Download MBBS Anatomy PPT 20 Front Of Forearm Notes

Forearm

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Two Compartments

Anterior (flexor) Compartment

Posterior (extensor) compartment Invested by

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deep fascia
Attached to olecranon & post. Border of ulna

Sending no. of septa

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Deep fascia ?thichened to form Fexor and

Extensor Retnaculum close to wrist

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to retain digital tendons in position

Septa and Flexor Retinaculum

Anterior (Flexor) Compartment

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Demarcated from post. compartment

Medially

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Olecranon process and post. border of Ulna

Laterally

by anterior border of radius

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Floor of Anterior Compartment

? Ant. Surface of Radius

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? Ant. and Medial surfaces of Ulna

? Interosseous Membrane

(Fibres ? downwards & medial y)

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Contents

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Muscles ? 8 muscles

-- arrranged in two groups

? Superficial (Five)

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-- Deep (Three)

Vessels ? Radial and Ulnar

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Common interosseous branch of ulnar artery

dividing into

Ant. & post. interosseous branches

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Nerves ? Median and Ulnar nerves

-- Anterior interosseous branch of median nerve

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Flexor Muscles of the Forearm

Superficial flexors

Five(5) in number

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common origin -- medial epicondyle of Humerus

All crosses Elbow Joint

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Pronator Teres Flexor Carpi Radialis

Palmaris Longus Flexor Carpi Ulnaris

Flexor Digitorum Superficialis

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Muscles with additional origin ? PT, FCU, FDS

Deep Flexors

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Three(3) in number

Origin confined to radius and Ulna

? Flexor Pollicis Longus

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? Flexor Digitorum Profundus

? Pronator Quadratus

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Pronator Teres

Origin

by Humeral (Superficial) And Ulnar (deep) Heads

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Humeral Head

Ulnar Head

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Medial border of coronoid process of ulna

Insertion

By a flat tendon to the middle of the lateral surface of

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Radius

N. Supply

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Median nerve , before it pass b/w two heads

Action : Pronation of Forearm , Weak Flexor of

Elbow

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Flexor Carpi Radialis

Origin

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? Medial epicondyle

? from adjoining deep fascia

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Insertion

Palmer surface of base of second and third

metacarpal bones

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Nerve supply

Median nerve

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Action

Flexor of wrist

Along with ECRL & ECRB ? abduction of wrist

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Palmaris

longus

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Nerve Supply

Median Nerve

Origin

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Action

Medial epicondyle of humerus

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Weak flexor of wrist

Course

Long tendon

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Passes in front of flexor retinaculum

Insertion

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Continues as central part of Palmer aponeurosis

Flexor Carpi Ulnaris

Origin

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Two heads

Humeral head

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Ulnar head

Medial margin of olecranon process and

2/3rd of the post border of ulna

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Insertion

To pisiform bone

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through pisohammate and pisometacarpal l

hook of hamate and base of fifth metacarp

Nerve supply

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igaments

Ulnar nerve

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al bone

Action

Flexor of wrist,along with ECU ? adduction of

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wrist

wrist
Flexor digitorum Superficialis

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Origin

Two heads

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Humero-ulnar

Medial epicondyle of humerus and

medial margin of coronoid process

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Radial head

Whole length of ant. Oblique line of

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radius

Course

Form four tendons above

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wrist arranged in superficial

(mostly radial) and deep

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group of two each

Passes below fl. Retinaculum

and diverge in palm

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Superficial ? for middle and

ring finger

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Deep ? for index and ring

finger

Nerve supply

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Median nerve

Insertion

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At base of proximal phalanx each digit tendon splits into two

Al ow the passage of tendon of F. digitorum porofundus

Slips reunite again, and split again to be attached to

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side of the shaft of middle phalanx

Action

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Flexion of middle phalanx at proximal interphalangeal joint

In prolonged contraction ? Flexion of metacarpophalangeal

joint and wrist joint

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Deep Flexors

Flexor Pol icis Longus

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Flexor Digitorum

Profundus

Pronator Quadratus

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Flexor Poli cis Longus

Origin

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Ant. Surface of shaft of radius below anterior

oblique line

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and adjoining Interosseous membrane Passes below

Fl. Retinaculum

Insertion

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Palmer surface of base of distal phalanx of thumb

Nerve supply

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Ant. Interosseous branch Of Median Nerve

Action

Flexor of Thumb

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Flexor Digitorum Profundus

Origin

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Ant. and Medial surface of upper 3/4th of

shaft of ulna

Including medial surface of coronoid and

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olecranon process

Adjoining Interosseous memb

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And upper3/4th of post. border of ulna

Course

Form four tendons

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Remain united except the tendon

for index finger

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Passes deep to flexor retinaculum

Diverge in palm

Passes in b/w slips of superficialis

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Give origin to four lumbricals


Insertion

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Palmer surface of base of terminal (distal) phalanx of medial

four fingers
Nerve Supply

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Medial part- Ulnar nerve

Latreral part - Ant. Interosseous branch Of Median Nerve
Action - Flexes terminal phalanx

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In anatomy, a vinculum (pl.

vincula) is a band of connective

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tissue, similar to a ligament, that

connect a flexor tendon to a

phalanx bone. They contain tiny

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vessels which supply blood to the

tendon.[1] In vertebrate

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anatomy, they are referred to as

mesotendons.

These vincula are four folds in

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the synovial membrane

Pronator Quadratus

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Origin

Bony ridge on antero-medial surface of

lower1/4th of ulna

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Insertion

Superficial fibres

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Ant. Surface of lower 1/4th of radius

and adjoining anterior border of radius

Deep Fibres

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Tiangular area just above the ulnar

notch

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Nerve Supply

Anterior Interosseous branch of Median

Nerve

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Action

Superficial fibres

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principal pronators

Deep fibres

prevent separation of two

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bones on thurst
Functional Classification of Flexor Muscles

Flexors of Wrist

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?Fl. Carpi Radialis

?Fl. Carpi Ulnaris

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Flexors of Middle Phalanges

?Fl. Digitorum Superficialis

Flexors of Distal Phalanges

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?Fl. Digitorum Profundus

?Fl. Pol icis Longus

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Pronator of the Forearm

?Pronator Teres

?Pronator Quadratus

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Flexor retinaculum of the hand

? Flexor retinaculum - strong, fibrous band that

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covers the carpal bones on palmar side of hand

near wrist.

? Attachment ?

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Ulnar side- attaches to the pisiform bone and

hook of hamate bone.

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Radial side- attaches to the tubercle of

scaphoid bone, and to medial part of the palmar

surface and the ridge of the trapezium bone.

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Flexor Retinaculum

Flexor Retinaculum

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Attachment

Medial y

Pisiform

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Hook of Hamate

Lateral y

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Tubercle of Scaphoid Crest of

Trapezium
Structures passing superficial to flexor

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retinaculum

Tendon of Palmaris longus
Palmer cutaneous branch of Median nerve
Palmer cutaneous branch of Ulnar nerve

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Ulnar vessels
Ulnar nerve

Structures passing deep to Flexor retinaculum

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Median nerve
Tendon of flexor digitorum

superficialis

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Tendon of flexor digitorum

profundus

Tendon of flexor pollicis

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longus

Ulnar bursa
Radial bursa

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Fibrous Flexor Sheath of Digits

Extend from head of metacarpal to

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Base of distal phalanx

Form osteofibrous canal for tendons

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Mechanism of injury In Colles' fracture

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Colles' fracture

Colles' fracture

? Colles' fracture - fracture of

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the distal forearm in which

broken end of the radius is

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bent backwards.

? The fracture is also referred to

as a "dinner fork" or

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"bayonet" deformity due to

the shape of the resultant

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forearm.

? Symptoms may include pain,

swel ing, deformity, and

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bruising.

? Complications may include

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damage to the median nerve.

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Smith's fracture

Monteggia and Galeazzi Fracture

Monteggia Fracture

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Galeazzi Fracture

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Anastomosis around Elbow joint

Carpal Tunnel Syndrome

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MCQ

? All structures passing superficial to flexor

retinaculum except

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a) Tendon of Palmaris longus
b) Palmer cutaneous branch of Median nerve
c) Median nerve
d) Ulnar nerve

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MCQ

? All structures passing superficial to flexor

retinaculum except

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a) Tendon of Palmaris longus
b) Palmer cutaneous branch of Median nerve
c) Median nerve
d) Ulnar nerve

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MCQ

? Al statements regarding Col es' fracture are true except

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-

a) Col es' fracture - fracture of the distal radius in which

broken end of the radius is bent backwards.

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b) The fracture is also referred to as a "dinner fork" or

"bayonet" deformity due to the shape of the resultant

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forearm.

c) Symptoms may include pain, swel ing, deformity, and

bruising.

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d) Complications may include damage to the ulnar

nerve.

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MCQ

? Al statements regarding Col es' fracture are true except

-

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a) Col es' fracture - fracture of the distal radius in which

broken end of the radius is bent backwards.

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b) The fracture is also referred to as a "dinner fork" or

"bayonet" deformity due to the shape of the resultant

forearm.

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c) Symptoms may include pain, swel ing, deformity, and

bruising.

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d) Complications may include damage to the ulnar

nerve.

MCQ

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? All Structures passes deep to Flexor

retinaculum except-

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a) Median nerve
b) Tendon of flexor digitorum superficialis
c) Tendon of flexor carpi radialis
d) Tendon of flexor pollicis longus
e) Radial bursa

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MCQ

? All Structures passes deep to Flexor

retinaculum except-

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a) Median nerve
b) Tendon of flexor digitorum superficialis
c) Tendon of flexor carpi radialis
d) Tendon of flexor pollicis longus

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e) Radial bursa