前臂肌肉解剖

GROSSANATOMYOFTHEFOREARM丁香園前臂肌肉解剖MainMenuBonesoftheforearm.Superficialmusclesoftheanteriorcompartment.Deepmusclesoftheanteriorcompartment.Arteriesandnervesoftheanteriorcompartment.Superficialmusclesoftheposteriorcompartment.Deepmusclesoftheposteriorcompartment.Arteriesandnervesoftheposteriorcompartment.Acknowledgements前臂肌肉解剖前臂肌肉解剖BonesoftheforearmTheradiusproximallyarticulateswiththehumerusattheelbowjoint.Distallyitarticulateswiththescaphoidandlunatebonesofthecarpus,andwiththeulnaatthedistalradioulnarjoint.Theulnaisthemoremedialofthetwobones.Itsproximalendarticulateswiththehumerusattheelbowjoint.Distallyitarticulateswiththeradius.Itisexcludedfromthewristjointbythearticulardisc.Theinterosseousmembranebindtheradiusandtheulnatogether.HeadInterosseousmembraneRadiusHumerusTuberosityofradiusUlnaHeadFig1.Anteriorviewofbonesoftheforearm.前臂肌肉解剖前臂肌肉解剖前臂肌肉解剖總體記憶前臂共有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塊前臂肌肉解剖前臂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)屈腕肌前臂肌肉解剖Superficialmusclesoftheanteriorcompartment.Titlepage.

1234Thesuperficialmusclesoftheanteriorcompartmentincludepronatorteres旋前圓肌,flexorcarpiradialis橈側(cè)腕屈肌,palmarislongus掌長肌,andflexorcarpiulnaris.Alsoincludedinthisgroupisflexordigitorumsuperficialis.Thesuperficialgroupofmusclesallhavethesameorigin,whichisattachedtothemedialepicondyleofthehumerus肱骨內(nèi)上髁.FORFURTHERDETAILSCLICKONEACHINDIVIDUALMUSCLEBELOW.PronatorteresFlexorcarpiradialisFlexorcarpiulnarisFlexordigitorumsuperficialisPalmarislongus

(notincludedinthediagram).Fig2.Showingsuperficialmusclesoftheposteriorcompartment.Brachio-radialisReturntomainmenu前臂肌肉解剖PronatorTeres[5te7ri:z]Thepronatortereshastwoheads,thehumeralheadandtheulnarhead.Themediannerve正中神經(jīng)enterstheforearmbetweenthetwoheads.Origin:- Humeralhead-Medialepicondyleofthehumerus.

Ulnarhead-Medialborderofthecoronoidprocess冠突,冠狀突oftheulna.Insertion附著:-

Lateralaspectoftheshaftoftheradius.Nervesupply:-Mediannerve,C6andC7.Action:-Pronationoftheforearm.Flexionoftheforearm.PronatorteresRadiusFig3.Pronatorteres.Returntotitlepage前臂肌肉解剖*Flexorcarpiradialis,palmarislongus,andflexor

carpiulnarisFlexorcarpiradialis 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-Medialaspectoftheolecranon鷹嘴(processoftheulnaandtheposteriorborderoftheulna.

Insertion:-Pisiform

bone豌豆?fàn)畹?hookofthehamate,andbaseofthefifthmetacarpalbone.

Nervesupply:-Theulnarnerve,C7,C8,andT1.

Action:-Flexesthehandatwristjoint. Adductsthehandatwristjoint PronatorteresFlexorcarpiradialisPalmarislongusFlexorcarpiulnarisFig4.FlexorcarpiradialisandulnarisandpalmarislongusReturntotitlepage前臂肌肉解剖Flexordigitorumsuperficialis.Origin:-Humeroulnarhead:Medialepicondyleofthehumerusandthemedialmarginofthecoronoidprocessoftheulna.Radialhead:Risingfromtheobliquelineontheanteriorsurfaceoftheshaftoftheradius.Insertion:-Themusclebellygivesrisetofourtendonsdistally.Eachofthetendonattachestothesidesofthemiddlephalanx指骨,趾骨

ofthefourmedialfinger.Nervesupply:-Mediannerve,C8andT1.Action:-Flexesthemiddlephalanxoffingers. Flexestheproximalphalanxoffingers(weak). Flexesthewrist.Flexordigitorumsuperficialis.Fig5.Flexordigitorumsuperficialis.Returntotitlepage前臂肌肉解剖前臂8塊屈肌深層3塊指深屈肌拇長屈肌旋前方肌前臂肌肉解剖DeepMusclesoftheanteriorcompartment.Titlepage

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

notshown.112Brachio-radialis(cut)Tendonofcarpiflexorradialis(cut)Fig6.Deepmusclesoftheanteriorcompartment.Returntomainmenu前臂肌肉解剖FlexordigitorumprofundusandflexorpollicislongusFlexorpollicislongusOrigin:-Middleoftheanteriorsurfaceoftheshaftoftheradiusandfromtheadjoiningpartoftheinterosseousmembrane.Insertion:-Thetendonpassesdistallythroughthecarpaltunnelandattachestothedistalphalanxofthethumb.Nervesupply:-Theanteriorinterosseousbranchofthemediannerve.Action:-Flexesthephalangesofthethumb.Flexordigitorumprofundus深的Origin:-Upperthree-quartersoftheanteriomedialshaftoftheulna.Insertion:-Themuscledividesintofourtendonsjustpriortotraversingthecarpaltunnel.Theyattachtothedistalphalanxofthefourfingers.Nervesupply:-Themedialpartissuppliedbytheulnarnerve,thelateralportionissuppliedbytheanteriorinterosseousbranchofthemediannerve,C8andT1.Action:-Flexesthefinger.Exclusiveflexorofthedistalphalanx.Weakflexorofthewrist.

FlexorpollicislongusPronatorquadratusFlexordigitorumprofundusFig7.Flexordigitorumprofundusandflexorpollicislongus.Returntotitlepage前臂肌肉解剖PronatorQuadratusOrigin:-Lowerquarteroftheanteriorsurfaceoftheshaftoftheulna.Insertion:-Lowerquarteroftheanteriorsurfaceoftheshaftoftheradius.Nervesupply:-Theanteriorinterosseousbranchofthemediannerve.Action:-Pronatestheforearm.PronatorquadratusFlexorcarpiradialis(cut)FlexorpollicislongusFlexordigitorumprofundusFlexorcarpiulnaris(cut)Fig8.Pronatorquadratus.Return

totitlepage前臂肌肉解剖ArteriesandNervesoftheanteriorcompartment.TitlepageUlnarartery:-

Largerthantheradialartery.Itpassesbetweenthearchformedbytheradialandulnarattachmentoftheflexordigitorumsuperficialisanddescendsthroughtheanteriorcompartment.Itentersthepalmofthehandinfrontoftheflexorretinaculum,andpromptlydividesinsuperficialanddeeppalmerbranches.Branches-

Muscularbranches-tothemusclesoftheanteriorcompartment.

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

BrachialarteryMediannerveUlnarnerveRadialnerveUlnararteryFig9.Arteriesandnervesoftheanteriorcompartment.NextReturntonerves前臂肌肉解剖ArteriesandNervesoftheanteriorcompartment.Posteriorinterosseousartery-arisesfromthecommoninterosseousarteryandandenterstheposteriorcompartment.Radialartery:-Itbeginsinthecubitalfossa肘窩whenthebrachialarterydividesintotheradialandulnaartery.Itpassesdistally,travelsunderthebrachioradialis,restingonthedeepflexormuscles.Thearterybrieflytravelsonthelateralsideoftheradius,beforetravellingovertheanteriorsurfaceoftheradius.Thearterythenwindsaroundthelateralaspectofthewrist,beforeenteringthepalmofthehandtoformthedeeppalmerarch.Branches-Muscularbranches:totheneighbouringmuscles.Branchestotheanastomosisaroundthewristandelbowjoint.Superficialpalmerjoint:arisesjustabovethewrist,frequentlyjoinstheulnararterytogiverisetothesuperficialpalmerarch.RadialnerveSuperficialradialnerveRadialarteryBrachialarteryMediannerveUlnarnerveUlnararteryMediannerveFig10.Arteriesandnervesoftheanteriorcompartment.NextReturntonerves前臂肌肉解剖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魚際.Dorsalcutaneousbranch:arisesinthedistalthirdoftheoftheforearm,andpassesmediallytothedorsumofthehand.

Returntomainmenu前臂肌肉解剖前臂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)腕伸肌前臂肌肉解剖Superficialmusclesoftheposteriorcompartment.Titlepage

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

Extensorcarpiradialislongus2.Extensordigitorum3.Extensorcarpiulnaris4.ExtensordigitiminimiBrachioradialisandextensorcarpibrevisarenotincludedinthefigure.24Anconeus231Fig11.Superficialmusclesoftheposteriorcompartment.Returntomainmenu前臂肌肉解剖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前臂肌肉解剖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前臂肌肉解剖BrachioradialisOrigin:-Fromtheuppertwpthirdsofthelateralsupracondylarridgeofthehumerus.Insertion:-Baseofthestyloidprocessoftheradius.Nervesupply:-Radialnerve,C5andC6.Action:-Itflexestheforearm(despitebeingbeingservedbyan‘extensor’nerve),assistsinrotatingorrestoringthearmintomidproneposition,dependingontheinitialposition.

Brachio-radialisExtensorcarpiradialislongusExtensorcarpiradialisbrevisFlexorcarpiradialisFig15.Brachioradialis(anteriorview).Fig14Brachioradialis(lateralview).Returntotitlepage前臂肌肉解剖Deepmusclesintheposteriorcompartment.Titlepage

Thedeepmusclesoftheforearmconsistofthreemusclesthatactonthethumb,theextensorindicisandsupinator.Exceptforthesupinatortheyalloriginatefromonlytheforearmbones.Forfurtherdetailsoneachofthebonesclickontheindividualmuscles.1.Supinator.2.Abductorpollicislongus.3.Extensorpollicislongus.4.Extensorindicis.5.Extensorpollicisbrevis.12435Fig16.Deepmusclesoftheposteriorcompartment.Returntomainmenu前臂肌肉解剖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前臂肌肉解剖SupinatorSupinatorThesupinatorconsistsofobliqueandatransversehead.Origin:-Obliquehead:Fromthelateralepicondyleofthehumerusandcollateralligamentoftheelbowjoint.Transversehead:Supinatorcrestoftheulna.Insertion:-Bothheadswindlaterallyaroundtheproximalpartoftheradius,attachingtotheanterioraspectoftheradius.Nervesupply:-Posteriorinterosseousnerve,C6andC7.Action:-Supinatestheforearm(mainlyassistsasthebicepsbrachiiismainsupinatoroftheforearm).TransverseheadObliqueheadFig18.Supinatormuscle(anteriorview).Returntotitlepage前臂肌肉解剖ExtensorindicisOrigin:-Posteriorsurfaceoftheulna.Insertion:-DorsalexpansionoftheindexfingerNervesupply:-Posteriorinterosseousnerve,C7andC8.Action:-Extendstheindexfinger.ReturntotitlepageExtensorindicisFig19.Extensorpollicis前臂肌肉解剖Arteriesandnerves