Posterior view of the supinator. (Right arm.)
|Origin||Lateral epicondyle of humerus, supinator crest of ulna, radial collateral ligament, annular ligament|
|Insertion||Lateral proximal radial shaft|
|Artery||Radial recurrent artery|
|Nerve||Deep branch of the radial nerve|
|Antagonist||Pronator teres, pronator quadratus|
|Anatomical terms of muscle|
Supinator consists of two planes of fibers, between which the deep branch of the radial nerve ls. The two planes arise in common — the superficial one by tendinous (the initial portion of the muscle is actually just tendon) and the deeper by muscular fibers — from the supinator crest of ulna, the lateral epicondyle of humerus, the radial collateral ligament, and the annular radial ligament.
The superficial fibers (pars superficialis) surround the upper part of the radius, and are inserted into the lateral edge of the radial tuberosity and the oblique line of the radius, as low down as the insertion of the pronator teres. The upper fibers (pars profunda) of the deeper plane form a sling-like fasciculus, which encircles the neck of the radius above the tuberosity and is attached to the back part of its medial surface; the greater part of this portion of the muscle is inserted into the dorsal and lateral surfaces of the body of the radius, midway between the oblique line and the head of the bone.
The proximal aspect of the superficial head is known as the arcade of Frohse or the supinator arch.
It is innervated by the deep branch of the radial nerve. The deep branch then becomes the posterior interosseous nerve upon exiting the supinator muscle. Its nerve roots are primarily from C6, with some C5 involvement. There is also possible additional C7 innervation.
The radial nerve divides into deep and sensory superficial branches just proximal to the supinator muscle — an arrangement that can lead to entrapment and compression of the deep part, potentially resulting in selective paralysis of the muscles served by this nerve (the extensor muscles and the abductor pollicis longus.) Many possible causes are known for this nerve syndrome, known as supinator entrapment syndrome, including compression by various soft-tissued masses surrounding the nerve, and stress caused by repetitive supination and pronation.
Supinator always acts together with biceps, except when the elbow joint is extended. It is the most active muscle in forearm supination during unresisted supination, while biceps becomes increasingly active with heavy loading. Supination strength decreases by 64% if supinator is disabled by, for example, injury.
The term "supinator" can also refer more generally to a muscle that causes supination of a part of the body. In older texts, the term "supinator longus" was used to refer to the brachioradialis, and "supinator brevis" was used to describe the muscle now known as the supinator.
- Platzer 2004, p. 168
- Gray's Anatomy (1918), see infobox
- Ross & Lamperti 2006, p. 345
- Chien et al. 2003, Discussion
- Boles, Kannam & Cardwell 2000, p. 153
- "Supinator". Loyola University Medical Education Network. Retrieved March 2011. Check date values in:
- Duqion, Chavan & Bisson 2010, p. 414
- Boles, CA; Kannam, S; Cardwell, AB (2000). "The Forearm: Anatomy of Muscle Compartments and Nerves". Am. J. Roentgenol. 174 (1): 151–159.
- Chien, A; Jamadar, DA; Jacobson, JA; Hayes, CW; Louis DS (2003). "Sonography and MR Imaging of Posterior Interosseous Nerve Syndrome with Surgical Correlation". Am. J. Roentgenol. 181 (1): 219–221.
- Duqion, TR; Chavan, RC; Bisson, LJ (2010). "Innervation of the Supinator Muscle and Its Relationship to Two-Incision Distal Biceps Tendon Repair: An Anatomic Study" (PDF). Clinical Anatomy. 23: 413–419. doi:10.1002/ca.20982.
- Platzer, W (2004). Color Atlas of Human Anatomy, Vol. 1: Locomotor System (5th ed.). Thieme. ISBN 1-58890-159-9.
- Ross, Lawrence M. (ed.); Lamperti, Edward D. (ed.) (2006). Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. ISBN 1-58890-419-9.CS1 maint: extra text: authors list (link)