Back of Forearm

BACK OF FOREARM
CONTENTS
1. Extensor muscles
2. Nerves
3. Blood vessels
 Covered by deep fascia, thick at wrist to form

extensor retinaculum.
 Floored by posterior surface of radius & ulna with

interosseous membrane.
Muscles are arranged in two groups:-
a) Superficial
b) Deep
 Main nerve supply of this compartment is from Posterior

Interosseous Branch Of Radial Nerve.
 Principal artery is Posterior Interosseous Artery supplemented

by anterior interosseous in lower part.
SUPERFICIAL EXTENSOR MUSCLES
All together 7 in number & subdivided into lateral and posterior
group.
LATERAL GROUP:-
a) Brachio-radialis
b) Extensor carpi radialis longus
c) Extensor carpi radialis brevis
POSTERIOR GROUP:-
d) Extensor digitorum
e) Extensor digiti minimi
f) Extensor carpi ulnaris
g) Anconeus
DEEP GROUP OF MUSCLES:-
a) Supinator
b) Abductor pollicis longus
c) Extensor pollicis longus
d) Extensor pollicis brevis
e) Extensor indicis
 They emerge downward and laterally from undercover of the

posterior group and wind superficial to lateral group of muscles
before reaching the thumb for insertion.
SUPERFICIAL EXTENSOR
MUSCLES
BRACHIORADIALIS
Origin:- Upper 2/3rd of lateral supracondylar

ridge and lateral intermuscular septa.
Insertion:- As tendon to the base of styloid

process of radius.
Nerve supply:- Radial nerve
Action:- Flexor of elbow joint at mid-prone

position.
EXTENSOR CARPI RADIALIS LONGUS
Origin :- Lower 1/3rd of lateral supracondylar

ridge and lateral intermuscular septa.
Insertion :- Dorsal surface of base of 2nd

metacarpal bone.
Nerve supply:- Radial nerve
Action:- Work along with ECRB

EXTENSOR CARPI RADIALIS BREVIS
Origin:- From common extensor origin that is

from lateral epicondyle and from radial
collateral ligament.
Insertion:- Dorsal surface of base 3rd

metacarpal bone.
Nerve supply:- Posterior interosseous nerve.
Action:-
a) Produces extension of wrist
b) Along with FCR act as abductors of wrist.
EXTENSOR DIGITORUM
Origin:- From lateral epicondyle and forms a round belly in the
middle of forearm where it divides into 4 digital tendons.
Insertion:-
Each tendon covers the dorsal surface of the metacarpal head and
proximal phalanx and forms a triangular dorsal digital expansion.
The base of the expansion forms a hood over the metacarpal head
while the apex of the expansion close to the distal end of proximal
phalanx trifurcates into median and lateral 2 bands.
The median band is inserted into base of middle phalanx & the
lateral band extend further distally and unite before insertion into
base of distal phalanx.
Nerve supply:- Posterior interosseous
nerve.
Action:- Extension at metacarpo-

phalangeal joint.
EXTENSOR DIGITI MINIMI
Origin :- From Common extensor tendon.
Insertion:- Dorsal digital expansion of that

finger.
Action:- Extension of little finger & assist the

action of extensor digitorum.
EXTENSOR CARPI
ULNARIS
Origin:-
a) Lateral epicondyle
b) Subcutaneous posterior border of ulna in

common with origin of FCU
Insertion:- Tubercle on the medial side of the

base of 5th metacarpal bone..
Action:-
c) Along with ECRL and ECRB produces
extension of wrist.
d) Along with ECU and FCU produces adduction
of wrist.
ANCONEUS
Origin:- Triangular muscle arising from posterior surface of lateral epicondyle.
Insertion:- Lateral surface of olecranon process and upper 1/4th of posterior

surface of shaft Of ulna.
Nerve supply:- Radial nerve in spiral groove.
Action:-
a) Extensor of elbow joint and assist the action of triceps.
b) Upper horizontal fibres help abduction of ulna during pronation of forearm.

DEEP GROUP OF MUSCLES
SUPINATOR
It wraps the upper 1/3rd of radius and

consist of superficial and deep strata.
Origin:- Superficial fibres arise

from lateral epicondyle, radial collateral
ligament and annular ligament.
 Deep strata takes origin from

supinator crest of ulna and from
depressed triangular area of bone.
INSERTION:-
a) Superficial fibres attaches to the upper

1/3rd of the anterior part of the lateral
surface of radius above anterior
oblique line.
b) Deep fibres are horizontal ,wraps the

radius from behind and are inserted
into bone between anterior and
posterior oblique line.
Nerve supply:- Posterior interosseous

nerve
Action:- Supination in extended elbow.

ABDUCTOR POLLICIS LONGUS
Origin:- From posterior surface of radius and ulna &
intervening interosseous membrane.
Insertion:- Radial side of the base of 1st metacarpal

bone.
Nerve supply:- Posterior interosseous nerve
Action:- Abduction & Extension of thumb.

EXTENSOR POLLICIS
BREVIS
Origin:- Posterior surface of radius below APL
and interosseous membrane.
Insertion:- Dorsal surface of the base of the

proximal phalanx of the thumb.
Action:-Extends the proximal phalanx of thumb.

EXTENSOR POLLICIS LONGUS
Origin:- Posterior
surface of shaft of ulna and
adjacent interosseous membrane.
Insertion:- Dorsal surface of the base of distal

phalanx of the thumb.
Action:- Extends the distal phalanx of the

thumb.
EXTENSOR INDICIS
Origin:- Posterior surface of ulna distal to extensor
pollicis longus and adjacent interosseous membrane.
Insertion:- it joins the index tendon of extensor digitorum

and enters into the formation of DDE.
Nerve supply:- PIN
Action :- Extension of index finger.

ANATOMICAL SNUFF BOX
Boundaries
 Laterally
 Medially
 Roof
 Floor
Contents
EXTENSOR RETINACULUM
ATTACHMENT
Laterally
Medially
STRUCTURE BENEATH RETINACULUM
From lateral to medial:-

a) APL & EPB
b) ECRL & ECRB
c) EPL
d) ED & EI
e) EDM
f) ECU
CLINICAL
Mallet or Base Ball Finger
Due to sudden extreme flexion of interphalangeal joint resulting in avulsion of

extensor tendon from the interphalangeal joint.

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BACK OF FOREARM

 Covered by deep fascia, thick at wrist to form

 Floored by posterior surface of radius & ulna with

 Main nerve supply of this compartment is from Posterior

 Principal artery is Posterior Interosseous Artery supplemented

 They emerge downward and laterally from undercover of the

Origin:- Upper 2/3rd of lateral supracondylar

Insertion:- As tendon to the base of styloid

Nerve supply:- Radial nerve

Action:- Flexor of elbow joint at mid-prone

Origin :- Lower 1/3rd of lateral supracondylar

Insertion :- Dorsal surface of base of 2nd

Nerve supply:- Radial nerve

Action:- Work along with ECRB

Origin:- From common extensor origin that is

Insertion:- Dorsal surface of base 3rd

Nerve supply:- Posterior interosseous nerve.

Action:- Extension at metacarpo-

Insertion:- Dorsal digital expansion of that

Nerve supply:- Posterior interosseous nerve.

Action:- Extension of little finger & assist the

b) Subcutaneous posterior border of ulna in

Insertion:- Tubercle on the medial side of the

Nerve supply:- Posterior interosseous nerve.

Insertion:- Lateral surface of olecranon process and upper 1/4th of posterior

Nerve supply:- Radial nerve in spiral groove.

b) Upper horizontal fibres help abduction of ulna during pronation of forearm.

It wraps the upper 1/3rd of radius and

Origin:- Superficial fibres arise

 Deep strata takes origin from

a) Superficial fibres attaches to the upper

b) Deep fibres are horizontal ,wraps the

Nerve supply:- Posterior interosseous

Action:- Supination in extended elbow.

Insertion:- Radial side of the base of 1st metacarpal

Nerve supply:- Posterior interosseous nerve

Action:- Abduction & Extension of thumb.

Insertion:- Dorsal surface of the base of the

Nerve supply:- Posterior interosseous nerve

Action:-Extends the proximal phalanx of thumb.

Insertion:- Dorsal surface of the base of distal

Nerve supply:- Posterior interosseous nerve

Action:- Extends the distal phalanx of the

Insertion:- it joins the index tendon of extensor digitorum

Nerve supply:- PIN

Action :- Extension of index finger.

From lateral to medial:-

Due to sudden extreme flexion of interphalangeal joint resulting in avulsion of

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