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pierces medial IM septum at the arcade of Struthers ~ 8cm from medial epicondyle and lies medial to the triceps. 2. Hence, fibres from the Ulnar N. may supply the OPP and/or APB (which are normally innervated by the median nerve- “Exception” in hand- along with the 1st and 2nd lumbricals). The superficial branch of the ulnar nerve branches into two sensory nerves within the hand and are composed of a common and a proper cutaneous branch (lateral to medial, anteriorly). The present study was performed to help the surgeon minimize postoperative complications of nerve decompression at the wrist. As the nerve crosses the retinaculum, it divides into superficial and deep terminal branches. The superficial palmar arch is mainly fed by the ulnar artery, passing superficial to the flexor retinaculum, then curving laterally to form an arch, lying just deep to the palmar aponeurosis. Unlike the median nerve which travels below the flexor retinaculum of the hand and through the carpal tunnel, the ulnar nerve and artery pass superficial to the flexor retinaculum via the ulnar canal. beneath palmar aponeurosis. It enters the hand via the ulnar canal (Guyon’s canal). Proximally, the superficial branches of the ulnar nerve (black arrowheads) and artery (white arrowhead) are well demonstrated. • The superficial branch travels distally to become the digital cutaneous branches. The superficial palmar branch of the radial artery (SPBRA) arises from the radial artery at the level of the distal forearm. The dorsal sensory branch of the ulnar nerve is blocked by inserting the needle at the level of the ulnar styloid because it travels from palmar to dorsal in the area of the ulnar styloid (Figure 9). The Radial Nerve. It also supplies palmaris brevis, a thin muscle beneath the skin which cannot be studiedelectromyographically. The ulnar nerve enters the palm anterior to the flexor retinaculum along the lateral border of the pisiform. Lines drawn across palm from fully extended thumb. Arm. Blood supply. The median nerve is the branch of the brachial plexus that supplies most of the superficial and deep flexors in the forearm, thenar and lumbrical muscles. 2. Terminal branches supply the fingertip pulp and the nail beds. deep branch of ulnar nerve. In the palm: Superficial branch: Motor : nerve to Palmaris brevis Unlike most of the median nerve innervation of the hand, the palmar branch travels superficial to the Flexor retinaculum of the hand. ... branch supplying skin of palmar aspect of little and medial half of ring fingers, the portion of the palm proximal to them and the palmaris brevis muscle. 132 Ghabriel and Makar Figure 1. ... (branches of the superficial palmar arch). What is labeled D? Nerve - dual innervation with fibers from both the median ( superficial head) and ulnar ( deep head) nerves Artery - branches of the radial artery; superficial palmar artery, branches of the princeps pollicis artery and radialis indicis artery The medial branch supplies the skin of the palm and communicates with the palmar cutaneous branch of the ulnar. Superficial branch of ulnar nerve (15) Superficial palmar arch (9, 15) Superficial palmar branch of radial artery (9,14) Tendon of flexor digitorum profundus (16) Tendon of flexor digitorum superficialis (16) Tendon of flexor pollicis longus (16) Palmar aponeurosis (17) Figure 9. runs between 1st … split the task equally) opponens digiti minimi In the hand, the nerve terminates by giving rise to superficial and deep branches. It supplies the palmaris brevis and the skin on the ulnar side of the hand. It supplies the palmaris brevis and the skin on the ulnar side of the hand. The muscular branches of ulnar nerve are a variety of branches of the ulnar nerve.One supplies the flexor carpi ulnaris muscle (a superficial muscle of the anterior compartment of the forearm), while the other supplies the ulnar half of the flexor digitorum profundus muscle (a deep muscle of the anterior compartment of the forearm).. The convexity of arch is pointed towards the digits. Articular branch: to wrist joint. and radial sensory blocks for ring finger ray fractures; - Anatomy: - ulnar nerve has two sensory branches that provide sensory innervation to ulnar side of the hand; - palmar branch - found radial to … In the forearm, the ulnar nerve pierces the two heads of the flexor carpi ulnaris, and travels alongside the ulna. Common Injuries of Ulnar Nerve. Guyon's canal is further subdivided into 3 zones: zone 1 is proximal to the bifurcation of the ulnar nerve into the deep motor branch and the superficial sensory branch. Median nerve sensation to the first web space can be restored using the dorsal cutaneous branch or noncritical branches of the ulnar nerve at the level of the hand or distal forearm (Figure 19.18). It supplies the palmaris brevis and the skin on the ulnar side of the hand, and divides into a common palmar digital nerve and a proper palmar digital nerve. lies posteromedial to brachial artery in anterior compartment of upper 1/2 arm. Anastomoses with superficial palmar branch of radial artery Above flexor tendons. Unlike most of the median nerve innervation of the hand, the palmar branch travels superficial to the Flexor retinaculum of the hand. lateral side of 1st metacarpal. Transfer of the SBRN to the SBUN was performed in 15 fresh specimens. The superficial branch of the ulnar nerve supplies and passes under the Palmaris brevis muscles and divides into palmar digital nerves. The common branch innervates the 4th webspace (and goes to the proper digital nerves that in turn innervate the ulnar aspect of the ring finger and the radial aspect of the small finger). Sensory branches: Palmar cutaneous branch innervates the skin over the hypothenar eminence. Summary. Along its course, the superficial palmar arch gives rise to three branches known as the common palmar digital arteries. Innervation of the hand is shared by the ulnar, median, and radial nerves (Figure 1). Nerve compression at the wrist can also be caused by bikers with excess pressure from handlebars and prolonged compression while typing at a desk. Deep branch of the ulnar nerve. Anterior forearm & palmar surface of the hand. Action. The deep branch of the ulnar nerve, accompanied by the deep branch of the ulnar artery, passes between the abductor digiti minimi and the flexor digiti minimi brevis. Superficial palmar branch of radial artery. Correlate any fractures or deep cuts of the hand with functional disruptions of associated muscular and neurovascular structures. of the ulnar n. no named branches: sympathetic motor to the skin: median: palmar skin and nail bed of digits 1-3 and the lateral side of 4th digit; ulnar: palmar and dorsal skin on medial side of the 4th digit and all of the 5th digit Superficial terminal branch: It supplies palmaris brevis & skin of palmar surface of medial 1,1/2 fingers. Classic and variant ulnar palmar cutaneous nerves (UPCN). We identify sensory branches of the ulnar nerve—palmar ulnar cutaneous nerve (PUCN), dorsal ulnar cutaneous nerve (DUCN), and superficial sensory branch—using ultrasonography. The superficial branch of the ulnar nerve is a terminal branch of the ulnar nerve. Along the radial aspect of the pisiform bone, the ulnar nerve divides into its terminal branches to the hand, the superficial and deep branches. 4. the medial branch is the larger of the terminal branches of the superficial radial nerve and innervates the ulnar aspect of the dorsum of the thumb, the dorsum of the index and middle fingers and the radial aspect of the fourth finger; note that this excludes supply to the subungual region which is supplied by the palmar cutaneous branch of the median nerve Muscles associated with the Lateral Sesmoid bone - Flexor Pollicis Brevis - Abductor Pollicis Brevis. Then it divides into its terminal branches at the level of the pisiform bone. of the ulnar nerve supply? It enters the hand via the ulnar canal (Guyon’s canal). Ulnar artery and vein. This relationship caused thrombosis of the superficial palmar arch proximal to this crossing nerve branch. Methods. (3) superficial palm, palmar surface of the digits excluding thumb, dorsum of the distal phalangeal segments of digits 2-5: superficial palmar arterial arch receives the majority of its blood supply from the ulnar a. axillary: subclavian a. At the wrist, the ulnar nerve lies just lateral to the pisiform bone. The common palmar digital arteries arise from which arterial arch? The palmar branch of the ulnar nerve arises about 5 cm above the wrist from where the ulnar nerve splits into palmar and dorsal branches. flexor retinaculum trapezium. The ulnar nerve originates from C8-T1 and is a terminal branch of the brachial plexus. Median nerve sensation to the first web space can be restored using the dorsal cutaneous branch or noncritical branches of the ulnar nerve at the level of the hand or distal forearm (Figure 19.18). Articular branches: to the elbow joint. Its first two branches are two motor nerve branches, in the arm. Ulnar nerve. superficial palmar archalso called-• superficial volar arch• superficial ulnar arch• arcus palmaris superficialis• arcus volaris superficilais 3. Tubercle of the trapezium and flexor retinaculum. Median nerve function was normal. Branches of the superficial palmar arterial arch supply the hypothenar compartment and the 2nd – 5th digits. median nerve (radial 2) via palmar digital nerves & ulnar nerve (ulnar 2) via deep branch superficial palmar arterial arch lumbricals, (lumbricus is latin for "worm") arise from the profundus tendons and have the same pattern of innervation as does the profundus muscle (ulnar … canal. At the canal exit, the deep nerve branch passes through a narrow area between the hook of the hamate and a fibrous tendinous arch, which serves as the origin of the flexor digiti minimi brevis muscle. The superficial branch continues distally and arises superficially between the brachioradialis tendon and the extensor carpi radialis longus tendon within the mid-forearm. • Superficial branch – Innervates the palmar surface of the medial one and a half fingers. The ulnar nerve is usually located medial to the hamulus but this relationship is variable. The nerve and artery pass superficial to the flexor retinaculum. For example, the ulnar nerve may branch proximal to the pisiform bone, with the superficial sensory branch communicating some, or all, of its sensory fibers to the palmar ulnar cutaneous nerve. What digit is innervated by the lateral palmer branch of the ulnar nerve in cows? Opponens Pollicis Origin. Respective tendons of flexor digitorum profundus. (Deep branch of ulnar labeled at center right.) 4. They pass distally to the webs, and divide into proper digital nerves. Mainly it covers the superficial palmar arch, long flexor tendons, the terminal part of the median nerve and the superficial branch of the ulnar nerve. The deep branch of the ulnar nerve innervates the three hypothenar muscles, the two medial lumbricals, the seven interrosei, the adductor pollicis and the deep head of the flexor pollicis brevis. • This palmar sensory territory overlaps the median nerve sensory of the hand territory which is innervated by the digital branches of the median nerve. artery and a communicating branch to SPA. What is the origin of the four lumbrical muscles? Lying directly beneath the skin, palmaris brevis is the most superficial muscle on the ulnar side of the hand. Deep to the muscle are the ulnar artery, superficial palmar arch, superficial branch of the ulnar nerve and the muscles of the hypothenar eminence (abductor digiti minimi, flexor digiti minimi brevis and opponens digiti minimi). Palmaris brevis is innervated by the superficial branch of ulnar nerve (C8, T1). The deep branch gives off motor innervation to the hand muscles. pass _____ (superficial or deep) to the flexor retinaculum and palmar aponeurosis superficial What does the palmar cutaneous br. It is responsible for the supply of the hypothenar muscles. 8. Branches and innervation Muscular. On 2 sides each, the PCUN communicated with the superficial and deep ulnar nerves. Opponens pollicis insertion. 3 and 4. 5. present in their studies . Ulnar nerve (1) trifurcation into superficial (2) and deep (3) division, and muscular branch (4).Medial branch (5) of the dorsal branch of the ulnar nerve (7) forms a loop with the muscular branch distal to the pisiform bone (6).Abductor digiti minimi has three heads: deep (8), intermediate (9) and superficial (10), located deep to flexor digiti minimi brevis (11). Neural connections from the Deep palmar branch of the Ulnar N. to the recurrent branch of Median N. in the hand (ulnar-to-median in hand). Common digital II, III, IV. DISCUSSION. predominant supply is the deep branch of the radial artery. The superficial terminal portion supplies sensation to the small finger and ulnar half of the ring finger. 1. 5. Methods: The SBRN, MN, and SBUN were identified in 15 specimens and the nerve Superficial Branch of the Ulnar Nerve. Zone 2 is distal to zone 1, surrounding only the motor branch. B) distal row of carpal bones &shows flexor retinaculum &carpal tunnel (contains median nerve &flexor tendons). On 2 sides each, the PCUN communicated with the superficial and deep ulnar nerves. Deep ulnar nerve … On 2 sides, the PCUN communicated with the palmar cutaneous branch of the median nerve. In the hand, the nerve bifurcates into the superficial terminal division and the deep palmar division. The superficial ulnar nerve (776/N459) supplies cutaneous branches to the medial one and a half digits in the hand. Adductor Pollicis Blood Supply. Superficial palmar nerves. Palmar Branches of the Ulnar Nerve. Description. The superficial palmar arterial arch is the primary extension of ulnar artery, is superficial palmar division of the ulnar artery away from flexor retinaculum.The artery turns laterally after inserting the palm at the back of the palmar aponeurosis and also in front of long flexor tendons. Additionally, it provides motor innervation to the palmaris brevis muscle  in the hypothenar region of the hand. Ulnar nerve compression at the elbow is called “cubital tunnel syndrome.” The deep palmar branch of ulnar artery is an ulnar artery branch division. It gives 4 digital arteries. Diagnostic imaging is a key tool for assessing arterial circulation and characterizing upper limb vascular lesions. In the palm, the ulnar nerve branch to the fourth web space can be transferred directly in an end-to-end fashion to the nerve to the first web space. The muscular branches of ulnar nerve are a variety of branches of the ulnar nerve. In 13 hands it was within 26.9 mm, and maximum in 9 specimens which ranged from 36.1 to 38 as shown in Fig 6.In Fig 7 the bistyloid line is shown and the distance is marked at the point the superficial The median nerve formed a ring enclosing the median artery has been reported 7).Bozkurt et al. In the metacarpus it anastomosed with branches from superficial branch of ulnar nerve to supply palmaris brevis Course: The palmar cutaneous branch of the ulnar nerve can branch as an individual branch from the medial aspect of the ulnar nerve at the wrist just proximal to Guyon’s canal. On 2 sides each, the PCUN communicated with the superficial and deep ulnar nerves. 6 Das and Brown2 and Lanz3 noted and described variations in the origins and distributions of the thenar and palmar branches of the median nerve. Palmar cutaneous branch of median nerve… The palmar branch represents the continuation of the ulnar nerve as it crosses the flexor retinaculum of the hand on the lateral side of the pisiform bone, medial to and a little behind the ulnar artery. Distally, the superficial branch innervates the dorsal radial aspect of the distal forearm/wrist and hand. Palmar cutaneous branches: passes superficial to the flexor retinaculum and supplies skin of the lateral 2/3 of the palm. ... Superficial ulnar nerve supplies? It then perforates the flexor retinaculum and ends in the skin of the palm communicating with the palmar branch of the median nerve. A branch of the brachial plexus that extends along the anterior aspect of the forearm and the hand. 42.26A). Median nerve function was normal. origin:. The palmar branch of the ulnar nerve arises about five cm proximal to the wrist from where the ulnar nerve splits into palmar and dorsal branches. Anterior interosseus nerve. 3. On 2 sides, the PCUN communicated with the palmar cutaneous branch of the median nerve. palmer interossei origin. Opponens pollicis action. This nerve emerges from the medial cord of the brachial plexus. In the palm, the ulnar nerve branch to the fourth web space can be transferred directly in an end-to-end fashion to the nerve to the first web space. ... location of superficial palmar branch of radial artery. (DBUN. Ulnar Nerve. Anatomy. The palmar cutaneous branch of the ulnar nerve arises near the middle of the forearm and accompanies the ulnar artery into the hand (see Fig. 42.26A). It then perforates the flexor retinaculum and ends in the skin of the palm communicating with the palmar branch of the median nerve. Pylogenetically the palmar aponeurosis is considered as the degenerated tendon of palmaris longus [3] . ulnar nerve at the wrist, with the artery slightly radial and superficial to the nerve (image) • The ulnar artery and nerve both pass through the canal of Guyon at the wrist Ultrasound image of the ulnar artery (UA) and ulnar nerve (UN) at the wrist Possible nerve … Muscular branches: to pronator teres, flexor carpi radialis, palmaris longus and flexor digitorum superficialis. DORSAL – Superficial branch of the radial nerve. The superficial branch of the ulnar nerve supplies the palmaris brevis and the skin on the ulnar side of the hand, and divides into a proper palmar digital nerve for the ulnar side of the little finger, and a common palmar digital nerve which gives a communicating twig to the median nerve and divides into two proper digital nerves for the adjoining sides of the little and ring fingers. • Superficial branch – Innervates the palmar surface of the medial one and a half fingers. The nerve exits the Guyon canal by passing beneath the pisohamate ligament. It is formed mainly from the ulnar artery and completed by the superficial palmar branch of the radial artery. T… The ulnar nerve bifurcates within the canal into superficial and deep branches. Dorsal and Dorsal Digital Branches of the Ulnar Nerve. Start the injection at the flexor carpi ulnaris and extend subcutaneously dorsally toward the distal radioulnar joint. Anastomosis and veins of the upper limb. Bozkurt et al. At the wrist, gives off a superficial branch, which contributes to the superficial palmar arch • Radial artery travels to the dorsal side of the hand, penetrating the 1 st dorsal interossei, and travelling through the anatomical snuffbox • Goes on to form the deep palmar arch superficial palmar arch • Radial artery travels to the dorsal side of M = Fifth metacarpal The palmaris brevis muscle, a small intrinsic muscle of the hand, is a quadrangular-shaped subcutaneous muscle that overlies the hypothenar muscles, ulnar artery and superficial branch of the ulnar nerve at the medial side of the palm. median nerve (radial 2) via palmar digital nerves & ulnar nerve (ulnar 2) via deep branch: superficial palmar arterial arch: lumbricals, (lumbricus is Latin for "worm") arise from the profundus tendons and have the same pattern of innervation as does the profundus muscle (ulnar and median nn. Three branches arise in the forearm: - Muscular branch: innervates some muscles in the anterior compartment of the forearm. The length of the follow-up period ranged from 1 to 3.5 years. Superficial palmar arch &digital branches of median (not shown) lie between palmar aponeurosis &flexor tendons. It is at times referred to as either the 'profunda branch… Deep palmar arch (Arcus palmaris profundus) The deep palmar arch is an anastomotic vessel found in the deep compartment of the hand.It is mainly formed by the radial artery with a contribution of the ulnar artery via its deep palmar branch.. Superficial palmar arch. The superficial branch of the radial nerve passes along the front of the radial side of the forearm to the commencement of its lower third. The deep palmar branch subserves no cutaneous Discussion The superficial palmar arch is a dominant vascular structure of the palm but variations in its formation are numerous and well studied. The Lying immediately deep (dorsal) to the superficial palmar arch are the common digital nerves. tomosed with superficial branch of ulnar nerve and next separately reached the ulnar margin of the V-th finger (Fig. Palmar cutaneous branch of median nerve… The medial branch supplies the skin of the palm and communicates with the palmar cutaneous branch of the ulnar. The deep branch of the ulnar nerve (black arrows) runs among the flexor tendons of the fingers (FTs), the fourth palmar interosseous muscle (PI) and the opponens digiti minimi muscle (ODM). The superficial palmar arterial arch is the primary extension of ulnar artery, is superficial palmar division of the ulnar artery away from flexor retinaculum.The artery turns laterally after inserting the palm at the back of the palmar aponeurosis and also in front of long flexor tendons. Within Guyon’s canal, the ulnar nerve bifurcates into the superficial branch (which contains superficial sensory branches and innervates the palmaris brevis muscle) and the deep branch (a motor nerve). Superficial palmar arch: It lies deep to palmar aponeurosis, at the level of the distal border of fully extended thumb. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Common Injuries of Ulnar Nerve. Ulnar artery and vein. Deep Branch of the Ulnar Nerve. On 2 sides, the PCUN communicated with the palmar cutaneous branch of the median nerve. MEDIAL – Palmar and digital cutaneous branches of the ulnar nerve. Diagnostic imaging is a key tool for assessing arterial circulation and characterizing upper limb vascular lesions. METHODS: In 60 forearms of 30 healthy adult volunteers, the origin and size of the PUCN, DUCN, and superficial sensory branch were measured by ultrasonography. The main function of the deep palmar arch is to provide blood supply for the bones, joints and deep muscles of the hand. Here the nerves lie superficial (volar) to the arteries There is a dorsal branch of each proper digital nerve arising just distal to the MP joint. branch from the common digital nerve of ulnar nerve or from the superficial branch was measured from bistyloid line. Variations in the ulnar and median nerves are not uncommon. The ulnar nerve innervates more intrinsic muscles than the median nerve, and supplies digital branches to the skin of the medial one and a half digits (Figure 2). [9] described medial proper palmar digital nerve of V-th fin-ger and a branch of ramus dorsalis manus. Arterial supply to the hand begins with the ulnar and radial arteries. The palmar branch of the ulnar nerve divides into its superficial and deep branches immediately in front of or in the proximal section of the canal. Innervation. Flexes thumb at metacarpophalangeal joint. Superficial palmar arch is the primary blood supply to the fingers and is the direct continuation of the ulnar artery once it enters the hand. The ulnar nerve enters the hand superficial to the flexor retinaculum and inside Guyon's canal traveling with the ulnar artery and vein. Results were graded by the Highet-Zachary scale. ... - Caused by trauma to ulnar nerve - Sensation on the medial side is lost (1 1/2 fingers) The ulnar nerve lies ulnarly and posteriorly to the ulnar artery within Guyon's canal. Palmar brevis Digital branches to 1/4 D4-5. The nerve continues distally and superficially to innervate the medial palmar aspect of the hand. The deep palmar arch was completed by the deep branch of ulnar artery (Figure 1). Push a probe deep to the flexor retinaculum (N444) through the carpal tunnel (680/N444). Ulnar nerve compression at the elbow is called “cubital tunnel syndrome.” At the wrist, gives off a superficial branch, which contributes to the superficial palmar arch • Radial artery travels to the dorsal side of the hand, penetrating the 1 st dorsal interossei, and travelling through the anatomical snuffbox • Goes on to form the deep palmar arch superficial palmar arch • Radial artery travels to the dorsal side of Subscribe. 2. arch, superficial palmar: ulnar a., superficial palmar br. flexor retinaculum trapezium. • Palmar cutaneous branch: Innervates the skin of the medial half of the palm of the hand. • Superficial branch – Innervates the palmar surface of the medial one and a half fingers. The most common place for compression of the nerve is the inside part of the elbow. Ulnar nerve compression at the elbow is called “cubital tunnel syndrome.” 7. Figure 1: Ulnar nerve (1) trifurcation into superficial (2) and deep (3) division, and muscular branch (4).Medial branch (5) of the dorsal branch of the ulnar nerve (7) forms a loop with the muscular branch distal to the pisiform bone (6).Abductor digiti minimi has three heads: deep (8), intermediate (9) and superficial (10), located deep to flexor digiti minimi brevis (11). Deep palmar branch. Dec 6, 2013 - A) metacarpals &shows palmar aponeurosis "mid palmar" &"thenar" spaces separated by oblique septum. The palmar branch of the ulnar nerve arises about 5 cm above the wrist from where the ulnar nerve splits into palmar and dorsal branches.. and then crosses the vessel, being separated from it by the ulnar head of the Pronator teres. Clinical significance. Axial proper digital III and IV. Palmaris brevis forms the roof of Guyon’s canal, the fibro-osseous canal found on the ulnar side of the palm through which the ulnar artery and nerve travel into the palmar hand. dorsal branch ulnar nerve; SBUN, superficial branch ulnar nerve.) Opponens Pollicis Origin. In 8 of 40 cadavers, this innervation was identified (Murakami, 1969). The median artery is present in 0.6-21.1% of the population, originates from the anterior interosseous artery (branch of the ulnar), accompanies the median nerve in its path and ends in the palm joining the superficial palmar arch. A corresponding area of the palm is innervated by palmar branches that arise from the ulnar nerve in the forearm. origin: palmar aponeurosis and flexor retinaculum The innervation to these joints is described as being a twig arising from the superficial ulnar nerve near the division into the 4th common palmar digital nerve and the proper palmar digital nerve or arising from one of these branches. INTRODUCTION: We identify sensory branches of the ulnar nerve-palmar ulnar cutaneous nerve (PUCN), dorsal ulnar cutaneous nerve (DUCN), and superficial sensory branch-using ultrasonography. This was accomplished by a distal connection of the anterior interosseous nerve and the superficial sensory palmar branch of the median nerve to the motor and sensory components of the ulnar nerve at Guyon's canal. Recurrent branch of median nerve, deep branch of ulnar nerve (deep head) Artery. ... runs with superficial radial nerve, lateral to flexor carpi radialis tendon. C) IN HAND: Ulnar nerve enters the palm by passing superficial to flexor retinaculum & divides into two terminal branches:-1. What does superficial branch of the ulnar nerve mean? 3. The ulnar artery enters the hand anteriorly to the flexor retinaculum and laterally to the ulnar nerve. Dorsal cutaneous branch innervates the skin over the medial 1/3 rd of the dorsum of hand and medial 1 ½ digits.

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