hand is such that they form many spaces Fascial spaces of the palm are potential spaces filled with loose connective tissue ID: 1047749
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1. DR A K SRIVASTAVAPROF. AND HEAD DEPARTMENT OF ANATOMYFASCIAL SPACES OF FOREARM AND HAND
2. Arrangement of the fascia and fascial septae in the hand is such that they form many spaces.Fascial spaces of the palm are potential spaces filled with loose connective tissue. Spaces are of surgical importance because they may become infected and distended with pus.Their boundaries are important clinically because they may limit the spread of infection in the palm.
3. Spaces Of Forearm & HandFOREARM SPACE OF PARONAPALMAR SPACESThenar spaceMidpalmar spaceWeb space DORSAL SPACES OF HANDDorsal subcutaneous spaceDorsal subaponeurotic space SUPERFICIAL PULP SPACE OF FINGERS
4. FOREARM SPACE OF PARONALocationBoundariesThe space of Parona and its boundaries. 1 Pronator quadratus; 2 Space of Parona; 3 Flexor carpi ulnaris;4 Flexor digitorum profundus; 5 Median nerve; 6 Flexor pollicis longus.
5. PALMAR SPACESThenar spaceMidpalmar spaceWeb spaces Distally - the thenar & midpalmar spaces are continuous with the appropriate lumbrical canals
6. Thenar SpaceLocationBoundariesThe thenar space contains the first lumbrical muscle and lies posterior to the long flexor tendons to the index finger and in front of the adductor pollicis muscle
7. Midpalmar SpaceLocationBoundaries Anterior - the long flexor tendons to the middle, ring, and little fingers.Posterior - interossei and the third, fourth, and fifth metacarpal bones
8. Web Spaces potential spaces surrounding the tendon of each lumbrical muscle, normally filled with connective tissue. Three in number They lie between the index, middle, ring, and little fingerProximally continuous with one of the palmar spaces.
9. RADIAL & ULNAR BURSAE
10. DORSAL SPACESDorsal subcutaneous spaceDorsal subaponeurotic space
11. SUPERFICIAL PULP SPACE OF FINGERSEach pulp space filled with fat is subdivided by the presence of numerous septa Through pulp space runs the terminal branch of the digital artery that supplying the diaphysis of the terminal phalanx. The epiphysis of the distal phalanx receives its blood supply proximal to the pulp space.
12. Applied anatomy
13. ParonychiaInfection along lateral nail fold.Follows trauma of nail bed.
14. Paronychial Drainage
15. Felon (Pulp-Space Infection)Subcutaneous abscess in pulp space of finger.Pressure on the blood vessels could result in necrosis of the diaphysis. Epiphysis of this bone is saved because it receives its arterial supply just proximal to the pulp space.
16. SURGICAL TREATMENTLongitudinal volar incisionUnilateral longitudinal incisionBilateral longitudinal incision
17. Infection Of Medial Palmar SpaceInfection reaches from a lumbrical canal or infected tendon sheath.
18. Infection Of Thenar SpaceLies under palmar fascia.Bounded dorsally by transverse head of adductor pollicis.
19. Web Space InfectionMost common site after pulp spaces.Pus mostly gathers near palmar space but may spread.
20. Infection Of Radial 0r Ulnar Bursa
21. Infection Of Dorsum Of HandDorsum swells but pus seldom collects.If pus collects it is subcutaneous.
22. Pyogenic Flexor TenosynovitisClosed space infection in of flexor tendon sheath of digit.Results from penetrating trauma or hematogenous spreading.
23. SURGICAL TREATMENTTwo methods:Closed irrigation- 2 incisionsProximalDistalOpen drainage and debridement- 2 incisions1st- Over pulley.2nd – Over digit.
24. Incisions for drainage of abscess
25. MULTIPLE CHOICE QUESTIONS
26. Question 1Which of the following is NOT a palmar fascial space1. Thenar space2. Midpalmar space3. Space of Parona4. Web space
27. Question 2The digital synovial sheath of which finger communicates with the ulnar bursa1. Index finger2. Middle finger3. Ring finger4. Little finger
28. Question 3Which of the following is a content of the Thenar space?1. Tendon of flexor carpi radialis2. Tendon of flexor carpi ulnaris3. Tendon of flexor pollicis longus4. Tendon of flexor digitorum superficialis for middle finger
29. QUESTION 4The posterior boundary of the midpalmar space is formed by all EXCEPT1. Palmar interossei2. Dorsal interossei3. Lumbricals4. Fascia covering medial part of transverse head of adductor pollicis
30. Question 5All of the following statements about the pulp space are true EXCEPT1. Present at the finger tips2. Fat present in loculated compartments3. Infection may cause necrosis of diaphysis in children4. Pulp space infections are usually painless
31. THANK YOU