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The flexor pollicis longus (; FPL, Latin ''flexor'', bender; ''pollicis'', of the thumb; ''longus'', long) is a
muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...
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 used to describe the entire appendage of the upper limb, but which in anatomy, techn ...
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#Characteristics, koala (which has two thumb#O ...
that flexes the thumb. It lies in the same plane as the
flexor digitorum profundus The flexor digitorum profundus or flexor digitorum communis profundus is a muscle in the forearm of humans that flexes the fingers (also known as digits). It is considered an Muscles of the hand#Extrinsic, extrinsic hand muscle because it acts on ...
. 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 or radiuses) of a circle or sphere is any of the line segments from its Centre (geometry), center to its perimeter, and in more modern usage, it is also their length. The radius of a regular polygon is th ...
, 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 ...
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 C ...
. 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 ...
, 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. Its ''apex'' is pointed, ...
. 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 of the humerus, lateral epicondyle and is directed slightly more posteriorly in the ...
, and in those cases a tendinous connection with the humeral head of the
flexor digitorum superficialis Flexor digitorum superficialis (''flexor digitorum sublimis'') or flexor digitorum communis 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 s ...
is present.Platzer 2004, p 162 The fibers end in a flattened
tendon A tendon or sinew is a tough band of fibrous connective tissue, dense fibrous connective tissue that connects skeletal muscle, muscle to bone. It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding tensi ...
, 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. Structur ...
through the
carpal tunnel In the human body, the carpal tunnel or carpal canal is a flattened body cavity on the flexor ( palmar/volar) side of the wrist, bounded by the carpal bones and flexor retinaculum. It forms the passageway that transmits the median nerve and the ...
. 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 ...
and the oblique part of the
adductor pollicis In human anatomy, the adductor pollicis muscle is a muscle in the hand that functions to Adduction, adduct the thumb. It has two heads: transverse and oblique. It is a fleshy, flat, triangular, and fan-shaped muscle deep in the Thenar eminence, ...
, and, entering an osseo
aponeurotic An aponeurosis (; : aponeuroses) is a flattened tendon by which muscle attaches to bone or fascia. Aponeuroses exhibit an ordered arrangement of collagen fibres, thus attaining high tensile strength in a particular direction while being vulnerabl ...
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
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 C ...
(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 cont ...
) and the
anterior interosseous artery The anterior interosseous artery (volar interosseous artery) is an artery in the forearm. It is a branch of the common interosseous artery. Course It passes down the forearm on the palmar surface of the interosseous membrane. It is accompanied ...
and vein pass downward on the front of the interosseous membrane between the flexor pollicis longus and
flexor digitorum profundus The flexor digitorum profundus or flexor digitorum communis profundus is a muscle in the forearm of humans that flexes the fingers (also known as digits). It is considered an Muscles of the hand#Extrinsic, extrinsic hand muscle because it acts on ...
. 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 (: phalanx ) are digit (anatomy), digital bones in the hands and foot, feet of most vertebrates. In primates, the Thumb, thumbs and Hallux, big toes have two phalanges while the other Digit (anatomy), digits have three phalanges. ...
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 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 ...
.


Innervation

The flexor pollicis longus is supplied by the anterior interosseous(C8-T1) 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 cont ...
(C5-T1).


Variations

Slips may connect with
flexor digitorum superficialis muscle Flexor digitorum superficialis (''flexor digitorum sublimis'') or flexor digitorum communis 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 s ...
,
flexor digitorum profundus muscle The flexor digitorum profundus or flexor digitorum communis 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 b ...
(resulting in the Linburg-Comstock syndrome), or the pronator teres muscle. 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
flexor digitorum profundus The flexor digitorum profundus or flexor digitorum communis profundus is a muscle in the forearm of humans that flexes the fingers (also known as digits). It is considered an Muscles of the hand#Extrinsic, extrinsic hand muscle because it acts on ...
(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 a type of fibrous connective tissue in the body that connects bones to other bones. It also connects flight feathers to bones, in dinosaurs and birds. All 30,000 species of amniotes (land animals with internal bones) have liga ...
, 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 genus ...
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
adductor pollicis In human anatomy, the adductor pollicis muscle is a muscle in the hand that functions to Adduction, adduct the thumb. It has two heads: transverse and oblique. It is a fleshy, flat, triangular, and fan-shaped muscle deep in the Thenar eminence, ...
. Lesser apes (i.e.
gibbon Gibbons () are apes in the family Hylobatidae (). The family historically contained one genus, but now is split into four extant genera and 20 species. Gibbons live in subtropical and tropical forests from eastern Bangladesh and Northeast Indi ...
s) and
Old World monkey Old World monkeys are primates in the family Cercopithecidae (). Twenty-four genera and 138 species are recognized, making it the largest primate family. Old World monkey genera include baboons (genus '' Papio''), red colobus (genus '' Piliocolob ...
s (e.g.
baboon Baboons are primates comprising the biology, genus ''Papio'', one of the 23 genera of Old World monkeys, in the family Cercopithecidae. There are six species of baboon: the hamadryas baboon, the Guinea baboon, the olive baboon, the yellow ba ...
s) 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
carpal tunnel In the human body, the carpal tunnel or carpal canal is a flattened body cavity on the flexor ( palmar/volar) side of the wrist, bounded by the carpal bones and flexor retinaculum. It forms the passageway that transmits the median nerve and the ...
and, because of the lack of differentiation in both the FDP and FPL
musculature 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 ...
, it is unlikely that baboons can control individual digits independently.


Additional images


References


Further reading

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External links


PTCentral
{{Authority control Muscles of the upper limb