KOL KASLARI (Devam)

M. articularis cubiti

M. anconeus

ÖNKOL ve ELİN ARKA YÜZ KASLARI 11 Mart 2010 Saat: 10:30-12:15

M. extensor carpi radialis longus M. extensor carpi radialis brevis YÜZEYEL GRUP KASLAR M. brachioradialis M. extensor carpi radialis longus M. extensor carpi radialis brevis M. extensor digitorum M. extensor digiti minimi M. extensor carpi ulnaris DERİN GRUP KASLAR M. supinator M. extensor indicis M. abductor pollicis longus M. extensor pollicis longus M. extensor pollicis brevis Baş parmağa gidecek şekilde yüzeyelleşirler

Kol, önkol ve elin arka yüz kaslarının tamamı n. radialis tarafından innerve edilir

Önkol’un arka yüz kaslarından M. supinator ve M Önkol’un arka yüz kaslarından M. supinator ve M. brachioradialis hariç diğer kaslar elbileğini çağrazlar

YÜZEYEL GRUP KASLAR

M. brachioradialis

M. brachioradialis, fossa cubiti’nin lateral kenarını oluşturur

M. brachioradialis, extensor kompartmanda bulunmasına rağmen önkola fleksiyon yaptırır

M. extensor carpi radialis longus

Tendonu, abductor pollicis longus ve extansor pollicis brevis tarafından çaprazlanır

M. extensor carpi radialis brevis

M. brachioradialis, extensor kompartmanda bulunmasına rağmen önkola fleksiyon yaptırır

M. extensor digitorum

Dört tendonu, retinaculum extensorum’un altından ortak bir vagina synovialis ile sarılı olarak geçer

Connexus intertendinea

M. extensor digiti minimi

M. extensor carpi ulnaris

DERİN GRUP KASLAR

M. supinator

(Posterior Interosseous Nerve Palsy) Supinator Syndrome (Posterior Interosseous Nerve Palsy)

M. supinator, N. radialis’in r. profundus’u (N M. supinator, N. radialis’in r. profundus’u (N. interosseus posterior) tarafından delinir

M. extensor indicis

İşaret parmağının iki ekstensor kası vardır M. extensor digitorum M. extensor indicis

M. abductor pollicis longus

M. abductor pollicis longus ve M M. abductor pollicis longus ve M. extensor pollicis brevis’in tendonları ortak bir vagina synovialis ile sarılır ve 1. kanaldan geçer

M. extensor pollicis brevis

Fritz de Quervain (1868–1940)

The Finkelstein test draws the tendons of the first dorsal compartment distally and causes sharp, local pain when tendon entrapment has occurred and inflammation is present In de Quervain tenosynovitis, the first dorsal compartment is thickened, raising the skin and creating a prominence at the radial styloid

M. extensor pollicis longus

Compartment Tendon Associated Pathology 1 2 3 4 5 6 Extensor pollicis brevis (EPB) Abductor pollicis longus (APL)  De Quervain's tenosynovitis  2 Extensor carpi radialis longus (ECRL) Extensor carpi radialis brevis (ECRB)  Intersection syndrome  3 Extensor pollicis longus (EPL)  Drummer's wrist, traumatic rupture with distal radius fx  4 Extensor indicis proprius (EIP) Extensor digitorum communis (EDC)  Extensor tenosynovitis  5 Extensor digiti minimi (EDM)  Vaughn-Jackson Syndrome  6 Extensor carpi ulnaris (ECU)  Snapping ECU 

Fovea radialis (enfiye çukuru): -İçte M. extensor pollicis longus, -dışta M. abductor pollicis longus ve M. extensor pollicis brevis krişleri, -aşağıda başparmağın dorsal yüzü arasındaki çukurluktur. -Baş parmağı ekstensiyon durumuna getirirsek, bu çukurda deri çökerek çukur belirginleşir. -Bu çukurdan A. radialis geçer.

Nabız oluğu: -M. brachioradialis ile M. flexor carpi radialis’in krişleri arasında bulunan oluk İçinde a. radialis bulunur.

ELİN ARKA YÜZ KASLARI

Mm. interossei dorsales

bipennat diziliş gösterirler

Superficial layer Brachioradialis Proximal two thirds of supraepicondylar ridge of humerus Lateral surface of distal end of radius proximal to styloid process Radial nerve (C5, C6, C7) Relatively week flexion of forearm, maximal when forearm is in midpronated position Extensor carpi radialis longus (ECRL) Lateral supraepicondylar ridge of humerus Dorsal aspect of base of 2nd metacarpal Radial nerve (C6, C7) Extend and abduct hand at the wrist joint; ECRL active during fist clenching Extensor carpi radialis brevis (ECRB) Lateral epicondyle of humerus (common extensor origin) Doral aspect of base of 3rd metacarpal Deep branch of radial nerve (C7, C8) Extensor digitorum Extensor expansions of medial four fingers Posterior interosseous nerve (C7, C8), continuation of deep branch of radial nerve Extends medial four fingers primarily at metacarpophalangeal joints, secondarily at interphalangeal joints Extensor digiti minimi (EDM) Extensor expansion of 5th finger Extends 5th finger primarily at metacarpophalangeal joint, secondarily at interphalangeal joint Extensor carpi ulnaris (ECU) Lateral epicondyle of humerus; posterior border of ulna via a shared aponeurosis Dorsal aspect of base of 5th metacarpal Extends and adducts hand at wrist joint (also active during fist clenching) Deep layer Supinator Lateral epicondyle of humerus; radial collateral and anular ligaments; supinator fossa; crest of ulna Lateral posterior, and anterior surfaces of proximal third of radius Supinates forearm; rotates radius to turn palm anteriorlyor superiorly (if elbow is flexed) Extensor indicis Posterior surface of distal third of ulna and interosseous membrane Extensor expansion of 2nd finger Extends 2nd finger (enabling its independent extension); helps extend hand at wrist Outcropping muscles of deep layer Abductor pollicis longus (APL) Posterior surface of proximal halves of ulna, radius, and interosseous membrane Base of 1st metacarpal Abducts thumb and extends it at carpometacarpal joint Extensor pollicis longus (EPL) Posterior surface of middle third of ulna and interosseous membrane Dorsal aspect of base of distal phalanx of thumb Extends distal phalanx of thumb at interphalangeal joint; extends metacarpophalangeal and carpometacarpal joints Extensor pollicis brevis (EPB) Posterior surface of distal third of radius and interosseous membrane Dorsal aspect of base of proximal phalanx of thumb Extends proximal phalanx of thumb at metacarpophalangeal joint; extends carpometacarpal joint aThe spinal cord segmental innervation is indicated (e.g., “C7, C8” means that the nerves supplying the extensor carpi radialis brevis are derived from the seventh and eighth cervical segments of the spinal cord). Numbers in boldface (C7) indicate the main segmental innervation. Damage to one or more of the listed spinal cord segments or to the motor nerve roots arising from them results in paralysis of the muscles concerned.