PALMAR APONEUROSIS

INTRODUCTION:

It is the central part of the deep fascia of the palm which covers

the superficial palmar arch, the long flexor tendons, the terminal part of the median nerve and the superficial branch of the Ulnar Nerve.

FEATURES:

• The palmar aponeurosis is triangular in shape. 
• The APEX is proximal and its bands with the flexor retinaculum and continuous with the tendon of the palmaris longus.
• The BASE is directed distally. It divides into superficial and deep strata, Superficial is attached to the dermis.
• Deep strata divide into four slips opposite to the head of the metacarpals of the medial four digits.
• Each slips divide into two parts which are continuous with the fibrous flexor sheaths.
• Extension passes to the deep transverse metacarpal ligaments, the Capsule of metacarpal- phalangeal joint and the sides of the base of the proximal phalanx.
• The digital vessels, nerves and tendons of the lumbricals emerge through the intervals between the slips.
• From the lateral and medial margins of the palmar aponeurosis, the lateral and medial palmar septa passes backward and divides the palm into the compartment.

FUNCTIONS:

• Palmar aponeurosis fixes the skin palm and thus improves the grip.
• It also protects the underlying nerve, vessel, and tendons.