Lecture 2 - Preparation for Module 2 Lab PDF

Preparation for Module 2 lab Bones of the upper extremity and back muscles  Learning outcomes Identify the bones that form the pectoral girdle and their prominent surface features. Identify the bone in the upper arm and their prominent surface features. Identify the bones in the forear...

Preparation for Module 2 lab Bones of the upper extremity and back muscles  Learning outcomes Identify the bones that form the pectoral girdle and their prominent surface features. Identify the bone in the upper arm and their prominent surface features. Identify the bones in the forearm and their prominent surface features. Identify the bones in the wrist and their prominent surface features. Identify the bones in the hand and their prominent surface features. Identify the muscles in different layers in the back and their attachments and nerve supply.  Bones of the Upper Limb Sh. Girdle Arm Forearm Hand Clavicle Humorus Radius Carpals Scapula Ulna Metacarpals Phalanges  BONES OF THE UPPER EXTREMITIES - The clavicle (collar bone) connects the upper limb to the trunk. - shaft of the clavicle The medial two thirds of the shaft of the clavicle are convex anteriorly, whereas the lateral third is flattened and concave anteriorly. - sternal end (flat, sternoclavicular joint) - acromial end (round, coracoacromial joint)  BONES OF THE UPPER EXTREMITIES - The scapula (shoulder blade) is a triangular flat bone overlying the 2nd–7th ribs. - The convex posterior surface of the scapula is unevenly divided by the spine of the scapula, into a small supraspinous fossa and a much larger infraspinous fossa - The concave anterior costal surface of most of the scapula forms a large subscapular fossa - The spine continues laterally as the flat, expanded acromion and articulates with the acromial end of the clavicle - The lateral surface of the scapula has a glenoid cavity, which receives and articulates with the head of the humerus at the glenohumeral joint - The beak-like coracoid process is superior to the glenoid cavity, and projects anterolaterally  BONES OF THE UPPER EXTREMITIES - The proximal end: - Head - Surgical and anatomical necks - Greater and lesser tubercles - Intertubercular sulcus (bicipital groove) - The shaft of the humerus: - The deltoid tuberosity (laterally) - The radial groove (spiral groove, posteriorly) - Medial and lateral supra-epicondylar ridges (end distally in the medial epicondyle and the lateral epicondyle)  BONES OF THE UPPER EXTREMITIES - The distal end of the humerus (condyle of the humerus): - Two articular surfaces: - lateral capitulum (for articulation with the head of the radius) - medial pulley-like trochlea (for articulation with the proximal end of the ulna) - Three fossae: - Anteriorly, the coronoid fossa and radial fossa - Posteriorly, the olecranon fossa  BONES OF THE UPPER EXTREMITIES - The ulna is the medial (pinky side) and longer of the two forearm bones: - Proximal end (more massive) articulates with the: - Humerus proximally by two projections: Olecranon and coronoid process, which form the walls of the trochlear notch - The head of the radius laterally through the radial notch - The shaft of the ulna: - is thick and cylindrical proximally, but it tapers, diminishing in diameter, as it continues distally - At the proximal Inferior to the coronoid process is the tuberosity of the ulna - The distal end: - Head of the ulna with a small, conical ulnar styloid process - Does not participate in—the wrist (radiocarpal) joint  BONES OF THE UPPER EXTREMITIES - The radius is the lateral (thumb side) and shorter of the two forearm bones. - The proximal end: - The head of the radius articulates with the capitulum of the humerus during flexion and extension of the elbow joint, and also articulates peripherally with the radial notch of the ulna for pivot joint for pronation and supination. - The neck of the radius is a constriction distal to the head - The oval radial tuberosity is distal to the medial part of the neck - The shaft of the radius: - in contrast to that of the ulna, gradually enlarges as it passes distally - Most of the length of the shafts of the radius and ulna is essentially triangular in cross section. The apex is formed by a section of the sharp interosseous border of the radius or ulna that connects to the thin, fibrous interosseous membrane of the forearm - The distal end: - Medial aspect forms a concavity, the ulnar notch, which accommodates the head of the ulna - lateral aspect is terminating distally in the styloid process of the radius, which is larger than ulnar styloid process  BONES OF THE UPPER EXTREMITIES The carpus is composed of eight carpal bones: - The proximal row from lateral to medial: - Scaphoid: a boat-shaped bone that articulates proximally with the radius, is the largest bone in the proximal row. - Lunate: a moon-shaped bone between the scaphoid and triquetral bones. It articulates proximally with the radius - Triquetrum: a pyramidal bone - Pisiform: a small, pea-shaped bone - The distal row from lateral to medial: - Trapezium: a four-sided bone, articulates with the 1st and 2nd metacarpals, scaphoid, and trapezoid bones. - Trapezoid: a wedge-shaped bone that resembles the trapezium. It articulates with the 2nd metacarpal. - Capitate: a head-shaped bone is the largest bone in the carpus. It articulates primarily with the 3rd metacarpal distally. - Hamate: a wedge-shaped bone on the medial side of the hand. It has a distinctive hooked process.  BONES OF THE UPPER EXTREMITIES - The metacarpus forms the skeleton of the palm of the hand, composed of five metacarpal bones (metacarpals). - The proximal bases of the metacarpals articulate with the carpal bones - The distal heads of the metacarpals articulate with the proximal phalanges and form the knuckles of the hand. - The 1st metacarpal (of the thumb) is the thickest and shortest of these bones. - The digits (fingers) has three phalanges except for the first (the thumb), which has only two. - Each phalanx has a base proximally, a shaft (body), and a head distally, the shafts of the phalanges taper distally. Carpals (Scaphoid) (Lunate) (Triquetrum) (Pisiform) (Trapezium) (Trapezoid) (Capitate) (Hamate)  BONES OF THE UPPER EXTREMITIES - Radiographs of the wrist and hand are commonly used to assess skeletal age. For clinical studies, the radiographs are compared with a series of standards in a radiographic atlas of skeletal development to determine skeletal age. Ossification centers are usually obvious during the 1st year; however, they may appear before birth. The centers for the capitate and hamate appear first.  BONES OF THE UPPER EXTREMITIES - In fractures of the humerus be aware of the elements that can be injured: - Surgical neck: axillary nerve. - Radial groove: radial nerve. - Distal end of humerus: median nerve and brachial artery. - Medial epicondyle: ulnar nerve. - - A complete transverse fracture of the distal 2 cm of the radius, called a Colles fracture, is the most common fracture of the forearm. The distal fragment is displaced dorsally. The fracture results from forced extension of the hand, usually as the result of trying to ease a fall by outstretching the upper limb.  Objectives: Describe the intermediate and deep muscles of the neck and back. Name their attachments, actions and innervations. Describe all bones and bony landmarks of the bones of the upper limb (include the scapula, clavicle, humorus, ulna, radius, carpal bones, and hand bones).  Muscles of the Back Extrinsic Back Intrinsic Back Muscles Muscles Superficial Layer Superficial Layer Intermediate Layer Intermediate Layer Deep Layer  Extrinsic Back Muscles Superficial Layer Intermediate Layer Trapezius, Serratus posterior Latissimus dorsi, superior Levator scapulae, Serratus posterior Rhomboids, inferior  For Each Muscle Know Attachments Actions Nerve Supply Superficial Layer Trapezius, Latissimus dorsi, Levator scapulae, Rhomboids, Intermediate Layer Serratus posterior superior Serratus posterior inferior  Intrinsic Back Muscles Superficial Layer Intermediate Layer Deep Layer Splenius cervicis Iliocostalis Semispinalis Splenius capitis Longissimus Multifidus Spinalis Rotatores Interspinales Intertransversarii Levatores costarum  Intrinsic Back Muscles Superficial Layer Splenius cervicis Splenius capitis Intermediate Layer Iliocostalis Longissimus Spinalis  Deep Layer Semispinalis Multifidus Rotatores Interspinales Intertransversarii Levatores costarum  Deep Layer Semispinalis Multifidus Rotatores Interspinales Intertransversarii Levatores costarum