anatomy of the forearm dr yasser seddeg
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Anatomy of the forearm dr: Yasser Seddeg. Forearm = antebrachium Two bones: ulna and radius Two compartments: flexor and extensor Each compartment has a supf. and deep part Flexor compartment mainly median nerve (median nerve for superficial part

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slide2
Forearm = antebrachium
  • Two bones: ulna and radius
  • Two compartments: flexor and extensor
  • Each compartment has a supf. and deep part
  • Flexor compartment mainly median nerve

(median nerve for superficial part

anterior interosseus nerve for deep part)

  • Extensor compartment mainly radial nerve

(posterior interosseus nerve after it has pierced supinator m.)

slide3
ulna

radius

interosseous membrane

slide4
COMPARTMENTS OF THE FOREARM
  • 2 compartments:
  • Flexor Compartment : anterior part of forearm
  • Extensor Compartment : posterior part of forearm
slide5
Anterior Intermuscular

Septum

Interosseous

Membrane

ANTERIOR

Flexor-Pronator

Mostly Median N

Radius

MEDIAL

LATERAL

Ulna

Extensor-Supinator

Radial N

POSTERIOR

bones of the elbow
Bones of the Elbow

The lower end of the humerus flairs out as epicondyles. These provide a mechanical advantage to the forearm muscle groups that attach at these sites.

Lateral

Medial

Medial

lateral

extensors

flexors

extensors

capitulum

trochlea

Anterior view

Posterior view

slide7
FRONT OF FOREARM
  • MUSCLES
  • 5 superficial muscles : all cross elbow joint
  • 3 deep muscles : do not cross elbow joint
  • Flexors = more bulky - antigravity muscles & used for grip
  • ARTERIES
  • Superficial radial; deep ulnar
  • Anterior interosseous a. (branch of ulnar) supplies deepest structures on front of forearm
  • NERVES
  • Median nerve (with its ant. Interosseous branch) is main nerve of front of forearm
  • Radial nerve (with its post. Interosseous branch) is main nerve of back of forearm
slide8
SUPERFICIAL MUSCLES : FRONT OF FOREARM
  • Pronator Teres (PT)
  • Flexor Carpi Radialis (FCR)
  • Palmaris Longus (PL)
  • Flexor Carpi Ulnaris (FCU)
  • Flexor Digitorum Superficialis (FDS)
superficial muscles of the anterior forearm
Superficial Muscles of the Anterior Forearm
  • 5 superficial muscles
  • From the common flexor tendon arising from the medial condyle of the humerus
  • Cross the elbow but have no function at that joint
surface anatomy anterior forearm
Surface Anatomy - Anterior Forearm

lateral

medial

Thumb = pronator teres

5th digit (tucked under) = flexor digitorum superficialis

2nd digit = flexor carpi radialis

3rd digit = palmaris longus

4th digit = flexor carpi ulnaris

slide11
SUPERFICIAL MUSCLES : FRONT OF FOREARM
  • ADDITIONAL ORIGINS
  • Deep (ulnar) head of PT
  • Medial margin of coronoid process of ulna
  • Ulnar head of FCU
  • Medial margin of olecranon
  • FDS (ulnar & radial heads)
  • Ulnar head
  • Sublime tubercle on medial border of cornoid process,
  • Radial head
  • Anterior border of radius
slide12
INSERTIONS
  • PT
  • middle 1/3 lateral surface shaft of radius
  • FCR
  • base 2nd & 3rd mertacarpal bones
  • PL
  • flexor retinaculum;
  • FCU
  • pisiform bone
  • FDS
  • forms 4 tendons for medial 4 fingers; opposite bases of proximal phalanges each tendon is perforated by tendon of FDP; split tendon inserts into 2 sides of shaft of middle phalanx
slide13
FRONT OF FOREARM
  • NERVE SUPPLY
  • FCU : ulnar nerve
  • PT, FCR, PL, FDS : median nerve
  • ACTION
  • PT : main pronator of forearm & hand
  • FCR, PL, FCU : chief flexors of wrist
  • FCR : abducts hand
  • FCU : fixes pisiform bone during contraction of hpyothenar muscles; abducts little finger
deep muscles of the anterior forearm
Deep Muscles of the Anterior Forearm
  • 3 Deep Muscles

Thumb

Fingers

Wrist

  • Arise from the ulna (pronator quadratus, flexor digitorum profundus) and radius (flexor pollicis longus)
slide15
FRONT OF FOREARM : FDP
  • Origin
  • Upper anterior & medial surfaces of shaft of ulna
  • Medial surfaces of olecranon & coronoid processes of ulna
  • Insertion
  • Palmar surface of base of distal phalanges
  • Innervation
  • Medial 1/2 - ulnar nerve
  • Lateral 1/2 - anterior interosseous nerve
  • Action
  • Flexion of distal phalanges
slide16
FRONT OF FOREARM : FPL
  • Origin
  • Upper 3/4 of anterior surface of shaft of radius
  • Adjoining part of anterior surface of
  • interosseous membrane
  • Insertion
  • Palmar surface of base of distal phalanx of thumb
  • Innervation
  • Anterior interosseous nerve
  • Action :Flexes distal phalanx of the thumb
slide17
PRONATOR QUADRATUS
  • Origin
  • lower 1/4 of anterior surface of shaft of ulna
  • Insertion
  • lower 1/4 of anterior surface of radius
  • Innervation
  • Anterior interosseous nerve
  • Action
  • Superficial fibers pronate forearm
  • Deep fibers bind lower ends of radius & ulna

PRONATOR

QUADRATUS

median nerve
Median Nerve
  • All forearm muscles are innervated by the MEDIAN nerve EXCEPT:

1 ½ muscles

    • flexor carpi ulnaris
    • ulnar side of the flexor digitorum profundus

Plus: All thenar mm except adductor pollicis

radial ulnar arteries
Radial & Ulnar Arteries

medial

lateral

Radial artery

Ulnar artery

Common interosseous

  • Anterior
  • Posterior

Dorsal and palmer carpal branches

Dorsal and palmer carpal branches

Deep (superficial) palmar arches

superficial (deep)palmar arches

slide21
EXTENSOR COMPARTMENT : BACK OF FOREARM

12 muscles

1. Anconeus

2. Brachioradialis (BR)

3. Extensor carpi radialis longus (ECRL)

4. Extensor carpi radialis brevis (ECRB)

5. Extensor digitorum (ED)

6. Extensor digiti minimi (EDM)

7. Extensor carpi ulnaris (ECU)

8. Supinator (Sup)

9. Abductor pollicis longus (APL)

10. Extensor pollicis brevis (EPB)

11. Extensor pollicis longus (EPL)

12 Extensor indicis (EI)

slide22
Superficial Posterior Muscles
  • Brachioradialis
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor digitorum
  • Extensor carpi ulnaris
  • Anconeus
slide23
Superficial muscles

Extensor side

Extensor

retinaculum

Brachioradialis

(flexor)

Anconeus

Ext. carpi rad. longus

Ext. carpi rad. brevis

Ext. carpi ulnaris

Ext. digit. comm.

Ext. digiti minimi

slide24
Deep Posterior Muscles

of the Forearm

  • Supinator
  • Abductor pollicis longus
  • Extensor pollicis brevis and longus
  • Extensor indicus
slide25
Deep muscles

Extensor side

Abductor pollicis

longus

Ext. indicis

Ext. pollicis brevis

Extensor pollicis longus

slide26
Origin
  • All 7 superficial muscles cross elbow joint
  • Arise from tip of lateral epicondyle of humerus
  • 5 deep muscles arise from 2 bones of forearm & interosseous membrane
slide29
EXTENSOR RETINACULUM

Definition : Deep fascia of back of wrist thickened for holding extensor tendons

Attachments :

Laterally:

to the lower part of the anterior border of radius

Medially:

(1) the styloid process of ulna

(2) triquetral

(3) pisiform bones

slide30
EXTENSOR COMPARTMENT : NERVE SUPPLY

Anconeus

BR

ECRL

Radial nerve

ECRB

ED

EDM

ECU

Sup

APL

EPB

EPL

EI

Posterior interosseous nerve

slide31
superficial radial n.

radial a.

abductor pollicis longus tendon

extensor pollicis brevis tendon

extensor pollicis longus tendon

1st dorsal interosseus m.

Anatomical snuff box: ABD, EPB, EPL

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