Flexor Region of the Forearm

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Contents
Bones of the forearm. Superficial muscles of the anterior compartment. Deep muscles of the anterior compartment.

Arteries and nerves of the anterior compartment.

Bones of the forearm

The radius proximally articulates with the humerus at the elbow joint. Distally it articulates with the scaphoid and lunate bones of the carpus, and with the ulna at the distal radioulnar joint.
The ulna is the more medial of the two bones. Its proximal end articulates with the humerus at the elbow joint. Distally it articulates with the radius. It is excluded from the wrist joint by the articular disc. The interosseous membrane bind the radius and the ulna together.

Humerus Head Tuberosity of radius

Interosseous membrane Radius

Ulna

Head

Fig 1. Anterior view of bones of the forearm.

 The radius is situated on the lateral side of the ulna, which exceeds it in length and size. Its upper end is small, and forms only a small part of the elbow-joint; but its lower end is large, and forms the chief part of the wrist-joint. It is a long bone, prismatic in form and slightly curved longitudinally. It has a body and two extremities.

Radius

Ulna
The ulna is placed at the medial side of the forearm, parallel with the radius. Its upper extremity, of great thickness and strength, forms a large part of the elbow-joint The bone diminishes in size from above downward, its lower extremity being very small, and excluded from the wrist-joint by the interposition of an articular disk. It is a long bone, prismatic in form. It is divisible into a body and two extremities.
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Superficial muscles of the anterior compartment.

1
2
Brachioradialis

The superficial muscles of the anterior compartment include pronator teres, flexor carpi radialis, palmaris longus, and flexor carpi ulnaris. Also included in this group is flexor digitorum superficialis. The superficial group of muscles all have the same origin, which is attached to the medial epicondyle of the humerus.

Muscles:
1. 4 2. Pronator teres Flexor carpi radialis

3.
4.

Flexor carpi ulnaris

Flexor digitorum superficialis

Palmaris longus (not included in the diagram).

Fig 2. Showing superficial muscles of the posterior compartment.

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Pronator Teres
The pronator teres has two heads, the humeral head and the ulnar head. The median nerve enters the forearm between the two heads. Origin :Humeral head- Medial epicondyle of the humerus. Ulnar head- Medial border of the coronoid process of the ulna. Insertion :Lateral aspect of the shaft of the radius. Nerve supply :- Median nerve, C6 and C7. Action :- Pronation of the forearm. Flexion of the forearm.
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Pronator teres

Radius

Fig 3. Pronator teres.

Flexor carpi radialis, palmaris longus, and flexor carpi ulnaris

Flexor carpi ulnaris. Palmaris longus Flexor Origin:carpi radialis Origin:- MedialMedial Origin:- Medial Humeral head-epicondyle epicondylehumerus. humerus. of the of the humerus. epicondyle of the Ulnar head- Medial aspect Insertion:- Base ofFlexor of Insertion:- the the olecranon process of the ulna. second and third metacarpal retinaculum and palmar Insertion:- Pisiform bone, bones. hamate, and base of the hook of the aponeurosis. Nerve supply:fifth metacarpal bone. Median Nerve C7. nerve, C6 andsupply:Nerve supply:- The ulnar nerve, C7, C8, Flexes the hand at Median nerve, C7 and C8 Action:- and T1. Action:- Flexes the hand at the wrist joint. Flexes the Action:wrist joint. hand at wristAbductsthe hand at joint. Adducts the hand wrist jointat the wrist joint.
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Palmaris longus Pronator teres

Flexor carpi ulnaris

Flexor carpi radialis

Fig 4. Flexor carpi radialis and ulnaris and palmaris longus

Flexor digitorum superficialis.

Origin:Humeroulnar head: Medial epicondyle of the humerus and the medial margin of the coronoid process of the ulna. Radial head: Rising from the oblique line on the anterior surface of the shaft of the radius.
Flexor digitorum superficialis.

Insertion:- The muscle belly gives rise to four tendons distally. Each of the tendon attaches to the sides of the middle phalanx of the four medial finger.
Nerve supply:- Median nerve, C8 and T1. Action:- Flexes the middle phalanx of fingers. Flexes the proximal phalanx of fingers (weak). Flexes the wrist.
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Fig 5. Flexor digitorum superficialis.

Deep Muscles of the anterior compartment.

Brachioradialis (cut)

1
2 1 Tendon of carpi flexor radialis (cut)

The deep muscles of the forearm comprise of the flexor pollicis longus, flexor digitorum profundus and pronator quadratus.

1. Flexor digitorum profundus. 2. Flexor pollicis longus. Pronator quadratus not shown.

Fig 6. Deep muscles of the anterior compartment.

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Flexor digitorum profundus and flexor pollicis longus

Flexor digitorum profundus
Origin:-pollicis three-quarters of the Flexor Upper longus anteriomedial shaft of the ulna. Origin:- Middle of the anterior Insertion:- The muscle of the radius surface of the shaft divides into fourand fromjust prior to traversing tendons the adjoining part of the carpal tunnel. They attach to the the interosseous membrane. distal phalanx of the fourpasses Insertion:- The tendon fingers. Nerve supply:- The the carpal is distally through medial part supplied by theattaches to the distal tunnel and ulnar nerve, the lateral portion is supplied by the phalanx of the thumb. anteriorsupply:- The branch of the Nerve interosseous anterior median nerve, C8 and T1. the interosseous branch of Action:- Flexes the finger. median nerve. Exclusive Flexes of the distal of Action:- flexor the phalanges phalanx. Weak flexor of the wrist. the thumb.
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Flexor pollicis longus Pronator quadratus

Flexor digitorum profundus

Fig 7. Flexor digitorum profundus and flexor pollicis longus.

Pronator Quadratus
Flexor pollicis longus Flexor digitorum profundus

Origin:- Lower quarter of the anterior surface of the shaft of the ulna. Insertion:- Lower quarter of the anterior surface of the shaft of the radius. Nerve supply:- The anterior interosseous branch of the median nerve. Action:- Pronates the forearm.
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Pronator quadratus

Flexor carpi radialis (cut) Flexor carpi ulnaris (cut)

Fig 8. Pronator quadratus.

Arteries and Nerves of the anterior compartment.

Ulnar Nerve
Brachial artery

Median nerve

Ulnar nerve Radial nerve Ulnar artery

Ulnar artery:- Larger than the radial artery. It passes The ulnar nerve passes behind between the arch formed the medial epicondyle and by the radial and ulnar enters the forearmthe flexor the attachment of between two heads of flexor carpi and digitorum superficialis descends through the anterior ulnaris. It descends between the compartment. It enters the flexor carpi ulnaris and the palm of the hand in front of flexor digitorum profundus. The the flexor retinaculum, and ulnarpromptly divides in nerve becomes superficial superficial and entering the at the wrist, before deep palmer palmbranches. of the flexor in front

retinaculum
Fig 9. Arteries and nerves of the anterior compartment.

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Arteries and Nerves of the anterior compartment.

Radial nerve

Brachial artery Median nerve Ulnar nerve Ulnar artery

Radial artery:- It Median Nerve begins in the

cubital fossa when the brachial artery divides into the radial the The median nerve leavesand ulna passes distally, cubitalartery. Itthe between the fossa in brachioradialis, travels under two heads of the pronator resting on the deep flexor muscles. The artery briefly travels on the teres. It descends between thelateral side of the radius, before superficial and deep travelling over the anterior surface flexor muscles. At the wrist of the radius. The artery then winds around the lateral aspect of the it lies superficially, before wrist, before entering the palm of entering theform thebehind the palm deep palmer the hand to flexor retinaculum. arch.

Superficial radial nerve

Radial artery

Median nerve

Fig 10. Arteries and nerves of the anterior compartment.