In human anatomy, the extensor carpi ulnaris is a
skeletal muscle
Skeletal muscle (commonly referred to as muscle) is one of the three types of vertebrate muscle tissue, the others being cardiac muscle and smooth muscle. They are part of the somatic nervous system, voluntary muscular system and typically are a ...
located on the
ulna
The ulna or ulnar bone (: ulnae or ulnas) is a long bone in the forearm stretching from the elbow to the wrist. It is on the same side of the forearm as the little finger, running parallel to the Radius (bone), radius, the forearm's other long ...
r side of the
forearm
The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is used to describe the entire appendage of the upper limb, but which in anatomy, techn ...
. The extensor carpi ulnaris acts to extend and adduct at the
carpus/wrist from
anatomical position
Anatomical terminology is a specialized system of terms used by anatomists, zoologists, and health professionals, such as doctors, surgeons, and pharmacists, to describe the structures and functions of the body.
This terminology incorpor ...
.
Being an extensor muscle, extensor carpi ulnaris is located on the posterior side of the forearm.
Origin and insertion
It originates from the
lateral epicondyle of the humerus
The lateral epicondyle of the humerus is a large, tuberculated eminence, curved a little forward, and giving attachment to the radial collateral ligament of the elbow joint, and to a tendon common to the origin of the supinator and some of the e ...
and the posterior border of the
ulna
The ulna or ulnar bone (: ulnae or ulnas) is a long bone in the forearm stretching from the elbow to the wrist. It is on the same side of the forearm as the little finger, running parallel to the Radius (bone), radius, the forearm's other long ...
, and crosses the forearm to the
ulna
The ulna or ulnar bone (: ulnae or ulnas) is a long bone in the forearm stretching from the elbow to the wrist. It is on the same side of the forearm as the little finger, running parallel to the Radius (bone), radius, the forearm's other long ...
r (medial) side to insert at the base of the
5th metacarpal.
Action
The extensor carpi ulnaris
extends the
wrist
In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carpal ...
, but when acting alone inclines the hand toward the ulnar side; by its continued action it extends the elbow-joint.
The muscle is a minor extensor of the carpus in carnivores, but has become a flexor in
ungulate
Ungulates ( ) are members of the diverse clade Euungulata ("true ungulates"), which primarily consists of large mammals with Hoof, hooves. Once part of the clade "Ungulata" along with the clade Paenungulata, "Ungulata" has since been determined ...
s. In this case it would be described as ''ulnaris lateralis''.
Innervation
Despite its name, the extensor carpi ulnaris is innervated by the
posterior interosseous nerve
The posterior interosseous nerve (or dorsal interosseous nerve/deep radial nerve) is a nerve in the forearm. It is the continuation of the deep branch of the radial nerve, after this has crossed the supinator muscle. It is considerably diminish ...
(C7 and C8), the continuation of the
deep branch of the radial nerve. It would therefore be paralyzed in an injury to the posterior cord of the
brachial plexus
The brachial plexus is a network of nerves (nerve plexus) formed by the anterior rami of the lower four Spinal nerve#Cervical nerves, cervical nerves and first Spinal nerve#Thoracic nerves, thoracic nerve (cervical spinal nerve 5, C5, Cervical spi ...
.
Injuries
A common injury to the extensor carpi ulnaris is
tennis elbow
Tennis elbow, also known as lateral epicondylitis is an enthesopathy (attachment point disease) of the origin of the extensor carpi radialis brevis on the lateral epicondyle. It causes pain and tenderness over the bony part of the lateral epi ...
. This injury occurs in people who participate in activities requiring repetitive arm, elbow, and wrist, especially when they are tightly gripping an object. Some symptoms of an extensor carpi ulnaris injury include pain when shaking hands or when squeezing/gripping an object. The pain worsens when a person moves their wrist with force. This pain intensifies because the extensor carpi ulnaris has an injury near the elbow area and as a person moves their arm, the muscle contracts, thus causing it to move over the medial epicondyle of the humerus. As a result, this causes irritation to the already existing injury. Some treatments for tennis elbow include occupational therapy, physical therapy, anti-inflammatory medication, and rest from the activity that caused the injury. A similar injury involving the medial elbow is known as
golfer's elbow.
Treatment and diagnosis
An ECU injury most often requires imaging (CT, MRI, ultrasound) for diagnosis.
After the ECU injury is diagnosed, a physician will choose a course of treatment, which depends upon the severity of the injury. Conservative treatments include immobilization and stabilization of the affected wrist by placing it in a cast.
A long arm cast may be required in order to ensure that all wrist movement has been stopped. The duration of the immobilization is at the treating physician's discretion. After the immobilization period has ended, the cast will be removed and further analysis of the injury will be required. If the injury did not improve with the conservative courses of treatment, or if the injury was initially too severe for conservative treatment, invasive procedures may become necessary. Steroid injections and surgical procedures are the most prominent invasive procedures.
Surgical repair or reconstruction of the ECU is not often required, yet a severe ECU injury may cause these approaches to be necessary.
Additional images
References
External links
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Muscles of the upper limb