Forearm

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Forearm
Forearm labeled.png
The forearm is highlighted in magenta
Details
Identifiers
Latin antebrachium
MeSH D005542
TA98 A01.1.00.024
TA2 146
FMA 9663
Anatomical terminology

The forearm is the 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 used to describe the entire appendage of the upper limb, but which in anatomy, technically, means only the region of the upper arm, whereas the lower "arm" is called the forearm. It is homologous to the region of the leg that lies between the knee and the ankle joints, the crus.

Contents

The forearm contains two long bones, the radius and the ulna, [2] forming the two radioulnar joints. 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 wrist, 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 flexor muscles are more massive than the extensors because they work against gravity and act as anti-gravity muscles. The ulnar nerve also runs the length of the forearm. [3]

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.

Structure

Bones and joints

The bones of the forearm are the radius (located on the lateral side) and the ulna (located on the medial side)

Bones of forearm, radius on left and ulna on the right Radius and Ulna - Forearm Bones.jpg
Bones of forearm, radius on left and ulna on the right

Radius

Proximally, the head of the radius articulates with the capitulum of the humerus and the radial notch of the ulna at the elbow. The articulation between the radius and the ulna at the elbow is known as the proximal radioulnar joint.

Distally, it articulates with the ulna again at the distal radioulnar joint. It forms part of the wrist joint by articulating with the scaphoid at its lateral aspect and with the lunate at its medial aspect.

Ulna

Proximally, the trochlear notch of the ulna articulates with the trochlea of the humerus and the radial notch articulates with the head of the radius at the elbow. [4]

Distally it forms part of the distal radioulnar joint and also articulates with the wrist. [5]

Muscles

CompartmentLevelMuscleE/INerve
Anteriorsuperficial flexor carpi radialis Emedian
Anteriorsuperficial palmaris longus Emedian
Anteriorsuperficial flexor carpi ulnaris Eulnar
Anteriorsuperficial pronator teres Imedian
Anteriorsuperficial (or intermediate) flexor digitorum superficialis (sublimis) Emedian
Anteriordeep flexor digitorum profundus Eulnar + median
Anteriordeep flexor pollicis longus Emedian
Anteriordeep pronator quadratus Imedian
Posterior(see below) brachioradialis Iradial
Posteriorsuperficial extensor carpi radialis longus Eradial
Posteriorsuperficial extensor carpi radialis brevis Eradial
Posteriorintermediate extensor digitorum (communis) Eradial
Posteriorintermediate extensor digiti minimi (proprius) Eradial
Posteriorsuperficial extensor carpi ulnaris Eradial
Posteriordeep abductor pollicis longus Eradial
Posteriordeep extensor pollicis brevis Eradial
Posteriordeep extensor pollicis longus Eradial
Posteriordeep extensor indicis (proprius) Eradial
Posteriordeep supinator Iradial
Posteriordeep anconeus Iradial

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.

Vessels

Veins of the forearm and hand Veins of the forearm and hand.jpg
Veins of the forearm and hand

Other structures

Function

The forearm can be brought closer to the upper arm (flexed) and brought away from the upper arm (extended) due to movement at the elbow. The forearm can also be rotated so that the palm of the hand rotates inwards (pronated) and rotated back so that the palm rotates outwards (supinated) due to movement at the elbow and the distal radioulnar joint. [5]

Clinical significance

Midshaft fracture of the radius and ulna FracRadUlnaMark.png
Midshaft fracture of the radius and ulna

A fracture of the forearm can be classified as to whether it involves only the ulna (ulnar fracture), only the radius (radius fracture), or both radioulnar fracture.

For treatment of children with torus fractures of the forearm splinting appears to work better than casting. [7] Genetically determined disorders like hereditary multiple exostoses can lead to hand and forearm deformities. Hereditary multiple exostoses is due growth disturbance of the epiphyses of the radius and ulna, the two bones of the forearm. [8]

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Carpal bones</span> Eight small bones that make up the wrist (or carpus) that connects the hand to the forearm

The carpal bones are the eight small bones that make up the wrist (carpus) that connects the hand to the forearm. The term "carpus" and "carpal" is derived from the Latin carpus and the Greek καρπός (karpós), meaning "wrist". In human anatomy, the main role of the carpal bones is to articulate with the radial and ulnar heads to form a highly mobile condyloid joint, to provide attachments for thenar and hypothenar muscles, and to form part of the rigid carpal tunnel which allows the median nerve and tendons of the anterior forearm muscles to be transmitted to the hand and fingers.

<span class="mw-page-title-main">Ulna</span> Medial bone from forearm

The ulna or ulnal bone is a long bone found in the forearm that stretches from the elbow to the wrist, and when in anatomical position, is found on the medial side of the forearm. That is, the ulna is on the same side of the forearm as the little finger. It runs parallel to the radius, the other long bone in the forearm. The ulna is longer and the radius is shorter, but the radius is thicker and the ulna is thinner. Therefore, the ulna is considered to be the smaller bone of the two bones in the lower arm. The corresponding bone in the lower leg is the fibula.

<span class="mw-page-title-main">Humerus</span> Long bone of the upper arm

The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.

<span class="mw-page-title-main">Brachioradialis</span> Muscle of the upper limb

The brachioradialis is a muscle of the forearm that flexes the forearm at the elbow. It is also capable of both pronation and supination, depending on the position of the forearm. It is attached to the distal styloid process of the radius by way of the brachioradialis tendon, and to the lateral supracondylar ridge of the humerus.

<span class="mw-page-title-main">Radial nerve</span> Nerve in the human body that supplies the posterior portion of the upper limb

The radial nerve is a nerve in the human body that supplies the posterior portion of the upper limb. It innervates the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin.

<span class="mw-page-title-main">Median nerve</span> Nerve of the upper limb

The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus.

<span class="mw-page-title-main">Wrist</span> Part of the arm between the lower arm and the hand

In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; (2) the wrist joint or radiocarpal joint, the joint between the radius and the carpus and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as wrist joints. This region also includes the carpal tunnel, the anatomical snuff box, bracelet lines, the flexor retinaculum, and the extensor retinaculum.

<span class="mw-page-title-main">Radius (bone)</span> One of the two long bones of the forearm

The radius or radial bone is one of the two large bones of the forearm, the other being the ulna. It extends from the lateral side of the elbow to the thumb side of the wrist and runs parallel to the ulna. The ulna is longer than the radius, but the radius is thicker. The radius is a long bone, prism-shaped and slightly curved longitudinally.

<span class="mw-page-title-main">Upper limb</span> Consists of the arm, forearm, and hand

The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.

In human anatomy, the extensor pollicis longus muscle (EPL) is a skeletal muscle located dorsally on the forearm. It is much larger than the extensor pollicis brevis, the origin of which it partly covers and acts to stretch the thumb together with this muscle.

<span class="mw-page-title-main">Supinator muscle</span> Muscle of the forearm in humans

In human anatomy, the supinator is a broad muscle in the posterior compartment of the forearm, curved around the upper third of the radius. Its function is to supinate the forearm.

<span class="mw-page-title-main">Posterior interosseous nerve</span> Nerve of the forearm

The posterior interosseous nerve is a nerve in the forearm. It is the continuation of the deep branch of the radial nerve, after this has crossed the supinator muscle. It is considerably diminished in size compared to the deep branch of the radial nerve. The nerve fibers originate from cervical segments C7 and C8 in the spinal column.

<span class="mw-page-title-main">Galeazzi fracture</span> Medical condition

The Galeazzi fracture is a fracture of the distal third of the radius with dislocation of the distal radioulnar joint. It classically involves an isolated fracture of the junction of the distal third and middle third of the radius with associated subluxation or dislocation of the distal radio-ulnar joint; the injury disrupts the forearm axis joint.

<span class="mw-page-title-main">Madelung's deformity</span> Medical condition

Madelung's deformity is usually characterized by malformed wrists and wrist bones and is often associated with Léri-Weill dyschondrosteosis. It can be bilateral or just in the one wrist. It has only been recognized within the past hundred years. Named after Otto Wilhelm Madelung (1846–1926), a German surgeon, who described it in detail, it was noted by others. Guillaume Dupuytren mentioned it in 1834, Auguste Nélaton in 1847, and Joseph-François Malgaigne in 1855.

<span class="mw-page-title-main">Anterior interosseous nerve</span>

The anterior interosseous nerve is a branch of the median nerve that supplies the deep muscles on the anterior of the forearm, except the ulnar (medial) half of the flexor digitorum profundus. Its nerve roots come from C8 and T1.

<span class="mw-page-title-main">Interosseous membrane of forearm</span>

The interosseous membrane of the forearm is a fibrous sheet that connects the interosseous margins of the radius and the ulna. It is the main part of the radio-ulnar syndesmosis, a fibrous joint between the two bones.

The posterior compartment of the forearm contains twelve muscles which primarily extend the wrist and digits. It is separated from the anterior compartment by the interosseous membrane between the radius and ulna.

<span class="mw-page-title-main">Elbow</span> Joint between the upper and lower parts of the arm

The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa, and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.

<span class="mw-page-title-main">Extrinsic extensor muscles of the hand</span>

The extrinsic extensor muscles of the hand are located in the back of the forearm and have long tendons connecting them to bones in the hand, where they exert their action. Extrinsic denotes their location outside the hand. Extensor denotes their action which is to extend, or open flat, joints in the hand. They include the extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor digitorum (ED), extensor digiti minimi (EDM), extensor carpi ulnaris (ECU), abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and extensor indicis (EI).

<span class="mw-page-title-main">Muscles of the thumb</span>

The muscles of the thumb are nine skeletal muscles located in the hand and forearm. The muscles allow for flexion, extension, adduction, abduction and opposition of the thumb. The muscles acting on the thumb can be divided into two groups: The extrinsic hand muscles, with their muscle bellies located in the forearm, and the intrinsic hand muscles, with their muscles bellies located in the hand proper.

References

  1. WebMD (2009). "forearm". Webster's New World Medical Dictionary (3rd ed.). Houghton Mifflin Harcourt. p. 166. ISBN   978-0-544-18897-6.
  2. "Forearm". The Lecturio Medical Concept Library. Retrieved 2021-06-22.
  3. Mitchell, Brittney; Whited, Lacey (2020-08-15). "Anatomy, Shoulder and Upper Limb, Forearm Muscles". National Center for Biotechnology Information, U.S. National Library of Medicine. StatPearls Publishing LLC. Retrieved 22 June 2021.
  4. "Structure of The Forearm". The Lecturio Medical Concept Library. Retrieved 2021-06-22.
  5. 1 2 Standring, Susan (2016). Gray's anatomy : the anatomical basis of clinical practice (Forty-first ed.). [Philadelphia]. ISBN   9780702052309. OCLC   920806541.{{cite book}}: CS1 maint: location missing publisher (link)
  6. "Dissector Answers — Axilla & Arm". The University of Michigan. Archived from the original on 3 January 2008. Retrieved 2008-01-17.
  7. Jiang N, Cao ZH, Ma YF, Lin Z, Yu B (November 2016). "Management of Pediatric Forearm Torus Fractures: A Systematic Review and Meta-Analysis". Pediatric Emergency Care. 32 (11): 773–778. doi:10.1097/pec.0000000000000579. PMID   26555307. S2CID   25796224.
  8. El-Sobky TA, Samir S, Atiyya AN, Mahmoud S, Aly AS, Soliman R (2018). "Current paediatric orthopaedic practice in hereditary multiple osteochondromas of the forearm: a systematic review". SICOT-J. 4: 10. doi:10.1051/sicotj/2018002. PMC   5863686 . PMID   29565244.