VESSELS & NERVES OF THE FOREARM
AT the end of lecture the student should able to know about:
 Different vessels & nerves in forearm
 Location, destination, course & relations of radial and ulnar arteries & their branches in
forearm
 Deep veins of forearm and their tributaries.
 Location, destination, course & relations of ulnar, radial and median nerves & their
branches in forearm.
ARTERIES OF FOREARM AND
• Radial artery
• Ulnar artery
RADIAL ARTERY
• One of the terminal branches of the brachial artery
• Arises from the brachial artery at the level of the neck of the radius
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COURSE OF RADIAL ARTERY
Travels along the radial side of the forearm
Winds backward around the carpus to the lateral side
Passes below the tendons of the abductor pollicis longus and the extensor pollicis longus
and brevis
Reaches the upper end of the space between the metacarpal bones of the thumb and the
index finger
TERMINATION OF THE RADIAL ARTERY
Passes through the two heads of the first dorsal interosseous and enter into the palm
Crosses the metacarpal bones and reaches the ulnar side
Joins the deep volar branch of the ulnar artery
Forms the deep volar arch of the palm
DIVISIONS
• The course of radial artery is divided into the:
1. Radial artery in the forearm
1. Radial artery on the dorsum of the wrist
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1. Radial artery in the hand
RADIAL ARTEY IN THE FOREARM
Extends from the neck of the radius to the styloid process of the radius
In the proximal part it is medial and in the lower part it is in front of the Radius
The Radial artery is accompanied by the venae commitantes throughout its whole course
ANTERIOR RELATIONS IN FOREARM
Proximal part is covered by the brachialis
Lower part of the radial artery is superficial
Anterior to it is skin, superficial and deep fascia
POSTERIOR RELATIONS OF THE RADIAL ARTERY IN THE FOREARM
• Biceps brachii
• Supinator
• Pronator teres
• Radial head of the flexor digitorium sublimis
• Flexor pollicis longus
• Pronator quadratus
• Radial bone
RADIAL ARTERY AT THE WRIST
• Reaches the wrist by passing between the radial collateral ligament of wrist and the
abductor pollicis longus and extensor pollicis brevis
BRANCHES OF THE RADIAL ARTERY
Branches in the forearm
1. Radial recurrent
2. Muscular
3. Volar carpal
4. Superficial volar
BRANCHES OF RADIAL ARTERY IN THE FOREARM
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Radial recurrent
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Arises from radial artery just below its origin and ascend on supinator and then between
brachialis and brachioradialis
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Anastomose with radial collateral branch of profunda brachii artery
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Muscular
Palmar carpal
• Joins the palmar carpal branch of ulnar to form volar carpal arch
Superficial palmar branch
• Passes through the thenar muscle and anastomoses with superficial branch of ulnar artery to
complete superficial palmar arterial arch
BRANCHES OF THE RADIAL ARTERY AT THE WRIST
Dorsal carpal
• Join the dorsal carpal branch of ulnar artery and the dorsal terminal branch of anterior
interosseous artery
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1 dorsal metacarpal
ULNAR ARTERY
• Arises from the brachial artery at the level of the radial neck
• Travel on the ulnar side of the forearm and reach midway between the elbow and the wrist
• Crosses the transverse carpal ligament on the radial side of the Pisiform bone, and
immediately divides into two branches that form Superficial and deep volar arches
RELATIONS
• Deeply lying structure
• It is accompanied by the venae comitantes on both the sides through out its course
• Relations in forearm
• Relation at wrist
RELATION OF ULNAR ARTERY IN FOREARM
• Pronator teres
• Flexor carpi radialis
• Palmaris longus
• Flexor digitorium sublimis
POSTERIOR RELATION OF ULNAR ARTERY IN FOREARM
• It lies on the
• Brachialis
• Flexor digitorium profondus
RELATIONS IN WRIST
• At the wrist it lies on the transverse carpal ligament and it is medial to the pisiform bone
and ulnar nerve is some what posterior to it
BRANCHES OF THE ULNAR ARTERY
The branches are arranged as under
• Branches in the forearm
• At the wrist
• In the hand
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BRANCHES OF THE ULNAR ARTERY IN FOREARM
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Anterior recurrent
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Posterior recurrent
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Common interosseous
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Muscular
BRANCHES OF THE ULNAR ARTERY IN FOREARM
Anterior recurrent
• Anastomose with inferior ulnar collateral
Posterior recurrent
• Anastomoses with superior ulnar collateral
BRANCHES OF THE ULNAR ARTERY IN FOREARM
Common interosseous
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Arises from lateral side of ulnar artery and divides into:
– Anterior interosseous artery
• Descends with anterior interosseous nerve in front of interosseous membrane
• Perforate the interosseous membrane to anastomose with posterior interosseous and
joins dorsal carpal network
BRANCHES OF THE ULNAR ARTERY IN FOREARM
b)Posterior interosseous artery
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Gives rise to interosseous recurrent artery that anastomose with middle collateral, a
branch of profunda brachii
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Descends behind the interosseous membrane
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Anastomose with anterior interosseous
BRANCHES AT THE WRIST
• Volar carpal
• Joins the volar (palmar) carpal branch of radial to form palmar carpal arch
• Dorsal carpal
• Joins the dorsal carpal branch of radial artery
VENAE COMMITANT IN FOREARM
• Radial and ulnar arteries are accompanied by the venae comitantes on both the sides
throughout their course
• Join to form venae commitant of brachial vein
NERVES OF THE FOREARM
• Ulnar nerve
– at the elbow the ulnar nerve is at the dorsum of the medial epicondyles
– enters the forearm between the two heads of the flexor carpi ulnaris superficial to
the posterior and oblique part of the ulnar collateral ligament.
– gives articular branches to the elbow joint
NERVES OF THE FOREARM
• Muscular branches of the ulnar nerve:
– usually two muscular branches
– flexor carpi ulnaris and
– medial half of the flexor digitorium profundus.
• Palmar Cutaneous branch
– it arises at the mid of the forearm,
– some times supply the Palmaris Brevis.
• Median nerve
– enters the forearm between the two heads of the Pronator teres.
• Anterior interosseous nerve
– with anterior interosseous artery it descends anterior to the interosseous
membrane
NERVES OF THE FOREARM
• Radial nerve:
– desends in the arm behind the third part of axillary artery and upper part of the
brachial artery.
– passes through triangular space with the profunda brachii artery.
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– On lateral side of the forearm it pierces the lateral intermuscular septum
– In the triangular space, gives the posterior Cutaneous nerve of the arm.
It supplies the flexor Pollicis longus and lateral part of the flexor digitorium
profundus.
It supplies all the flexors of the forearm superficial muscles except the flexor carpi
ulnaris, i.e. Pronator teres, flexor carpi radialis, flexor digitorium superficialis,
Palmaris longus.
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Radial nerve:
– supplies the extensor carpi radialis Brevis and
– the supinator muscle.
• Posterior interosseous nerve:
– deep terminal branch of the radial nerve.
– supplies the supinator and the extensor carpi radialis Brevis
it also supplies
• Extensor digitorium, extensor digiti minimi, extensor carpi ulnaris.
• Extensor Pollicis longus
• Abductor Pollicis longus and extensor polices Brevis.
REFERENCE
HUMAN ANATOMY
KLM
6TH EDITION