Carpal Tunnel - Structure

Structure

The carpus, the bony elements of the wrist, form an arch which is convex on the dorsal side of the hand and concave on the palmar side. The groove on the palmar side, the sulcus carpi, is covered by the flexor retinaculum, a sheath of tough connective tissue, thus forming the carpal tunnel. The flexor retinaculum is attached radially to the scaphoid tubercle and the ridge of trapezium, and on the ulna side to the pisiform and hook of hammate.

The narrowest section of the tunnel is located a centimetre beyond the mid-line of the distal row of carpal bones where the sectional area is limited to 1.6 cm2.

The tendons of the flexor digitorum superficialis and profundus pass through a common ulnar sheath, while the tendon of the flexor pollicis longus passes through a separate radial sheath. The mesotendon shared by these tendons is attached to the radial and palmar walls of the carpal tunnel.

Superficial to the carpal tunnel and the flexor retinaculum, the ulnar artery and ulnar nerve pass through the ulnar tunnel.

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