Upper Limb Muscles II

Innervation, Blood Supply

Miloš Grim/Petr Valášek

Institute of Anatomy, First Faculty of Medicine,

Charles University

winter semester 2017/2018

 Muscle
compartments
on the upper limb

Stingl, Grim, Druga:

Regional Anatomy,
Prague, 2012
Cross section of forearm, MRI
Muscles of forearm
 Cross section of forearm

Anterior (flexor) compartment of forearm – superficial and

deep part. Posterior (extensor) compartment - radial part
Anterior muscles of the forearm

1st layer (common head):

Pronator teres
Flexor carpi radialis
Palmaris longus,
Flexor carpi ulnaris
2nd layer:
Flexor digitorum superficialis
3rd layer:
Flexor pollicis longus
Flexor digitorum profundus
4th layer:
Pronator quadratus
Anterior muscles of the forearm

1st layer:
(common
head)

PT,
FCR
PL,
FCU
Anterior muscles of the forearm

2nd
layer: 3rd layer:
FDS FPL,
FDP
Anterior muscles of the forearm

3rd layer:
FPL,
FDP

4th layer:
PQ
chiasma tendinum
Fibrous and synovial sheath of fingers
Radial artery
Ulnar artery
Interosseal artery
Deep palmar arch
Superficial palmar arch
Palmar digital arteries
 Veins of upper limb
VS – subclavian vein
VA – axillary vein
VBR – brachial veins

VC – cephalic vein
VB – basilic vein
VMC – median cubital vein
VMA – median antebrachial vein
VCA – cephalic antebrachial vein
VBA – basilic antebrachial vein
RVD – dorsal venous network

Grim M, Druga R et al.: Základy anatomie II. Kardiovaskulární systém, Galén, Praha 2015
(v tisku)
Subcutaneous
veins:
cephalic,
basilic
Carpal tunnel, tendons of flexors
 Carpal tunnel

Palmar carpal tendinous sheaths:

Common flexor sheath
Tendinous sheath of flexor carpi radialis
Tendinous sheath of flexor pollicis longus
Carpal tunnel
Flexor retinaculum

Palmar carpal tendinous

sheaths:

Tendinous sheath of
flexor pollicis longus

Tendinous sheath of
flexor carpi radialis

Common flexor sheath

Fibrous and synovial

sheaths of digits
Nerves and vessels of the forearm
Dorsal group of forearm muscles

Superficial layer:
Extensor digitorum,
Extensor digiti minimi,
Extensor carpi ulnaris

Deep layer:
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis
Dorsal group of forearm muscles. Superficial layer: ED, EDM, ECU
Deep layer: ABPL, EPB, EPL, EDI
Retinaculum
musculorum
extensorum
Dorsal group of forearm muscles. Superficial layer: ED, EDM, ECU
Deep layer: ABPL, EPB, EPL, EDI
Radial group of forearm muscles:
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Supinator
Radial group BR, Radial n., median n. Radial n.
of forearm muscles ECRL,
ECRB
S
Extensor retinaculum

Tendinous sheath of
AbPL and EPB
Tendinous sheath of
ECRL + B
Tendinous sheath of
EPL
Tendinous sheath of
ED + EI
Tendinous sheath of
EDM
Tendinous sheath of
ECU
Intertendinous
connections
fossa la tabatiere
Groups of hand muscles:
Thenar group
Abductor pollicis brevis,
Opponens pollicis,
Flexor pollicis brevis (superficial head, deep head),
Adductor pollicis (oblique head, transverse head)
Hypothenar group
Palmaris brevis
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Mm. Interossei palmares (I.- III.), dorsales (I. – IV.)
Mm. Lumbricales I. – IV.
Groups of hand muscles:
thenar group (AbdPB, OP, FPB, AddP), hypothenar group
(AbdDM, FDMB, OpDM), interossei (ID, IP), middle palmar
space (L)
Cross section of hand
Palmar aponeurosis, dorsal fascia of hand, thenar compartment,
hypothenar compartment, middle palmar compartment,
intermetacarpal compartments, dorsal compartment
 Aponeurosuis palmaris, palmaris brevis

Thenar group (AbdPB, OP, FPB, AddP), Hypothenar group (AbdDM,

FDMB, OpDM), flexor retinaculum synovial sheaths, lumbricals
Thenar group (AbdPB, OP, FPB, AddP), Hypothenar group
(AbdDM, FDMB, OpDM),palmar interossei, lumbricals
Palmar interossei, dorsal interossei , innervation from ulnaris n.

Adductors of digits Abductors of digits

Dorsal interossei, radial a., superficial radial n.,
dorsal branch of ulnar n.
Superficial and deep palmar arch, ulnar n. median n.
Vessels of hand, ventral
view
AU – ulnar artery,
APS – superficial palmar rch,
AaDPP – palmar digital aa.
APP – princeps pollicis artery
ArPP – deep palmar arch
AR – radial artery,
AM – metacarpal arteries
RPS(AR) – superficial palmar
branch
ARI – radialis indicis artery,
ArPP (AU) – deep palmar
branch

Grim M, Druga R et al.: Základy anatomie II.

Kardiovaskulární systém, Galén, Praha 2015
(v tisku)
Superficial and deep palmar arch, ulnar n. median n

Common palmar digital aa., proper palmar digital aa.,

palmar metacarpal arteries
Vessels of hand, dorsal
view
AR – radialis a.
RCD (AR) – dorsal carpal radial
branch
RCD (AU) – dorsal carpal ulnar
branch
AIP – posterior interosseous
artery
AaDD– dorsal digital arteries
AaMD – dorsal metacarpal
arteries

Grim M, Druga R et al.: Základy anatomie II.

Kardiovaskulární systém, Galén, Praha 2015
(v tisku)
Distribution of cutaneous nerves of upper limb (areae nervinae)
 Palsy of upper extremity nerves

Radial n. Ulnar n.
Clawhand
Wrist drop
Median n.
Hand of benediction
Sources of used illustrations:
Gray´s Anatomy,
Sobotta: Atlas of Human Anatomy, 15th Edition, 2011
Stingl, Grim, Druga: Regional Anatomy, 2012
Benninghoff, Drenckhahn: Anatomie I., II. 2003 or
Netter: Atlas of Human Anatomy, Saunders 2010, 5th Edition
Grim, Naňka, Helekal: Atlas of human anatomy, Grada 2014
Recommended Textbooks:
W. Platzer: Color Atlas of Human Anatomy, Vol. 1 Locomotor System.
Thieme, 6th Edition, 2008
Kahle, Frotscher: Color Atlas of Human Anatomy – Vol.3 Nervous
System and Sensory Organs, Thieme 2010, 6th Edition
Stingl, Grim, Druga: Regional Anatomy, 2012
Snell: Clinical Anatomy by systems, Lippincott Williams and Wilkins
2007 or
K. L. Moore, A.F.Dalley, A.M.R. Agur: Clinically oriented Anatomy, 6th
Edition, Wolters Kluwer, Lippincot Williams & Wilkins 2006