flexor compartment of forearm

1. FRONT OF
FOREARM
Mrs vidya prashant

2. ANTERIOR (FLEXOR) COMPARTMENT
Superficial flexors
Five(5) in number
common origin -- medial epicondyle
Pronator Teres
Flexor Carpi Radialis
Palmaris Longus
Flexor Carpi Ulnaris
Flexor Digitorum Superficialis
Deep Flexors
3 in number
confined to radius and Ulna
Flexor Pollicis Longus
Flexor Digitorum Profundus
Pronator Quadratus

3. Pronator Teres
Origin
Humeral Head :medial supracondylar ridge
medial epicondyle
Ulnar Head :medial border of coronoid process of ulna
Insertion : middle of lateral surface of radius
Nerve supply : median nerve
Action: pronation of forearm
weak flexor of elbow joint

4. Action : Pronation of Forearm , Weak Flexor of
Elbow

5. Origin : Medial epicondyle
Insertion : Palmer surface of base of 2nd & 3rd
metacarpal bones
Nerve supply :Median nerve
Action: Flexor of wrist
Along with ECRL & ECRB – abduction of wrist
Flexor Carpi Radialis

6. Palmaris longus
Origin : medial epicondyle of humerus
insertion: continious as palmar
aponeurosis in hand
Nerve supply : median nerve
Action: weak flexor of wrist

7. Flexor Carpi Ulnaris
Origin
Humeral head :Medial epicondyle of humerus
Ulnar head: Medial margin of olecranon process
&2/3rd of the post border of ulna through
deep fascia
Insertion : Pisiform bone
Nerve supply: ulnar nerve
Action: flexor of wrist, along with ECU - adduction of wrist

8. Flexor Digitorum Superficialis(Sublimis)
Origin
Humeral head :medial epicondyle
Ulnar head :medial margin of coronoid process of ulna
Radial head : anterior oblique line of radius
Insertion : gives 4 tendons for medial 4 fingers
each tendon splits to enclose FDP ,inserted to the sides of
shaft of middle phalanx of medial 4 fingers
Nerve supply : median nerve
Action: flexion of poximal interphalangeal joint

9. Flexor Digitorum Superficialis(Sublimis)

10. Flexor Digitorum Profundus
Origin :
•Ant.& Medial surface of upper 3/4th of shaft of ulna,
• medial surface of coronoid & olecranon processes of ulna,
• posterior border of ulna through deep fascia,
• interosseous membrane.
Insertion: base of terminal phalanx of medial 4 fingers
Nerve supply:
Medial part – ulnar nerve
Lateral part- anterior interosseous nerve branch of median
nerve
Action: flexes distal interphalangeal joint

11. Pronator Quadratus
Origin : antero-medial surface of lower1/4th of ulna
Insertion: lower 1/4th of radius
Nerve supply: anterior interosseous branch of median nerve
Action: principal pronator of forearm

12. SPACE OF PARONA
It is a potential space deep to long flexor tendons of forearm, where the proximal part of
synovial sheath of flexor tendon of hand extend
Infection may extend to space of parona fron the infected synovial sheaths of flexor tendons
Pus is drained by incision along border of forearm.

13. Functional Classification OF FLEXOR MUSCLES
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

14. Flexor Retinaculum
Attachment
Medially
Pisiform
Hook of Hamate
Laterally
Tubercle of Scaphoid
Crest of Trapezium

15. STRUCTURES PASSING ABOVE THE
FLEXOR RETINACULUM
 Tendon of Palmaris longus
 Palmer cutaneous branch of Median nerve
 Palmer cutaneous branch of Ulnar nerve
 Ulnar vessels
 Ulnar nerve

16. STRUCTURES PASSING BELOW
THE FLEXOR RETINACULUM
 Median nerve
 Tendon of flexor digitorum superficialis
 Tendon of flexor digitoum profundus
• Tendon of flexor pollicis longus
•Radial bursa
•Ulnar bursa

17. RADIAL ARTERY
ORIGIN : at the level of neck of radius
COURSE : leaves the apex of cubital fossa
Overlapped by brachioradialis
Lies in between BR & FCR
extend to the styloid process of radius
where the pulsation of artery is felt.

18. Branches : Radial Recurrent Artery –anastomosis wit radial collateral branch of profunda brachi
Palmar & Dorsal Carpal branch – anastomosis wit corr. Carpal branch of ulnar artery
to form palmar & dorsal carpal arch
Superficial Palmar branch – joins wit ulnar artery to form SUPERFICIAL PALMAR ARCH
Muscular branches

19. ULNAR ARTERY
Origin: larger terminal branch of brachial artery ,
arises abt 1cm below the bend of elbow
Course: lies deep to superficial flexor muscles
in lower 2/3rd of forearm , lies in bet. FCU & FDS
runs along wit ulnar nerve medially
above the flexor retinaculum
In palm it lies on lateral side of pisiform bone ,
here it divides into SUPERFICIAL & DEEP BRANCH
FORMS SUPERFICIAL & DEEP PALMAR ARCH

20. Branches:
1.Anterior ulnar recurrent artery -anastomosis wit inferior ulnar collateral artery(brachial art.)
2.Posterior ulnar recurrent artery -with s.ulnar collateral & interosseous recurrent arteries

21. 3.Common interosseous artery :
Anterior interosseous artery-
descends in contact wit ant.surface of interosseous
membrane accompany by ant.interosseous nerve
(median nerve),
anastomosis wit posterior interosseou artery &
enters in the formation of dorsal carpal arch.
It gives descending branch before piercing
interosseous memb. to join wit palmar carpal arch.
GIVES NUTRIENT BRANCH TO RADIUS & ULNA
Posterior interosseous artery: close to post. surface
of interosseous membrane acc. by post.interosseous
nerve( radial nerve). Joins wit AIA
Gives interosseous recurrent – anast. With middle
collateral branch of profunda brachi
4.Palmar & dorsal carpal branch
5.Muscular branch

23. Median nerve
Course: pass inbet.heads of pronator teres
undersurface of FDS
Abt 5 cm above flexor retinaculum, it emerges from the
lateral border of FDS
Lies bet. PL &FCR
Pass beneath the flexor retinaculum
Enters into the palm
Supply: superficial group of flexor muscles (except FCU)
BRANCHES:
1.Anterior interosseous nerve : deep group of flexor
muscles (except medial half of FDP)
2.Articular branch- elbow,sup.&inf.RU ,wrist joint
3.Muscular branches
4.Cutaneous branch –skin of thenar eminance
5.Communicating branches- with ulnar nerve

24. ULNAR NERVE
COURSE: enters forearm bet.2 heads of FCU
in upper half rest on FDP & covered by FCU
In lower half it runs lateral to FCU tendon
Acc by ulnar artery laterally
Enters palm on lateral side of pisiform bone above the
flexor retinaculum
Divides into SUPERFICIAL & DEEP TERMINAL BRANCH
Branches:
1.Muscular branches- FCU & medial half of FDP
2.Articular branch: elbow
3.Dorsal branch
4.Palmar cutaneous branch

25. Thank u