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 Flexor carpi
ulnaris

Palamris longus
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
. 3 4 adjacent sides of two tendon.
rd th

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

Ulnar
Radial artery 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)