Bones and Muscles and regional anatomy of the upper limb part1 Lecturer Dr M Samsam University of Central Florida Orlando Source textbook of human anatomy by Platzer and K Moore clinically oriented anatomy and Netter atlas of anatomy Bones of the upper limb Scapula Surfaces Borders Angles Spine of scapula Acromion process glenoid cavity supraglenoid tubercle neck of scapula coracoid process Scapular notch Clavicle S shape Medial 2 3 is convex anteriorly and lateral 1 3 is concave anteriorly sternal end acromial end Surfaces Lower surface costoclavicular impression conoid tubercle trapezoid line Costoclavicular ligament anterior sternoclavicular lig interclavicular lig Trapezoid ligament Conoid ligament Fractures of clavicle Cleidocranial dysostosis Sternoclavicular joint Acromioclavicular joint Humerus Has a shaft and 2 ends Proximal end head Anatomical neck Surgical neck Greater tubercle Lesser tubercle intertubercular sulcus Deltoid tuberosity lateral medial border lateral border Sulcus for radial nerve post Surface Distal end Condyles Trochlea 1capitulum Epicondyles medial lateral Radial fossa Coronoid fossa Sulcus for Ulnar nerve Olecranon fossa Fractures of the Humerus Fractures of the surgical neck injury to the Axillary nerve Fractures of the middle of the shaft may cause injury to the radial nerve Wrist drop Fractures of the distal end of humerus injury to the Median nerve Fractures to the medial epicondyle injury to the ulnar nerve Traumatic separation of the proximal epiphysis under 18 20 years Also in younger children since the capsule is stronger Dislocation of the shoulder joint Radius and Ulna bones Radius Body Head Articular fovea Articular circumference Neck Radial tuberosity Interosseous margin Anterior surface Ant Margin Lat surface Post Margin Post Surface Pronator tuberosity Styloid process Ulnar notch Carpal articular surface Sulcus for tendon of Abd Pollicis longus and ext Pollicis brevis Sulcus for tendon of Ext carpi radialis longus and brevis sulci for Extensor pollicis longus extensor digitorum and Ext indicis Dorsal tubercle Radius and Ulna bones Ulna Shaft of Ulna Olecranon process Trochlear notch Coronoid process Radial notch Ulnar tuberosity Supinator crest Interosseous margin Anterior surface Ant Margin Medial surface Post Surface Post Margin Nutrient foramen Head of Ulna Articular circumference Styloid process Colles Fracture fracture of the distal end of the radius posterior displacement Falling on hand with extended arm eg falling on ice May be accompanied by avulsion of ulnar styloid process Carpal Bones 2 rows each row has 4 bones Proximal row Scaphoid largest in this row Tubercle of scaphoid Lunate Triquetrum Articular facet for Pisiform Pisiform Distal row Trapezium Tubercle of trapezium Groove for flexor carpi radialis tendon Articular facet for first metacarpal bone Trapezoid Capitate bigest in 2nd row Hamate Hamulus hook of Hamate Scaphoid bone is the most frequent bone to fracture among the carpal bones Lunate is the most dislocated carpal bone Carpal tunnel The 2 rows of the carpal bones produce the carpal groove which is concave anteriorly Flexor Retinaculum Is a double layer of membrane covering the carpal groove anteriorly and produces the carpal tunnel for transmission of flexor muscles and median nerve Points of insertion of flexor retinaculum Tubercle of scaphoid pisiform tubercle of Trapezium and hook of Hamate Carpal Tunnel Syndrome Compression to the median nerve in the tunnel due to hypothyroidism rheumatoid arthritis pregnancy Amyloidosis etc It is a very painful condition Metacarpal and phalangeal bones Head of the metacarpal bone Body Base Styloid process of the 3rd metacarpal B Phalanx digital bones Body Head or trochlea Base Tuberosity of distal phalanx Sesamoid bones at 1st metacarpo phalangeal J Brachial Plexus Axillary region Pyramidal shape Borders Pectoralis Major Latis dorsi ribs and intercostal muscles humerus and coracobrachialis Atlas only look at the items Shoulder muscles inserted to Humerus Dorsal group Supraspinatus Abductor of the arm belongs to the rotator cuff muscle group NN Suprascapular N C4 C6 Infraspinatus Lateral rotator of the arm belongs to the rotator cuff muscle group NN Suprascapular N C5 C6 Teres minor Lateral rotator of the arm Rotator cuff group NN Axillary circumflex N C5 C6 Pathology tendinopathy of supraspinatus baseball calcification pain tendon rupture 40 y and in younger people avulsion of greater tub Rotator cuff function help to maintain the stability of the shoulder joint Deltoid Origin clavicular acromial and spinal parts Insertion Deltoid tuberosity NN Axillary N C5 C6 Function Most important abductor of the arm up to 90 degree Ant Part flexes anteversion the arm medial rotation of the arm Middle part abducts the arm Post Part extends retroversion lateral rotation Subscapularis M Origin subscapular fossa Insertion lesser tubercle Function Arm adduction and medial rotation NN upper lower Subscapular nerves C5 C6 C7 Pathology paralysis cause maximal lat Rotation Rotator cuff muscles supra infra spinatus teres minor and subscapularis Teres major M Origin lateral border of scapula close to inferior angle Insertion crest of lesser tubercle of the humerus Function Arm adduction and medial rotation NN Lower subscapular N C6 C7 Latissimus dorsi M coughing M Origin vertebral part thoracolumbar part iliac part and costal part Insertion crest of the lesser tubercle Function Adduction and medial rotation and extension of the arm NN Thoracodorsal N C6 C7 C8 Ventral Muscle group Coracobrachialis M Origin coracoid process Insertion medial surface of the humerus Flexion anteversion and adduction of arm Musculocutaneous N C5 C6 C7 Pectoralis Minor M Origin 3 5th ribs Insertion coracoid process It lowers and rotates the scapula Medial pectoral N C8 T1 Pectoralis major M Origin clavicular part sternocostal part abdominal part Insertion crest of the greater tubercle F Adduction and medial rotation of humerus NN lateral and medial pectoral N C5 T1 Dorsal muscle group Serratus anterior M Origin 1st 9th ribs Insertion From superior to inferior angle and the medial border of the scapula Function Elevation of the arm over 90o Protracts the scapula and holds it against the thoracic wall and rotates the scapula laterally to elevate the arm Long thoracic N C5 C6 C7 Paralysis Winged scapula lifting the arm beyond 90o is not possible Differential diagnosis Rhomboid M injury Here you have winged scapula as well