Muscles Of Forearm

MUSCLES OF FOREARM .ANTERIOR GROUP : FLEXORS OF THE WRIST & FINGERS AND PRONATOR .POSTERIOR GROUP:EXTENSORS OF WRIST & FINGERS AND SUPINATOR

.ANTERIOR GROUP IS LOCATED IN FRONT AND MEDIAL SIDE OF FORAMEN .CAN BE DIVIDED INTO TWO LAYERS: 1.SUPERFICIAL MUSCLES 2.DEEP MUSCLES

SUPERFICIAL GROUP: .brachioradialis .pronator teres .flexor carpi radialis .palmaris longus .flexor carpi ulnaris .flexor digitorum superficialis

BRACHIORADIALIS origin: above lateral epicondyle insertion: stylod process of radius

PRONATOR TERES origin; medial epicondyl and medial border of coronoid process insertion: middle 1/3 of the lateral aspect of shaft of radius

FLEXOR CARPI RADIALIS origin;medial epicondyl insertion:base of the 2nd metacarpal

Pronator teres

Flexor carpi radialis

Palamris longus

Flexor carpi ulnaris

PALMARIS LONGUS origin:medial epicondyl insertion; flexor retinaculam and palmar aponeurosis

FLEXOR CARPI ULNARIS .origin; medial epicondyl and medial apect of olecranon proces .insertion: pisiform,hook of hamate and base of 5th mtacarpal bone

FLEXOR DIGITORUM SUPERFICIALIS origin:meial epicondyl and anterior aspect of saft of radius insertion: attach sides of the middle phalanx of medial four finger action: flex the middle phalanx and wrist

DEEP MUCLES .FLEXOR POLLICIS LONGUS .FLEXOR DIGITORUM PROFUNDUS .PRONATOR QUADRATUS

FLEXOR POLLICIS LONGUS .origin: middle anterior surface of the radius and interosious mem. Insertion:distal phalanx of thumb

Flexor pollicis longus

FLEXOR DIGITORUM PROFUNDUS origin: upper anteromedial saft of ulna insertion: distal phalanx of medial four fingers

Flexor digitorum profundus

PRONATOR QUADRATUS Origin: lower anterior surface of ulna Insertion:lower anterior surface of radius

POSTERIOR GROUP divided into; superficial layer deep layer

SUPERFICIAL LAYER .EXTENSOR CARPI RADIALIS LONGUS & BREVIS .EXTENSOR DIGITORUM .EXTENSOR DIGITI MINIMI .EXTENSOR CARPI ULNARIS

EXTENSOR CARPI RADIALIS LONGUS .origin: lateral one third of the lateral uppercondylar ridge .insertion: dorsal base of the 2nd metacarpal bone EXTENSOR carpi RADIALIS BREVIS .origin; lateral epicondyl Insertion: dorsal base of th 3rd metatarsal bone . EXTENSOR CARPI ULNARIS Origin: lateral epicondyl Insertion; dorsal surface of the base of 5th metacarpal

EXTENSOR DIGITORUM .origin:lateral epicondyl Insertion: attach in 2-5th fingers,over proximal phalanx th tendon divides into three slips-one intermediate nd two collateral. Intermdiat inserted into dorsal aspect of the base of the middle phalanx. The collateral slips reunite to be inserted into dorsal aspect of the base of the disatl phalanx.

Extensor digiti minimi

EXTENSOR DIGITI MINIMI .origin: lateral epicondyl .insertion:inserted through the dorsal digital expansion,into the dorsal aspect of the base of the middle phalanx and the base of the distal phalanx

ANCONEUS Origin: posterior aspect of lateral epicondy Insertion:lateral aspect of olecranon process and upper one fourth of the posterior surface of ulna

DEEP LAYER .SUPINATOR .ABDUCTOR POLLICIS LONGUS .EXTENSOR POLLICIS BREVIS EXTENSOR POLLICIS LONGUS EXTENSOR INDICIS

SUPIANTOR Origin: lateral epicondyl and upper part of the lateral border of the ulna Insertin; upper one third of the lateral surface of radius

ABDUCTOR POLLICIS LoNGUS Origin; upper part of the posterior surface of ulna nad radius and interosseus memebrane Insertion; posterior base of 1st metacarpal bone

EXTENSOR POLLICIS longus origin:posterior surface of the ulna Insertion; posterior surface of the base of the distall phlanx of the thumb EXTENSOR POLLICIS brevis Origin; middle posterior surface of ulna and radius below the abductor pollicis longus Insertion:posterior surface of the base of the proximal phalanx of the thumb brevis

longus

EXTENSOR INDICIS .ORIGIN:POSTERIOR SURFACE OF ULNA BELOW THE EXTENSOR POLLICIS LONGU INSERTION: EXTENSOR EXPANSON OF THE INDEX FINGER

MUSCLES OF HAND LATERAL GROUP------THENAR MUSCLES MEDIAL GROUP--------HYPOTHENAR MUSCLES INTERMEDIATE GROUP---LUMBRICALES & INTEROSSOUS

THENAR MUSCLES Four muscles in two layers: SUPERFICIAL LAYER: .ABDUCTOR POLLICIS BREVIS .FLEXOR POLLICIS BREVIS DEEP LAYER: .OPPONENS POLLICIS .ADDUCTOR POLLICIS

ABDUCTOR POLLICIS BREVIS origin: tubercle of scaphoid &trapezium and flexor retinaculam insertion: lateral ide of proximal phalanx of thumb FLEXOR POLLICIS BREVIS .origin: superficial head from tubercle of trapezium& flexor retinaculam deep head from trapezouid and capital .insertion; lateral side of base of proximal phalanx

OPPONENS POLLICIS Origin: tubercle of trapezium and flexor retinaculam Insertion: lateral half of palmar surface of the 1st metacarpal bone ADDUCTOR POLLICIS Origin: oblic head from capitate and2nd &3rd mtatcarpal Insertion; proximal phalanx of the thumb

HYPOTHENAR MUSCLES SUPERFICIAL ABDUCTOR DIGITI MINIMI: piciform to ulnar side of base of proximal phalanx FLEXOR DIGITI MINIMI: from hook of hamate &flexor retinaculam to ulnar side of base of proxiaml phalanx OPPONENS DIGITI MINIMI: hook of hamate&flexor retinaculam to medial surfce of 5th metacarpal bone

INTERMEDIATE GROUP LUBRICALES: arise from the tendons of flexor digitorum profundus in palm .1st &2nd from lateral side of the tendon for index finger 1&2 by median nerve rd th . 3 4 adjacent sides of two tendon. 3&4 by deep ulnar They pass on radial side of 2nd ,3rd ,4th ,5th metacarpo-phalangeal joints respectively and insert into the dorsal digital expansion of corresponding digits.

INTEROSSEOUS MUSCLES PALMAR INETROSSOUS MUSCLES: Origin: side of metacarpal Insertion; base of proxiaml phalanx Function: adductt the finger and flex the metcarpophalax joint extend ipj DORSL INTEROSSEOUS MUSCLES: Origin: bettween each metacarpal Insertion: base of proxiamal phalanx Action: abduct the fingers,flex the metacarpo phalangeal joint and extend ipj

Nerve supply by deep branch of ulanr nerve

FLEXOR RETINACULUM A strong fibrous band which bridges the anterior caoncavity of the carpus and converts it into a tunnel

1-scaphoid 2-trapezium 3-pisiform 4-hamate

1. Median nerve 2.Tendons of flexor digitorum superficialis 3.Tendons of flexor digitorum profundus 4.Tendons of flexor pollicis longus 5.tendons of flexor carpi redialis

PALMAR APONEUROSIS Thickened deep fascia of the central part of the palm.it is triangular in shape. The apex which is proximal blends with the flexor retinaculam and is continuous with tendon of the palamris longus. The base is directed distally.it divides into four slips opposite the head of the metacarpals of the medial four fingers and continuous with the fibrous fleor sheaths. DUPUYTREN’S CONTRACTURE:

ANATOMIC SNUFFBOX Medially: tendon of extensor pollicis longus Laterally: tendons of abductor pollicis longus and extensor pollicis brevis

Brachial artery Median nerve

Radial artery

Ulnar artery Ulnar nerve

CUBITAL FOSSA Laterallly –brachioradialis Medially—pronator teres Superiorly-imaginary line from medial and lateral epicondyl

1.Brachial artery 2.Median nerve 1.Cephalic 2.Basilic 3.Median cubital vein

Erb’s palsy:upper brachi plexusinjury especialy C5&C6,,drooping,wasted,pronated,exten Limb hangs,loss of innervation in movement,,loss of sensation in lateral aspect Klumpke’s palsy: lower brachial plexus injury especialy C8&T1,,claw hand and loss of sensation in medial aspect of limb

Superficial arterial arche mainly formed by ulnar artery and supficial radial artery Deep arch maily deep radial artery and terminal of ulna artey

VEINS OF HAND Dorsal venous plexus

1.Cephalic( into axilary vein) 2.basilic(into brachial vein)