The flexor pollicis longus (; FPL, Latin ''flexor'', bender; ''pollicis'', of the thumb; ''longus'', long) is a

muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...

in 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 most often used to describe the entire appendage of the upper limb, but which in anat ...

and

hand A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala (which has two opposable thumbs on each "h ...

that flexes the thumb. It lies in the same plane as the

flexor digitorum profundus The flexor digitorum profundus is a muscle in the forearm of humans that flexes the fingers (also known as digits). It is considered an extrinsic hand muscle because it acts on the hand while its muscle belly is located in the forearm. Together t ...

. This muscle is unique to humans, being either rudimentary or absent in other primates. A meta-analysis indicated accessory flexor pollicis longus is present in around 48% of the population.

Human anatomy

Origin and insertion

It arises from the grooved anterior (side of palm) surface of the body of the

radius In classical geometry, a radius ( : radii) of a circle or sphere is any of the line segments from its center to its perimeter, and in more modern usage, it is also their length. The name comes from the latin ''radius'', meaning ray but also the ...

, extending from immediately below the

radial tuberosity Beneath the neck of the radius, on the medial side, is an eminence, the radial tuberosity; its surface is divided into: * a ''posterior, rough portion'', for the insertion of the tendon of the biceps brachii. * an ''anterior, smooth portion'', on w ...

and oblique line to within a short distance of the pronator quadratus muscle.Gray 1918, ''Flexor Pollicis Longus'', paras 20, 25 An occasionally present accessory long head of the flexor pollicis longus muscle is called 'Gantzer's muscle'. It may cause compression of the

anterior interosseous nerve The anterior interosseous nerve (volar interosseous nerve) is a branch of the median nerve that supplies the deep muscles on the anterior of the forearm, except the ulnar (medial) half of the flexor digitorum profundus. Its nerve roots come from C8 ...

. It arises also from the adjacent part of the

interosseous membrane of the forearm The interosseous membrane of the forearm (rarely middle or intermediate radioulnar joint) is a fibrous sheet that connects the interosseous margins of the radius and the ulna. It is the main part of the radio-ulnar syndesmosis, a fibrous joint be ...

, and generally by a fleshy slip from the medial border of the

coronoid process of the ulna The coronoid process of the ulna is a triangular process projecting forward from the anterior proximal portion of the ulna. Structure Its ''base'' is continuous with the body of the bone, and of considerable strength. Anatomy Its ''apex'' is ...

. In 40 percent of cases, it is also inserted from the

medial epicondyle of the humerus The medial epicondyle of the humerus is an epicondyle of the humerus bone of the upper arm in humans. It is larger and more prominent than the lateral epicondyle and is directed slightly more posteriorly in the anatomical position. In birds, whe ...

, and in those cases a tendinous connection with the humeral head of the

flexor digitorum superficialis Flexor digitorum superficialis (''flexor digitorum sublimis'') is an extrinsic flexor muscle of the fingers at the proximal interphalangeal joints. It is in the anterior compartment of the forearm. It is sometimes considered to be the deepest pa ...

is present.Platzer 2004, p 162 The fibers end in a flattened

tendon A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...

, which passes beneath the

flexor retinaculum of the hand The flexor retinaculum (transverse carpal ligament, or anterior annular ligament) is a fibrous band on the palmar side of the hand near the wrist. It arches over the carpal bones of the hands, covering them and forming the carpal tunnel. Structu ...

through the

carpal tunnel In the human body, the carpal tunnel or carpal canal is the passageway on the palmar side of the wrist that connects the forearm to the hand. The tunnel is bounded by the bones of the wrist and flexor retinaculum from connective tissue. Norma ...

. It is then lodged between the lateral head of the

flexor pollicis brevis The flexor pollicis brevis is a muscle in the hand that flexes the thumb. It is one of three thenar muscles. It has both a superficial part and a deep part. Origin and insertion The muscle's superficial head arises from the distal edge of the fl ...

and the oblique part of the

adductor pollicis In human anatomy, the adductor pollicis muscle is a muscle in the hand that functions to adduct the thumb. It has two heads: transverse and oblique. It is a fleshy, flat, triangular, and fan-shaped muscle deep in the thenar compartment benea ...

, and, entering an osseo

aponeurotic An aponeurosis (; plural: ''aponeuroses'') is a type or a variant of the deep fascia, in the form of a sheet of pearly-white fibrous tissue that attaches sheet-like muscles needing a wide area of attachment. Their primary function is to join muscl ...

canal similar to those for the flexor tendons of the fingers, is inserted into the base of the distal phalanx of the thumb.

Relations

The

(a branch of the

median nerve The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus. The median nerve originates from the lateral and medial cords of the brachial plexus, and has contr ...

) and the anterior interosseous artery and vein pass downward on the front of the interosseous membrane between the flexor pollicis longus and

. Injuries to tendons are particularly difficult to recover from due to the limited blood supply they receive.

Actions

The flexor pollicis longus is a flexor of the

phalanges The phalanges (singular: ''phalanx'' ) are digital bones in the hands and feet of most vertebrates. In primates, the thumbs and big toes have two phalanges while the other digits have three phalanges. The phalanges are classed as long bones. ...

of the

thumb The thumb is the first digit of the hand, next to the index finger. When a person is standing in the medical anatomical position (where the palm is facing to the front), the thumb is the outermost digit. The Medical Latin English noun for thumb ...

; when the thumb is fixed, it assists in flexing the

wrist In human anatomy, the wrist is variously defined as (1) the Carpal bones, 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 ...

Innervation

The flexor pollicis longus is supplied by the anterior interosseous(C8-T1) branch of the

(C5-T1).

Variations

Slips may connect with

flexor digitorum superficialis muscle Flexor digitorum superficialis (''flexor digitorum sublimis'') is an extrinsic flexor muscle of the fingers at the proximal interphalangeal joints. It is in the anterior compartment of the forearm. It is sometimes considered to be the deepest par ...

flexor digitorum profundus muscle The flexor digitorum profundus is a muscle in the forearm of humans that flexes the fingers (also known as digits). It is considered an extrinsic hand muscle because it acts on the hand while its muscle belly is located in the forearm. Together ...

(resulting in the Linburg-Comstock syndrome), or the

pronator teres muscle The pronator teres is a muscle (located mainly in the forearm) that, along with the pronator quadratus, serves to pronate the forearm (turning it so that the palm faces posteriorly when from the anatomical position). It has two attachments, to t ...

. An additional tendon to the index finger is sometimes found.

Evolutionary variation

Modern humans are unique among

hominids The Hominidae (), whose members are known as the great apes or hominids (), are a taxonomic family of primates that includes eight extant species in four genera: '' Pongo'' (the Bornean, Sumatran and Tapanuli orangutan); ''Gorilla'' (the ...

in having a flexor pollicis longus (FPL) muscle belly that is separate from that of the

(FDP). While the FPL is not a separate muscle belly in extant

great apes The Hominidae (), whose members are known as the great apes or hominids (), are a taxonomic family of primates that includes eight extant species in four genera: '' Pongo'' (the Bornean, Sumatran and Tapanuli orangutan); ''Gorilla'' (the ...

, a distinct tendon from the FDP belly might be present. In some individuals, this tendon tend to act more like a

ligament A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the: * Peritoneal li ...

, which restricts extension of the interphalangeal joint of the thumb. In

orangutan Orangutans are great apes native to the rainforests of Indonesia and Malaysia. They are now found only in parts of Borneo and Sumatra, but during the Pleistocene they ranged throughout Southeast Asia and South China. Classified in the genu ...

s there is a tendon similar in insertion and function to the FPL in humans, but which has an intrinsic origin on the oblique head of the

. Lesser apes (i.e. gibbons) and

Old World monkey Old World monkey is the common English name for a family of primates known taxonomically as the Cercopithecidae (). Twenty-four genera and 138 species are recognized, making it the largest primate family. Old World monkey genera include baboons ...

s (e.g. baboons) share an extrinsic FPL muscle tendon with humans. In most lesser apes, the FPL belly is separate from the FDP belly, but in baboons, the FPL tendon bifurcates from the FDP tendon at the wrist within the

and, because of the lack of differentiation in both the FDP and FPL

musculature Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscle ...

Human anatomy

Origin and insertion

Relations

Actions

Innervation

Variations

Evolutionary variation

Additional images

Reference

Further reading

External links