The small intrinsic muscles that attach laterally are responsible for delicate finger movements that would not be possible with the extensor digitorum, flexor digitorum superficialis, and profundus muscles alone. Laterally, the lumbricals and the dorsal and palmar interossei muscles attach. Proximally and centrally, the extensor digitorum, extensor digiti minimi, extensor indicis, and extensor pollicis brevis muscles attach to the dorsal digital expansion. An aponeurosis covering the dorsum of the digits and attaches distal to the distal phalanx. The extensor retinaculum works to retain the tendons that are near the bone while allowing proximal and distal gliding of the tendons ( Figure 33-1B). Continuous with the fascia of the forearm and attached laterally to the radius and medially to the triquetrum and pisiform bones. This ligament should not be confused with the flexor retinaculum, which is located deeper to the transverse palmar ligament. Continuous with the extensor retinaculum from the dorsal side of the wrist and wraps around, anteriorly, to form a fascial band around the flexor tendons. Laterally, the flexor retinaculum is anchored to the scaphoid and trapezium. The flexor retinaculum anchors medially to the pisiform and the hook of the hamate. The median nerve and the tendons of the flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus muscles, and their associated synovial sheaths, pass through this tunnel. Forms a roof over the concavity created by the carpal bones, forming a tunnel (i.e., the carpal tunnel). Flexor retinaculum (transverse carpal ligament).Form a tunnel that encloses the flexor tendons of digits 2 to 5 and the tendon of the flexor pollicis longus muscle and their associated synovial sheaths. The palmar aponeurosis extends distally and becomes continuous with the fibrous digital sheaths. Located over the palm of the hand and covers the flexor tendons and deeper structures of the hand.
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