Fascial Compartments of the Upper Arm

- The upper arm is enclosed in a sheath of deep fascia.

- Two fascial septa: Medial and Lateral side
- the upper arm is divided into an anterior and a posterior fascial compartment, each having its
muscles, nerves, and arteries.
Upper Arm
Anterior Compartment Posterior Compartment
Muscles Biceps brachii, brachialis three heads of the triceps
coracobrachialis, (BBC) muscle
(long head, medial head, short
head)
Blood supply Brachial artery Profunda brachii and ulnar
collateral arteries
Nerve supply to the muscles Musculocutaneous nerve Radial nerve
Structures passing through Musculocutaneous, median, Radial nerve
the compartment and ulnar nerves; brachial Ulnar nerve
artery and basilic vein.
The radial nerve is present in
the lower part of the
compartment.

The cubital fossa is a triangular depression that lies in frontof the elbow, with following
boundaries: laterally: The brachioradialis muscle and medially: The pronator teres muscle

The base of the triangle is formed by an imaginary line drawn between the two epicondyles of
the humerus.
The floor of the fossa is formed by the supinator musclelaterally and the brachialis muscle
medially.
The roof is formed by skin and fascia and is reinforced by the bicipital aponeurosis.

Contents of the cubital fossa contains the following structures:

 the median nerve
 the bifurcation of the brachial artery into the ulnar and radial arteries
 the tendon of the biceps muscle,
 the radial nerve and its deep branch.

supratrochlear lymph node - It receives afferent lymph vessels from the third, fourth, and fifth
fingers; the medial part of the hand; and the medial side of the forearm.

Fascial Compartments of the Forearm

-The forearm is enclosed in a sheath of deep fascia, which is attached to the periosteum of the
posterior subcutaneous border of the ulna
-This fascial sheath, together with the interosseous membrane and fibrous intermuscular septa,
divides the forearm into several compartments, each having its own muscles, nerves, and blood
supply.

Interosseous Membrane
The interosseous membrane is a strong membrane that unites the shafts of the radius and the
ulna;

Flexor and Extensor Retinacula are strong bands of deep fascia that hold the long flexor and
extensor tendons in position at the wrist.

Flexor Retinaculum is a thickening of deep fascia that holds the long flexor tendons in position at
the wrist

Extensor Retinaculum - is a thickening of deep fascia that stretches across the back of the wrist
and holds the long extensor tendons in position

Carpal Tunnel. the bones of the hand and the flexor retinaculum form the carpal tunnel. The
median nerve lies in a restricted space between the tendons of the flexor digitorum superficialis
and the flexor carpi radialis muscles

Forearm
Anterior Fascial Lateral Fascial Posterior Fascial
Compartment Compartment Compartment
Muscles superficial group: Brachioradialis and superficial group:
- pronator teres, the extensor carpi radialis -extensor carpi
flexor carpi radialis longus radialis brevis
- palmaris longus, -extensor digitorum
- flexor carpi ulnaris; -extensor digiti
minimi
intermediate group: -extensor carpi ulnaris
- flexor digitorum -anconeus
superficialis;
deep group
Deep group -supinator
- flexor pollicis -abductor pollicis
longus, longus
- flexor digitorum -extensor pollicis
profundus brevis
- pronator quadratus -extensor pollicis
(ALL FLEXORS) longus
-extensor indicis
(ALL EXTENSORS)
Blood supply Ulnar and radial Radial and brachial Posterior and anterior
arteries arteries interosseous arteries
Nerve supply All the muscles: Radial nerve Deep branch of the
 median nerve and its radial
branches

except:
-flexor carpi ulnaris
and the medial part of
the
- flexor digitorum
profundus, supplied
by the ulnar nerve.

Blood Supply of Upper Limb:

Arteries: 1. Subclavian artery

2. Axillary artery
3. Brachial artery
4. Ulnar Artery

Brachial Artery - it provides the main arterial supply to the arm.

Anterior branches:
o Muscular branches to the anterior compartment of the upper arm
o nutrient artery to the humerus
o profunda artery
o superior ulnar collateral artery
o inferior ulnar collateral artery

Posterior Branches:
o Profunda Brachii Artery
o Superior and Inferior Ulnar Collateral Arteries

Ulnar Artery - is the larger of the two terminal branches of the brachial artery
It ends by forming the superficial palmar arch, often anastomosing with the superficial palmar
branch of the radial artery. with the following branches:
o Muscular branches to neighboring muscles
o Recurrent branches that take part in the arterial anastomosis around the elbow joint
o common interosseous artery, which arises from the upper part of the ulnar artery and
after a brief course divides into the anterior and posterior interosseous arteries. they
provide nutrient arteries to the radius and ulna bone.

Radial Artery - is the smaller of the terminal branches of the brachial arter. with the following
branches:
o Radial recurrent artery
o Muscular branch
o Cutaneous branch
VEINS

The veins of the upper limb can be divided into two groups: superficial and deep.
o The deep veins comprise the venae comitantes, which accompany all the large arteries,
usually in pairs, and the axillary vein.
o The superficial veins of the arm lie in the superficial fascia.

Superficial Veins
o cephalic vein ascends in the superficial fascia on the lateral side of the biceps and, on
reaching the infraclavicular fossa, drains into the axillary vein.
o basilic vein ascends in the superficial fascia on the medial side of the biceps. Halfway up
the arm, it pierces the deep fascia and at the lower border of the teres major joins the
venae comitantes of the brachial artery to form the axillary vein.
o median cubital vein, a branch of the cephalic vein in the cubital fossa, runs upward and
medially and joins the basilic vein.