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Forearm muscles.pptx
- 2. Compartments ⢠Forearm is divided into ⢠Anterior and posterior compartments by ⢠Aninterosseousmembrane ⢠Lateral intermuscular septum ⢠Attachment of deepfasciaalongtheposterior border of theulna
- 3. Anterior compartment of forearm ⢠Eight muscles present ⢠Five muscles cross the elbow joint ⢠Three musclesdonot ⢠Flexor compartment is much more bulky ⢠Necessary power of grip ⢠Movementsofwristjoint ⢠Flexionoffingers ⢠Pronation ⢠All are innervated by median nerve ⢠Except ⢠Flexor carpi ulnaris muscle ⢠Medial half of Flexor digitorum profundus muscle ⢠Innervated byulnarnerve
- 4. Anterior compartment of forearm ⢠Deep (3) ⢠Has been arranged in 2 groups ⢠Superficial (5)
- 5. Superficial muscles ⢠5 muscles ⢠Have common origin ⢠Anterior surface of medial epicondyle ⢠3 muscles have additional origin ⢠Pronator teres ⢠Flexor carpi ulnaris ⢠Flexor digitorum superficialis
- 6. Pronator Teres ⢠Origin ⢠Humeral head ⢠Medial epicondyle of humerus (CFO) ⢠Ulnar head ⢠Medial border of coronoid process of ulna ⢠Insertion ⢠Middle of lateral aspect of shaft of radius ⢠Nerve supply ⢠Median nerve ⢠Action ⢠Pronation and flexion of elbow
- 7. Flexor carpi radialis ⢠Origin ⢠Medial epicondyle of humerus (CFO) ⢠Insertion ⢠Bases of second and third metacarpal bones ⢠Nerve supply ⢠Median nerve ⢠Action ⢠Flexes elbow & wrist ⢠Abducts hand at wrist joint
- 8. Palmaris longus ⢠Origin ⢠Medial epicondyle of humerus (CFO) ⢠Insertion ⢠Flexor retinaculum and palmar aponeurosis ⢠Nerve supply ⢠Median nerve ⢠Action ⢠Flexes elbow & wrist
- 9. Flexor Carpi Ulnaris ⢠Origin ⢠Humeral head ⢠Medial epicondyle of humerus (CFO) ⢠Ulnar head ⢠Medial aspect of olecranon process and posterior border of ulna ⢠Insertion ⢠Pisiform bone, hook of the hamate, base at fifth metacarpal bone ⢠Nerve supply ⢠Ulnar nerve ⢠Action ⢠Flexes and adducts hand at wrist joint
- 10. Flexor Digitorum Superficialis ⢠Origin ⢠Humeroulnar head ⢠Medial epicondyle of humerus (CFO); medial border of coronoid process of ulna ⢠Radial head ⢠Oblique line on anterior surface of shaft of radius ⢠Insertion ⢠Middle phalanx of medial four fingers ⢠Nerve supply ⢠Median nerve ⢠Action ⢠Flexes middle phalanx of fingers and assists in flexing proximal phalanx and hand
- 11. Deep group ⢠3 muscles ⢠Flexor digitorum profundus ⢠Flexor pollicis longus ⢠Pronator quadratus
- 12. Flexor digitorum profundus ⢠Origin ⢠Anteromedial surface of shaft of ulna ⢠Insertion ⢠Base of distal phalanges ⢠of medial four fingers ⢠Action ⢠Flexion of middle and proximal phalanges and wrist ⢠Nerve supply ⢠Ulnar (medial half) ⢠Anterior interosseous branch of median nerve (lateral half)
- 13. Flexor pollicis longus ⢠Origin ⢠Anterior surface of shaft of radius ⢠Insertion ⢠Distal phalanx of thumb ⢠Action ⢠Flexes distal phalanx of thumb ⢠Nerve supply ⢠Anterior interosseous branch of median nerve
- 14. Pronator quadratus ⢠Origin ⢠Lower Ÿ of anterior surface of shaft of ulna ⢠Insertion ⢠Lower Ÿ of anterior surface of shaft of radius ⢠Action ⢠Pronates radioulnar joint ⢠Nerve Supply ⢠Anterior interosseous ⢠Branch of median nerve
- 15. Space of Parona ⢠Space in front of pronator quadratus ⢠Deep to long flexor tendons of fingers and their synovial sheaths ⢠Limited proximally by ⢠Oblique origin of flexor digitorum superficialis ⢠Space involved in proximal extensions of synovial sheath infections ⢠Can be drained through radial and ulnar incisions to the side of the flexor tendons
- 16. ⢠Flexors of Wrist ⢠Fl. Carpi Radialis ⢠Fl. Carpi Ulnaris ⢠Flexors of Middle Phalanges ⢠Fl. Digitorum Superficialis ⢠Flexors of Distal Phalanges ⢠Fl. Digitorum Profundus ⢠Fl. Pollicis Longus ⢠Pronator of the Forearm ⢠Pronator Teres ⢠Pronator Quadratus
- 17. Flexor Retinaculum ⢠Strong, fibrous band that covers the carpal bones on palmar side of hand near wrist ⢠Attachment ⢠Ulnar side ⢠Pisiform bone and hook of hamate bone ⢠Radial side ⢠Tubercle of scaphoid bone and ridge of trapezium bone
- 18. Structures passing superficial to flexor retinaculum ⢠Tendon of Palmaris longus ⢠Palmer cutaneous branch of Median nerve ⢠Palmer cutaneous branch of Ulnar nerve ⢠Ulnar vessels ⢠Ulnar nerve
- 19. Structures passing deep to Flexor retinaculum ď§ Median nerve ď§ Tendon of flexor digitorum superficialis ď§ Tendon of flexor digitorum profundus ď§ Tendon of flexor pollicis longus ď§ Ulnar bursa ď§ Radial bursa
- 20. Posterior compartment of forearm ⢠Muscles are arranged in 2 layers ⢠Superficial ⢠Deep ⢠Muscles are associated with ⢠Movement of the wristjoint ⢠Extension of the fingers and thumb ⢠Supination ⢠All the muscles of posterior compartment are supplied by ⢠Radial nerve
- 21. Arrangement of posterior compartment muscles ⢠Upper part ⢠Anconeus (superficial) ⢠Supinator (deep) ⢠Lateral part of humerus ⢠Pass along the radial side ⢠Brachioradialis ⢠Extensors carpi radialis longus ⢠Extensors carpi radialis brevis ⢠Passing along posterior surface of the forearm ⢠Extensor digitorum ⢠Extensor digiti minimi and ⢠Extensor carpi ulnaris ⢠At lower end of forearm ⢠These two groups are separated by three muscles ⢠They emerge from deeply in between them and go to the thumb ⢠Abductor pollicis longus ⢠Extensors pollicis longus and ⢠Extensors pollicis longus brevis ⢠One muscle for the forefinger runs deeply to reach the back of the hand ⢠Extensor indicis
- 22. Superficial muscles of the back of forearm ⢠There are 7 muscles ⢠Common extensor origin ⢠Four of the superficialmuscles ⢠Arise from the tip of lateral epicondyle of the humerus ⢠Extensor carpi radialis brevis ⢠Extensor digitorum ⢠Extensor digiti minimi, and ⢠Extensor carpi ulnaris ⢠All seven muscles cross elbow joint
- 23. Superficial muscles of back of forearm ⢠Categorized into two groups ⢠Lateral and posterior ⢠Each group consists of three muscles ⢠Lateral group ⢠Brachioradialis ⢠Extensor carpi radialis longus ⢠Extensor carpi radialis brevis ⢠Posterior group ⢠Extensor digitorum ⢠Extensor digiti minimi ⢠Extensor carpi ulnaris ⢠In the upper end ⢠Anconeus
- 24. Brachioradialis ⢠Origin ⢠Upper 2/3rd of lateral supracondylar ridge of humerus ⢠Insertion ⢠Into base of styloid process of radius ⢠Nerve Supply ⢠Radial nerve ⢠Action ⢠Flexion of the forearm (specially in midprone position)
- 25. Extensor carpi radialis longus ⢠Origin ⢠From the lower 1/3rd of the lateral supracondylar ridge of the humerus ⢠Insertion ⢠Into posterior surface of base of 2nd metacarpal bone ⢠Nerve Supply ⢠Radial nerve ⢠Action ⢠Extension & Abduction of wrist joint ⢠Extension of elbow joint
- 26. ⢠Common extensor origin ⢠4 out of 7 superficial muscles ⢠Extensor carpi radialis brevis ⢠Extensor digitorum ⢠Extensor digiti minimi ⢠Extensor carpi ulnaris
- 27. Extensor carpi radialis brevis ⢠Origin ⢠Lateral epicondyle of humerus (common extensor origin) ⢠Insertion: ⢠Posterior surface of base of 3rd metacarpal bone ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Extension & abduction of the hand at wrist joint
- 28. Extensor digitorum ⢠Origin ⢠Lateral epicondyle of humerus (common extensor origin) ⢠Insertion ⢠Extensor expansion of the medial 4 fingers ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Extension of metacarpophalangeal and interphalangeal joints of the medial 4 fingers ⢠Extension of the hand at wrist joint
- 29. Dorsal digital expansion ⢠Tendons of extensor digitorum expands ⢠Covers dorsal surface of ⢠Head of metacarpal & proximal phalanx ⢠Triangular shape ⢠Base ⢠Forms a hood over metacarpal head ⢠Apex ⢠At proximal phalanx ⢠Trifurcates into median & two lateral bands
- 30. Dorsal digital expansion ď The tendon splits into three parts: ď One Central: inserted into the base of Middle phalanx ď Two laterals: inserted into the base of the Distal phalanx ď Receives the insertions of: ď Corresponding Interosseous muscle (on each side) ď Lumbrical muscle (on the lateral side) ď Also receives ď Extensor indicis ď Extensor digiti minimi
- 31. Dorsal digital expansion ⢠Muscles inserted ⢠Index finger ⢠1st lumbrical ⢠1st dorsal interosseous ⢠2nd palmar interosseous ⢠Middle finger ⢠2nd lumbrical ⢠2nd & 3rd dorsal interossei ⢠Ring finger ⢠3rd lumbrical ⢠4th dorsal interosseous ⢠3rd palmar interosseous ⢠Little finger ⢠4th lumbrical ⢠4th palmar interosseous
- 32. Applied anatomy
- 33. Extensor digiti minimi ⢠Origin ⢠Lateral epicondyle of the humerus (common extensor origin) ⢠Insertion ⢠Extensor expansion of the little finger ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Extension of metacarpophalangeal and interphalangeal joints of the little finger
- 34. Extensor carpi ulnaris ⢠Origin ⢠Lateral epicondyle of the humerus (common extensor origin) ⢠Insertion ⢠Posterior surface of the base of the 5th metacarpal bone ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Extension & Adduction of the hand at wrist joint
- 35. Anconeus ⢠Origin ⢠Posterior aspect of the lateral epicondyle of the humerus ⢠Insertion ⢠Lateral surface of olecranon process of ulna ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Helps the triceps in extension of the elbow joint
- 36. Deep Layer ⢠There are five deep muscles ⢠Three deep extensorsof the forearm ⢠Function on thumb ⢠Abductor pollicis longus(APL) ⢠Extensor pollicis brevis (EPB) ⢠Extensor pollicis longus (EPL) ⢠To acquire insertion on the three bones of thumb âcrop outâ ⢠From furrow in lateralelementof forearmbetweenlateral andposterior groupsof superficialextensor ⢠One muscle ⢠Functiononindexfinger ⢠Extensor indicis ⢠In the upper part ⢠Supinator
- 37. Supinator ⢠Origin ⢠Lateral epicondyle of the humerus ⢠Radial collateral lig ⢠Annular ligament of the superior radio-ulnar joint ⢠Supinator fossa and crest of the ulna ⢠Insertion ⢠Upper 1/3rd of the lateral surface of shaft of radius ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Supination of the forearm ⢠At radio-ulnar joint
- 38. Abductor pollicis longus ⢠Origin ⢠Middle of the posterior surface of radius and ulna ⢠Interosseus membrane ⢠Insertion ⢠Posterior surface of the base of the 1st metacarpal bone ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Abduction and extension of the thumb at the carpo-metacarpal joint
- 39. Extensor pollicis brevis ⢠Origin ⢠Posterior surface of the shaft of radius ⢠Insertion ⢠Posterior surface of the base of the proximal phalanx of the thumb ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Extension of the metacarpophalangeal joint of the thumb
- 40. Extensor pollicis longus ⢠Origin ⢠Posterior surface of ulna ⢠Insertion ⢠Posterior surface of the base of the distal phalanx of the thumb ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Extension of the interphalangeal joints of the thumb
- 41. Anatomical snuff box ⢠Triangular depression ⢠On lateral aspect of wrist ⢠Boundaries ⢠Medial ⢠Extensor pollicis longus ⢠Lateral ⢠Abductor pollicis longus ⢠Extensor pollicis brevis ⢠Roof ⢠Superficial fascia contains ⢠Cephalic vein ⢠Superficial branch of radial nerve ⢠Floor ⢠Scaphoid ⢠Content ⢠Radial artery
- 42. Extensor indicis ⢠Origin ⢠Posterior surface of ulna (below extensor pollicis longus) ⢠Insertion ⢠Extensor expansion of the index finger. ⢠Nerve Supply ⢠Posterior interosseous nerve ⢠Action ⢠Extension of the interphalangeal joints of the thumb
- 43. Wrist Drop ⢠Sign of radial nerve injury ⢠There are two common characteristic sites of damage ⢠Axilla ⢠Injured viahumeral dislocationsor fractures of the proximalhumerus ⢠Radial groove of the humerus ⢠Injured via a humeral shaft fracture ⢠Radial nerve innervates ⢠All muscles in extensor compartment of forearm ⢠In radial nerve lesion ⢠These muscles are paralysed ⢠Muscles that flex the wrist ⢠Innervated by median nerve ⢠Flexor muscles produces unopposed flexion at the wrist joint â wrist drop
- 44. Supination and pronation ⢠These movements occur at ⢠Radioulnar joint ⢠Head of radius & ulna rotate in their sockets ⢠Supination ⢠Movement of forearm ⢠Radius is rotating along a longitudinal axis ⢠Pronation ⢠Movement of forearm ⢠Radius is rotating along the longitudinal axis ⢠Thumb directed medially ⢠Palm faces backwards ⢠Body of radius lies obliquely across ulna
- 45. Dorsal interossei ⢠4 in number ⢠Present in middle 3 fingers ⢠Middle finger has 2 muscles ⢠Ring and index finger has one each ⢠Numbered from lateral to medial ⢠Bipennate in nature ⢠Origin from adjacent sides of shaft of metacarpals ⢠Inserts on dorsal digital expansion and base of proximal phalanx ⢠Abductors ⢠Supplies by deep branch of ulnar nerve
- 46. Palmar interossei ⢠4 in number ⢠No palmar interossei for middle finger ⢠Unipennate ⢠Origin from ⢠Medial side of 1st metacarpal bone ⢠Medial half of palmar aspect of shaft of 2nd metacarpal ⢠Lateral part of palmar aspect of shaft of 4th and 5th metacarpal bones ⢠Inserted to ⢠Medial side of dorsal digital expansion of thumb ⢠Medial side of dorsal digital expansion of index ⢠Lateral side of dorsal digital expansion of ring ⢠Lateral side of dorsal digital expansion of little