Thenar eminence
The thenar eminence is the mound formed at the base of the thumb on the palm of the hand by the intrinsic group of muscles of the thumb. The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex. The word thenar comes.
Structure
The following three muscles are considered part of the thenar eminence:- Abductor pollicis brevis abducts the thumb. This muscle is the most superficial of the thenar group.
- Flexor pollicis brevis, which lies next to the abductor, will flex the thumb, curling it up in the palm.
- Opponens pollicis lies deep to abductor pollicis brevis. As its name suggests it opposes the thumb, bringing it against the fingers. This is a very important movement, as most of human hand dexterity comes from this action.
Nerve supply
The opponens pollicis and abductor pollicis brevis are normally innervated by the recurrent branch of the [median nerve].The flexor pollicis brevis has two heads: a superficial and a deep head. The superficial head is usually innervated by the recurrent branch of the median nerve. The deep part is often innervated by the deep branch of ulnar nerve.
There are normal variations. In a Cannieu-Riche anastomosis, fibers from the deep branch of ulnar nerve innervate the opponens pollicis and/or abductor pollicis brevis. Regardless of their final innervation, the nerves that reach the thenar muscles arise from the C8 and T1 roots, pass through the lower trunk of the brachial plexus, and then through the medial cord of the plexus.
The adductor pollicis is typically innervated by the ulnar nerve.
The ulnar nerve is exclusively responsible for the innervations of the hypothenar eminence. Both nerves contribute to the innervations of the midpalmar group.
The innervation of these muscles by the median nerve is unusual, as most of the intrinsic muscles on the palm of the hand are supplied by the ulnar nerve. The lateral two lumbrical muscles are the other exception.