Unit 16: Posterior Forearm and Hand

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supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis

From a posterior view, name the deep muscles of post forearm from lat --> medial:

brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, anconeus

From a posterior view, name the superficial muscles of post forearm from lat --> medial:

dorsal digital arteries

G?

recurrent interosseous artery

G?

Anconeus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris (which also attaches to posterior border of ulna), supinator (also radial colalteral and anular ligaments, supinator fossa and crest of ulna)

What has its origin at the lateral epicondyle of the humerus?

Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis

What muscles make up the deep layer of the posterior forearm?

Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, anconeus

What muscles make up the superficial layer of the forearm?

Abductor pollicis longus

A?

Posterior interosseous

A?

deep artery of arm (profunda brachii)

A?

abducts the thumb at carpometacarpal joint

Abductor pollicis longus: action

posterior interosseus artery (a branch of ulnar artery)

Abductor pollicis longus: blood supply

posterior interosseous nerve (C7, C8), a branch of the radial nerve

Abductor pollicis longus: innervation

lateral supracondylar ridge of the humerus

Brachioradialis: origin

Trapezium, scaphoid, radial artery, cephalic vein

Contents of the anatomical snuff box:

deep radial n. passes through the supinator m.; some authors believe that the posterior interosseous n. and the deep radial n. are synonymous, others say that when the deep radial n. emerges from the supinator in the posterior forearm it becomes the posterior interosseous n.,

Course of deep radial nerve?

Extensor digiti minimi

G?

dorsal branches of proper palmar digital arteries

H?

Extensor carpi radialis brevis (C7,C8), and Supinator (C5,C6)

Innervations of the deep radial nerve?

anterior interosseous artery

L?

supinates the forearm

Supinator: action

posterior interosseous nerve (C7, C8), a branch of the radial nerve

Extensor pollicis longus: innervation

radial recurrent artery

Brachioradialis: blood supply

radial nerve (C5,6,7)

Brachioradialis: innervation

lateral surface of distal end of radius

Brachioradialis: insertion

1st compartment post to ext. pol. brevis, insert on the radial side of the base of the first metacarpal

Abductor pollicis longus: insertion

middle one-third of the posterior surface of the radius, interosseous membrane, mid-portion of posterolateral ulna

Abductor pollicis longus: origin

extends the forearm assists in dynamic stabilization of elbow joint

Anconeus: action

interosseous recurrent artery

Anconeus: blood supply

radial nerve (C7, C8, and T1)

Anconeus: innervation

lateral surface of olecranon and superior part of post. surface of ulna

Anconeus: insertion

lateral epicondyle of humerus

Anconeus: origin

Extensor pollicis brevis

B?

anterior interosseous

B?

superior ulnar collateral artery

B?

posterior border - tendon of the extensor pollicis longus anterior border - tendons of extensor pollicis brevis and the abductor pollicis longus proximal border - styloid process of the radius

Boundaries of the anatomical snuff box?

flexes forearm

Brachioradialis: action

Extensor carpi radialis longus

C?

dorsal carpal branch of ulnar artery

C?

inferior ulnar collateral artery

C?

passes through third compartment, uses dorsal radial tubercle (Lister's) as pivot point to change direction, and inserts on base of distal phalanx of thumb

Extensor pollicis longus: insertion ALSO COURSE?

interosseous membrane and middle part of the posterolateral surface of the ulna

Extensor pollicis longus: origin

Extensor digitorum

F?

brachial artery (in cubital fossa)

F?

dorsal metacarpal arteries

F?

posterior interosseus artery (a branch of ulnar artery)

Extensor indicis: blood supply

posterior interosseous nerve (C7, C8), a branch of the radial nerve

Extensor indicis: innervation

passes through fourth compartment to insert on extensor hood of index finger

Extensor indicis: insertion

interosseous membrane and the posterolateral surface of the distal ulna

Extensor indicis: origin

extends the thumb at the metacarpophalangeal joint

Extensor pollicis brevis: action

posterior interosseus artery (a branch of ulnar artery)

Extensor pollicis brevis: blood supply

posterior interosseous nerve (C7, C8), a branch of the radial nerve

Extensor pollicis brevis: innervation

It is the continuation of the deep branch of the radial nerve, after this has crossed the supinator muscle. descends on the interosseous membrane, in front of the Extensor pollicis longus, to the back of the carpus,

Course of posterior interosseous nerve?

1st compartment ant to abductor pol. longus, inserts on proximal phalanx of the thumb

Extensor pollicis brevis: insertion

interosseous membrane and the posterior surface of the distal radius

Extensor pollicis brevis: origin

extends the thumb at the interphalangeal joint

Extensor pollicis longus: action

Extensor carpi radialis brevis

D?

dorsal carpal arch

D?

radial collateral artery

D?

posterior interosseus artery (a branch of ulnar artery)

Extensor pollicis longus: blood supply

Extensor pollicis longus

E?

middle collateral artery

E?

perforating branches

E?

extends the wrist; abducts the hand

Extensor carpi radialis brevis: action

radial artery

Extensor carpi radialis brevis: blood supply

deep radial nerve (C7,8)

Extensor carpi radialis brevis: innervation

2nd compartment (medial) base of the third metacarpal bone (base)

Extensor carpi radialis brevis: insertion

common extensor tendon (lateral epicondyle of humerus)

Extensor carpi radialis brevis: origin

Extend and abduct hand at wrist

Extensor carpi radialis longus: action

Radial artery

Extensor carpi radialis longus: blood supply

radial nerve (C6,7)

Extensor carpi radialis longus: innervation

passes through second compartment under extensor retinaculum to insert on the base of 2nd metacarpal

Extensor carpi radialis longus: insertion

Lateral supraepicondylar ridge of humerus

Extensor carpi radialis longus: origin

Extends and also adducts hand at wrist joint

Extensor carpi ulnaris: action

Ulnar artery

Extensor carpi ulnaris: blood supply

posterior interosseous nerve (C7,8), a branch of the radial nerve. The deep radial branch of the radial artery becomes the posterior interosseous nerve.

Extensor carpi ulnaris: innervation

Passes through sixth compartment under the extensor retinaculum to insert on the base of the fifth metacarpal

Extensor carpi ulnaris: insertion

1. Common extensor tendon (lateral epicondyl of humerus. 2. Posterior border of ulna

Extensor carpi ulnaris: origin

extends the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the 5th digit

Extensor digiti minimi: action

interosseous recurrent a.

Extensor digiti minimi: blood supply

posterior interosseous nerve (C7,8), a branch of the radial nerve. The deep radial branch of the radial artery becomes the posterior interosseous nerve.

Extensor digiti minimi: innervation

(5th compartment) joins the extensor digitorum tendon to the 5th digit and inserts into the extensor expansion.

Extensor digiti minimi: insertion

common extensor tendon (lateral epicondyle of the humerus)

Extensor digiti minimi: origin

extends medial four digits at metacarpophalangeal joints, extends hand at wrist joint

Extensor digitorum: action

interosseous recurrent a. and posterior interosseous a.

Extensor digitorum: blood supply

posterior interosseous nerve (C7,8), a branch of the radial nerve

Extensor digitorum: innervation

passes through fourth compartment under extensor retinaculum to insert as the extensor hood on middle and distal phalanges of digits 2-5, but sometimes not 5

Extensor digitorum: insertion

common extensor tendon (lateral epicondyle of the humerus)

Extensor digitorum: origin

extends the index finger at the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints

Extensor indicis: action

Extensor carpi ulnaris

H?

radial recurrent artery

H?

Extensor indicis

I?

anterior ulnar recurrent

I?

dorsalis indicis

I?

Anconeus (C7,C8,T1), extensor carpi radialis longus(C6,C7), brachioradialis (C5,C6,C7).

Innervations of the main trunk of the radial nerve?

posterior ulnar recurrent

J?

radial artery

J?

common interosseous artery (branch of ulnar artery)

K?

dorsalis pollicis

K?

radial artery

M?

ulnar artery

N?

posterior interosseous artery

O?

recurrent interosseous artery (branch of posterior interosseous artery, a branch of ulnar artery)

Supinator: blood supply

deep radial nerve (C5, C6)

Supinator: innervation

lateral, posterior, and anterior surfaces of proximal third of radius

Supinator: insertion

lateral epicondyle of the humerus, supinator crest & fossa of the ulna, radial collateral and anular ligaments

Supinator: origin

Divides into superficial and deep radial nerves at the anterior of the elbow. superficial goes to skin, deep enters supinator muscle Superficial radial nerve - purely cutaneous to posterior forearm and hand. Deep radial nerve - supplies extensor carpi radialis brevis (C7,C8) and supinator (C5,C6). Once the deep radial nerve crosses supinator, it becomes the posterior interosseous nerve. This nerve supplies all other muscles of the posterior forearm.

Where does the radial nerve divide? Names its divisions & continuations, and innervations of those divisions?


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