Pronator Quadratus: Difference between revisions
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=== Nerve === | === Nerve === | ||
Anterior interosseous nerve, a branch of the [[Median Nerve|median nerve]] (C8-T1).<ref name=":1" /> | Anterior interosseous nerve, a branch of the [[Median Nerve|median nerve]] (C8-T1) with 12.25 cm of average length.<ref name=":1" /><ref name=":2">Carlson TL, Bhandari L, Chang J, Konofaos P. Pronator quadratus muscle flap: a preliminary cadaveric study. European Journal of Orthopaedic Surgery & Traumatology. 2020 Jan 1;30(1):103-7.</ref> | ||
=== Artery === | === Artery === | ||
It is vascularized by the anterior interosseous artery.<ref name=":1" /> | It is vascularized by the anterior interosseous artery with an average length and diameter of 12cm and 2.25 cm respectavely.<ref name=":1" /><ref name=":2" /> | ||
== Function == | == Function == | ||
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Mean width of the muscle is 3.5cm.<ref name=":1" /> | Mean width of the muscle is 3.5cm.<ref name=":1" /> | ||
== Myofascial Trigger point (TrP) | == Myofascial Trigger point (TrP) == | ||
Pronator Quadratus muscle has two main referred pain pattern of the TrP.Most commonly pain spreads into the medial aspect of the forearm both distally and proximally.In many cases, the pain is referred proximally to the medial epicondyle and distally to the fifth digit of the hand.Pain also spread distally to the third and fourth finger, which is the second most common pattern. | Pronator Quadratus muscle has two main referred pain pattern of the TrP.Most commonly pain spreads into the medial aspect of the forearm both distally and proximally.In many cases, the pain is referred proximally to the medial epicondyle and distally to the fifth digit of the hand.Pain also spread distally to the third and fourth finger, which is the second most common pattern.<ref>Hwang M, Kang YK, Kim DH. [https://www.sciencedirect.com/science/article/abs/pii/S0304395905001867 Referred pain pattern of the pronator quadratus muscle.] Pain. 2005 Aug 1;116(3):238-42.</ref> | ||
== Treatment == | == Treatment == | ||
Revision as of 07:21, 20 September 2020
Original Editor - Kakshya Rupakheti
Top Contributors - Kakshya Rupakheti and Amanda Ager
Description[edit | edit source]
Pronator Quadratus is a deep-seated,short, flat and quadrilateral muscle with fibres running in a parallel direction.[1] The pronator quadratus muscle is compacted in a small closed compartment, covered by the interosseous membrane dorsally and distally and by its own fascia on the volarly.[2] In the anatomical and functional literature, the muscle has been neglected to a high extend.A study shows that the muscle consist of two different heads. The superficial head which is the prime mover in forearm pronation, and the deep head which is dynamic stabilizer of radioulnar joint.[3]
Origin[edit | edit source]
Muscle arises from the oblique ridge on the anterior surface of the distal fourth of the Ulna.[1]
Insertion[edit | edit source]
Muscle is inserted in lateral border and anterior surface of the distal fourth of the radius.[1]
Nerve[edit | edit source]
Anterior interosseous nerve, a branch of the median nerve (C8-T1) with 12.25 cm of average length.[2][4]
Artery[edit | edit source]
It is vascularized by the anterior interosseous artery with an average length and diameter of 12cm and 2.25 cm respectavely.[2][4]
Function[edit | edit source]
The action of the pronator teres and pronator quadratus muscle result in the pronation of radioulnar joint.Contraction of this muscle pulls the distal end of radius over the ulna, resulting in pronation of the radioulna joint.[5]
Clinical Uses[edit | edit source]
The electrophysiologic diagnosis of AIN lesions is done by using the Pronator Quadratus muscle which is the key muscle for this diagnosis procedure.[1]
Spasticity[edit | edit source]
The injection of neurolytic agents such as Botulinum toxin, phenol or alcohol is used into the motor point of the pronator Quadratus for the management of pronator spasticity in stroke patients.[1]
Palpation[edit | edit source]
It can neither be palpated nor be observed as it is the deepest muscle of the forearm.[1]
Length[edit | edit source]
The mean length of the muscle is 6 cm.[2]
Width[edit | edit source]
Mean width of the muscle is 3.5cm.[2]
Myofascial Trigger point (TrP)[edit | edit source]
Pronator Quadratus muscle has two main referred pain pattern of the TrP.Most commonly pain spreads into the medial aspect of the forearm both distally and proximally.In many cases, the pain is referred proximally to the medial epicondyle and distally to the fifth digit of the hand.Pain also spread distally to the third and fourth finger, which is the second most common pattern.[6]
Treatment[edit | edit source]
Stretching[edit | edit source]
Strengthening[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Choung PW, Kim MY, Im HS, Kim KH, Rhyu IJ, Park BK, Kim DH. Anatomic characteristics of pronator quadratus muscle: a cadaver study. Annals of rehabilitation medicine. 2016 Jun;40(3):496.
- ↑ 2.0 2.1 2.2 2.3 2.4 Créteur V, Madani A, Brasseur JL. Pronator quadratus imaging. Diagnostic and Interventional Imaging. 2012 Jan 1;93(1):22-9.
- ↑ Stuart PR. Pronator quadratus revisited. Journal of Hand Surgery. 1996 Dec;21(6):714-22.
- ↑ 4.0 4.1 Carlson TL, Bhandari L, Chang J, Konofaos P. Pronator quadratus muscle flap: a preliminary cadaveric study. European Journal of Orthopaedic Surgery & Traumatology. 2020 Jan 1;30(1):103-7.
- ↑ Standring S, Ellis H, Healy J, Johnson D, Williams A, Collins P, Wigley C. Gray's anatomy: the anatomical basis of clinical practice. American journal of neuroradiology. 2005 Nov;26(10):2703.
- ↑ Hwang M, Kang YK, Kim DH. Referred pain pattern of the pronator quadratus muscle. Pain. 2005 Aug 1;116(3):238-42.
- ↑ Pronator Quadratus stretch
- ↑ Pronator Quadratus Strengthening
