In the middle years, as in the emerging mature phase, a long plateau of very slow change takes place. Skin texture, especially on the dorsal surface, tends to be firm and thick, with the beginning of a fine network of lines and wrinkles not conditioned by any specific behavior. Palm pads are thicker, and creases tend to be softer and puffier, the palm surface cut through with major and minor horizontal and vertical lines and irregular fissures. The dorsal side tends to be hairy (in the male) with an apparent vein system extending visibly up into the ami. Fingers have bccomc chunkier, with decisive grooves cutting across the knuckle separations, and elevated tendons strongly dominate the dorsal surface,
The sixty-year-old hand shown here from a palmar undervicw shows the siill firm and competent quality of the hand. It shows a complex of activity and passivity, with its flaccid surface and deep furrows cutting across points of active stress. Marks of age can be seen m the fine. cross*gnitn network of wrinkles, the dull, striated, and brnde fingernails, the tense look of the tendons, and the unruly, curling hairs.
Tte dominant characteristic of the hands in advanced age is a transparency of all top surfaces. Forms tend 10 contract, but the overall look is one of elongation because of the emerging skeletal structure from underneath. The musculature has become wasted and infirm, the skin thin, fine, and fragile, with veins prominent. Random wrinkling, thickened muscle creases, and enlarged joints also add to the typical iged look, along with the slight tremor suggesting loss of alertness and activity. Higher, the carpus with its boniness and the thin shanks of the arm bones all suggest advancing age.
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