Anatomy of Upper Limbs Lecture Notes PDF
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University of Mosul, College of Medicine
Dr. Ashraf Al-Samady
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Summary
These lecture notes cover the anatomy of the upper limbs, focusing on the radial nerve, muscles, and arteries of the forearm. The document provides details on structures, origins, insertions, actions, and nerve supplies. It also explores clinical aspects of injuries to the radial nerve and artery.
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University of Mosul College of Medicine Lecture: 7 Subject/year: Anatomy of Upper limbs/2024-2025 Lecturer: Dr. Ashraf Al-Samady Department: Anatomy Date: 15/12/2024 The AIM of this lecture is To discuss radial n., show muscles of the forearm, and to identify radial a.. ❖ Intended learning...
University of Mosul College of Medicine Lecture: 7 Subject/year: Anatomy of Upper limbs/2024-2025 Lecturer: Dr. Ashraf Al-Samady Department: Anatomy Date: 15/12/2024 The AIM of this lecture is To discuss radial n., show muscles of the forearm, and to identify radial a.. ❖ Intended learning outcomes: By the end of this lecture the student will be able to: List the muscles in the forearm and discuss their origin, insertion, action and nerve supply. List and trace the course of radial n. in the forearm region. Analyse the clinical presentation of radial n. injury in different areas of the upper limb. Identify the radial a. and summarize its branches. Radial n. Origin. End. Course & relation. Branches of radial n. In axilla: (2 muscular & 1 cutaneous) 1. Muscular: to long & medial heads of triceps. 2. Cutaneous: posterior cutaneous n. of arm. In spiral groove (arm): (3 muscular & 2 cutaneous) 1. Muscular: to lateral & medial heads of triceps & anconeus. 2. Cutaneous: lower lateral cutaneous n. of arm & posterior cutaneous n. of forearm. On lateral side of arm: (3 muscular & 1 articular) 1. Muscular: to brachialis (lateral part), brachioradialis & extensor carpi radialis longus. 2. Articular: to elbow joint. Terminal branches: 1. Superficial branch (cutaneous). 2. Deep branch (posterior interosseous n.): It gives: (1) muscular branches: to muscles of posterior compartment except anconeus. (2) articular branches: to wrist & carpal joints. Superficial radial branch (cutaneous). Deep branch (posterior interosseous n.). Applied anatomy Injury of radial n. in spiral groove. Injury to superficial branch. Injury to deep branch. Carrying angle. MUSCLES OF FOREARM Anterior compartment: Superficial group: (1) Pronator teres. (2) Flexor carpi radialis. (3) Flexor carpi ulnaris. (4) Palmaris longus. Intermediate group: (5) Flexor digitorum superficialis. Deep group: (6) Flexor digitorum profundus. (7) Flexor pollicis longus. (8) Pronator quadratus. Lateral compartment: (1) Brachioradialis. (2) Extensor carpi radialis longus. Posterior compartment: Transverse: (1) Anconeus. (2) Supinator. Longitudinal: (3) Extensor carpi ulnaris. (4) Extensor carpi radialis brevis. To digits: (5) Extensor digitorum. (6) Extensor digiti minimi. (7) Extensor indicis. To thumb: (8) Extensor pollicis longus. (9) Extensor pollicis brevis. (10) Abductor pollicis longus. ARTERIES OF FOREARM & HAND Radial a.: Beginning. End. Branches In forearm: 1. Radial recurrent a. 2. Muscular branches. 3. Palmar (anterior) carpal a. 4. Superficial palmar branch. In dorsum of hand: 1. Dorsal (posterior) carpal a.: joins dorsal (posterior) branch of ulnar a. to form the dorsal carpal arch which gives: (a) dorsal digital a. (b) second, third & fourth metacarpal arteries. 2. First dorsal metacarpal a. 3. Dorsal digital a. In palm of hand: 1. Princeps pollicis a. 2. Radialis indicis a. 3. Deep palmar arch: continuation of radial a., giving: (a) three palmar metacarpal arteries. (b) three perforating arteries. (c) recurrent branch. Course & relation of radial a.: Anterior (superficial) relation: Upper two-thirds of forearm: covered only by brachioradialis. Lower third: is subcutaneous, and pulsation can be felt. Posterior (deep) relation: (1) Tendon of biceps brachii. (2) Supinator. (3) Pronator teres. (4) Flexor digitorum superficialis (radial head). (5) Flexor pollicis longus. (6) Pronator quadratus. (7) Radius (lower end). Lateral relation: Radial n. & brachioradialis. Medial relation: Pronator teres & flexor carpi radialis. (To swim properly, flex forearm & pronate radius). Radial a. winds posteriorly (at distal end of radius) to reach anatomical snuffbox (passing deep to abductor pollicis longus & extensor pollicis brevis). It leaves the snuffbox deep to extensor pollicis longus reaching the first interosseous space. It enters the palm of the hand between 2 heads of the 1st dorsal interosseous & 2 heads of adductor pollicis and continues as deep palmar arch. Applied anatomy of radial a. Surface anatomy 1. Ulnar a.: by drawing 3 points: ∙ Point at midway between 2 epicondyles of humerus. ∙ Point at junction of upper third & lower two-thirds of forearm at medial side. ∙ Point just lateral to pisiform. 2. Superficial palmar arch: at distal border of fully extended thumb. 3. Deep palmar arch: at proximal border of extended thumb. Summary Radial n.: ▪ Course and relation. ▪ Branches. ▪ Clinical aspect. Muscles of forearm: ❑ Anterior compartment. ❑ Lateral compartment. ❑ Posterior compartment. Radial a.: o Course and relation. o Branches. o Clinical aspect. Lets check your knowledge 1. Muscle not paralyzed in injury to radial n. in spiral groove is: A. Long head of triceps. B. Brachioradialis.. C. Anconeus. D. Extensor carpi radialis longus. E. Lateral head of triceps. Activity What are the four muscles that form the superficial layer of the anterior compartment of the forearm? What is the clinical importance of the radial a.? References and recommended further readings 1. Snell clinical anatomy by regions. 2. Gray anatomy of the human body. 3. Grant atlas of anatomy. 4. Cunningham manual of practical anatomy. 5. Lecture notes. The end
