Cubital fossa & muscles of forearm

This presentation describes Cubital fossa & muscles of forearm of the upper limb

Transcript

1. Cubital Fossa
2. Cubital fossa Site: Infront elbow joint and upper 1/3 of forearm. Shape: inverted triangular depression.
3. Boundaries
4. Pronator teres Brachio-radialis Imaginary line between 2 epicondyles Apex is the overlap of brachio- radialis m. over pronator teres m. Lateral Medial
5. Roof
6. Medial Lateral Basilic vein &medial cutaneous n of forearm Cephalic vein and lateral cutaneous n. of forearm Median cubital vein Bicipital aponeurosis Epitrochlear lymph nodes
7. Floor
8. Brachialis m. Supinator m. Medial Lateral
9. Contents
10. Tendon of biceps brachii Brachial artery with venae commitants Median nerve Lateral Medial
11. Tendon of biceps brachii m. Radial nerve Superficial radial nerve Deep radial nerve (posterior interosseous nerve) Brachial art. Median nerve Ulnar art. Radial art. Brachio-radialis (Reflected) Medial Lateral
12. Applied Anatomy
13. Measuring blood pressure at lower end of brachial artery Median cubital vein
14. Forearm Is divided into: ➢Anterior (Flexor) compartment. ➢Posterior (Extensor) compartment. By: Radius & ulna. Interosseous membrane. Ulnar aponeurosis.
15. Ulnar aponeurosis Interosseous membrane Shaft of ulna Shaft of radius
16. Muscles of the Anterior Compartment of Forearm
17. Muscles of the Front of the Forearm (8 muscles-Superficial & Deep) ➢2 pronator (teres & quadratus). ➢2 flexor digitorum (superficialis & profundus). ➢2 flexor carpi (radialis & ulnaris). ➢1 flexor pollicis longus. ➢1 Palmaris longus.
18. Arrangement of Muscles of the front of Forearm Superficial Group A- Superficial layer: 1) Pronator teres. 2) Flexor carpi radialis. 3) Palmaris longus. 4) Flexor carpi ulnaris. B- Dee layer: 1) Flexor digitorum superficialis. Deep Group A- Superficial layer: 1) Flexor pollicis longus. 2) Flexor digitorum profundus. B- Deep layer: 1) Pronator quadratus
19. Revision of Skeleton of Forearm & Hand With Related Joints
20. Humerus Radius Ulna Elbow joint Wrist joint
21. Medial supracondylar ridge (pronator teres) Front of medial epicondyle (Common flexor origin) Medial margin of coronoid process (Flexor digitorum superficialis & pronator teres) Common flexor origin Elbow joint Superior radio-ulnar joint
22. Anterior oblique line of radius Coronoid process Olecranon process Superior radio-ulnar joint Anterior surface of shaft of radius Anterior surface of ulna Interosseous membrane
23. Tubercle of scaphoid Crest of trapezium Groove of trapezium Pisiform bone Hook of hamate metacarpal bones Flexor retinaculum Phalanges
24. Joints of the Hand
25. Wrist joint Carpo-metacarpal joint of thumb Metacarpo-phalangeal joint of thumb Interphalangeal joint of thumb Proximal interphalangeal joints Distal interphalangeal joint
26. (A) Superficial Flexor Muscles of Forearm
27. Common rules of superficial flexors ➢Muscles are named after their action. ➢All muscles arises partially or totally from common flexor origin (front of medial epicondyle). ➢All muscles have 2 heads except flexor carpi radialis and palmaris longus. ➢Each 2 headed muscle has a nerve that passes and supplies the muscle. Nerve supply: ➢Median nerve except flexor carpi ulnaris is supplied by ulnar nerve. Common action: ➢All are week flexors of elbow. ➢All are flexors of wrist except pronator teres.
28. Orientation of Muscle Arrangement
29. Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris Flexor digitorum superficialis Flexor retinaculum Palmar aponeurosis Superficial flexor muscles Med. Lat. Medial epicondyle
30. Relations of 8 flexor tendons to flexor retinaculum: ➢Tendons of flexor digitorum (superficialis & profundus) and flexor pollicis longus pass deep to it. ➢Tendon of palmaris longus passes superficial to it. ➢Tendon of flexor carpi radialis passes through a special compartment in the lateral attachment of the retinaculum. ➢Tendon of flexor carpi ulnaris on its medial margin. ➢Tendons of 2 pronator muscles have no relations.
31. 1-Pronator Teres Muscle
32. Superficial head Deep head Insertion of pronator teres Median nerve Attachments and nerve supply of pronator teres m. From lower part of medial supracondylar ridge and front of medial epicondyle (CFO) From medial margin of coronoid process To pronator tuberosity at middle of lateral surface of radius (at maximum convexity of the shaft of radius). Ulnar artery
33. Nerve supply: Median nerve. Action: -Pronation of forearm. -Weak flexion of elbow joint.
34. Pronator teres Supination Pronation
35. 2-Flexor Carpi Radialis
36. Flexor carpi radialis Common flexor origin Insertion to front of bases of 2nd & 3rd metacarpal bones
37. Trapezium Flexor retinaculum Special compartment for tendon of flexor carpi radialis Med. Lat. tendon of flexor carpi radialis with its synovial sheath
38. Groove of trapezium Insertion of tendon of flexor carpi radialis
39. Nerve supply: Median nerve. Action: -Flexion and abduction of hand at wrist joint. -Weak flexion of elbow.
40. 3-Palmaris Longus Muscle
41. Palmaris longus Palmar aponeurosis Common flexor origin
42. Nerve supply: -Median nerve. Action: -Weak flexion of wrist and elbow. -It makes the palmar aponeurosis more tense to protect underlying vessels and nerves.
43. 4-Flexor Carpi Ulnaris Muscle
44. Humeral head Ulnar head Flexor carpi ulnaris m. Origin Pisiform bone Ulnar nerve
45. Tendon of flexor carpi ulnaris Pisiform bone Piso-hammate lig. Piso-metacarpal lig.
46. Nerve supply: -Ulnar nerve. Action: -Flexes and adducts the hand at wrist. -Weak flexion of elbow.
47. 5-Flexor Digitorum Superficialis Muscle
48. Radial head of flexor digitorum superficialis Humero-ulnar head of flexor digitorum superficialis Origin of flexor digitorum superficialis Anterior oblique line
49. Humero-ulnar head Radial head Tendinous arch Flexor retinaculum Insertion of flexor digitorum superficialis Flexor digitorum superficialis Attachments of flexor digitorum superficialis
50. Flexor retinaculum Tendons of flexor digitorum superficialis
51. Tendons of flexor digitorum profundus Tendon of flexor digitorum superficialis muscle
52. Common synovial sheath (Ulnar bursa) Flexor retinaculum Synovial sheath Fibrous flexor sheath
53. Nerve supply: Median nerve. Action: -Flexion of medial 4 fingers at proximal inter- phalangeal joints and metacarpo-phalangeal joints. -Flexion of wrist. -Weak flexion of elbow.
54. Dr. Sherif Fahmy