前臂大體解剖

前臂大體解剖第1頁，共30頁，2023年，2月20日，星期日MainMenuBonesoftheforearm.Superficialmusclesoftheanteriorcompartment.Deepmusclesoftheanteriorcompartment.Arteriesandnervesoftheanteriorcompartment.Superficialmusclesoftheposteriorcompartment.Deepmusclesoftheposteriorcompartment.Arteriesandnervesoftheposteriorcompartment.Acknowledgements第2頁，共30頁，2023年，2月20日，星期日第3頁，共30頁，2023年，2月20日，星期日BonesoftheforearmTheradiusproximallyarticulateswiththehumerusattheelbowjoint.Distallyitarticulateswiththescaphoidandlunatebonesofthecarpus,andwiththeulnaatthedistalradioulnarjoint.Theulnaisthemoremedialofthetwobones.Itsproximalendarticulateswiththehumerusattheelbowjoint.Distallyitarticulateswiththeradius.Itisexcludedfromthewristjointbythearticulardisc.Theinterosseousmembranebindtheradiusandtheulnatogether.HeadInterosseousmembraneRadiusHumerusTuberosityofradiusUlnaHeadFig1.Anteriorviewofbonesoftheforearm.第4頁，共30頁，2023年，2月20日，星期日第5頁，共30頁，2023年，2月20日，星期日第6頁，共30頁，2023年，2月20日，星期日總體記憶前臂共有18塊肌肉分為屈肌與伸肌二部分屈肌8塊分為淺層與深層淺層有5塊深層有3塊伸肌10塊淺深各5塊前臂屈肌屈肌8塊伸肌10塊淺5深3淺5深5第7頁，共30頁，2023年，2月20日，星期日前臂8塊屈肌淺層5塊旋前圓肌橈側(cè)屈腕肌掌長肌指淺屈肌尺側(cè)屈腕肌第8頁，共30頁，2023年，2月20日，星期日Superficialmusclesoftheanteriorcompartment.Titlepage.

1234Thesuperficialmusclesoftheanteriorcompartmentincludepronatorteres,flexorcarpiradialis,palmarislongus,andflexorcarpiulnaris.Alsoincludedinthisgroupisflexordigitorumsuperficialis.Thesuperficialgroupofmusclesallhavethesameorigin,whichisattachedtothemedialepicondyleofthehumerus.FORFURTHERDETAILSCLICKONEACHINDIVIDUALMUSCLEBELOW.PronatorteresFlexorcarpiradialisFlexorcarpiulnarisFlexordigitorumsuperficialisPalmarislongus

(notincludedinthediagram).Fig2.Showingsuperficialmusclesoftheposteriorcompartment.Brachio-radialisReturntomainmenu第9頁，共30頁，2023年，2月20日，星期日PronatorTeresThepronatortereshastwoheads,thehumeralheadandtheulnarhead.Themediannerveenterstheforearmbetweenthetwoheads.Origin:- Humeralhead-Medialepicondyleofthehumerus.

Ulnarhead-Medialborderofthecoronoidprocessoftheulna.Insertion:-

Lateralaspectoftheshaftoftheradius.Nervesupply:-Mediannerve,C6andC7.Action:-Pronationoftheforearm.Flexionoftheforearm.PronatorteresRadiusFig3.Pronatorteres.Returntotitlepage第10頁，共30頁，2023年，2月20日，星期日Flexorcarpiradialis,palmarislongus,andflexorcarpiulnarisFlexorcarpiradialis Origin:-Medialepicondyleofthehumerus.

Insertion:-Baseofthesecondandthirdmetacarpalbones.

Nervesupply:-Mediannerve,C6andC7.

Action:-Flexesthehandatthe

wristjoint.Abductsthehandatthewristjoint.Palmarislongus Origin:-Medialepicondyleofthehumerus.

Insertion:-Flexorretinaculumandpalmaraponeurosis.

Nervesupply:-Mediannerve,C7andC8

Action:-Flexesthehandatwristjoint.Flexorcarpiulnaris.

Origin:-

Humeralhead-Medialepicondyleofthehumerus.

Ulnarhead-Medialaspectoftheolecranonprocessoftheulnaandtheposteriorborderoftheulna.

Insertion:-Pisiform

bone,hookofthehamate,andbaseofthefifthmetacarpalbone.

Nervesupply:-Theulnarnerve,C7,C8,andT1.

Action:-Flexesthehandatwristjoint. Adductsthehandatwristjoint PronatorteresFlexorcarpiradialisPalmarislongusFlexorcarpiulnarisFig4.FlexorcarpiradialisandulnarisandpalmarislongusReturntotitlepage第11頁，共30頁，2023年，2月20日，星期日Flexordigitorumsuperficialis.Origin:-Humeroulnarhead:Medialepicondyleofthehumerusandthemedialmarginofthecoronoidprocessoftheulna.Radialhead:Risingfromtheobliquelineontheanteriorsurfaceoftheshaftoftheradius.Insertion:-Themusclebellygivesrisetofourtendonsdistally.Eachofthetendonattachestothesidesofthemiddlephalanxofthefourmedialfinger.Nervesupply:-Mediannerve,C8andT1.Action:-Flexesthemiddlephalanxoffingers. Flexestheproximalphalanxoffingers(weak). Flexesthewrist.Flexordigitorumsuperficialis.Fig5.Flexordigitorumsuperficialis.Returntotitlepage第12頁，共30頁，2023年，2月20日，星期日前臂8塊屈肌深層3塊指深屈肌挴長屈肌旋前方肌第13頁，共30頁，2023年，2月20日，星期日DeepMusclesoftheanteriorcompartment.Titlepage

Thedeepmusclesoftheforearmcompriseoftheflexorpollicislongus,flexordigitorumprofundusandpronatorquadratus.Forfurtherdetailsclickoneachoftheindividualmuscles.1.Flexordigitorumprofundus.2.Flexorpollicislongus.Pronatorquadratus

notshown.112Brachio-radialis(cut)Tendonofcarpiflexorradialis(cut)Fig6.Deepmusclesoftheanteriorcompartment.Returntomainmenu第14頁，共30頁，2023年，2月20日，星期日FlexordigitorumprofundusandflexorpollicislongusFlexorpollicislongusOrigin:-Middleoftheanteriorsurfaceoftheshaftoftheradiusandfromtheadjoiningpartoftheinterosseousmembrane.Insertion:-Thetendonpassesdistallythroughthecarpaltunnelandattachestothedistalphalanxofthethumb.Nervesupply:-Theanteriorinterosseousbranchofthemediannerve.Action:-Flexesthephalangesofthethumb.FlexordigitorumprofundusOrigin:-Upperthree-quartersoftheanteriomedialshaftoftheulna.Insertion:-Themuscledividesintofourtendonsjustpriortotraversingthecarpaltunnel.Theyattachtothedistalphalanxofthefourfingers.Nervesupply:-Themedialpartissuppliedbytheulnarnerve,thelateralportionissuppliedbytheanteriorinterosseousbranchofthemediannerve,C8andT1.Action:-Flexesthefinger.Exclusiveflexorofthedistalphalanx.Weakflexorofthewrist.

FlexorpollicislongusPronatorquadratusFlexordigitorumprofundusFig7.Flexordigitorumprofundusandflexorpollicislongus.Returntotitlepage第15頁，共30頁，2023年，2月20日，星期日PronatorQuadratusOrigin:-Lowerquarteroftheanteriorsurfaceoftheshaftoftheulna.Insertion:-Lowerquarteroftheanteriorsurfaceoftheshaftoftheradius.Nervesupply:-Theanteriorinterosseousbranchofthemediannerve.Action:-Pronatestheforearm.PronatorquadratusFlexorcarpiradialis(cut)FlexorpollicislongusFlexordigitorumprofundusFlexorcarpiulnaris(cut)Fig8.Pronatorquadratus.Return

totitlepage第16頁，共30頁，2023年，2月20日，星期日ArteriesandNervesoftheanteriorcompartment.TitlepageUlnarartery:-Largerthantheradialartery.Itpassesbetweenthearchformedbytheradialandulnarattachmentoftheflexordigitorumsuperficialisanddescendsthroughtheanteriorcompartment.Itentersthepalmofthehandinfrontoftheflexorretinaculum,andpromptlydividesinsuperficialanddeeppalmerbranches.Branches-

Muscularbranches-tothemusclesoftheanteriorcompartment.

Recurrentbranches-totheanastomosisaroundthewristjointBranchestotheanastomosisaroundthewristjointCommoninterosseousartery-arisesintheupperpartoftheulnararteryandthendividesintheanteriorandposteriorinterosseousarteries.Anteriorinterosseousartery:-arisesfromthecommoninterosseousarteryanddescendsintheanteriorcompartmenttoeventuallyjointheanastomosisaroundthewristjoint.Itsuppliesthedeepflexormuscles,andgivesoffnutrientbranchestothetheradiusandulna.

BrachialarteryMediannerveUlnarnerveRadialnerveUlnararteryFig9.Arteriesandnervesoftheanteriorcompartment.NextReturntonerves第17頁，共30頁，2023年，2月20日，星期日ArteriesandNervesoftheanteriorcompartment.Posteriorinterosseousartery-arisesfromthecommoninterosseousarteryandandenterstheposteriorcompartment.Radialartery:-Itbeginsinthecubitalfossawhenthebrachialarterydividesintotheradialandulnaartery.Itpassesdistally,travelsunderthebrachioradialis,restingonthedeepflexormuscles.Thearterybrieflytravelsonthelateralsideoftheradius,beforetravellingovertheanteriorsurfaceoftheradius.Thearterythenwindsaroundthelateralaspectofthewrist,beforeenteringthepalmofthehandtoformthedeeppalmerarch.Branches-Muscularbranches:totheneighbouringmuscles.Branchestotheanastomosisaroundthewristandelbowjoint.Superficialpalmerjoint:arisesjustabovethewrist,frequentlyjoinstheulnararterytogiverisetothesuperficialpalmerarch.RadialnerveSuperficialradialnerveRadialarteryBrachialarteryMediannerveUlnarnerveUlnararteryMediannerveFig10.Arteriesandnervesoftheanteriorcompartment.NextReturntonerves第18頁，共30頁，2023年，2月20日，星期日NervesoftheanteriorcompartmentMedianNerve(fig9,fig10)Themediannerveleavesthecubitalfossainbetweenthetwoheadsofthepronatorteres.Itdescendsbetweenthesuperficialanddeepflexormuscles.Atthewristitliessuperficially,beforeenteringthepalmbehindtheflexorretinaculum.Branches:-Muscularbranch:-allthesuperficialmusclesoftheanteriorcompartmentexceptflexorcarpiulnaris.Articularbranches:totheelbowjointAnteriorinterosseousnerve:arisesfromthemediannerveasitemergesfromthetwoheadsofthepronatorteres.(seebelow)PalmercutaneousBranch:Distributedtotheskinoverthelateralpartofthepalm.Anteriorinterosseousnerve

Itarisesfromthemediannerve(seeabove)andthendescendsdowntheanteriorsurfaceoftheinterosseousmembrane.Branches-Muscularbranches:allthemusclesofdeepflexionintheanteriorcompartmentexceptthemedialpartofdigitorumprofundus.Articularbranches:tothewristjoint,thedistalradioulnarjoint,andthejointsofthecarpus.UlnarNerve(fig9,fig10)Theulnarnervepassesbehindthemedialepicondyleandenterstheforearmbetweenthetwoheadsofflexorcarpiulnaris.Itdescendsbetweentheflexorcarpiulnarisandtheflexordigitorumprofundus.Theulnarnervebecomessuperficialatthewrist,beforeenteringthepalminfrontoftheflexorretinaculum.Branches-Muscularbranches:totheflexorcarpiulnarisandtothemedialhalfoftheflexordigitorumprofundus.Articularbranches:totheelbowjoint.Palmarcutaneousbranch:arisesinthemiddleoftheforearm,Suppliesskinoverthethenareminence.Dorsalcutaneousbranch:arisesinthedistalthirdoftheoftheforearm,andpassesmediallytothedorsumofthehand.

Returntomainmenu第19頁，共30頁，2023年，2月20日，星期日前臂10塊伸肌淺層5塊橈側(cè)腕長伸肌橈側(cè)腕短伸肌指伸肌小指伸肌尺側(cè)腕伸肌第20頁，共30頁，2023年，2月20日，星期日Superficialmusclesoftheposteriorcompartment.Titlepage

Thesuperficialmusclesoftheanteriorcompartmentaremainlyconcernedwiththeextensionatwristjointandofthedigit.ThemusclesinthisgroupcompriseoftheExtensorcarpiradialisbrevis,extensordigitorum,extensordigitiminimi,extensorcarpiulnaris,andthetwomorelaterallyingbrachioradialisandextensorcarpiradialislongus.NB-Theanconeusalsoliesintheposteriorcompartmentbutisfunctionallyverydifferenttotherestofthemusclesinthisgroup.Itsactionaretoaidthetricepsinextensionattheelbowjoint.Clickbelowoneachofthemusclesforfurtherdetailabouteachoftheindividualmuscles.1.

Extensorcarpiradialislongus2.Extensordigitorum3.Extensorcarpiulnaris4.ExtensordigitiminimiBrachioradialisandextensorcarpibrevisarenotincludedinthefigure.24Anconeus231Fig11.Superficialmusclesoftheposteriorcompartment.Returntomainmenu第21頁，共30頁，2023年，2月20日，星期日Extensorcarpiradialislongusandbrevis,andextensorcarpiulnarisExtensorcarpiradialislongusOrigin:-Fromthelowerthirdofthelateralsupracondylarridgeofthehumerus.Insertion:-Posteriorsurfaceofthebaseofthesecondmetacarpalbone.Nervesupply:-Radialnerve,C6andC7.Action:-Extendsandabductsthehandatthewristjoint.ExtensorcarpiradialisbrevisOrigin:-Fromthecommontendonattachedtothelateralepicondyleofthehumerus.Insertion:-Posteriorsurfaceofthebaseofthethirdmetacarpalbone.Nervesupply:-Posteriorinterosseousnerve,C7andC8.Action:-Extendsandabductsthehandatthewristjoint.ExtensorcarpiulnarisOrigin:-Fromthecommontendonattachedtothelateralepicondyleofthehumerus.Insertion:-Posteriorsurfaceofthebaseofthefifthmetacarpalbone.Nervesupply:-Posteriorinterosseousnerve,C7andC8Action:-Extendsandadductsthehandatwristjoint.ExtensorcarpiradialislongusExtensorcarpiradialisbrevisExtensorcarpiulnarisFig12.Extensorcarpiradialisbrevisandlongusandextensorcarpiulnaris.Returntotitlepage第22頁，共30頁，2023年，2月20日，星期日ExtensordigitorumandextensordigitiminimiExtensordigitorumOrigin:-Fromthecommontendonattachedtothelateralepicondyleofthehumerus.Insertion:-Themuscledividesintofourtendonswhichpasstothefingersandformthedorsalexpansion.Onthedorsumofthehandtheseareinterconnectedbyfibroustissue.Neartheproximalinterphalangealjointofeachfingertheexpansionsdivideintothecentralpart,whichinsertsintobaseofthemiddlephalanx,andthetwolateralparts,whichinsertintothebaseofthedistalphalanx.Nervesupply:-Posteriorinterosseousnerve,C7andC8Action:-Mainlyitextendsthemetacarpophalangealjoint,butitalsoassistsinextendingtheproximalanddistalinterphalangealjointandthearm.Extensordigitiminimi

Origin:-Fromthecommontendonattachedtothelateralepicondyleofthehumerus.Insertion:-Viatwotendonstothedorsalexpansionforthelittlefinger.Nervesupply:-Posteriorinterosseousnerve,C7andC8Action:-Assistsintheextensionofthelittlefinger.ExtensordigitorumExtensordigitiminimiFig13.Extensordigitorumandextensordigitiminimi.Returntotitlepage第23頁，共30頁，2023年，2月20日，星期日BrachioradialisOrigin:-Fromtheuppertwpthirdsofthelateralsupracondylarridgeofthehumerus.Insertion:-Baseofthestyloidprocessoftheradius.Nervesupply:-Radialnerve,C5andC6.Action:-Itflexestheforearm(despitebeingbeingservedbyan‘extensor’nerve),assistsinrotatingorrestoringthearmintomidproneposition,dependingontheinitialposition.

Brachio-radialisExtensorcarpiradialislongusExtensorcarpiradialisbrevisFlexorcarpiradialisFig15.Brachioradialis(anteriorview).Fig14Brachioradialis(lateralview).Returntotitlepage第24頁，共30頁，2023年，2月20日，星期日Deepmusclesintheposteriorcompartment.Titlepage

Thedeepmusclesoftheforearmconsistofthreemusclesthatactonthethumb,theextensorindicisandsupinator.Exceptforthesupinatortheyalloriginatefromonlytheforearmbones.Forfurtherdetailsoneachofthebonesclickontheindividualmuscles.1.Supinator.2.Abductorpollicislongus.3.Extensorpollicislongus.4.Extensorindicis.5.Extensorpollicisbrevis.12435Fig16.Deepmusclesoftheposteriorcompartment.Returntomainmenu第25頁，共30頁，2023年，2月20日，星期日Extensorpollicislongusandbrevis,andabductorpollicislongusAbductorpollicislongusOrigin:-Middleoftheposteriorsurfaceoftheshaftoftheulnaandradius.Insertion:-Posteriorsurfaceofthebaseofthefirstmetacarpalbone.Nervesupply:-Theposteriorinterosseousnerve,C7andC8.Action:-Abductsandextendsthethumb.ExtensorpollicislongusOrigin:-Fromtheposteriorsurfaceoftheulna.Insertion:-Posteriorsurfaceofthebaseofthedistalphalanxofthethumb.Nervesupply:-Theposteriorinterosseousnerve,C7andC8.Action:-Extendsthethumb.ExtensorpollicisbrevisOrigin:-Posteriorsurfaceoftheradius.Insertion:-PosteriorsurfaceoftheproximalphalanxofthethumbNervesupply:-Theposteriorinterosseousnerve,C7andC8.Action:-Extendsthethumb.Anatomicalsnuffbox:medialboundaryisthethetendonoftheextensorpollicislongusandthelateralboundaryisthetendonoftheabductorpollicislongusandextensorpollicisbrevis.Abductorpollicislongus.ExtensorpollicislongusFig17.Abductorpollicislongus,extensorpollicislongusandbrevis.ExtensorpollicisbrevisReturntotitlepage第26頁，共30頁，2023年，2月20日，星期日SupinatorSupinatorThesupinatorconsistsofobliqueandatransversehead.Origin:-Obliquehead:Fromthelateralepicondyleofthehumerusandcollateralligamentoftheelbowjoint.Transversehead:Supinatorcrestoftheulna.Insertion:-Bothheadswindlaterallyaroundtheproximalpartoftheradius,attachingtotheanterioraspectoftheradius.Nervesupply:-Posteriorinterosseousnerve,C6andC7.Action:-Supinatestheforearm(mainlyassistsasthebicepsbrachiiismainsupinatoroftheforearm).TransverseheadObliqueheadFig18.Supinatormuscle(anteriorview).Returntotitlepage第27頁，共30頁，2023年，2月20日，星期日ExtensorindicisOrigin:-Posteriorsurfaceoftheulna.Insertion:-DorsalexpansionoftheindexfingerNervesupply:-Posteriorinterosseousnerve,C7andC8.Action:-Extendstheindexfinger.ReturntotitlepageExtensorindicisFig19.Extensorpollicis第28頁，共30頁，2023年，2月20日，