Below is a description of the extensor tendon zones of the thumb: The subclavian artery branches off from the aortic arch. 71. It often affects rowers, weightlifters, individuals performing secretarial work, and carpenters. Thank you extremely much. This form of intersection syndrome is more common than distal intersection syndrome. An injury of this kind is going to be proximal to the wrist extensors, thus wrist drop is a . [1][2], To achieve neutral wrist extension movements, theextensor carpi radialis brevis (ECRB), extensor carpi radialis longus (ECRL), and the extensor carpi ulnaris (ECU) musclesact synergistically based on each muscle's insertion and dynamic function. Dr. Ronald Oakley Bailey, MD. The posterior interosseous artery is a branch from the ulnar artery. An injury to zone III disrupts the central slipover the PIP joint. firmly bound to deep fascia in many places why are there flexion ceases on palm of hand? To test the function of the muscle, the forearm is pronated, and the fingers extended against resistance. Howdy! As a group, the primary action of the wrist flexors is, you guessed it wrist flexion! A positive test is when this maneuver causes pain. The SBRN branches from the radial nerve and runs deep to the brachioradialis muscle in the forearm before emerging between the brachioradialis and ECRL muscles approximately 9 cm proximal to the radial styloid. Force USA X15 Pro Review: A Compact Multi-Gym With a Half Rack & Functional Trainer, Force USA G10 Review: A Plate-Loaded All-In-One with Interchangable Pulley Ratios, Force USA X20 Pro Review: A Full Power Rack with an Integrated Selectorized Funtional Trainer, Medial epicondyle of humerus via the common flexor tendon, Distal half of flexor retinaculum and apex of palmar aponeurosis, Olecranon process and posterior border of ulna (via aponeurosis), Medial epicondyle of the humerus via the common flexor tendon and the coronoid process, Shafts of middle phalanges of medial four digits, Superior half of the anterior border of radius, Proximal three quarters of medial and anterior surfaces of ulna and interosseous membrane, Bases of distal phalanges of 4th and 5th digits, Bases of distal phalanges of 2nd and 3rd digits, Anterior interosseous branch of median nerve (C8-T1), Anterior surface of radius and adjacent interosseous membrane, Thumb flexion at interphalangeal and metacarpophalangeal and carpometacarpal joints, Flexion of the index, middle, ring and little fingers at proximal interphalangeal and metacarpophalangeal joints, Flexion of the ring and little fingers at distal interphalangeal, proximal interphalangeal and metacarpophalangeal joints, Flexion of the index and middle fingers at distal interphalangeal, proximal interphalangeal and metacarpophalangeal joints. Much obliged. Exercise Of Knee Joint hand exercises at home Below a summary of the general origin and insertion points can be found. 2018 [PubMed PMID: 29992133], Inagaki K, Current concepts of elbow-joint disorders and their treatment. It is supplied by deep branch of the radial artery. [4]A high origin of the radial artery has also been observed, with branch points occurring as high as the axillary artery. [1][2], To achieve neutral wrist extension movements, theextensor carpi radialis brevis (ECRB), extensor carpi radialis longus (ECRL), and the extensor carpi ulnaris (ECU) musclesact synergistically based on each muscle's insertion and dynamic function. Surgical intervention aims at debriding angiofibroblastic tissue at the origin of the ECRB. The subacute phase is managed by exercise, stretching, bracing, coordinated rehabilitation, and corticosteroid injection to the affected area. In some instances, tendon repair or complete muscle release may be indicated depending on the extent of pathology appreciated. The supinator muscle, abductor pollicis longus muscle, extensor pollicis brevis muscle, extensor pollicis longus muscle, and extensor indicis muscle comprise this deep compartment. This includes any heavy exercise where you are gripping the bar or dumbbells directly against gravity (i.e. [9], Reports exist that anatomic variants of the EIP muscle have an incidence of 16%. The average age is 38.2 years old, with only 62.50% of the people owning property. It has 2 heads Humeral head : It originates from lateral epicondyle of the humerus. An injury to zone III disrupts the central slipover the PIP joint. In contrast, the superficial palmar arch's predominant blood supply is derived from the ulnar artery. The posterior interosseous nerve (PIN, also known as the dorsal branch of the radial nerve) innervates and then courses between the two heads of the supinator muscle before entering the posterior compartment of the forearm. To start with, trainthem twice a week for 6-8 sets of 12-20+ slow and controlled (2-3 secs) reps. Nerve supply: Median nerve. Origin: Originates from the posterior surface of the ulna and interosseous membrane, distal to the extensor pollicis longus. Bilateral RTS is rare. Howdy are using WordPress for your blog platform? It thenbecomes the brachial artery once it passes the lower edge of the teres minor muscle. Below a summary of the general origin and insertion points can be found. Thanks , I have recently been looking for info approximately this subject for awhile and yours is the best I have came upon till now. Griffin M, Hindocha S, Jordan D, Saleh M, Khan W. Management of extensor tendon injuries. It extends inferiorly and narrows into a tendon that passes deep to the extensor retinaculum. [9] Estimations are that in 30to 60% of cases, the tendons of the first compartment are partially or wholly separated by a septum. This nerve branches from the radial nerve at the level of theradiocapitellar joint and are typically located immediately proximal to the supinator muscle in an area of a fibrous band known as the arcade of Frohse.[5][6]. Want more. Enjoyed every bit of your blog.Really thank you! 2017 Nov [PubMed PMID: 28858545], Muscles of the Wrist and hand, External Carpi radialis longus and brevis, Abductor pollicis longus, Flexor digitorum profundus, Flexor Carpi Ulnaris, Cupinaor, Anatomy, Shoulder and Upper Limb, Wrist Extensor Muscles, Zone I: covers the fingertip to the distal interphalangeal (DIP) joint, Zone III: locatedat the proximal interphalangeal (PIP) joint, Zone V: situatedat the metacarpal phalangeal (MP) joint, Zone I: covers the fingertip to the DIP joint, Zone II: covers the interphalangeal joint, Brachioradialis origin: proximal lateral epicondyle of the humerus, Brachioradialis insertion: lateral distal radius, ECRL origin: proximal lateral epicondyle of the humerus, ECRL insertion: dorsal surface of the second metacarpal base, ECRB origin: lateral epicondyle of the humerus, ECRB insertion: dorsal surface of the second and third metacarpal bases, EDC origin: lateral epicondyle of the humerus, EDC insertion: extensor hoods of the pointer, long, ring, and small finger, EDM origin: lateral epicondyle of the humerus, EDM insertion: extensor hood of the small finger, ECU origin: lateral epicondyle of the humerus, ECU insertion: medial base of the fifth metacarpal, Anconeus origin: lateral epicondyle of the humerus, Anconeus insertion: olecranon and proximal posterior ulna, Supinator origin: superficial lateral epicondyle of the humerus, radial collateral ligament, and annular ligament, Supinator insertion: the lateral proximal third of the radius, APL origin: the posterior proximal surface of the ulna and radius, APL insertion: lateral base of the first metacarpal, EPB origin: the posterior proximal surface of the radius (distal to abductor pollicis longus), EPB insertion: dorsal surface of the base of the thumb, EPL origin: the posterior proximal surface of the radius (distal to abductor pollicis longus), EPL insertion: dorsal surface of the base of the thumb, EIP origin: posterior surface of the proximal ulna, EIP insertion: extensor hood of the index finger. Patients will present with this deformity in part due to the lateral bands of the dorsal interossei muscles. In closed injuries, clinical suspicion includes ruling out sagittal band ruptures. A motor nerve that branches from the radial nerve is the posterior interosseous nerve. Treatment in the acute stage of lateral epicondylitis aims to reduce inflammation mainly by rest, ice, and compression of the affected arm. As it travels to the elbow, it innervates the triceps muscle. Good article and straight to the point. physiotherapy treatment pelvic tilt exercise for low back pain Extends and abducts hand at wrist joint Extensor carpi radialis brevis: Insertion: The posterior surface of the base of the third metacarpal bone Nerve supply: Deep branch of the radial nerve Action: Extends and abducts hand at wrist joint Extensor digitorum: Insertion: Bases of middle phalanges of the 2nd-5th digits Nerve supply: [15]Distal to the extensor retinaculum, the EPL crosses medially over the ECRB and ECRL. (extensor compartment 2), Distal intersection syndrome isclassically experienced by skiers and kickboxers, who present with dorsal wrist pain complaints. using most hand tools: hammer, screwdriver, hand saw, chain saw, garden tools, etc.). Vaquero-Picado A, Barco R, Antua SA. Their fiberstravel distally,down the back of the forearm, and insert on the back of thecarpals, metacarpals and phalanges. exercises for vastus medialis Flex the fist up toward the body. Lumbricals muscles are very crucial to finger movement, joining the extensor tendons to the flexor tendons. If conservative management fails, then surgical intervention is indicated. wrist pain exercises with pictures A motor nerve that branches from the radial nerve is the posterior interosseous nerve. Nice article and review. There is variability in the SBRNs course in the distal forearm.[8]. My goal is to help you learn proper weight training and nutrition principles so that you can get strong and build the physique of your dreams! In 22% of cadaveric specimens, an aberrant slip of the ECU muscle was observed inserting on the fifth metacarpal. It thenbecomes the brachial artery once it passes the lower edge of the teres minor muscle. This condition is considered rare and can be missed if there is no clinical suspicion of the syndrome. It acts as extensor of the wrist and the little finger.. As a group, the primary action of the wrist flexors is, you guessed itwrist flexion! physiotherapy clinic ahmedabad Home > Anatomy > Wrist Flexors: Functional Anatomy Guide. Distal intersection syndrome occurs when this area of crossing over becomes inflamed and causes dorsal wrist pain. Also, many thanks for permitting me to comment. Subramaniyam SD, Purushothaman R, Zacharia B. When using these techniques, give special attention to the common trigger points shown in the image below. Hey! Radial Tunnel Syndrome, Diagnostic and Treatment Dilemma. The supinator muscle, abductor pollicis longus muscle, extensor pollicis brevis muscle, extensor pollicis longus muscle, and extensor indicis muscle comprise this deep compartment. In this setting, irrigation and debridement should be performed. The most reliable physical examination test for diagnosing a central slip injury is an Elson test: Conservative management should be attempted before performing surgery. Thumbextension is carried out by abductor pollicis longus (APL), extensor pollicis brevis (EPB), and extensor pollicis longus (EPL). chiropractor BioMed research international. POSTERIOR INTEROSSEOUS A. Stretches & Myofascial Release Techniques: Vitruve Encoder Review: Is This VBT Device Worth It? That is, theyre endurance muscles, which contract slowly (i.e. Extensor tendon injuries occur more frequently than their flexor tendon counterparts. Clinical pathology affecting one or multiple muscles in this group is not uncommon. [3]The first extensor compartment is comprised of the APL and EPB tendons. Clinicians must rule out "Fight Bite" injuries and carefully inspect the skin for open wounds/lacerations. Independent small finger extension is accomplished by the extensordigitiminimi(EDM)muscle.[3]. Against resistance, the examiner asks the patient to extend the digit. The muscles of the superficial compartment originate on the lateral epicondyle of the humerus. The wrist joint (also known as the radiocarpal joint) is a synovial joint in the upper limb, marking the area of transition between the forearm and the hand. Amongst women, those who are recently postpartum are commonly affected. EXTENSOR CARPI RADIALIS LONGUS. The wrist extensors are a group of nine individual muscles on the back of the forearm that act on the wrist and fingers. It is supplied by posterior interosseous nerve. These injuries to the digits includeinjury to thecommon extensor tendon(s). These variants are the extensor carpi radialis intermedius (ECRI), extensor carpi radialis tertius (ECRT), and extensor carpi radialis accessories (ECRA). When using these techniques, give special attention to the common trigger points shown in the image below. Thanks so much for the post.Much thanks again. Tennis Elbow The superficial arch also receives contributions from the superficial branch of the radial artery. [3], Lateral epicondylitis (tennis elbow) ranks as one of the most prevalent pathologies affecting the wrist extensor muscles, affecting approximately 1to 5% of the population. Proximally, the capitate has a rounded surface whilst the distal end has a triangular shape with a palmarly directed apex. Nerve Supply : It is supplied by the median nerve and deep branch of ulnar nerve. Note: Most sources I found classified the ECRB and ECU as fusiform, but at least one source contradicts that and classes them as bipennate muscles. Part of this increased susceptibility to injuryis attributed to the natural anatomy, as the extensors are more superficial in location. Wrist Circles : Sit or stand with the spine erect, shoulders rolled back, and look forward. Implement the above guidelines for 2+ months and monitor your progress. A positive test is when this maneuver causes pain. Stand at a table with the palms down, fingers flat, and elbows straight. Everything you need to know about: Forearm. Below is a description of the extensor tendon zones: The thumb zones are classified differently from the tip of the thumb to the carpal-metacarpal joint. III: extensor pollicis longus. triceps workout at home with dumbbells West CT, Ricketts D, Brassett C. An anatomical study of additional radial wrist extensors including a unique extensor carpi radialis accessorius. Looking forward to reading more. Physiotherapy clinic in Amaraiwadi the deep fascia is firmly bound to the skin Extensor tendon zones are a helpful way to identify the region where injuries to the extensor tendons occur in the hand and wrist. The third extensor compartment is comprised of the EPL muscle tendon. European journal of medical research. If damage occurs to an extensor tendon in zone II, treatment via immobilization and splinting is the management of choice during the acute phase. [3], Lateral epicondylitis (tennis elbow) ranks as one of the most prevalent pathologies affecting the wrist extensor muscles, affecting approximately 1to 5% of the population. In idea I want to put in writing like this moreover taking time and precise effort to make a very good article however what can I say I procrastinate alot and under no circumstances appear to get something done. [3] Thus, in various clinical pathologies that may cause a dynamic imbalance between the radial-based extensors (ECRL and ECRB) versus the ulnar-based extensor (ECU), wrist extension will occur with simultaneous and involuntary radial/ulnar deviation.[3]. Compression can occur at five sites, but the Arcade of Frohse is the most common location of the compression. 2009 Jan [PubMed PMID: 26998456], Subramaniyam SD,Purushothaman R,Zacharia B, Snapping wrist due to multiple accessory tendon of first extensor compartment. It often affects rowers, weightlifters, individuals performing secretarial work, and carpenters. Really Cool. A completeabsence of the EPB muscle has also been observed. Upper Extremity Muscles (Origin, Insertion, Action, and Nerve Supply) 5.0 (1 review) Term 1 / 60 Muscles connecting upper limb to vertical column (superficial muscles of the back) Click the card to flip Definition 1 / 60 Trapezius Latissimus dorsi Levator scapulae Rhomboid minor Rhomboid major Click the card to flip Flashcards Learn [11], Anatomists have noted several variations in the anatomy of the radial artery. They then flex all four digits over the thumb and deviate their wrist towards the ulna. Im thankful for the article post.Much thanks again. The tendon continues into the distal part of the forearm. 2nd - lateral side of the tendon of the 3rd digit. It is supplied by posterior interosseous nerve(C7-C8). Dr. Nitesh Patel ( Physiotherapist ) : Mo No : 09898607803, Pingback: origin, insertion, innervation and blood supply - Quick Weight Loss. physiotherapy center near me Radiographs help to rule out bone disease, arthropathy, and the presence of loose or foreign bodies. In this case, the total number of wrist extensor compartments increases from six to seven. Accessory Slip of the Extensor Carpi Ulnaris: A Cadaveric Assessment. Youll also have to practice taping your wrists to get the right amount of pain reduction/flexibility. This form of intersection syndrome is more common than distal intersection syndrome. Radial nerve Nervus radialis [9]At the wrist, the extensor retinaculum of the hand overlies the tendons of the extensor compartment of the wrist. In: StatPearls [Internet]. [1]For these reasons, the necessity of imaging is rare in diagnosing this condition.[13]. Wysiadecki G, Polguj M, Haadaj R, Topol M. Low origin of the radial artery: a case study including a review of literature and proposal of an embryological explanation. Ahmedabad It then innervates the APL, EPB, EPL, and EIP muscles. Initial management of most cases utilizes DIP extension splinting and conservative management. vastus medialis oblique Below a summary of the general origin and insertion points can be found. Extensor indicis is a narrow muscle that originates mainly from the ulna, arising from the posterior two-thirds of its distal surface, distal to extensor pollicis longus muscle. Id like to see more posts like this. Physiotherapist in Samarpan Physiotherapy Clinic Hello, everything is going perfectly here and ofcourse every one is sharingfacts, thats truly excellent, keep up writing. leg press exercise at home A caveat includes managing zone V injuries (zone V injuries include disruption over the MCP joint of the digit or the CMC joint of the thumb. Orthopaedics [PubMed PMID: 26547256], Folberg CR,Ulson H Jr,Scheidt RB, THE SUPERFICIAL BRANCH OF THE RADIAL NERVE: A MORPHOLOGIC STUDY. I just would like to offer you a big thumbs up for your excellent info you have right here on this post.I will be coming back to your blog for more soon. AJR. Extend the hands forward at the shoulder level, and fold each palm into a fist. [2]The ECRB tendon is most commonly affected and will show angiofibroblastic hyperplasia (immature reparative tissue). Extensor carpi ulnaris (ECU) muscle is a muscle of the superficial layer of the posterior compartment of the forearm.It is separated from the extensor digitorum and the extensor digiti minimi muscles by a distinct intermuscular septum. Haadaj R, Wysiadecki G, Dudkiewicz Z, Polguj M, Topol M. The High Origin of the Radial Artery (Brachioradial Artery): Its Anatomical Variations, Clinical Significance, and Contribution to the Blood Supply of the Hand. Patients will present with this deformity in part due to the lateral bands of the dorsal interossei muscles. In this article, we shall look at the structures of the wrist joint, the movements of the joint, and the relevant clinical syndromes. The wrist extensors are a group of nine individual muscles on the back of the forearm that act on the wrist and fingers. STRENGTHENING EXERCISE OF WRIST EXTENSORS : 1. Radiographs help to rule out bone disease, arthropathy, and the presence of loose or foreign bodies. They then flex all four digits over the thumb and deviate their wrist towards the ulna. Surgical techniques described include: Zone IV is located over the proximal phalanx of the digits (or the thumb metacarpal). 2017 May 29 [PubMed PMID: 28553852], Haadaj R,Wysiadecki G,Dudkiewicz Z,Polguj M,Topol M, The High Origin of the Radial Artery (Brachioradial Artery): Its Anatomical Variations, Clinical Significance, and Contribution to the Blood Supply of the Hand. The extensor digitorum muscle (also known as extensor digitorum communis) [2] is a muscle of the posterior forearm present in humans and other animals. The wrist extensor muscles comprise a significant component of the posterior forearm musculature. A low origin of the radial artery has an incidence of 0.2% and has multiple variations within itself. The SBRN branches from the radial nerve and runs deep to the brachioradialis muscle in the forearm before emerging between the brachioradialis and ECRL muscles approximately 9 cm proximal to the radial styloid. Whats up mates, its wonderful article concerningcultureand completely defined, keep it up all the time. MRI can provide more information about the nature ofthe pathology, but this modality is expensive and generally does not correlate accurately with the severity of clinical symptoms. As the PIN enters the posterior compartment of the forearm, it passesdeep to the supinator muscle (between its two heads). Read more, Wrist Extensors: Functional Anatomy Guide. This patient is instructed to adduct their thumb. compartments 2 and 3 are divided by . Surgical intervention aims at debriding angiofibroblastic tissue at the origin of the ECRB. Blood supply of extensor pollicis longus. Pretty section of content. The sixth extensor compartment harbors the ECU muscle tendon. 2016 Nov [PubMed PMID: 27777817], West CT,Ricketts D,Brassett C, An anatomical study of additional radial wrist extensors including a unique extensor carpi radialis accessorius. Additionally, the aberrant ERCA muscle is identified as having multiple deviations. A negative Elson test consists ofthe DIP joint remaining flexible (or "floppy") during PIP joint extension against resistance. In order to get them to grow, you need to train with high reps/volume/frequency. Really Cool. [6], Vaquero-Picado A,Barco R,Antua SA, Lateral epicondylitis of the elbow. Extensor carpi radialis longus receives blood supply mainly from the radial artery. From their origin attachments, the wrist flexors move in adistaldirection,downthe front of the forearm, andinsert onthe anterior surfaces of the carpals, metacarpals and phalanges. Assuming thats the case, I know that a lot of guys will use wrist wraps (like these ones) to reduce pain on power cleans/front squats. Your email address will not be published. [10], Three variants of superfluous wrist extensor muscles have previously been described. As it traverses towards the upper extremity, it becomes the axillary artery at the lateral border of the first rib. Thumb spica splinting can be used to immobilize the thumb. Thanks-a-mundo for the blog article.Really looking forward to read more. If your forearms arent burning and pumped full of blood after each set, youre doing it wrong! The second extensor compartment is comprised of the ECRB and ECRL muscle tendons. Do wrist flexor training toward the end of your workout so you dont interfere with major lifts that require full grip strength (e.g. Thumbextension is carried out by abductor pollicis longus (APL), extensor pollicis brevis (EPB), and extensor pollicis longus (EPL). Anatomy, Shoulder and Upper Limb, Wrist Extensor Muscles - StatPearls - NCBI Bookshelf Last Update: August 30, 2022 Zone I: covers the fingertip to the distal interphalangeal (DIP) joint Zone II: covers the middle phalanx Zone III: located at the proximal interphalangeal (PIP) joint Zone IV: covers the proximal phalanx Individuals who experience a distal radius fracture are also at increased risk of this condition. The sixth extensor compartment harbors the ECU muscle tendon. I know how much it sucks to not be able to lift at full capacity, but its not worth prolonging your healing time, or possibly re-injuring yourself. I just stumbled upon your website and in accession capital to assert that I get in fact enjoyed account your blog posts. Distal intersection syndrome occurs when this area of crossing over becomes inflamed and causes dorsal wrist pain. Extensor Carpi Ulnaris: Origin, Insertion, Nerve Supply & Action Extensor Carpi Ulnaris: The extensor carpi ulnaris muscle is located on the medial aspect of the posterior forearm. Lumbricals : Origin : It originates from the Flexor Digitorum Profundus muscle. Dorsum of the Hand: A view of the Dorsal Interossei. Sciatica Extensor denotes their action which is to extend, or open flat, joints in the hand. As it courses medially, it travels distally to Lister's tubercle. Insertion: Apex of plamer aponeurosis. Thx! Best Physiotherapist in Bapunagar, Ahmedabad: Active drawer test of the Knee : |Quadriceps drawer test, Triceps muscle tightness: Cause, Symptoms, Stretching exercise, Tarsal tunnel syndrome :- Physiotherapy Management, Physiotherapy clinic in India colony road. Thank you, Ive recently been searching for information approximately this subject for ages and yoursis the best I have came upon so far. Contributed by Gray's Anatomy plates. It acts as the extensor of hand, wrist and fingers. Lateral epicondylitis of the elbow. These injuries to the digits includeinjury to thecommon extensor tendon(s). Blood supply of Extensor carpi ulnaris. Money and freedom is the best way to change, may you be rich and continue to guide others. Hi Fred, thanks for reading and commenting. StatPearls Publishing, Treasure Island (FL). My brother suggested I may like this blog. He was once totally right. There have been reports of fusion of the APL and EPB muscles. I started this website back in late 2009 during college, and it has been my pet project ever since. There is definately a great deal to find outabout this issue. Insertion: Posterior base of the 2nd metacarpal. International journal of surgery case reports. [15], Compression of the PIN can occur in the posterior forearm compartment causing radial tunnel syndrome (RTS). Aw, this was a very nice post. DeQuervainTenosynovitis (extensor compartment 1), DeQuervain tenosynovitis classically affects women more often than men. Keeping the elbows stationary, turn the wrists to the left, flex them up, turn to the right, and then flex down. Extension of the second (index finger), third (long finger), fourth (ring finger), and fifth (small finger) digits occurs via the extensor digitorum communis (EDC) muscles. Some fibers also stem from the adjacent interosseous membrane. These muscles generally originate on or near the lateral epicondyle and insert on the distal forearm or in the hand. This condition is typically managed by conservative treatment, including thumb spica splinting, activity modification, non-steroidal anti-inflammatories, and steroid injection in the second extensor compartment. It is seen as a stenosing synovitis that occurs in the first wrist extensor compartment affecting APL and EPB. Dont neglect the rest of your forearm musculature. Actions: Flexion of the wrist, and Tension of the palmar aponeurosis. Compression can occur at five sites, but the Arcade of Frohse is the most common location of the compression. Independent small finger extension is accomplished by the extensordigitiminimi(EDM)muscle.[3]. Awesome. If you have developed lateral epicondylitis, see. The flexor retinaculum overlying the compartment becomes thickened, and the tendon sheaths become inflamed. 79%. wrist strengthening exercises. Once it branches from the ulnar nerve, it travels posterolateral, eventually supplying blood to muscles in the posterior compartment. [3]The first extensor compartment is comprised of the APL and EPB tendons. As it traverses towards the upper extremity, it becomes the axillary artery at the lateral border of the first rib. As I'll detail later, these muscles are also responsible for other movements of the fingers and wrist. Extension of the second (index finger), third (long finger), fourth (ring finger), and fifth (small finger) digits occurs via the extensor digitorum communis (EDC) muscles. The wrist flexors refer to six muscles in the anterior compartment of the forearm that act on the wrist and finger joints. what are leg raises good for THE SUPERFICIAL BRANCH OF THE RADIAL NERVE: A MORPHOLOGIC STUDY. It inserts on the dorsal surface of the base of the second metacarpal bone. These muscles generally originate on or near the lateral epicondyle and insert on the distal forearm or in the hand. 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