The four smaller muscles are attached to the palmar surface to the first, second, fourth and fifth metacarpal bones.
Palmar muscle adducts- PAD
We have four fingers but the muscle is absent in the middle finger because the middle finger don't perform adduction, it is the mid-line of our hand and can possibly to abduction from both the sides but no adduction.
ATTACHMENTS:
1.First- Originates from Base of the Thumb and attaches to the Medial side of Thumb.
2.Second- Originates medially from the length of the 2nd metacarpal bone and attaches to the medial side of the index finger.
3.Third- Originates laterally from the length of 4th metacarpal bone and attaches to the lateral side of the 4thdigit.
4.Fourth- Originates laterally from the length of 5th metacarpal bone and attaches to the lateral side of the 5thdigit.
ACTIONS:
Adduction of thumb, index ring and little finger towards middle finger (axial line)
Flexion of metacarpophalangeal joint and Extension of interphalangeal joint of fingers.
NERVE SUPPLY: Ulnar nerve (C8, T1)
CLINICAL TESTING:
The patient lies their palm flat on a table and tries to hold a piece of paper in between their second and third digits. The examiner attempts to pull that piece of paper away to assess the strength of adduction and ensure the ulnar nerve is intact.
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