前臂肌肉解剖.pptx

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,前臂肌肉解剖,前臂肌肉解剖,第1页,Main Menu,Bones of the forearm.,Superficial muscles of the anterior compartment.,Deep muscles of the anterior compartment.,Arteries and nerves of the anterior compartment.,Superficial muscles of the posterior compartment.,Deep muscles of the posterior compartment.,Arteries and nerves of the posterior compartment.,Acknowledgements,前臂肌肉解剖,第2页,前臂肌肉解剖,第3页,Bones of the forearm,The,radius,proximally articulates with the humerus at the elbow joint.Distally it articulates with the scaphoid and lunate bones of the carpus,and with the ulna at the distal radioulnar joint.,The,ulna,is the more medial of the two bones.Its proximal end articulates with the humerus at the elbow joint.Distally it articulates with the radius.It is excluded from the wrist joint by the articular disc.,The,interosseous membrane,bind the radius and the ulna together.,Head,Interosseous membrane,Radius,Humerus,Tuberosity of radius,Ulna,Head,Fig 1.Anterior view of bones of the forearm.,前臂肌肉解剖,第4页,前臂肌肉解剖,第5页,前臂肌肉解剖,第6页,总体记忆,前臂共有,18,块肌肉,分为屈肌与伸肌二部分,屈肌,8,块,分为浅层与深层,浅层有,5,块,深层有,3,块,伸肌,10,块,浅深各,5,块,前臂屈肌,屈肌,8,块,伸肌,10,块,浅,5,深,3,浅,5,深,5,前臂肌肉解剖,第7页,前臂,8,块屈肌,浅层,5,块,旋前圆肌,桡侧屈腕肌,掌长肌,指浅屈肌,尺侧屈腕肌,前臂肌肉解剖,第8页,Superficial muscles of the anterior compartment.Title page.,1,2,3,4,The superficial muscles of the anterior compartment include pronator teres,旋前圆肌,flexor carpi radialis,桡侧腕屈肌,palmaris longus,掌长肌,and flexor carpi ulnaris.Also included in this group is flexor digitorum superficialis.The superficial group of muscles all have the same origin,which is attached to the medial epicondyle of the humerus,肱骨内上髁,.,FOR FURTHER DETAILS CLICK ON EACH INDIVIDUAL MUSCLE BELOW.,Pronator teres,Flexor carpi radialis,Flexor carpi ulnaris,Flexor digitorum superficialis,Palmaris longus,(not included in the diagram).,Fig 2.Showing superficial muscles of the posterior compartment.,Brachio-,radialis,Return to main menu,前臂肌肉解剖,第9页,Pronator Teres,5te7ri:z,The pronator teres has two heads,the humeral head and the ulnar head.The median nerve,正中神经,enters the forearm between the two heads.,Origin:-,Humeral head-,Medial epicondyle of the humerus.,Ulnar head-,Medial border of the coronoid process,冠突,冠状突,of the ulna.,Insertion,附着,:-,Lateral aspect of the shaft of the radius.,Nerve supply:-,Median nerve,C6 and C7.Action:-,Pronation of the forearm.,Flexion of the forearm.,Pronator teres,Radius,Fig 3.Pronator teres.,Return to title page,前臂肌肉解剖,第10页,*,Flexor carpi radialis,palmaris longus,and flexor carpi ulnaris,Flexor carpi radialis,Origin:-,Medial epicondyle of the humerus.,Insertion:-,Base of the second and third metacarpal bones.,Nerve supply:-,Median nerve,C6 and C7.,Action:-,Flexes the hand at the,wrist joint.,Abducts the hand at the wrist joint.,Palmaris longus,Origin:-,Medial epicondyle of the humerus.,Insertion:-,Flexor retinaculum and palmar aponeurosis.,Nerve supply:-,Median nerve,C7 and C8,Action:-,Flexes the hand at wrist joint.,Flexor carpi ulnaris.,Origin:-,Humeral head,-,Medial epicondyle of the humerus.,Ulnar head,-,Medial aspect of the olecranon,鹰嘴,(process of the ulna and the posterior border of the ulna.,Insertion:-,Pisiform,bone,豌豆状,hook of the hamate,and base of the fifth metacarpal bone.,Nerve supply:-,The ulnar nerve,C7,C8,and T1.,Action:-,Flexes the hand at wrist joint.,Adducts the hand at wrist joint,Pronator teres,Flexor carpi radialis,Palmaris longus,Flexor carpi ulnaris,Fig 4.Flexor carpi radialis and ulnaris and palmaris longus,Return to title page,前臂肌肉解剖,第11页,Flexor digitorum superficialis.,Origin:-,Humeroulnar head:,Medial epicondyle of the humerus and the medial margin of the coronoid process of the ulna.,Radial head:,Rising from the oblique line on the anterior surface of the shaft of the radius.,Insertion:-,The muscle belly gives rise to four tendons distally.Each of the tendon attaches to the sides of the middle phalanx,指骨,趾骨,of the four medial finger.,Nerve supply:-,Median nerve,C8 and T1.,Action:-,Flexes the middle phalanx of fingers.,Flexes the proximal phalanx of fingers(weak).,Flexes the wrist.,Flexor digitorum superficialis.,Fig 5.Flexor digitorum superficialis.,Return to title page,前臂肌肉解剖,第12页,前臂,8,块屈肌,深层,3,块,指深屈肌,拇长屈肌,旋前方肌,前臂肌肉解剖,第13页,Deep Muscles of the anterior compartment.Title page,The deep muscles of the forearm comprise of the flexor pollicis longus,flexor digitorum profundus and pronator quadratus.,For further details click on each of the individual muscles.,1.,Flexor digitorum profundus.,2.,Flexor pollicis longus.,Pronator quadratus,not shown.,1,1,2,Brachio-radialis(cut),Tendon of carpi flexor radialis(cut),Fig 6.Deep muscles of the anterior compartment.,Return to main menu,前臂肌肉解剖,第14页,Flexor digitorum profundus and flexor pollicis longus,Flexor pollicis longus,Origin:-,Middle of the anterior surface of the shaft of the radius and from the adjoining part of the interosseous membrane.,Insertion:-,The tendon passes distally through the carpal tunnel and attaches to the distal phalanx of the thumb.,Nerve supply:-,The anterior interosseous branch of the median nerve.,Action:-,Flexes the phalanges of the thumb.,Flexor digitorum profundus,深,Origin:-,Upper three-quarters of the anteriomedial shaft of the ulna.,Insertion:-,The muscle divides into four tendons just prior to traversing the carpal tunnel.They attach to the distal phalanx of the four fingers.,Nerve supply:-,The medial part is supplied by the ulnar nerve,the lateral portion is supplied by the anterior interosseous branch of the median nerve,C8 and T1.,Action:-,Flexes the finger.Exclusive flexor of the distal phalanx.Weak flexor of the wrist.,Flexor pollicis longus,Pronator quadratus,Flexor digitorum profundus,Fig 7.Flexor digitorum profundus and flexor pollicis longus.,Return to title page,前臂肌肉解剖,第15页,Pronator Quadratus,Origin:-,Lower quarter of the anterior surface of the shaft of the ulna.,Insertion:-,Lower quarter of the anterior surface of the shaft of the radius.,Nerve supply:-,The anterior interosseous branch of the median nerve.,Action:-,Pronates the forearm.,Pronator quadratus,Flexor carpi radialis(cut),Flexor pollicis longus,Flexor digitorum profundus,Flexor carpi ulnaris(cut),Fig 8.Pronator quadratus.,Return,to title page,前臂肌肉解剖,第16页,Arteries and Nerves of the anterior compartment.Title page,Ulnar artery,:-,Larger than the radial artery.It passes between the arch formed by the radial and ulnar attachment of the flexor digitorum superficialis and descends through the anterior compartment.It enters the palm of the hand in front of the flexor retinaculum,and promptly divides in superficial and deep palmer branches.,Branches,-,Muscular branches,-to the muscles of the anterior compartment.,Recurrent branches,-to the anastomosis around the wrist joint,Branches to the anastomosis,around the wrist joint,Common interosseous artery,-arises in the upper part of the ulnar artery and then divides in the anterior and posterior interosseous arteries.,Anterior interosseous artery,:-arises from the common interosseous artery and descends in the anterior compartment to eventually join the anastomosis around the wrist joint.It supplies the deep flexor muscles,and gives off nutrient branches to the the radius and ulna.,Brachial artery,Median nerve,Ulnar nerve,Radial nerve,Ulnar artery,Fig 9.Arteries and nerves of the anterior compartment.,Next,Return to nerves,前臂肌肉解剖,第17页,Arteries and Nerves of the anterior compartment.Posterior interosseous artery,-arises from the common interosseous artery and and enters the posterior compartment.,Radial artery,:-,It begins in the cubital fossa,肘窝,when the brachial artery divides into the radial and ulna artery.It passes distally,travels under the brachioradialis,resting on the deep flexor muscles.The artery briefly travels on the lateral side of the radius,before travelling over the anterior surface of the radius.The artery then winds around the lateral aspect of the wrist,before entering the palm of the hand to form the deep palmer arch.,Branches,-,Muscular branches,:to the neighbouring muscles.,Branches to the anastomosis,around the wrist and elbow joint.,Superficial palmer joint:,arises just above the wrist,frequently joins the ulnar artery to give rise to the superficial palmer arch.,Radial nerve,Superficial radial nerve,Radial artery,Brachial artery,Median nerve,Ulnar nerve,Ulnar artery,Median nerve,Fig 10.Arteries and nerves of the anterior compartment.,Next,Return to nerves,前臂肌肉解剖,第18页,Nerves of the anterior compartment,Median Nerve(,fig 9,fig 10,),The median nerve leaves the cubital fossa in between the two heads of the pronator teres.It descends between the superficial and deep flexor muscles.At the wrist it lies superficially,before entering the palm behind the flexor retinaculum.,Branches,:-,Muscular branch,:-all the superficial muscles of the anterior compartment except flexor carpi ulnaris.,Articular branches,:to the elbow joint,Anterior interosseous nerve,:arises from the median nerve as it emerges from the two heads of the pronator teres.(see below),Palmer cutaneous Branch,:Distributed to the skin over the lateral part of the palm.,Anterior interosseous nerve,It arises from the median nerve(see above)and then descends down the anterior surface of the interosseous membrane.,Branches-,Muscular branches:all the muscles of deep flexion in the anterior compartment except the medial part of digitorum profundus.,Articular branches:to the wrist joint,the distal radioulnar joint,and the joints of the carpus.,Ulnar Nerve(,fig9,fig 10,),The ulnar nerve passes behind the medial epicondyle and enters the forearm between the two heads of flexor carpi ulnaris.It descends between the flexor carpi ulnaris and the flexor digitorum profundus.The ulnar nerve becomes superficial at the wrist,before entering the palm in front of the flexor retinaculum.,Branches-,Muscular branches:to the flexor carpi ulnaris and to the medial half of the flexor digitorum profundus.,Articular branches:to the elbow joint.,Palmar cutaneous branch:arises in the middle of the forearm,Supplies skin over the thenar eminence,鱼际,.,Dorsal cutaneous branch:arises in the distal third of the of the forearm,and passes medially to the dorsum of the hand.,Return to main menu,前臂肌肉解剖,第19页,前臂,10,块伸肌,浅层,5,块,桡侧腕长伸肌,桡侧腕短伸肌,指伸肌,小指伸肌,尺侧腕伸肌,前臂肌肉解剖,第20页,Superficial muscles of the posterior compartment.Title page,The superficial muscles of the anterior compartment are mainly concerned with the extension at wrist joint and of the digit.The muscles in this group comprise of the Extensor carpi radialis brevis,extensor digitorum,extensor digiti minimi,extensor carpi ulnaris,and the two more lateral lying brachioradialis and extensor carpi radialis longus.,NB-The anconeus also lies in the posterior compartment but is functionally very different to the rest of the muscles in this group.Its action are to aid the triceps in extension at the elbow joint.,Click below on each of the muscles for further detail about each of the individual muscles,.,1.,Extensor carpi radialis longus,2.,Extensor digitorum,3.,Extensor carpi ulnaris,4.,Extensor digiti minimi,Brachioradialis,and extensor carpi brevis are not included in the figure.,2,4,Anconeus,2,3,1,Fig 11.Superficial muscles of the posterior compartment.,Return to main menu,前臂肌肉解剖,第21页,Extensor carpi radialis longus and brevis,and extensor carpi ulnaris,Extensor carpi radialis longus,Origin:-,From the lower third of the lateral supracondylar ridge of the humerus.,Insertion:-,Posterior surface of the base of the second metacarpal bone.,Nerve supply:-,Radial nerve,C6 and C7.,Action:-,Extends and abducts the hand at the wrist joint.,Extensor carpi radialis brevis,Origin:-,From the common tendon attached to the lateral epicondyle of the humerus.,Insertion:-,Posterior surface of the base of the third metacarpal bone.,Nerve supply:-,Posterior interosseous nerve,C7 and C8.,Action:-,Extends and abducts the hand at the wrist joint.,Extensor carpi ulnaris,Origin:-,From the common tendon attached to the lateral epicondyle of the humerus.,Insertion:-,Posterior surface of the base of the fifth metacarpal bone.,Nerve supply:-,Posterior interosseous nerve,C7 and C8,Action:-,Extends and adducts the hand at wrist joint.,Extensor carpi radialis longus,Extensor carpi radialis brevis,Extensor carpi ulnaris,Fig 12.Extensor carpi radialis brevis and longus and extensor carpi ulnaris.,Return to title page,前臂肌肉解剖,第22页,Extensor digitorum and extensor digiti minimi,Extensor digitorum,Origin:-,From the common tendon attached to the lateral epicondyle of the humerus.,Insertion:-,The muscle divides into four tendons which pass to the fingers and form the,dorsal expansion,.On the dorsum of the hand these are interconnected by fibrous tissue.Near the proximal interphalangeal joint of each finger the expansions divide into the central part,which inserts into base of the middle phalanx,and the two lateral parts,which insert into the base of the distal phalanx.,Nerve supply:-,Posterior interosseous nerve,C7 and C8,Action:-,Mainly it extends the metacarpophalangeal joint,but it also assists in extending the proximal and distal interphalangeal joint and the arm.,Extensor digiti minimi,Origin:-,From the common tendon attached to the lateral epicondyle of the humerus.,Insertion:-,Via two tendons to the dorsal expansion for the little finger.,Nerve supply:-,Posterior interosseous nerve,C7 and C8,Action:-,Assists in the extension of the little finger.,Extensor digitorum,Extensor digiti minimi,Fig 13.Extensor digitorum and extensor digiti minimi.,Return to title page,前臂肌肉解剖,第23页,Brachioradialis,Origin:-,From the upper twp thirds of the lateral supracondylar ridge of the humerus.,Insertion:-,Base of the styloid process of the radius.,Nerve supply:-,Radial nerve,C5 and C6.,Action:-,It flexes the forearm(despite being being served by an extensor nerve),assists in rotating or restoring the arm into midprone position,depending on the initial position.,Brachio-radialis,Extensor carpi radialis longus,Extensor carpi radialis brevis,Flexor carpi radialis,Fig 15.Brachioradialis(anterior view).,Fig 14 Brachioradialis(lateral view).,Return to title page,前臂肌肉解剖,第24页,Deep muscles in the posterior compartment.Title page,The deep muscles of the fore arm consist of three muscles that act on the thumb,the extensor indicis and supinator.Except for the supinator they all originate from only the forearm bones.,For further details on each of the bones click on the individual muscles.,1,.,Supinator.,2.,Abductor pollicis longus.,3.,Extensor pollicis longus.,4.,Extensor indicis.,5.,Extensor pollicis brevis.,1,2,4,3,5,Fig 16.Deep muscles of the posterior compartment.,Return to main menu,前臂肌肉解剖,第25页,Extensor pollicis longus and brevis,and abductor pollicis longus,Abductor pollicis longus,Origin:-,Middle of the posterior surface of the shaft of the ulna and radius.,Insertion:-,Posterior surface of the base of the first