Forearm
The forearm is the structure and distal region of the upper limb, between the elbow and the wrist.[1]. The term forearm is used in anatomy to distinguish it from the arm, a word which is most often used to describe the entire appendage of the upper limb but in anatomy, technically means only the region of the upper arm whereas the lower "arm" is called the forearm. It is homologous to the leg that lies between the knee and the ankle joints.
The forearm contains two long bones, the radius and the ulna, forming the radioulnar joint. The interosseous membrane connects these bones. Ultimately, the forearm is covered by skin, the anterior surface usually being less hairy than the posterior surface.
The forearm contains many muscles, including the flexors and extensors of the digits, a flexor of the elbow (brachioradialis), and pronators and supinators that turn the hand to face down or upwards, respectively. In cross-section the forearm can be divided into two fascial compartments. The posterior compartment contains the extensors of the hands, which are supplied by the radial nerve. The anterior compartment contains the flexors, and is mainly supplied by the median nerve. The ulnar nerve also runs the length of the forearm.
The radial and ulnar arteries, and their branches, supply the blood to the forearm. These usually run on the anterior face of the radius and ulna down the whole forearm. The main superficial veins of the forearm are the cephalic, median antebrachial and the basilic vein. These veins can be used for cannularisation or venipuncture, although the cubital fossa is a preferred site for getting blood.
Anatomy
Bones
Joints
- proximal to forearm
- in the forearm
- proximal radioulnar joint
- distal radioulnar joint
- distal to forearm
Muscles
Compartment |
Level |
Muscle |
E/I |
Nerve |
Anterior |
superficial |
flexor carpi radialis |
E |
median |
Anterior |
superficial |
palmaris longus |
E |
median |
Anterior |
superficial |
flexor carpi ulnaris |
E |
ulnar |
Anterior |
superficial |
pronator teres |
I |
median |
Anterior |
superficial (or intermediate) |
flexor digitorum superficialis (sublimis) |
E |
median |
Anterior |
deep |
flexor digitorum profundus |
E |
ulnar + median |
Anterior |
deep |
flexor pollicis longus |
E |
median |
Anterior |
deep |
pronator quadratus |
I |
median |
Posterior |
(see below) |
brachioradialis |
I |
radial |
Posterior |
superficial |
extensor carpi radialis longus |
E |
radial |
Posterior |
superficial |
extensor carpi radialis brevis |
E |
radial |
Posterior |
intermediate |
extensor digitorum (communis) |
E |
radial |
Posterior |
intermediate |
extensor digiti minimi (proprius) |
E |
radial |
Posterior |
superficial |
extensor carpi ulnaris |
E |
radial |
Posterior |
deep |
abductor pollicis longus |
E |
radial |
Posterior |
deep |
extensor pollicis brevis |
E |
radial |
Posterior |
deep |
extensor pollicis longus |
E |
radial |
Posterior |
deep |
extensor indicis (proprius) |
E |
radial |
Posterior |
deep |
supinator |
I |
radial |
Posterior |
deep |
anconeus |
I |
radial |
- "E/I" refers to "extrinsic" or "intrinsic". The intrinsic muscles of the forearm act on the forearm, meaning, across the elbow joint and the proximal and distal radioulnar joints (resulting in pronation or supination, whereas the extrinsic muscles act upon the hand and wrist. In most cases, the extrinsic anterior muscles are flexors, while the extrinsic posterior muscles are extensors.
- The Brachioradialis, flexor of the forearm, is unusual in that it is located in the posterior compartment, but it is actually in the anterior portion of the forearm.
Nerves
(See separate nerve articles for details on divisions proximal to the elbow and distal to the wrist; see Brachial plexus for the origins of the median, radial and ulnar nerves)
- Median nerve – principle nerve of the anterior compartment (PT, FCR, PL, FDS).
- anterior interosseous nerve (supplies FPL, lat. 1/2 of FDP, PQ).
- Radial nerve – supplies muscles of the posterior compartment (ECRL, ECRB).
- Superficial branch of radial nerve
- Deep branch of radial nerve, becomes Posterior interosseus nerve and supplies muscles of the posterior compartment (ED, EDM, ECU, APL, EPB, EPL, EI).
- Ulnar nerve - supplies some medial muscles (FCU, med. 1/2 of FDP).
Vessels
- Brachial artery
- Radial artery
- Ulnar artery
- Pulmonary artery
- Anterior ulnar recurrent artery and posterior ulnar recurrent artery
- Common interosseous artery
- Posterior interosseous artery
- Anterior interosseous artery
Other structures
- Interosseous membrane of forearm
- Annular ligament of ulna
Additional images
|
Superficial muscles of the forearm
|
|
Deep muscles of the anterior forearm
|
|
Deep muscles of the posterior forearm
|
|
Cross-section through the middle of the forearm.
|
|
References
See also
List of muscles of upper limbs (TA A04.6, GA 4.432) |
|
Shoulder |
deltoid · rotator cuff (supraspinatus, infraspinatus, teres minor, subscapularis) · teres major
fascia: Deltoid fascia · Supraspinous fascia · Infraspinous fascia
|
|
Arm
(compartments) |
Anterior
|
|
|
Posterior
|
triceps brachii · anconeus · Articularis cubiti
|
|
Fascia
|
Axillary sheath · Axillary fascia · Brachial fascia · intermuscular septa (Lateral, Medial)
|
|
Other
|
spaces (Quadrangular space, Triangular space, Triangular interval)
|
|
|
Forearm |
Anterior
|
superficial: pronator teres · palmaris longus · flexor carpi radialis · flexor carpi ulnaris · flexor digitorum superficialis
deep: pronator quadratus · flexor digitorum profundus · flexor pollicis longus
|
|
Posterior
|
superficial: mobile wad (brachioradialis, extensor carpi radialis longus and brevis) · extensor digitorum · extensor digiti minimi · extensor carpi ulnaris
deep: supinator · anatomical snuff box (abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus) · extensor indicis
|
|
Fascia
|
Bicipital aponeurosis · common tendons (Extensor, Flexor) · Antebrachial fascia
|
|
Other
|
Cubital tunnel
|
|
|
Hand |
Lateral volar
|
thenar (opponens pollicis, flexor pollicis brevis, abductor pollicis brevis) · adductor pollicis
|
|
Medial volar
|
hypothenar (opponens digiti minimi, flexor digiti minimi brevis, abductor digiti minimi) · palmaris brevis
|
|
Intermediate
|
lumbrical · interossei (dorsal, palmar)
|
|
Fascia
|
posterior: Extensor retinaculum · Extensor expansion
anterior: Flexor retinaculum · Palmar aponeurosis
|
|
|
|
anat (h/n, u, t/d, a/p, l)/phys/hist
|
noco(m, s, c)/cong(d)/tumr, sysi/, injr
|
|
|
|
|