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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. [1] The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex. The word thenar comes from Ancient Greek θέναρ (thenar) 'palm of the hand'. [2]
The intrinsic muscles of the thumb can be divided into two groups; the thenar eminence and other muscles. The thenar eminence refers to the group of muscles on the palm at the base of the thumb. The three muscles composing the thenar eminence are the abductor pollicis brevis, flexor pollicis brevis and opponens pollicis. [5]
It also supplies the muscles of the thenar eminence by a recurrent thenar branch. [8] The rest of the intrinsic muscles of the hand are supplied by the ulnar nerve. The median nerve innervates the skin of the palmar (volar) side of the index finger, thumb, middle finger, and half the ring finger, and the nail bed.
In the thenar eminence, the recurrent branch of the median nerve provides motor innervation to: [4] opponens pollicis muscle; abductor pollicis brevis muscle; superficial part of flexor pollicis brevis muscle; A separate, more proximal branch of the median nerve additionally provides motor innervation to the 1st and 2nd lumbricals of the hand.
The intrinsic muscle groups are the thenar and hypothenar (little finger) muscles; the interossei muscles (four dorsally and three volarly) originating between the metacarpal bones; and the lumbrical muscles arising from the deep flexor (and which are special because they have no bony origin) to insert on the dorsal extensor hood mechanism.
The thenar eminence is stroked briskly with a thin stick, from proximal (edge of wrist) to distal (base of thumb) using moderate pressure. A positive response is considered if there is a single visible twitch of the ipsilateral mentalis muscle (chin muscle on the same side as the hand tested).
The muscles of hypothenar eminence are from medial to lateral: Opponens digiti minimi; Flexor digiti minimi brevis; Abductor digiti minimi; The intrinsic muscles of hand can be remembered using the mnemonic, "A OF A OF A" for, Abductor pollicis brevis, Opponens pollicis, Flexor pollicis brevis (the three thenar muscles), Adductor pollicis, and the three hypothenar muscles, Opponens digiti ...
Once in the hand, the nerve splits into a muscular branch and palmar digital branches. The muscular branch supplies the thenar eminence while the palmar digital branch supplies sensation to the palmar aspect of the lateral 3 + 1 ⁄ 2 digits and the lateral two lumbricals. [5]