前臂肌肉解剖.ppt

1、a,1,GROSSANATOMYOFTHEFOREARM,丁香园,a,2,MainMenu,Bonesoftheforearm.Superficialmusclesoftheanteriorcompartment.Deepmusclesoftheanteriorcompartment.Arteriesandnervesoftheanteriorcompartment.Superficialmusclesoftheposteriorcompartment.Deepmusclesoftheposteriorcompartment.Arteriesandnervesoftheposteriorcom

2、partment.,Acknowledgements,a,3,a,4,Bonesoftheforearm,Theradiusproximallyarticulateswiththehumerusattheelbowjoint.Distallyitarticulateswiththescaphoidandlunatebonesofthecarpus,andwiththeulnaatthedistalradioulnarjoint.Theulnaisthemoremedialofthetwobones.Itsproximalendarticulateswiththehumerusattheelbo

3、wjoint.Distallyitarticulateswiththeradius.Itisexcludedfromthewristjointbythearticulardisc.Theinterosseousmembranebindtheradiusandtheulnatogether.,Head,Interosseousmembrane,Radius,Humerus,Tuberosityofradius,Ulna,Head,Fig1.Anteriorviewofbonesoftheforearm.,a,5,a,6,a,7,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

4、层浅层有5块深层有3块伸肌10块浅深各5块,a,8,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,a,9,Superficialmusclesoftheanteriorcompartment.Titlepage.,1,2,3,4,Thesuperficialmusclesoftheanteriorcompartmentincludepronatorteres旋前圆肌,flexorcarpiradialis桡侧腕屈肌,palmarislongus掌长肌,andflexorcarpiulnaris.Alsoincludedinthisgroupisflexordigitorum

5、superficialis.Thesuperficialgroupofmusclesallhavethesameorigin,whichisattachedtothemedialepicondyleofthehumerus肱骨内上髁.,FORFURTHERDETAILSCLICKONEACHINDIVIDUALMUSCLEBELOW.,PronatorteresFlexorcarpiradialisFlexorcarpiulnarisFlexordigitorumsuperficialisPalmarislongus(notincludedinthediagram).,Fig2.Showing

6、superficialmusclesoftheposteriorcompartment.,Brachio-radialis,Returntomainmenu,a,10,PronatorTeres5te7ri:z,Thepronatortereshastwoheads,thehumeralheadandtheulnarhead.Themediannerve正中神经enterstheforearmbetweenthetwoheads.Origin:-Humeralhead-Medialepicondyleofthehumerus.Ulnarhead-Medialborderofthecoronoi

7、dprocess冠突,冠状突oftheulna.Insertion附着:-Lateralaspectoftheshaftoftheradius.Nervesupply:-Mediannerve,C6andC7.Action:-Pronationoftheforearm.Flexionoftheforearm.,Pronatorteres,Radius,Fig3.Pronatorteres.,Returntotitlepage,a,11,*Flexorcarpiradialis,palmarislongus,andflexorcarpiulnaris,FlexorcarpiradialisOri

8、gin:-Medialepicondyleofthehumerus.Insertion:-Baseofthesecondandthirdmetacarpalbones.Nervesupply:-Mediannerve,C6andC7.Action:-Flexesthehandatthewristjoint.Abductsthehandatthewristjoint.PalmarislongusOrigin:-Medialepicondyleofthehumerus.Insertion:-Flexorretinaculumandpalmaraponeurosis.Nervesupply:-Med

9、iannerve,C7andC8Action:-Flexesthehandatwristjoint.Flexorcarpiulnaris.Origin:-Humeralhead-Medialepicondyleofthehumerus.Ulnarhead-Medialaspectoftheolecranon鹰嘴(processoftheulnaandtheposteriorborderoftheulna.Insertion:-Pisiformbone豌豆状的,hookofthehamate,andbaseofthefifthmetacarpalbone.Nervesupply:-Theulna

10、rnerve,C7,C8,andT1.Action:-Flexesthehandatwristjoint.Adductsthehandatwristjoint,Pronatorteres,Flexorcarpiradialis,Palmarislongus,Flexorcarpiulnaris,Fig4.Flexorcarpiradialisandulnarisandpalmarislongus,Returntotitlepage,a,12,Flexordigitorumsuperficialis.,Origin:-Humeroulnarhead:Medialepicondyleofthehu

11、merusandthemedialmarginofthecoronoidprocessoftheulna.Radialhead:Risingfromtheobliquelineontheanteriorsurfaceoftheshaftoftheradius.Insertion:-Themusclebellygivesrisetofourtendonsdistally.Eachofthetendonattachestothesidesofthemiddlephalanx指骨,趾骨ofthefourmedialfinger.Nervesupply:-Mediannerve,C8andT1.Act

12、ion:-Flexesthemiddlephalanxoffingers.Flexestheproximalphalanxoffingers(weak).Flexesthewrist.,Flexordigitorumsuperficialis.,Fig5.Flexordigitorumsuperficialis.,Returntotitlepage,a,13,前臂8块屈肌,深层3块指深屈肌拇长屈肌旋前方肌,a,14,DeepMusclesoftheanteriorcompartment.Titlepage,Thedeepmusclesoftheforearmcompriseoftheflexo

13、rpollicislongus,flexordigitorumprofundusandpronatorquadratus.Forfurtherdetailsclickoneachoftheindividualmuscles.1.Flexordigitorumprofundus.2.Flexorpollicislongus.Pronatorquadratusnotshown.,1,1,2,Brachio-radialis(cut),Tendonofcarpiflexorradialis(cut),Fig6.Deepmusclesoftheanteriorcompartment.,Returnto

14、mainmenu,a,15,Flexordigitorumprofundusandflexorpollicislongus,FlexorpollicislongusOrigin:-Middleoftheanteriorsurfaceoftheshaftoftheradiusandfromtheadjoiningpartoftheinterosseousmembrane.Insertion:-Thetendonpassesdistallythroughthecarpaltunnelandattachestothedistalphalanxofthethumb.Nervesupply:-Thean

15、teriorinterosseousbranchofthemediannerve.Action:-Flexesthephalangesofthethumb.Flexordigitorumprofundus深的Origin:-Upperthree-quartersoftheanteriomedialshaftoftheulna.Insertion:-Themuscledividesintofourtendonsjustpriortotraversingthecarpaltunnel.Theyattachtothedistalphalanxofthefourfingers.Nervesupply:

16、-Themedialpartissuppliedbytheulnarnerve,thelateralportionissuppliedbytheanteriorinterosseousbranchofthemediannerve,C8andT1.Action:-Flexesthefinger.Exclusiveflexorofthedistalphalanx.Weakflexorofthewrist.,Flexorpollicislongus,Pronatorquadratus,Flexordigitorumprofundus,Fig7.Flexordigitorumprofundusandf

17、lexorpollicislongus.,Returntotitlepage,a,16,PronatorQuadratus,Origin:-Lowerquarteroftheanteriorsurfaceoftheshaftoftheulna.Insertion:-Lowerquarteroftheanteriorsurfaceoftheshaftoftheradius.Nervesupply:-Theanteriorinterosseousbranchofthemediannerve.Action:-Pronatestheforearm.,Pronatorquadratus,Flexorca

18、rpiradialis(cut),Flexorpollicislongus,Flexordigitorumprofundus,Flexorcarpiulnaris(cut),Fig8.Pronatorquadratus.,Returntotitlepage,a,17,ArteriesandNervesoftheanteriorcompartment.Titlepage,Ulnarartery:-Largerthantheradialartery.Itpassesbetweenthearchformedbytheradialandulnarattachmentoftheflexordigitor

19、umsuperficialisanddescendsthroughtheanteriorcompartment.Itentersthepalmofthehandinfrontoftheflexorretinaculum,andpromptlydividesinsuperficialanddeeppalmerbranches.Branches-Muscularbranches-tothemusclesoftheanteriorcompartment.Recurrentbranches-totheanastomosisaroundthewristjointBranchestotheanastomo

20、sisaroundthewristjointCommoninterosseousartery-arisesintheupperpartoftheulnararteryandthendividesintheanteriorandposteriorinterosseousarteries.Anteriorinterosseousartery:-arisesfromthecommoninterosseousarteryanddescendsintheanteriorcompartmenttoeventuallyjointheanastomosisaroundthewristjoint.Itsuppl

21、iesthedeepflexormuscles,andgivesoffnutrientbranchestothetheradiusandulna.,Brachialartery,Mediannerve,Ulnarnerve,Radialnerve,Ulnarartery,Fig9.Arteriesandnervesoftheanteriorcompartment.,Next,Returntonerves,a,18,ArteriesandNervesoftheanteriorcompartment.,Posteriorinterosseousartery-arisesfromthecommoni

22、nterosseousarteryandandenterstheposteriorcompartment.Radialartery:-Itbeginsinthecubitalfossa肘窝whenthebrachialarterydividesintotheradialandulnaartery.Itpassesdistally,travelsunderthebrachioradialis,restingonthedeepflexormuscles.Thearterybrieflytravelsonthelateralsideoftheradius,beforetravellingoverth

23、eanteriorsurfaceoftheradius.Thearterythenwindsaroundthelateralaspectofthewrist,beforeenteringthepalmofthehandtoformthedeeppalmerarch.Branches-Muscularbranches:totheneighbouringmuscles.Branchestotheanastomosisaroundthewristandelbowjoint.Superficialpalmerjoint:arisesjustabovethewrist,frequentlyjoinsth

24、eulnararterytogiverisetothesuperficialpalmerarch.,Radialnerve,Superficialradialnerve,Radialartery,Brachialartery,Mediannerve,Ulnarnerve,Ulnarartery,Mediannerve,Fig10.Arteriesandnervesoftheanteriorcompartment.,Next,Returntonerves,a,19,Nervesoftheanteriorcompartment,MedianNerve(fig9,fig10)Themedianner

25、veleavesthecubitalfossainbetweenthetwoheadsofthepronatorteres.Itdescendsbetweenthesuperficialanddeepflexormuscles.Atthewristitliessuperficially,beforeenteringthepalmbehindtheflexorretinaculum.Branches:-Muscularbranch:-allthesuperficialmusclesoftheanteriorcompartmentexceptflexorcarpiulnaris.Articular

26、branches:totheelbowjointAnteriorinterosseousnerve:arisesfromthemediannerveasitemergesfromthetwoheadsofthepronatorteres.(seebelow)PalmercutaneousBranch:Distributedtotheskinoverthelateralpartofthepalm.AnteriorinterosseousnerveItarisesfromthemediannerve(seeabove)andthendescendsdowntheanteriorsurfaceoft

27、heinterosseousmembrane.Branches-Muscularbranches:allthemusclesofdeepflexionintheanteriorcompartmentexceptthemedialpartofdigitorumprofundus.Articularbranches:tothewristjoint,thedistalradioulnarjoint,andthejointsofthecarpus.UlnarNerve(fig9,fig10)Theulnarnervepassesbehindthemedialepicondyleandentersthe

28、forearmbetweenthetwoheadsofflexorcarpiulnaris.Itdescendsbetweentheflexorcarpiulnarisandtheflexordigitorumprofundus.Theulnarnervebecomessuperficialatthewrist,beforeenteringthepalminfrontoftheflexorretinaculum.Branches-Muscularbranches:totheflexorcarpiulnarisandtothemedialhalfoftheflexordigitorumprofu

29、ndus.Articularbranches:totheelbowjoint.Palmarcutaneousbranch:arisesinthemiddleoftheforearm,Suppliesskinoverthethenareminence鱼际.Dorsalcutaneousbranch:arisesinthedistalthirdoftheoftheforearm,andpassesmediallytothedorsumofthehand.,Returntomainmenu,a,20,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,a,21,Superfic

30、ialmusclesoftheposteriorcompartment.Titlepage,Thesuperficialmusclesoftheanteriorcompartmentaremainlyconcernedwiththeextensionatwristjointandofthedigit.ThemusclesinthisgroupcompriseoftheExtensorcarpiradialisbrevis,extensordigitorum,extensordigitiminimi,extensorcarpiulnaris,andthetwomorelaterallyingbr

31、achioradialisandextensorcarpiradialislongus.NB-Theanconeusalsoliesintheposteriorcompartmentbutisfunctionallyverydifferenttotherestofthemusclesinthisgroup.Itsactionaretoaidthetricepsinextensionattheelbowjoint.Clickbelowoneachofthemusclesforfurtherdetailabouteachoftheindividualmuscles.1.Extensorcarpir

32、adialislongus2.Extensordigitorum3.Extensorcarpiulnaris4.ExtensordigitiminimiBrachioradialisandextensorcarpibrevisarenotincludedinthefigure.,2,4,Anconeus,2,3,1,Fig11.Superficialmusclesoftheposteriorcompartment.,Returntomainmenu,a,22,Extensorcarpiradialislongusandbrevis,andextensorcarpiulnaris,Extenso

33、rcarpiradialislongusOrigin:-Fromthelowerthirdofthelateralsupracondylarridgeofthehumerus.Insertion:-Posteriorsurfaceofthebaseofthesecondmetacarpalbone.Nervesupply:-Radialnerve,C6andC7.Action:-Extendsandabductsthehandatthewristjoint.ExtensorcarpiradialisbrevisOrigin:-Fromthecommontendonattachedtothela

34、teralepicondyleofthehumerus.Insertion:-Posteriorsurfaceofthebaseofthethirdmetacarpalbone.Nervesupply:-Posteriorinterosseousnerve,C7andC8.Action:-Extendsandabductsthehandatthewristjoint.ExtensorcarpiulnarisOrigin:-Fromthecommontendonattachedtothelateralepicondyleofthehumerus.Insertion:-Posteriorsurfa

35、ceofthebaseofthefifthmetacarpalbone.Nervesupply:-Posteriorinterosseousnerve,C7andC8Action:-Extendsandadductsthehandatwristjoint.,Extensorcarpiradialislongus,Extensorcarpiradialisbrevis,Extensorcarpiulnaris,Fig12.Extensorcarpiradialisbrevisandlongusandextensorcarpiulnaris.,Returntotitlepage,a,23,Exte

36、nsordigitorumandextensordigitiminimi,ExtensordigitorumOrigin:-Fromthecommontendonattachedtothelateralepicondyleofthehumerus.Insertion:-Themuscledividesintofourtendonswhichpasstothefingersandformthedorsalexpansion.Onthedorsumofthehandtheseareinterconnectedbyfibroustissue.Neartheproximalinterphalangea

37、ljointofeachfingertheexpansionsdivideintothecentralpart,whichinsertsintobaseofthemiddlephalanx,andthetwolateralparts,whichinsertintothebaseofthedistalphalanx.Nervesupply:-Posteriorinterosseousnerve,C7andC8Action:-Mainlyitextendsthemetacarpophalangealjoint,butitalsoassistsinextendingtheproximalanddis

38、talinterphalangealjointandthearm.ExtensordigitiminimiOrigin:-Fromthecommontendonattachedtothelateralepicondyleofthehumerus.Insertion:-Viatwotendonstothedorsalexpansionforthelittlefinger.Nervesupply:-Posteriorinterosseousnerve,C7andC8Action:-Assistsintheextensionofthelittlefinger.,Extensordigitorum,E

39、xtensordigitiminimi,Fig13.Extensordigitorumandextensordigitiminimi.,Returntotitlepage,a,24,Brachioradialis,Origin:-Fromtheuppertwpthirdsofthelateralsupracondylarridgeofthehumerus.Insertion:-Baseofthestyloidprocessoftheradius.Nervesupply:-Radialnerve,C5andC6.Action:-Itflexestheforearm(despitebeingbei

40、ngservedbyanextensornerve),assistsinrotatingorrestoringthearmintomidproneposition,dependingontheinitialposition.,Brachio-radialis,Extensorcarpiradialislongus,Extensorcarpiradialisbrevis,Flexorcarpiradialis,Fig15.Brachioradialis(anteriorview).,Fig14Brachioradialis(lateralview).,Returntotitlepage,a,25

41、,Deepmusclesintheposteriorcompartment.Titlepage,Thedeepmusclesoftheforearmconsistofthreemusclesthatactonthethumb,theextensorindicisandsupinator.Exceptforthesupinatortheyalloriginatefromonlytheforearmbones.Forfurtherdetailsoneachofthebonesclickontheindividualmuscles.1.Supinator.2.Abductorpollicislong

42、us.3.Extensorpollicislongus.4.Extensorindicis.5.Extensorpollicisbrevis.,1,2,4,3,5,Fig16.Deepmusclesoftheposteriorcompartment.,Returntomainmenu,a,26,Extensorpollicislongusandbrevis,andabductorpollicislongus,AbductorpollicislongusOrigin:-Middleoftheposteriorsurfaceoftheshaftoftheulnaandradius.Insertio

43、n:-Posteriorsurfaceofthebaseofthefirstmetacarpalbone.Nervesupply:-Theposteriorinterosseousnerve,C7andC8.Action:-Abductsandextendsthethumb.ExtensorpollicislongusOrigin:-Fromtheposteriorsurfaceoftheulna.Insertion:-Posteriorsurfaceofthebaseofthedistalphalanxofthethumb.Nervesupply:-Theposteriorinterosse

44、ousnerve,C7andC8.Action:-Extendsthethumb.ExtensorpollicisbrevisOrigin:-Posteriorsurfaceoftheradius.Insertion:-PosteriorsurfaceoftheproximalphalanxofthethumbNervesupply:-Theposteriorinterosseousnerve,C7andC8.Action:-Extendsthethumb.Anatomicalsnuffbox:medialboundaryisthethetendonoftheextensorpollicisl

45、ongusandthelateralboundaryisthetendonoftheabductorpollicislongusandextensorpollicisbrevis.,Abductorpollicislongus.,Extensorpollicislongus,Fig17.Abductorpollicislongus,extensorpollicislongusandbrevis.,Extensorpollicisbrevis,Returntotitlepage,a,27,Supinator,SupinatorThesupinatorconsistsofobliqueandatr

46、ansversehead.Origin:-Obliquehead:Fromthelateralepicondyleofthehumerusandcollateralligamentoftheelbowjoint.Transversehead:Supinatorcrestoftheulna.Insertion:-Bothheadswindlaterallyaroundtheproximalpartoftheradius,attachingtotheanterioraspectoftheradius.Nervesupply:-Posteriorinterosseousnerve,C6andC7.A

47、ction:-Supinatestheforearm(mainlyassistsasthebicepsbrachiiismainsupinatoroftheforearm).,Transversehead,Obliquehead,Fig18.Supinatormuscle(anteriorview).,Returntotitlepage,a,28,Extensorindicis,Origin:-Posteriorsurfaceoftheulna.Insertion:-DorsalexpansionoftheindexfingerNervesupply:-Posteriorinterosseousnerve,C7andC8.Action:-Extendstheindexfinger.,Returntotitlepage,Extensorindicis,Fig19.Extensorpollicis,a,29,Arteriesandnervesintheposterio