Cubital Fossa, deep flexor muscles, median nerve & carpal tunnel

This presentation shows Cubital Fossa, deep flexor muscles, median nerve & carpal tunnel

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. Deep Muscles of Flexor (Anterior) Compartment of Forearm
15. 1- Flexor digitorum profundus. 2- Flexor pollicis longus. 3- Pronator quadratus.
16. Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris Flexor digitorum superficialis (cut) Flexor digitorum profundus Flexor pollicis longus Pronator quadratus Flexor retinaculum Lumbricals Deep muscles of forearm Lateral Medial
17. Flexor digitorum profundus Flexor pollicis longus Pronator quadratus Origin of flexor digitorum profundus Ulnar aponeurosis Origin of pronator quadratus Origin of flexor pollicis longus m. Insertion of pronator quadratus m. Interosseous membrane
18. Flexor Digitorum Profundus
19. Interosseous membrane Flexor digitorum profundus from upper ¾ of anterior and medial surfaces of ulna (main origin) Flexor retinaculum Ulnar aponeurosis
20. Common synovial sheath (ulnar bursa) Flexor retinaculum Synovial sheath Fibrous flexor sheath
21. Tendons of flexor digitorum profundus Tendons of flexor digitorum superficialis Lumbricals
22. Action of flexor digitorum profundus • Flexes all joints of the medial four fingers. • Flexes the wrist. Nerve supply -Medial ½ from ulnar nerve. -Lateral ½ from anterior interosseous nerve (branch from median)
23. Flexor Pollicis Longus
24. Interosseous membrane Flexor retinaculum Flexor pollicis longus Tendon of flexor pollicis longus Upper 2/3 of anterior surface of radius Insertion to palmar aspect of distal phalanx of thumb
25. Tendon of flexor carpi radialis Flexor retinaculum Tendon of flexor pollicis longus Tendons of flexor digitorum superficialis Tendons of flexor digitorum profundus
26. Action of flexor pollicis longus • Flexes all joints of the thumb. • Assists in flexion of the wrist. Nerve supply -Anterior interosseous nerve (branch from median)
27. Pronator Quadratus Muscle
28. Pronator Quadratus M. Origin: from oblique ridge on the lower ¼ of anterior surface of the shaft of ulna Insertion: into lower ¼ of anterior and medial surfaces of radius
29. Pronator quadratus m.
30. Action of pronator quadratus Pronation of forearm on radioulnar joints. Nerve supply -Anterior interosseous nerve (branch from median)
31. Median Nerve (C5,6,7,8,T1)
32. Course & Relations of Median Nerve
33. Brachial artery Median nerve Median nerve in cubital fossa Bicipital aponeurosis Medial root from medial cord Lateral root from lateral cord 3rd part of axillary artery Median nerve crosses brachial artery at level of insertion of coraco- brachialis m. Lateral Medial
34. Median nerve Humero-ulnar head of flexor digitorum superficialis Radial head of flexor digitorum superficialis Superficial head of pronator teres m. Median nerve Deep head of pronator teres m. Flexor retinaculum Lateral Medial
35. Median nerve Flexor retinaculum Lateral division Medial division
36. Branches of Median N. At cubital fossa: -To pronator teres, flexor carpi radialis, palmaris longus and flexor digitorum superficialis. Between 2 heads of pronator teres m.: Anterior interosseous branch which supplies flexor pollicis longus, pronator quadratus and lateral ½ of flexor digitorum profundus.
37. One inch Proximal to flexor retinaculum: -Palmar cutaneous branch. In the palm: ➢Gives muscular branches to thenar and 1st two lumbricals. ➢Cutaneous to palmar surfaces of lateral three and half fingers and their distal dorsal parts.
38. Median nerve Anterior interosseous br.
40. Median nerve Palmar cutaneous branch of median nerve Flexor retinaculum Lateral division Medial division Recurrent branch
41. Median nerve Palmar cutaneous branch of median nerve Flexor retinaculum Lateral division of median nerve Recurrent branch Medial division
42. Carpal Tunnel
43. Boundaries of carpal tunnle Carpal bones Flexor retinaculum Carpal tunnle
44. Contents of carpal tunnle Tendons of flexor digitorum superficialis Tendons of flexor digitorum profundus Tendon of flexor pollicis longus Median n. Dr. Sherif Fahmy
45. Common synovial sheath (ulnar bursa) Synovial sheath around flexor pollicis longus tendon (radial bursa)
46. Common synovial sheath around tendons of flexor digitorum muscles Contents of carpal tunnle Tendon of flexor pollicis longus with its synovial sheath (radial bursa) Median nerve