前臂肌肉解剖PPT课件

GROSSANATOMYOFTHEFOREARM 丁香园 1 MainMenu Bonesoftheforearm Superficialmusclesoftheanteriorcompartment Deepmusclesoftheanteriorcompartment Arteriesandnervesoftheanteriorcompartment Superficialmusclesoftheposteriorcompartment Deepmusclesoftheposteriorcompartment Arteriesandnervesoftheposteriorcompartment Acknowledgements 2 3 Bonesoftheforearm Theradiusproximallyarticulateswiththehumerusattheelbowjoint Distallyitarticulateswiththescaphoidandlunatebonesofthecarpus andwiththeulnaatthedistalradioulnarjoint Theulnaisthemoremedialofthetwobones Itsproximalendarticulateswiththehumerusattheelbowjoint Distallyitarticulateswiththeradius Itisexcludedfromthewristjointbythearticulardisc Theinterosseousmembranebindtheradiusandtheulnatogether Head Interosseousmembrane Radius Humerus Tuberosityofradius Ulna Head Fig1 Anteriorviewofbonesoftheforearm 4 5 6 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 7 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 8 Superficialmusclesoftheanteriorcompartment Titlepage 1 2 3 4 Thesuperficialmusclesoftheanteriorcompartmentincludepronatorteres旋前圆肌 flexorcarpiradialis桡侧腕屈肌 palmarislongus掌长肌 andflexorcarpiulnaris Alsoincludedinthisgroupisflexordigitorumsuperficialis Thesuperficialgroupofmusclesallhavethesameorigin whichisattachedtothemedialepicondyleofthehumerus肱骨内上髁 FORFURTHERDETAILSCLICKONEACHINDIVIDUALMUSCLEBELOW PronatorteresFlexorcarpiradialisFlexorcarpiulnarisFlexordigitorumsuperficialisPalmarislongus notincludedinthediagram Fig2 Showingsuperficialmusclesoftheposteriorcompartment Brachio radialis Returntomainmenu 9 PronatorTeres 5te7ri z Thepronatortereshastwoheads thehumeralheadandtheulnarhead Themediannerve正中神经enterstheforearmbetweenthetwoheads Origin Humeralhead Medialepicondyleofthehumerus Ulnarhead Medialborderofthecoronoidprocess冠突 冠状突oftheulna Insertion附着 Lateralaspectoftheshaftoftheradius Nervesupply Mediannerve C6andC7 Action Pronationoftheforearm Flexionoftheforearm Pronatorteres Radius Fig3 Pronatorteres Returntotitlepage 10 Flexorcarpiradialis palmarislongus andflexorcarpiulnaris FlexorcarpiradialisOrigin Medialepicondyleofthehumerus Insertion Baseofthesecondandthirdmetacarpalbones Nervesupply Mediannerve C6andC7 Action Flexesthehandatthewristjoint Abductsthehandatthewristjoint PalmarislongusOrigin Medialepicondyleofthehumerus Insertion Flexorretinaculumandpalmaraponeurosis Nervesupply Mediannerve C7andC8Action Flexesthehandatwristjoint Flexorcarpiulnaris Origin Humeralhead Medialepicondyleofthehumerus Ulnarhead Medialaspectoftheolecranon鹰嘴 processoftheulnaandtheposteriorborderoftheulna Insertion Pisiformbone豌豆状的 hookofthehamate andbaseofthefifthmetacarpalbone Nervesupply Theulnarnerve C7 C8 andT1 Action Flexesthehandatwristjoint Adductsthehandatwristjoint Pronatorteres Flexorcarpiradialis Palmarislongus Flexorcarpiulnaris Fig4 Flexorcarpiradialisandulnarisandpalmarislongus Returntotitlepage 11 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 12 前臂8块屈肌 深层3块指深屈肌拇长屈肌旋前方肌 13 DeepMusclesoftheanteriorcompartment Titlepage Thedeepmusclesoftheforearmcompriseoftheflexorpollicislongus flexordigitorumprofundusandpronatorquadratus Forfurtherdetailsclickoneachoftheindividualmuscles 1 Flexordigitorumprofundus 2 Flexorpollicislongus Pronatorquadratusnotshown 1 1 2 Brachio radialis cut Tendonofcarpiflexorradialis cut Fig6 Deepmusclesoftheanteriorcompartment Returntomainmenu 14 Flexordigitorumprofundusandflexorpollicislongus FlexorpollicislongusOrigin Middleoftheanteriorsurfaceoftheshaftoftheradiusandfromtheadjoiningpartoftheinterosseousmembrane Insertion Thetendonpassesdistallythroughthecarpaltunnelandattachestothedistalphalanxofthethumb Nervesupply Theanteriorinterosseousbranchofthemediannerve Action Flexesthephalangesofthethumb Flexordigitorumprofundus深的Origin Upperthree quartersoftheanteriomedialshaftoftheulna Insertion Themuscledividesintofourtendonsjustpriortotraversingthecarpaltunnel Theyattachtothedistalphalanxofthefourfingers Nervesupply Themedialpartissuppliedbytheulnarnerve thelateralportionissuppliedbytheanteriorinterosseousbranchofthemediannerve C8andT1 Action Flexesthefinger Exclusiveflexorofthedistalphalanx Weakflexorofthewrist Flexorpollicislongus Pronatorquadratus Flexordigitorumprofundus Fig7 Flexordigitorumprofundusandflexorpollicislongus Returntotitlepage 15 PronatorQuadratus Origin Lowerquarteroftheanteriorsurfaceoftheshaftoftheulna Insertion Lowerquarteroftheanteriorsurfaceoftheshaftoftheradius Nervesupply Theanteriorinterosseousbranchofthemediannerve Action Pronatestheforearm Pronatorquadratus Flexorcarpiradialis cut Flexorpollicislongus Flexordigitorumprofundus Flexorcarpiulnaris cut Fig8 Pronatorquadratus Returntotitlepage 16 ArteriesandNervesoftheanteriorcompartment Titlepage Ulnarartery Largerthantheradialartery Itpassesbetweenthearchformedbytheradialandulnarattachmentoftheflexordigitorumsuperficialisanddescendsthroughtheanteriorcompartment Itentersthepalmofthehandinfrontoftheflexorretinaculum andpromptlydividesinsuperficialanddeeppalmerbranches Branches Muscularbranches tothemusclesoftheanteriorcompartment Recurrentbranches totheanastomosisaroundthewristjointBranchestotheanastomosisaroundthewristjointCommoninterosseousartery arisesintheupperpartoftheulnararteryandthendividesintheanteriorandposteriorinterosseousarteries Anteriorinterosseousartery arisesfromthecommoninterosseousarteryanddescendsintheanteriorcompartmenttoeventuallyjointheanastomosisaroundthewristjoint Itsuppliesthedeepflexormuscles andgivesoffnutrientbranchestothetheradiusandulna Brachialartery Mediannerve Ulnarnerve Radialnerve Ulnarartery Fig9 Arteriesandnervesoftheanteriorcompartment Next Returntonerves 17 ArteriesandNervesoftheanteriorcompartment Posteriorinterosseousartery arisesfromthecommoninterosseousarteryandandenterstheposteriorcompartment Radialartery Itbeginsinthecubitalfossa肘窝whenthebrachialarterydividesintotheradialandulnaartery Itpassesdistally travelsunderthebrachioradialis restingonthedeepflexormuscles Thearterybrieflytravelsonthelateralsideoftheradius beforetravellingovertheanteriorsurfaceoftheradius Thearterythenwindsaroundthelateralaspectofthewrist beforeenteringthepalmofthehandtoformthedeeppalmerarch Branches Muscularbranches totheneighbouringmuscles Branchestotheanastomosisaroundthewristandelbowjoint Superficialpalmerjoint arisesjustabovethewrist frequentlyjoinstheulnararterytogiverisetothesuperficialpalmerarch Radialnerve Superficialradialnerve Radialartery Brachialartery Mediannerve Ulnarnerve Ulnarartery Mediannerve Fig10 Arteriesandnervesoftheanteriorcompartment Next Returntonerves 18 Nervesoftheanteriorcompartment MedianNerve fig9 fig10 Themediannerveleavesthecubitalfossainbetweenthetwoheadsofthepronatorteres Itdescendsbetweenthesuperficialanddeepflexormuscles Atthewristitliessuperficially beforeenteringthepalmbehindtheflexorretinaculum Branches Muscularbranch allthesuperficialmusclesoftheanteriorcompartmentexceptflexorcarpiulnaris Articularbranches totheelbowjointAnteriorinterosseousnerve arisesfromthemediannerveasitemergesfromthetwoheadsofthepronatorteres seebelow PalmercutaneousBranch Distributedtotheskinoverthelateralpartofthepalm AnteriorinterosseousnerveItarisesfromthemediannerve seeabove andthendescendsdowntheanteriorsurfaceoftheinterosseousmembrane Branches Muscularbranches allthemusclesofdeepflexionintheanteriorcompartmentexceptthemedialpartofdigitorumprofundus Articularbranches tothewristjoint thedistalradioulnarjoint andthejointsofthecarpus UlnarNerve fig9 fig10 Theulnarnervepassesbehindthemedialepicondyleandenterstheforearmbetweenthetwoheadsofflexorcarpiulnaris Itdescendsbetweentheflexorcarpiulnarisandtheflexordigitorumprofundus Theulnarnervebecomessuperficialatthewrist beforeenteringthepalminfrontoftheflexorretinaculum Branches Muscularbranches totheflexorcarpiulnarisandtothemedialhalfoftheflexordigitorumprofundus Articularbranches totheelbowjoint Palmarcutaneousbranch arisesinthemiddleoftheforearm Suppliesskinoverthethenareminence鱼际 Dorsalcutaneousbranch arisesinthedistalthirdoftheoftheforearm andpassesmediallytothedorsumofthehand Returntomainmenu 19 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 20 Superficialmusclesoftheposteriorcompartment Titlepage Thesuperficialmusclesoftheanteriorcompartmentaremainlyconcernedwiththeextensionatwristjointandofthedigit ThemusclesinthisgroupcompriseoftheExtensorcarpiradialisbrevis extensordigitorum extensordigitiminimi extensorcarpiulnaris andthetwomorelaterallyingbrachioradialisandextensorcarpiradialislongus NB Theanconeusalsoliesintheposteriorcompartmentbutisfunctionallyverydifferenttotherestofthemusclesinthisgroup Itsactionaretoaidthetricepsinextensionattheelbowjoint Clickbelowoneachofthemusclesforfurtherdetailabouteachoftheindividualmuscles 1 Extensorcarpiradialislongus2 Extensordigitorum3 Extensorcarpiulnaris4 ExtensordigitiminimiBrachioradialisandextensorcarpibrevisarenotincludedinthefigure 2 4 Anconeus 2 3 1 Fig11 Superficialmusclesoftheposteriorcompartment Returntomainmenu 21 Extensorcarpiradialislongusandbrevis andextensorcarpiulnaris ExtensorcarpiradialislongusOrigin 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 Extensorcarpiradialislongus Extensorcarpiradialisbrevis Extensorcarpiulnaris Fig12 Extensorcarpiradialisbrevisandlongusandextensorcarpiulnaris Returntotitlepage 22 Extensordigitorumandextensordigitiminimi ExtensordigitorumOrigin Fromthecommontendonattachedtothelateralepicondyleofthehumerus Insertion Themuscledividesintofourtendonswhichpasstothefingersandformthedorsalexpansion Onthedorsumofthehandtheseareinterconnectedbyfibroustissue Neartheproximalinterphalangealjointofeachfingertheexpansionsdivideintothecentralpart whichinsertsintobaseofthemiddlephalanx andthetwolateralparts whichinsertintothebaseofthedistalphalanx Nervesupply Posteriorinterosseousnerve C7andC8Action Mainlyitextendsthemetacarpophalangealjoint butitalsoassistsinextendingtheproximalanddistalinterphalangealjointandthearm ExtensordigitiminimiOrigin Fromthecommontendonattachedtothelateralepicondyleofthehumerus Insertion Viatwotendonstothedorsalexpansionforthelittlefinger Nervesupply Posteriorinterosseousnerve C7andC8Action Assistsintheextensionofthelittlefinger Extensordigitorum Extensordigitiminimi Fig13 Extensordigitorumandextensordigitiminimi Returntotitlepage 23 Brachioradialis Origin Fromtheuppertwpthirdsofthelateralsupracondylarridgeofthehumerus Insertion Baseofthestyloidprocessoftheradius Nervesupply Radialnerve C5andC6 Action Itflexestheforearm despitebeingbeingservedbyan extensor nerve assistsinrotatingorrestoringthearmintomidproneposition dependingontheinitialposition Brachio radialis Extensorcarpiradialislongus Extensorcarpiradialisbrevis Flexorcarpiradialis Fig15 Brachioradialis anteriorview Fig14Brachioradialis lateralview Returntotitlepage 24 Deepmusclesintheposteriorcompartment Titlepage Thedeepmusclesoftheforearmconsistofthreemusclesthatactonthethumb theextensorindicisandsupinator Exceptforthesupinatortheyalloriginatefromonlytheforearmbones Forfurtherdetailsoneachofthebonesclickontheindividualmuscles 1 Supinator 2 Abductorpollicislongus 3 Extensorpollicislongus 4 Extensorindicis 5 Extensorpollicisbrevis 1 2 4 3 5 Fig16 Deepmusclesoftheposteriorcompartment Returntomainmenu 25 Extensorpollicislongusandbrevis andabductorpollicislongus AbductorpollicislongusOrigin 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 Extensorpollicislongus Fig17 Abductorpollicislongus extensorpollicislongusandbrevis Extensorpollicisbrevis Returntotitlepage 26 Supinator SupinatorThesupinatorconsistsofobliqueandatransversehead Origin Obliquehead Fromthelateralepicondyleofthehumerusandcollateralligamentoftheelbowjoint Transversehead Supinatorcrestoftheulna Insertion Bothheadswindlaterallyaroundtheproximalpartoftheradius attachingtotheanterioraspectoftheradius Nervesupply Posteriorinterosseousnerve C6andC7 Action Supinatestheforearm mainlyassistsasthebicepsbrachiiismainsupinatoroftheforearm Transversehead Obliquehead Fig18 Supinatormuscle anteriorview Returntotitlepage 27 Extensorindicis Origin Posteriorsurfaceoftheulna Insertion DorsalexpansionoftheindexfingerNervesupply Posteriorinterosseousnerve C7andC8 Action Extendstheindexfinger Returntotitlepage Extensorindicis Fig19 Extensorpollicis 28 Arteriesandnervesintheposteriorcompartment