GROSS ANATOMY OF THE

FOREARM

A CAL package
designed by-
Pratik Sinha

Revision Guide for second year

Medical Students

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Bones of the forearm.

Superficial muscles of the anterior compartment.

Deep muscles of the anterior compartment.

Arteries and nerves of the anterior compartment.

Superficial muscles of the posterior compartment.

Deep muscles of the posterior compartment.

Arteries and nerves of the posterior compartment.

Acknowledgements
 Acknowledgements
• Supervision
Dr John Humpherson
• Anatomy Dissection Pictures
Gosling , Harris, Humpherson, Whitmore, Willan
Atlas of Human Anatomy, Gower Publishing, 1985
• Anatomy Drawings
Richard Neave & Medical Illustration
• Technical Help
Tony Bentley, Mike Mahon

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 Bones of the forearm

The radius proximally articulates with the

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

Fig 1. Anterior view of bones of the forearm. Return to main menu

 Superficial muscles of the anterior
compartment. Title page.
The superficial muscles of the anterior
1 compartment include pronator teres,
flexor carpi radialis, palmaris longus, and
2 flexor carpi ulnaris. Also included in this
group is flexor digitorum superficialis. The
Brachio- superficial group of muscles all have the
radialis 3 same origin, which is attached to the
medial epicondyle of the humerus.

FOR FURTHER DETAILS CLICK ON EACH INDIVIDUAL

MUSCLE BELOW.

1. Pronator teres
4
2. Flexor carpi radialis
3. Flexor carpi ulnaris
4. Flexor digitorum superficialis
Palmaris longus (not included in the diagram).

Fig 2. Showing superficial muscles of the Return to main menu

posterior compartment.
 Pronator Teres

The pronator teres has two heads, the humeral

head and the ulnar head. The median
Pronator nerve enters the forearm between the two
teres heads.
Origin :-
Humeral head- Medial epicondyle of the
humerus.
Ulnar head- Medial border of the
coronoid process of the ulna.
Radius
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.

Fig 3. Pronator teres.

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 Flexor carpi radialis, palmaris longus, and flexor
carpi ulnaris
Flexor carpi radialis
Origin:- Medial epicondyle of the humerus.
Insertion:- Base of the second and third metacarpal
bones.
Nerve supply:- Median nerve, C6 and C7.
Palmaris Action:- Flexes the hand at the wrist joint.
longus Abducts the hand at the wrist joint.
Pronator
teres Palmaris longus
Flexor Origin:- Medial epicondyle of the humerus.
carpi Insertion:- Flexor retinaculum and palmar aponeurosis.
ulnaris Nerve supply:- Median nerve, C7 and C8
Flexor Action:- Flexes the hand at wrist joint.
carpi
radialis Flexor carpi ulnaris.
Origin:-
Humeral head- Medial epicondyle of the humerus.
Ulnar head- Medial aspect of the olecranon process of the
ulna and the posterior border of the ulna.
Insertion:- Pisiform bone, hook of the hamate, and base
of the fifth metacarpal bone.
Nerve supply:- The ulnar nerve, C7, C8, and T1.
Action:- Flexes the hand at wrist joint.
Fig 4. Flexor carpi radialis and ulnaris and palmaris longus Adducts the hand at wrist joint

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 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 Insertion:- The muscle belly gives rise to four tendons
superficialis. 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.

Fig 5. Flexor digitorum superficialis.

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 Deep Muscles of the anterior compartment.
Title page
Brachio-
radialis
(cut) The deep muscles of the forearm comprise
of the flexor pollicis longus, flexor
digitorum profundus and pronator
quadratus.
1
2 1
For further details click on each of the individual
muscles.

Tendon of 1. Flexor digitorum profundus.

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

Fig 7. Flexor digitorum profundus and flexor

pollicis longus.
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Flexor
Pronator Quadratus
pollicis
longus Flexor digitorum
profundus Origin:- Lower quarter of the
anterior surface of the shaft of
the ulna.
Pronator
quadratus
Insertion:- Lower quarter of the
anterior surface of the shaft of
Flexor
carpi
the radius.
radialis
(cut)
Nerve supply:- The anterior
Flexor interosseous branch of the
carpi median nerve.
ulnaris
(cut)
Action:- Pronates the forearm.

Fig 8. Pronator quadratus.

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to title page
 Arteries and Nerves of the anterior compartment.
Title page
Ulnar artery:- Larger than the radial artery. It passes
between the arch formed by the radial and ulnar
attachment of the flexor digitorum superficialis
and descends through the anterior compartment. It
enters the palm of the hand in front of the flexor
retinaculum, and promptly divides in superficial
and deep palmer branches.
Branches-
Brachial
Muscular branches- to the muscles of the anterior
artery
Median compartment.
nerve Recurrent branches- to the anastomosis around the wrist
joint
Branches to the anastomosis around the wrist joint
Common interosseous artery- arises in the upper part of
the ulnar artery and then divides in the anterior and
Ulnar posterior interosseous arteries.
nerve
Radial Anterior interosseous artery:- arises from the common
nerve interosseous artery and descends in the anterior
compartment to eventually join the anastomosis
around the wrist joint. It supplies the deep flexor
Ulnar
muscles, and gives off nutrient branches to the the
artery radius and ulna.

Fig 9. Arteries and nerves of the

anterior compartment.
Return to nerves Next
 Arteries and Nerves of the anterior compartment.

Radial Brachial Posterior interosseous artery- arises from the

nerve artery common interosseous artery and and enters the
posterior compartment.
Median
Superficial nerve Radial artery:- It begins in the cubital fossa when the
radial nerve brachial artery divides into the radial and ulna artery.
Ulnar It passes distally, travels under the brachioradialis,
nerve resting on the deep flexor muscles. The artery briefly
travels on the lateral side of the radius, before
Ulnar travelling over the anterior surface of the radius. The
artery artery then winds around the lateral aspect of the
Radial wrist, before entering the palm of the hand to form
artery Median
the deep palmer arch.
nerve
Branches-
Muscular branches: to the neighbouring muscles.
Branches to the anastomosis around the wrist and elbow
joint.
Superficial palmer joint: arises just above the wrist,
frequently joins the ulnar artery to give rise to the
superficial palmer arch.

Fig 10. Arteries and nerves of the

anterior compartment. Return to nerves Next
 Nerves of the anterior compartment
Median Nerve (fig 9, fig 10)
The median nerve leaves the cubital fossa in between the two heads of the pronator teres. It descends between the superficial and
deep flexor muscles. At the wrist it lies superficially, before entering the palm behind the flexor retinaculum.
Branches:-
Muscular branch:- all the superficial muscles of the anterior compartment except flexor carpi ulnaris.
Articular branches: to the elbow joint
Anterior interosseous nerve: arises from the median nerve as it emerges from the two heads of the pronator teres. (see below)
Palmer cutaneous Branch: Distributed to the skin over the lateral part of the palm.
Anterior interosseous nerve
It arises from the median nerve (see above) and then descends down the anterior surface of the interosseous membrane.
Branches-
Muscular branches: all the muscles of deep flexion in the anterior compartment except the medial part of digitorum profundus.
Articular branches: to the wrist joint, the distal radioulnar joint, and the joints of the carpus.
Ulnar Nerve(fig9, fig 10)
The ulnar nerve passes behind the medial epicondyle and enters the forearm between the two heads of flexor carpi ulnaris. It
descends between the flexor carpi ulnaris and the flexor digitorum profundus. The ulnar nerve becomes superficial at the wrist,
before entering the palm in front of the flexor retinaculum.
Branches-
Muscular branches: to the flexor carpi ulnaris and to the medial half of the flexor digitorum profundus.
Articular branches: to the elbow joint.
Palmar cutaneous branch: arises in the middle of the forearm, Supplies skin over the thenar eminence.
Dorsal cutaneous branch: arises in the distal third of the of the forearm, and passes medially to the dorsum of the hand.

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 Superficial muscles of the posterior compartment.
Title page
The superficial muscles of the anterior compartment are mainly
concerned with the extension at wrist joint and of the digit. The
muscles in this group comprise of the Extensor carpi radialis brevis,
extensor digitorum, extensor digiti minimi, extensor carpi ulnaris,
Anconeus
and the two more lateral lying brachioradialis and extensor carpi
radialis longus.
3 NB- The anconeus also lies in the posterior compartment but is functionally
2 1
very different to the rest of the muscles in this group. Its action are
to aid the triceps in extension at the elbow joint.
2

Click below on each of the muscles for further detail

about each of the individual muscles.
1. Extensor carpi radialis longus
2. Extensor digitorum
3. Extensor carpi ulnaris
4. Extensor digiti minimi
4
Brachioradialis and extensor carpi brevis are not
included in the figure.

Fig 11. Superficial muscles of the posterior

compartment. Return to main menu
 Extensor carpi radialis longus and brevis, and
extensor carpi ulnaris
Extensor carpi radialis longus
Origin:- From the lower third of the lateral supracondylar ridge of the
humerus.
Insertion:- Posterior surface of the base of the second metacarpal
bone.
Extensor carpi Nerve supply:- Radial nerve, C6 and C7.
radialis longus Action:- Extends and abducts the hand at the wrist joint.
Extensor carpi
radialis brevis Extensor carpi radialis brevis
Origin:- From the common tendon attached to the lateral epicondyle
Extensor of the humerus.
carpi ulnaris Insertion:- Posterior surface of the base of the third metacarpal bone.
Nerve supply:- Posterior interosseous nerve, C7 and C8.
Action:- Extends and abducts the hand at the wrist joint.

Extensor carpi ulnaris

Fig 12. Extensor carpi radialis brevis and
longus and extensor carpi ulnaris.
Origin:- From the common tendon attached to the lateral epicondyle
of the humerus.
Insertion:- Posterior surface of the base of the fifth metacarpal bone.
Nerve supply:- Posterior interosseous nerve, C7 and C8
Action:- Extends and adducts the hand at wrist joint.
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 Extensor digitorum and extensor digiti minimi
Extensor digitorum
Origin:- From the common tendon attached to the lateral
epicondyle of the humerus.
Insertion:- The muscle divides into four tendons which pass to
the fingers and form the dorsal expansion. On the dorsum
of the hand these are interconnected by fibrous tissue.
Near the proximal interphalangeal joint of each finger the
expansions divide into the central part, which inserts into
base of the middle phalanx, and the two lateral parts,
which insert into the base of the distal phalanx.
Extensor Nerve supply:- Posterior interosseous nerve, C7 and C8
digitorum
Action:- Mainly it extends the metacarpophalangeal joint, but it
also assists in extending the proximal and distal
interphalangeal joint and the arm.
Extensor
digiti Extensor digiti minimi
minimi Origin:- From the common tendon attached to the lateral
epicondyle of the humerus.
Insertion:- Via two tendons to the dorsal expansion for the little
finger.
Nerve supply:- Posterior interosseous nerve, C7 and C8
Action:- Assists in the extension of the little finger.

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Fig 13. Extensor digitorum and extensor
digiti minimi.
 Brachioradialis

Flexor carpi
radialis Origin:- From the upper twp thirds of
the lateral supracondylar ridge of the
humerus.
Brachio-
radialis
Insertion:- Base of the styloid process
of the radius.

Extensor carpi
Nerve supply:- Radial nerve, C5 and
radialis longus
C6.
Extensor carpi
radialis brevis Action:- It flexes the forearm (despite
being being served by an ‘extensor’
nerve), assists in rotating or
restoring the arm into midprone
position, depending on the initial
position.
Fig 15. Brachioradialis (anterior
Fig 14 Brachioradialis (lateral view).
view). Return to title page
Deep muscles in the posterior compartment. Title
page
1 The deep muscles of the fore arm consist of
three muscles that act on the thumb, the
extensor indicis and supinator. Except for
2 the supinator they all originate from only
the forearm bones.

3
4
5
For further details on each of the bones click on
the individual muscles.

1. Supinator.
2. Abductor pollicis longus.
3. Extensor pollicis longus.
4. Extensor indicis.
5. Extensor pollicis brevis.
Fig 16. Deep muscles of the posterior compartment.
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 Extensor pollicis longus and brevis, and abductor
pollicis longus
Abductor pollicis longus
Origin:- Middle of the posterior surface of the shaft of the ulna and
radius.
Insertion:- Posterior surface of the base of the first metacarpal bone.
Nerve supply:- The posterior interosseous nerve, C7 and C8.
Action:- Abducts and extends the thumb.

Extensor pollicis longus

Origin:- From the posterior surface of the ulna.
Insertion:- Posterior surface of the base of the distal phalanx of the
thumb.
Abductor pollicis
longus. Nerve supply:- The posterior interosseous nerve, C7 and C8.
Action:- Extends the thumb.

Extensor
Extensor pollicis brevis
pollicis longus
Origin:- Posterior surface of the radius.
Insertion:- Posterior surface of the proximal phalanx of the thumb
Extensor pollicis Nerve supply:- The posterior interosseous nerve, C7 and C8.
brevis Action:- Extends the thumb.

Anatomical snuff box: medial boundary is the the tendon of the

extensor pollicis longus and the lateral boundary is the tendon of
the abductor pollicis longus and extensor pollicis brevis.
Fig 17. Abductor pollicis longus, extensor
pollicis longus and brevis.
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 Supinator
Supinator
The supinator consists of oblique and a
transverse head.

Origin:-
Oblique head: From the lateral epicondyle
of the humerus and collateral
ligament of the elbow joint.
Transverse head: Supinator crest of the
ulna.

Ins ertion:- Both heads wind laterally

around the proximal part of the
Transverse head radius, attaching to the anterior
aspect of the radius.
Nerv e s upply:- Posterior interosseous
nerve, C6 and C7.

Oblique head Action:- Supinates the forearm (mainly

assists as the biceps brachii is main
supinator of the forearm).

Fig 18. Supinator muscle

(anterior view). Return to title page
 Extensor indicis

Origin:- Posterior surface of

the ulna.

Insertion:- Dorsal expansion of

the index finger

Nerve supply:- Posterior

Extensor indicis interosseous nerve, C7 and
C8.

Action:- Extends the index

finger.

Fig 19. Extensor Return to title page

pollicis
 Arteries and nerves in the posterior
compartment. Title page
Arteries
Posterior interosseous artery:-
As discussed previously, in the cubital fossa,
the common interosseous artery divides in the
anterior and posterior interosseous muscle.
The posterior interosseous artery lies between
the superficial and deep extensor muscles. It
terminates by anastomosing with the anterior
Oblique head interosseous muscle and taking part in the
Posterior anastomosis around the wrist joint.
of supinator (cut)
interosseous Branches:
nerve Muscular branch- to the neighbouring muscles.
Recurrent branch- takes part in the anastomosis
Posterior around the wrist joint.
interosseous Extensor carpi
artery Anterior interosseous artery (discussed
radialis brevis earlier):-
Enters the posterior compartment in the distal
Extensor third of the forearm. Supplies branches to
neighbouring muscles.
carpi ulnaris
Radial artery (discussed earlier)
Has branches that supply the muscles in the
lateral aspect of compartment.

Fig 19. Posterior interosseous

artery and nerve.
Next
 Arteries and nerves in the posterior
compartment
Nerves
The posterior compartment of the arm is
supplied by branches of the radial nerve.
Posterior interosseous nerve (Deep
branch):
It arises from the radial nerve just in front of
the lateral epicondyle of the humerus. It
enters the posterior compartment in
between the two heads of the supinator.
Posteror
Branches:
Posteror interosseous
Muscular branches: To most of the muscles of
interosseous nerve the posterior compartment (see individual
artery muscles for detail).
Articular branches: To the elbow, wrist and
carpal joints.

Radial nerve:
Branches:
Muscular branches: supply the brachioradialis
and the extensor carpi radialis longus.

Articular branches: To the elbow joint.

Fig 20. Posteror interosseous

artery and nerve
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