Gross Anatomy of Arm & Forearm OFR ANA203

Royhaan Folarin
Department of Anatomy,
Olabisi Onabanjo University, Sagamu, Nigeria
royhaan.folarin@oouagoiwoye.edu.ng
ANA203: Gross of Arm & 1
Forearm...Royhaan FOLARIN
Bones of Upper Extremity
 Appendicular Skeleton
 Pectoral Girdle = scapula,clavicle
 Upperlimb
 Arm: humerus
 Forearm: radius, ulna
• Interosseus membrane
 Hand: carpals, metacarpals,
phalanges
 Review Bones + Landmarks
studied in Lab!!
Joints of Upper Extremity
 Sternoclavicular
 Synovial-saddle
 Diarthrosis
 Acromioclavicular
 Synovial-plane
 Diarthrosis
 Glenohumeral joint
 Synovial-ball&socket
 Diarthrosis
 Many ligaments
 Muscle reinforcement
 Great Mobility
Joints of the Upper Extremity
 Elbow Joint
 Synovial – hinge
 Diarthrosis
 Articulations
 Humerus & Ulna
 Humerus & Radius
 Many Ligaments

Joints of Upper Extremity
 Proximal Radioulnar joint

 Synovial - pivot
 Diarthrosis
 Distal Radioulnar joint
 Synovial – pivot
 Diarthrosis
 Allows pronation and
supination of forearm

Review of Naming
What do the following names TELL you about the muscle?
 Naming
 Flexor carpi ulnaris
 Flexor digitorum superficialis
 Flexor pollicis longus
 Pronator quadratus
 Extensor carpi radialis brevis
Know at least 1 action of every muscle

Muscles of Arm: Cross elbow, Move forearm
 2 Compartments
 Anterior: Flexors of forearm
 Posterior: Extensors of forearm
 Anterior Compartment
 Biceps brachii = MC nerve
 Brachialis = MC nerve
 Brachioradialis = Radial nerve
 Coracobrachialis = MC nerve
 O = coracoid process of scapula
 I = medial side humeral shaft
 A = flex, adduct arm
 Posterior Compartment
 Triceps brachii = Radial nerve
 Anconeus = Radial nerve
MC = musculocutaneous nerve
Muscles of forearm: Cross wrist + finger
joints, moves hand
 Cross Wrist = flex, extend, abduct, adduct hand
 Cross Fingers = flex, extend fingers
 Most muscles fleshy proximally, long tendons distally
 Flexor + Extensor Retinacula
 wristbands keep tendons from bowing
 thick, deep fascia
 Anterior Flexor Compartment (Superficial + Deep layers)
 Most flexors have common tendon on medial epicondyle
 Contains 2 pronators
 Innervated by *Median, Ulna nerves
 Posterior Extensor Compartment (Superficial + Deep layers)
 Innervated by Radial nerveForearm...Royhaan
(or branchesFOLARIN
of)
Innervation of Anterior
Compartment-Forearm Muscles
Muscle Nerve
 Superficial Muscles
 Flexor digitorum superficialis Median
 Flexor carpi radialis Median
 Pronator teres Median
 Palmaris longus Median
 Flexor carpi ulnaris Ulnar
 Deep Muscles
 Pronator quadratus Median
 Flexor pollicis longus Median
 Flexor digitorum profundus Ulnar (med 1/2)
Forearm...Royhaan FOLARIN Median (lat 1/2)
Anterior Compartment Forearm
pg 302
Medial Epicondyle
Brachioradialis
Pronator Teres
Flexor Carpi Radialis
Flexor Carpi Ulnaris

Flexor Retinaculum
Flexor Digitorum Superficialis

Anterior View is deep to other flexors
Innervation of Posterior
Compartment-Forearm Muscles
Muscle Nerve
 Superficial
 Extensor carpi radialis longus Radial
 Extensor digitorum Radial
 Extensor carpi ulnaris Radial
 Deep
 Supinator Radial
 Abductor pollicis longus Radial
 Extensor pollicis longus + brevis Radial
 Extensor indicus Forearm...Royhaan
ANA203: Gross of Arm &
FOLARIN Radial 11
Posterior Compartment of Forearm
Lateral Epicondyle
Brachioradialis
Extensor digitorum
Extensor carpi ulnaris Ext Carpi Radialis Longus

Posterior View Forearm...Royhaan FOLARIN
The Cubital Fossa

The Cubital Fossa
 A triangular depression that lies in
front of the elbow
 Boundaries
 Laterally: The brachioradialis
muscle
 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 muscle laterally and the
brachialis muscle medially
 The roof is formed by skin and
fascia and is reinforced by the
bicipital aponeurosis.
Contents
 The cubital fossa contains the following
structures, from the medial to the lateral
side
 the median nerve, the bifurcation of the
brachial artery into the ulnar and radial
arteries, the tendon of the biceps muscle,
and the radial nerve and its deep branch.
 The supratrochlear lymph node lies in the
superficial fascia over the upper part of the
fossa
 receives afferent lymph vessels from the
third, fourth, and fifth fingers; the medial
part of the hand; and the medial side of the
forearm
 The efferent lymph vessels pass up to the
axilla and enter the lateral axillary group of
nodes

The Forearm

Contents of the Anterior Fascial
Compartment of the Forearm
 Muscles: A superficial group,
consisting of the pronator teres, the
flexor carpi radialis, the palmaris
longus, and the flexor carpi ulnaris
 an intermediate group consisting of
the flexor digitorum superficialis
 and a deep group consisting of the
flexor pollicis longus, the flexor
digitorum profundus, and the
pronator quadratus
 Blood supply to the muscles: Ulnar
and radial arteries
 Nerve supply to the muscles: All
the muscles are supplied by the
median nerve and its branches
 except the flexor carpi ulnaris and
the medial part of the flexor
digitorum profundus, which are
supplied by the ulnar nerve ANA203: Gross of Arm & 18
SUPERFICIAL
GROUP
Pronator Teres
 Humeral head: Medial epicondyle
of humerus
 Ulnar head: Medial border of
coronoid process of ulna
 Insertion: Lateral aspect of shaft

of radius
 Nerve Supply: Median nerveC6, 7
 Action: Pronation and flexion of

forearm

Flexor carpi radialis
 Origin : Medial epicondyle
of humerus
 Insertion: Bases of second

and third metacarpal bones
 Nerve supply: Median

nerveC6, 7
 Action: Flexes and abducts

hand at wrist joint

Palmaris longus
 Origin : Medial epicondyle

of humerus
 Insertion: Flexor
retinaculum and palmar
aponeurosis
 Nerve supply: Median

nerveC7, 8
 Action: Flexes hand

Flexor Carpi Ulnaris
 Origin:
 Humeral head: Medial epicondyle

of humerus
 Ulnar head: Medial aspect of
olecranon process and posterior
border of ulna
 Insertion: Pisiform bone, hook of
the hamate, base at fifth metacarpal
bone
 Nerve supply: Ulnar nerveC8; T1
 Action: Flexes and adducts hand at

wrist joint
Flexor Digitorum Superficialis
 Origin :
 Humeroulnar head: Medial
epicondyle of humerus; medial
border of coronoid process of
ulna
 Radial head: Oblique line on
anterior surface of shaft of
radius
 Insertion: Middle phalanx of

medial four fingers
 Nerve supply: Median nerveC7,

8; T1
 Action: Flexes middle phalanx

of fingers and assists in flexing
proximal phalanx and handANA203: Gross of Arm & 24
DEEP GROUP

Flexor pollicis longus
 Origin : Anterior surface
of shaft of radius
 Insertion: Distal phalanx

of thumb
 Nerve supply: Anterior

interosseous branch of
median nerve C8; T1
 Action: Flexes distal

phalanx of thumb
Flexor digitorum profundus
 Origin : Anteromedial surface of
shaft of ulna
 Insertion: Distal phalanges of

medial four fingers
 Nerve supply: Ulnar (medial half)

and median (lateral half) nerves
C8; T1
 Action: Flexes distal phalanx of

fingers; then assists in flexion of
middle and proximal phalanges
and wrist

Pronator quadratus
 Origin : Anterior surface
of shaft of ulna
 Insertion: Anterior surface

of shaft of radius
 Nerve supply: Anterior

interosseous branch of
median nerve C8; T1
 Action: Pronates forearm

Ulnar Artery
 The ulnar artery is the larger of
the two terminal branches of the
brachial artery
 It begins in the cubital fossa at

the level of the neck of the
radius
 descends through the anterior

compartment of the forearm and
enters the palm in front of the
flexor retinaculum in company
with the ulnar nerve
 It ends by forming the

superficial palmar arch, often
anastomosing with the
superficial palmar branch of the
radial artery ANA203: Gross of Arm & 29
Blood Supply: Arteries
 Subclavian (neck)
 Axillary (armpit)
 Subscapular
 Brachial (arm)
 Deep brachial
 Radial (forearm)
 Ulnar (forearm)
 Common Interosseous
 Superficial & Deep
Palmar arches
Pg 536
 Digital
Ulnar Artery
 the ulnar artery lies deep to
most of the flexor muscles
 Below, it becomes superficial

and lies between the tendons
of the flexor carpi ulnaris and
the tendons of the flexor
digitorum superficialis
 In front of the flexor

retinaculum, it lies just lateral
to the pisiform bone and is
covered only by skin and
fascia (site for taking ulnar
pulse).
Branches
 Muscular branches to
neighboring muscles
 Recurrent branches that take

part in the arterial anastomosis
around the elbow joint
 Branches that take part in the

arterial anastomosis around the
wrist joint
 The 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
Radial Artery
 The radial artery is the
smaller of the terminal
branches of the brachial
artery
 It begins in the cubital

fossa at the level of the
neck of the radius
 It passes downward and

laterally, beneath the
brachioradialis muscle and
resting on the deep muscles
of the forearm
 In the middle third of its

course, the superficial
branch of the radial nerve
lies on its lateral side. ANA203: Gross of Arm & 33
Radial Artery
 In the distal part of the
forearm, the radial artery lies
on the anterior surface of the
radius and is covered only by
skin and fascia
 Here, the artery has the tendon

of brachioradialis on its lateral
side and the tendon of flexor
carpi radialis on its medial side
(site for taking the radial
pulse).
 The radial artery leaves the

forearm by winding around the
lateral aspect of the wrist to
reach the posterior surface of
the hand
Branches in the Forearm
 Muscular branches to
neighboring muscles
 Recurrent branch, which

takes part in the arterial
anastomosis around the
elbow joint
 Superficial palmar branch,

which arises just above the
wrist enters the palm of
the hand, and frequently
joins the ulnar artery to
form the superficial
palmar arch
THE VEINS OF THE UPPER
LIMB
There are superficial & deep
veins in the upper limb .
1-the deep veins are the veins
which accompany the main
Aa.
2- The superficial Vv. : start
as superficial venous
network on the back of the
hand. this network drains in 2
directions ;laterally into
Cephalic V & medially ANA203:toGross
theof Arm & 36
basilic V.
THE CEPHALIC VEIN :
It starts in the superficial
fascia just behind the
styloid process of the
radius . Then it runs
upward to the anterior
surface of the forearm ; in
the upper arm it lies in a
groove along the lateral
border of biceps M. then
pierces the deep fascia in a
groove between the deltoid
& pectoralis major Mm. to
inter the axillary vein.
THE VEINS OF THE UPPER LIMB
THE BASILIC VEIN:
It ascends along the postero-medial surface of
the forearm; to go in the ant. surface just below
the Elbow. It pierces the deep fascia in the
middle of the arm .At the edge of the post. fold
of the axilla its joined by the brachial Vv. to
form the Axillary vein.

THE MEDIAN CUBITAL VEIN :
It is the most prominent superficial vein in the
body .
It joins the cephalic & the basilic Vv just distal
to the front of the elbow joint.
These superficial veins are more important than
the deep Vv. Because they are larger in size &
used for intravenous injections.

Median Nerve
 The median nerve leaves the
cubital fossa by passing between
the two heads of the pronator
teres
 It continues downward behind the

flexor digitorum superficialis and
rests posteriorly on the flexor
digitorum profundus
 At the wrist, the median nerve

emerges from the lateral border of
the flexor digitorum superficialis
muscle and lies behind the tendon
of the palmaris longus
 It enters the palm by passing

behind the flexor retinaculum
Branches
 Muscular branches in the
cubital fossa to the pronator
teres, the flexor carpi radialis,
the palmaris longus, and the
flexor digitorum superficialis
 Articular branches to the

elbow joint
 Anterior interosseous nerve
 Palmar cutaneous branch.

This arises in the lower part of
the forearm and is distributed
to the skin over the lateral part
of the palm
Ulnar Nerve
 passes from behind the medial epicondyle of the
humerus, crosses the medial ligament of the elbow
joint, and enters the front of the forearm by passing
between the two heads of the flexor carpi ulnaris
 runs down the forearm between the flexor carpi ulnaris

and the flexor digitorum profundus muscles. In the
distal two thirds of the forearm, the ulnar artery lies on
the lateral side of the ulnar nerve
 At the wrist, the ulnar nerve becomes superficial and

lies between the tendons of the flexor carpi ulnaris and
flexor digitorum superficialis muscles
 The ulnar nerve enters the palm of the hand by passing

in front of the flexor retinaculum and lateral to the
pisiform bone; here it has the ulnar artery lateral to it
Branches
 Muscular branches to the flexor carpi
ulnaris and to the medial half of the
flexor digitorum profundus
 Articular branches to the elbow joint
 The palmar cutaneous branch is a

small branch that arises in the middle
of the forearm
 The dorsal posterior cutaneous

branch is distributed on the posterior
surface of the hand and fingers

Flexor Retinaculum
 A thickening of deep fascia that holds the long
flexor tendons in position at the wrist
 It stretches across the front of the wrist and

converts into an osteofascial tunnel, the carpal
tunnel, for the passage of the median nerve and
the flexor tendons of the thumb and fingers
 It is attached medially to the pisiform bone and

the hook of the hamate and laterally to the
tubercle of the scaphoid and the trapezium
bones
 The upper border of the retinaculum

corresponds to the distal transverse skin crease
in front of the wrist and is continuous with the
deep fascia of the forearm.
 The lower border is attached to the palmar
aponeurosis

Surface Anatomy of Upper Limb
 Biceps + Triceps brachii
 Olecrenon Process
 Medial Epicondyle
 Cubital Fossa
 Anterior surface elbow
 Contents
• Median Cubital Vein
• Brachial Artery
• Median Nerve
 Boundaries
• Medial= Pronator teres
• Lateral= Brachioradialis
• Superior= Line between epicondyles
ANA203: Gross of Arm & pg 748 46
Surface Anatomy  Carpal Tunnel
Carpals concave anteriorly
of Upper Limb

 Carpal ligament covers it

 Contains: long tendons,
Median nerve
 Inflammation of tendons =
compression of Median
nerve
 Anatomical Snuffbox
 Lateral = E. pollicis brevis
 Medial = E. pollicis longus
 Floor = scaphoid, styloid of
radius
 Contains Radial Artery
pg 749 (pulse)
Surface Anatomy of Arm
 Biceps brachii
 Triceps brachii
 Olecrenon Process
 Medial Epicondyle
 Lateral Epicondyle

Surface Anatomy of
Elbow
 Cephalic vein
 Cubital Fossa
 Anterior surface elbow
 Contents
• Median Cubital Vein
• Brachial Artery
• Median Nerve
 Boundaries
• Medial= Pronator teres
• Lateral= Brachioradialis
• Superior= Line between epicondyles

ANA203: Gross of Arm &
Forearm...Royhaan FOLARIN 50

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Royhaan Folarin

ANA203: Gross of Arm & 4

 Proximal Radioulnar joint

ANA203: Gross of Arm & 5

Know at least 1 action of every muscle

ANA203: Gross of Arm & 6

Flexor Carpi Ulnaris

Flexor Digitorum Superficialis

ANA203: Gross of Arm & 12

ANA203: Gross of Arm & 13

ANA203: Gross of Arm & 15

ANA203: Gross of Arm & 17

 Insertion: Lateral aspect of shaft

 Nerve Supply: Median nerveC6, 7

 Action: Pronation and flexion of

ANA203: Gross of Arm & 20

 Insertion: Bases of second

 Nerve supply: Median

 Action: Flexes and abducts

ANA203: Gross of Arm & 21

 Origin : Medial epicondyle

 Nerve supply: Median

 Action: Flexes hand

 Humeral head: Medial epicondyle

 Nerve supply: Ulnar nerveC8; T1

 Action: Flexes and adducts hand at

 Insertion: Middle phalanx of

 Nerve supply: Median nerveC7,

 Action: Flexes middle phalanx

ANA203: Gross of Arm & 25

 Insertion: Distal phalanx

 Nerve supply: Anterior

 Action: Flexes distal

 Insertion: Distal phalanges of

 Nerve supply: Ulnar (medial half)

 Action: Flexes distal phalanx of

ANA203: Gross of Arm & 27

 Insertion: Anterior surface

 Nerve supply: Anterior

 Action: Pronates forearm

 It begins in the cubital fossa at

 descends through the anterior

 It ends by forming the

 Below, it becomes superficial

 In front of the flexor

 Recurrent branches that take

 Branches that take part in the

 The common interosseous

 It begins in the cubital

 It passes downward and

 In the middle third of its

 Here, the artery has the tendon

 The radial artery leaves the

 Recurrent branch, which

 Superficial palmar branch,

ANA203: Gross of Arm & 38

ANA203: Gross of Arm & 39

 It continues downward behind the

 At the wrist, the median nerve

 It enters the palm by passing

 Articular branches to the

 Anterior interosseous nerve

 Palmar cutaneous branch.

 runs down the forearm between the flexor carpi ulnaris

Gross Anatomy of Arm & Forearm OFR ANA203

Gross Anatomy of Arm & Forearm OFR ANA203