Flexor Aspect of Forearm Anatomy PDF

Flexor aspect of forearm ProfDrMT Flexor (anterior) aspect of forearm Skin Superficial fascia Deep fascia Muscles  Cutaneous Innervation Medial cutaneous nerve of forearm Lateral cutaneous nerve of forearm  SUPERFICIAL VEINS PALMAR ASPECT Begin as pal...

Flexor aspect of forearm ProfDrMT Flexor (anterior) aspect of forearm Skin Superficial fascia Deep fascia Muscles  Cutaneous Innervation Medial cutaneous nerve of forearm Lateral cutaneous nerve of forearm  SUPERFICIAL VEINS PALMAR ASPECT Begin as palmar digital veins which communicate with the dorsal veins They drain into the superficial palmar plexus from which begins the median vein of the forearm  SUPERFICIAL VEINS DORSAL ASPECT Begin as dorsal digital veins joined by oblique veins. They unite to form on the dorsum of the hand usually as three dorsal metacarpal veins which eventually form the dorsal venous network From the lateral side of the network begins the cephalic vein, from its medial aspect emerges the basilic vein  Cephalic v Basilic v Median cubital v Deep fascia Continuation of deep fascia of arm, tickens and forms flexor retinaculum at the wrist Flexor retinaculum Dist Left Left Med Lat Prox  Distal row Deep Fascia & Flexor Retinaculum M L H C Td Tm M L P Tq L S Proximal row M L Floor of anatomical snuff box Tendons of the flexor muscles of the forearm Flexor retinaculum COMMON FLEXOR TENDON Common origin for flexor muscles of forearm v Medial epicondyle of humerus Muscles v Superficial group Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris v Middle group Flexor digitorum superficialis v Deep group Flexor digitorum profundus Flexor pollicis longus Pronator quadratus Pronator teres O: Humeral head: Medial epicondyle Ulnar head: Coronoid process I: Middle part of lateral surface of radius N: Median n F: Pronates and flexes forearm Flexor carpi radialis O: Medial epicondyle I: Bases of 2nd&3rd metacarpals N: Median n F: Flexes and abducts hand Palmaris longus O: Medial epicondyle I: Palmar aponeurosis N: Median n F: Flexes hand and tightens palmar aponeurosis The tendon of palmaris longus passes superficial to the flexor retinaculum Flexor carpi ulnaris O: Humeral head: medial epicondyle Ulnar head: Olecranon, posterior border of ulna I: Pisiform bone, hook of hamate, base of 5th metacarpal bone N: Ulnar n F: Flexion and adduction of hand Flexor digitorum superficialis O: Humeroulnar head: F: Flexion of Medial epicondyle, middle ulnar collateral lig, phalanges of 2- coronoid process of ulna 5 digits at Radial head: Ant part of radius proximal interphalangeal I: Bases of middle phalanges of 2nd-5th digits joints and flexion of hand N: Median n Each tendon divides into two slips at level of prox. phalanges and each slip inserts to lateral sides of middle phalanges on both sides Flexor digitorum profundus O: Anterior surface of ulna and interosseous membrane I: Distal phalanges of 2nd-5th digits N: Medial part (4th&5th digits) by ulnar n Lateral part (2nd&3rd digits) ant interosseous nerve from median n F: Flexion of distal phalanges of 2-5 digits flexion of hand Flexor pollicis longus O: Ant surface of radius interosseous membrane I: Distal phalanx of thumb N: Ant interosseous n (median n) F: Flexes thumb Pronator quadratus O: Ant surface of ulna I: Distal part of ant surface of radius N: Ant interosseous nerve (median n) F: Main pronator of forearm pronator teres assists for rapid pronation of forearm * Cubital Fossa Base: line connecting medial and lateral epicondyle Medial: pronator teres m Lateral: brachioradialis m Floor: brachialis & supinator mm Contents of cubital fossa: Median cubital v (sf) From lateral to medial: T- Tendon of biceps brachii m A- Brachial a N- Median n  N TA Arteries of Forearm Ulnar artery 4. Palmar carpal br 5. Dorsal carpal br 6. Deep palmar br Branches: 1. Ant ulnar recurrent a 2. Post ulnar recurrent a 3. Common interosseous a Ant interosseous a Post interosseous a Radial Artery deep to brachioradialis m (prox) only covered by sf.& deep fascia at distal end (pulsations) Branches: 1. Recurrent radial a 2. Superficial palmar br 3. Palmar carpal br 4. Dorsal carpal br dorsal metacarpal brs dorsal digital brs 5. Princeps pollicis a 6. Radialis indicis a Deep palmar arch: radial a Superficial palmar arch: ulnar a Synovial sheaths of the long flexor tendons CARPAL TUNNEL Carpal Tunnel Syndrome Any lesion reducing the size of Carpal Tunnel may cause the median nerve compression. The palmar cutaneous innervation usually is not affected as it runs superficial to flexor retinaculum