SMU_Upper_Limb.pdf

Applied Anatomy of Upper Limb Member of Medical Education Department 11  Anatomy, Basics  Framework  Upper Limb  Lower Limb  Vertebral Column  Upper Limb Osteology Sat. 30/9 Muscles Sun. 1/10‎...

Applied Anatomy of Upper Limb Member of Medical Education Department 11  Anatomy, Basics  Framework  Upper Limb  Lower Limb  Vertebral Column  Upper Limb Osteology Sat. 30/9 Muscles Sun. 1/10‎ Nerves and Vessels Mon. 2/10 Lower Limb 9 Lectures Osteology Tues. 3/10‎ Muscles Wed. 4/10 Nerves and Vessels Others Sun. 8/10‎ Special Regions Tues. 10/10‎ Vertebral Column Sat. 21/10 Development Wed. 25/10 ‎  ILOs 1 2 3 4 5 Anatomy, Framework Upper Lower Vertebral Basics Limb Limb Column What does Anatomy mean???  Dissection Cutting up Structure  SSupport SHAPER Haemopoiesis H Blood cell formation A Ability to move Movement P Protection Endocrine regulation Reservoir R  ILOs 1 2 3 4 5 Anatomy, Framework Upper Lower Vertebral Basics Limb Limb Column  What ever the region, We will concentrate on Bones & Muscles Nerve Blood Joints Supply Supply  To make it easy Divide into regions Categorize Link in groups Use similars Use Mnemonics Mind maps  Regions in this course Upper Limb Lower Limb Vertebral Column  ILOs 1 2 3 4 5 Anatomy , Framework Upper Lower Vertebral Basics Limb Limb Column Bones &What ever the region, We will Joints concentrate on Bones & Muscles Nerve Blood Joints Supply Supply Bones & Joints Scapula 1- Connection 2- Weight Transmission 3- Muscle Attachment 1- Triangular in shape 4- Movements 2- Subcutaneous, spine 5- Protection 3- 3 articulations 4- Difficult to visualize in x ray 5- Usually managed conservatively Bones & Joints Scapula 1- Connection 2- Weight Transmission 3- Muscle Attachment 1- Triangular in shape 4- Movements 2- Subcutaneous, spine 5- Protection 3- 3 articulations 4- Difficult to visualize in x ray 5- Usually managed conservatively Bones & Joints Scapula Clavicle 1- Connection 2- Weight Transmission 3- Muscle Attachment 1- S shaped 4- Movements 2- Subcutaneous 5- Protection 3- the only transverse long bone 4- The only intramembranous ossification 5- The most commonly fractured bone Bones & Joints Scapula Clavicle 1- Connection 2- Weight Transmission 3- Muscle Attachment 1- S shaped 4- Movements 2- Subcutaneous 5- Protection 3- the only transverse long bone 4- The only intramembranous ossification 5- The most commonly fractured bone Bones & Joints Clavicle Scapula Humerus 1- Connection 2- Weight Transmission 1- The longest and largest bone in 3- Muscle Attachment Upper Limb 4- Movements 2- Numerous important neighbors 5- Protection 3- 3 articulations https://anatomy.app/encyclopedia/humerus Bones & Joints Clavicle Scapula Humerus 1- Connection 2- Weight Transmission 3- Muscle Attachment 4- Movements 5- Protection Surgical neck Vs Anatomical neck Bones & Joints Clavicle Scapula Humerus Radius Ulna 1- Connection R Vs U 2- Weight Transmission Position Lateral Medial 3- Muscle Attachment Proximal end Rounded U - Shaped 4- Movements Distal end Broad Small 5- Protection Shape Curved Straight Bones & Joints Clavicle Scapula Humerus Radius Ulna 1- Connection R Vs U 2- Weight Transmission Position Lateral Medial 3- Muscle Attachment Proximal end Rounded U - Shaped 4- Movements Distal end Broad Small 5- Protection Shape Curved Straight Bones & Joints Clavicle Scapula Humerus Radius Ulna 1- Small irregular bones Carpal 2- Wide articular surface Bones 3- Numerous ligaments and muscles 4- Median nerve and Carpal Tunnel Syndrome Bones & Joints Clavicle Scapula Humerus Radius Ulna Carpal Bones Bones & Joints Clavicle Scapula Humerus Radius Ulna Carpal Bones Metacarpals Phalanges Bones & Joints Scapula She Shoulder Clavicle So Looks Arm Humerus Crazy, Too How Pretty Forearm Radius Rare Try Ulna U To wrist Carpal Bones Cook Catch Hand Metacarp Me a Her als Phalanges Pear? Overview of body joints According to Structure Fibrous Cartilagenous Synovial (immovable) (slightly movable). (freely movable) Symphysis Syndesmosis Plane Hinge Pivot Condyloid Saddle shaped Ball and Socket Tarsal Elbow Sup. RU J Wrist Thumb CMJ Shoulder Bones & Joints Bones Type Motions Others Shoulder Glenohumeral H +S All Dislocation F+E+R+Ad+Ab +Cir Acromioclavicular A+C Gliding Bones & Joints Bones Type Motions Others Shoulder Glenohumeral H +S All Dislocation Acromioclavicular A+C Gliding Bones & Joints Bones Type Motions Others Shoulder Glenohumeral H +S All Dislocation Acromioclavicular A+C Gliding Elbow H+R+U F+E Deformity Bones & Joints Bones Type Motions Others Shoulder Glenohumeral H +S All Dislocation Acromioclavicular A+C Gliding Elbow H+R+U F+E Deformity Bones & Joints Bones Type Motions Others Shoulder Glenohumeral H +S All Dislocation Acromioclavicular A+C Gliding Elbow H+R+U F+E Deformity R+S+L F+E +Ad+Ab Scaphoid Wrist Bones & Joints Bones Type Motions Others Shoulder Glenohumeral H +S All Dislocation Acromioclavicular A+C Gliding Elbow H+R+U F+E Deformity R+S+L F+E +Ad+Ab Scaphoid Wrist MP Joints M+P F+E +Ad+Ab Hand + R thumb Joints Rheumatoid IP Joints Phalanges F+E Bones & Joints Mnemonic Shoulder Acromioclavicular As Glenohumeral Game Elbow Ends, Wrist Working MP Joints Hand More Joints IP Joints Is my role Bones & Joints https://forms.office.com/r/Y6d8vW9fGL Muscles Origin Insertion Nerve Action Pectoralis Major C+SC+Ab Biciptal LPN,MPN Ad,MR Pectoral Region 4 Groove , Lat. Lip Muscles Origin Insertion Nerve Action Pectoralis Major C+SC+Ab Biciptal LPN,MPN Ad,MR Pectoral Region 4 Groove , Lat. Lip Muscles Origin Insertion Nerve Action Pectoralis Minor Rib 3-5 Coracoid MPN Scapula Pectoral Region 4 Respiration Muscles Origin Insertion Nerve Action Subclavius Pectoral Region 4 Muscles Origin Insertion Nerve Action Serratus Anterior Ribs 1-8 Scapula LTN Protraction Pectoral Region 4 Muscles Origin Insertion Nerve Action Pectoral Region Deltoid Deltoid Abduction, 15-90 Ant.: clavicle Axillary Tuberosity F “Ant. Fibers Shoulder Region Middle : E “Post. Fibers Acromion Posterior: Spine of scapula Muscles Origin Insertion Nerve Action Pectoral Region SSF GT,Tip SSN Supraspinatous Abd 0-15 Shoulder Region Infraspinatous ISF GT, Mid Lat Rot. SSN Teres Minor Scap, Lat GT, Inf Axillary Lat Rot. Subscapularis Scap, inf H, Lateral Upper &lower Med. Rot. SubScap. N Muscles Origin Insertion Nerve Action Pectoral Region Biciptal Teres Major Scap, inf Lower Med. Rot. Groove , Exten. Shoulder Region SubScap. N Lat. Lip Muscles Origin Insertion Nerve Action Pectoral Region Biceps Scapula Radius MCN Flex, supination Shoulder Region Arm Region Muscles Origin Insertion Nerve Action Pectoral Region Biceps Scapula Radius MCN Flex, supination Shoulder Region Arm Region Muscles Origin Insertion Nerve Action Pectoral Region Coracobrachialis Coracoid Hum, med MCN Add, flex Shoulder Region Brachialis Hum, ant MCN Ulna coronoid Flex, main Radial Arm Region Muscles Origin Insertion Nerve Action Pectoral Region Triceps SC,Hu Ulna, Olecraneon Radial Extension Shoulder Region Arm Region Muscles Origin Insertion Nerve Action Pectoral Region Flexor Carpi Radialis CFO 2,3 Metacarp. Median Flex, Rad.devi Shoulder Region Palmaris Longus CFO Palmar Appon Median flex Arm Region Forearm Region Anterior Muscles Origin Insertion Nerve Action Pectoral Region Flexor Carpi Radialis CFO 2,3 Metacarp. Median Flex, Rad.devi Shoulder Region Palmaris Longus CFO Palmar Appon Median flex Arm Region Forearm Region Anterior PL graft Muscles Origin Insertion Nerve Action Pectoral Region CFO Pronation Pronator Teres Radius, Lat Median Shoulder Region Coronoid Arm Region Forearm Region Anterior Muscles Origin Insertion Nerve Action Pectoral Region Flexor Carpi Radialis CFO 2,3 Metacarp. Median Flex, Abd. Shoulder Region Palmaris Longus CFO Palmar Appon Median flex Arm Region Pronator Teres CFO Hu, Lat Median Pronation Coronoid Forearm Region Flexor Carpi Ulnaris CFO 5th MTC,Pisiform Ulnar Flex, Add. Olecraneon Anterior Flexor Digitorum Hamate CFO Superficialis Radius 2,3,4,5 fingers Median Flex MTP,PIP Muscles Pectoral Region Shoulder Region Arm Region Forearm Region Anterior Muscles Origin Insertion Nerve Action Pectoral Region Superficial group Shoulder Region Flexor Pollicis Longus Radius thumb Median AIN flex Arm Region Pronator Quadratus Radius Ulna Median, AIN Pronation Forearm Region Flexor Digitorum Profundus Prox. ¾ 2,3,4,5 fingers Median Flex (DIP) Anterior Ulna Ulnar Muscles Pectoral Region Superficial group All originate from CFO + /- other site Shoulder Region 5 All insert in the hand except PT Arm Region All are innervated from Median except FCU Forearm Region Deep group 2 originate from Radius and one from Ulna Anterior 3 All are innervated from Median + Ulnar for FDP Muscles Origin Insertion Nerve Action Pectoral Region 1- Upper 2/3 of Styloid process Radial Flexion of Brachioradialis lateral of radius N elbow at Shoulder Region supracondyl midprone Arm Region ar ridge of position humerus Forearm Region Anterior Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 2- Common Base of 2nd Radial Extension of Extensor Carpi Extensor metacarpal N wrist , Shoulder Region Radialis Longus origin , Abduction of Arm Region distal Third hand of Forearm Region supracondyl Anterior ar ridge of humerus Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 2- Common Base of 2nd Radial Extension of Extensor Carpi Extensor metacarpal N wrist , Shoulder Region Radialis Longus origin , Abduction of Arm Region distal Third hand of Forearm Region supracondyl Anterior ar ridge of humerus Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 3- Common Base of 3rd Radial Extension of Extensor Carpi Extensor metacarpal N wrist , Shoulder Region Radialis Brevis origin , Abduction of Arm Region distal Third hand of Forearm Region supracondyl Anterior ar ridge of humerus Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 4- Extensor Common 2–5 Radial Extension of Digitorum Extensor finger N Fingers and Shoulder Region origin wrist Arm Region (CEO) Forearm Region Anterior Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 4- Extensor Common 2–5 Radial Extension of Digitorum Extensor finger N Fingers and Shoulder Region origin wrist Arm Region (CEO) Forearm Region Anterior Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 5- Extensor Common Dorsal Radial Extension of Digiti Minimi Extensor expansion N little finger Shoulder Region origin of little Arm Region (CEO) finger Forearm Region Anterior Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 6- Extensor CEO + Base of Radial Extension of Carpi Ulnaris subcutaneous 5th N wrist, Shoulder Region border metacarpal adduction of Arm Region of ulna hand Forearm Region Anterior Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 7-Anconeus Lateral Lateral Radial Extension of Shoulder Region epicondyle of side of N Elbow humerus olecranon Arm Region process Forearm Region Anterior Posterior Superficial Muscles Origin Insertion Nerve Action Pectoral Region 1- Supinator Supinator Lateral PIN of Supination of Shoulder Region crest of ulna, side of Radial Forearm Lateral radial N Arm Region epicondyle of shaft humerus, Forearm Region radial Anterior collateral ligament Posterior Superficial Deep Muscles Origin Insertion Nerve Action Pectoral Region 2- Abductor Dorsum of Lateral side PIN of Abduction of Pollicis Longus ulna, of base of Radial Thumb Shoulder Region interosseous 1st N MTP joint Arm Region membrane metacarpal Forearm Region Anterior Posterior Superficial Deep Muscles Origin Insertion Nerve Action Pectoral Region 3- Extensor Dorsum of Terminal PIN of Abduction & Pollicis Longus ulna, phalanx Radial Extension of Shoulder Region interosseous of thumb N Thumb Arm Region membrane Extension of Wrist Forearm Region Anterior Posterior Superficial Deep Muscles Origin Insertion Nerve Action Pectoral Region 4- Extensor Dorsum of Base of PIN of Extension of Pollicis Brevis ulna, Proximal Radial Thumb Shoulder Region interosseous phalanx N Arm Region membrane of thumb Forearm Region Anterior Posterior Superficial Deep Muscles Origin Insertion Nerve Action Pectoral Region 5-Extensor Dorsum of Proximal PIN of Extension of Indicis ulna, phalanx of Radial Index Shoulder Region interosseous index N MTP joint Arm Region membrane (Medial side ) Forearm Region Anterior Posterior Superficial Deep Muscles Pectoral Region Shoulder Region Arm Region Forearm Region Anterior Posterior Muscles https://forms.office.com/r/LNTfjzQsbU Muscles Pectoral Region Shoulder Region Arm Region Forearm Region Thenar Muscles Hand Region Hypothenar Muscles Hypothenar Muscles Muscles Pectoral Region Shoulder Region Arm Region Forearm Region Thenar Muscles Hand Region Hypothenar Muscles Hypothenar Muscles Muscles Pectoral Region Shoulder Region Arm Region Forearm Region Thenar Muscles Hand Region Hypothenar Muscles Hypothenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 1- Flexor Flexor Lateral Superficial Thumb Pollicis Brevis retinaculum, aspect of head: Flexion Shoulder Region trapezium, base of Recurrent Arm Region Trapezoid proximal branch of and capitate phalanx 1 median Forearm Region bones (via radial nerve sesamoid Deep head: bone) Deep branch of ulnar Hand Region nerve (C8, T1) Thenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 2- Abductor Scaphoid proximal Median Thumb Pollicis Brevis and phalanx of nerve Abduction Shoulder Region trapezium thumb Arm Region Forearm Region Hand Region Thenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 3- Opponens trapezium Metacarpal Median Moves thumb Pollicis of thumb nerve against little Shoulder Region finger Arm Region Forearm Region Hand Region Thenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 4- Adductor Transverse Proximal Ulnar Adduction of Pollicis head: Palmar phalanx of nerve the thumb Shoulder Region base of thumb metacarpal Arm Region bone 3 Oblique head: Forearm Region Capitate bone, palmar bases of metacarpal bones 2 & 3 Hand Region Thenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 1- Opponens Hook of 5th Ulnar Opposition of Digiti Minimi hamate Metacapal nerve little finger Shoulder Region Arm Region Forearm Region Hand Region Thenar Muscles Hypothenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 2- Flexor Digiti Hook of Proximal Ulnar Flexion of Minimi Brevis hamate phalanx of nerve little finger Shoulder Region little finger Arm Region Forearm Region Hand Region Thenar Muscles Hypothenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 3- Abductor Pisiform Proximal Ulnar Abduction of Digiti Minimi phalanx of nerve little finger Shoulder Region little finger Arm Region Forearm Region Hand Region Thenar Muscles Hypothenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 4- Palmaris Palmar Skin of Ulnar Tense the Brevis aponeurosis, medial side nerve hypothenar Shoulder Region transverse of palm of skin >> deepen Arm Region carpal hand the cup, ligament improves hand Forearm Region grip and protect ulnar N Hand Region Thenar Muscles Hypothenar Muscles Muscles Origin Insertion Nerve Action Pectoral Region 1- Lumbricals Tendons of Dorsal Median 1- Flex MTP FDP expansion N (1st & joints Shoulder Region 2nd) 2- Extend IP Arm Region Ulnar N joints (3rd Forearm Region &4th) Hand Region Thenar Muscles Hypothenar Muscles Middle Muscles Muscles Origin Insertion Nerve Action Pectoral Region 1- Lumbricals Tendons of Dorsal Median 1- Flex MTP FDP expansion N (1st & joints Shoulder Region 2nd) 2- Extend IP Arm Region Ulnar N joints (3rd Forearm Region &4th) Hand Region Thenar Muscles Hypothenar Muscles Middle Muscles Muscles Origin Insertion Nerve Action Pectoral Region 2- Palmar Metacarpals Prox. Phal. Ulnar N Finger Interossei 2nd,4th,5th Of Adduction Shoulder Region 2nd,4th,5th Arm Region fingers Forearm Region Hand Region Thenar Muscles Hypothenar Muscles Middle Muscles Muscles Origin Insertion Nerve Action Pectoral Region 2- Palmar Metacarpals Prox. Phal. Ulnar N Finger Interossei 2nd,4th,5th Of Adduction Shoulder Region 2nd,4th,5th Arm Region fingers Forearm Region Hand Region Thenar Muscles Hypothenar Muscles Middle Muscles Muscles Origin Insertion Nerve Action Pectoral Region 3- Dorsal All Metacarpal Prox. Phal. Of Ulnar N Finger Interossei (Adjacent sides 2nd - 4th Abduction Shoulder Region fingers Arm Region Forearm Region Hand Region Thenar Muscles Hypothenar Muscles Middle Muscles Muscles Origin Insertion Nerve Action Pectoral Region 3- Dorsal All Metacarpal Prox. Phal. Of Ulnar N Finger Interossei (Adjacent sides 2nd - 4th Abduction Shoulder Region fingers Arm Region Forearm Region Hand Region Thenar Muscles Hypothenar Muscles Middle Muscles  Peripheral nerves 62 Spinal nerves Cranial nerves 24 C3,4,5 keeps the diaphragm alive. Serves the head, neck and shoulders Serves the chest, shoulders, arms and hands Serves the back, abdomen, groin, Lower limb Serves the posterior thigh, most of the lower leg, the entire foot, and part of the pelvis  ULNAR Upper Subscapular N Lower Subscapular N N to Latismus dorsi Axillary N Radial N Cutaneous N to arm Cutaneous N to forearm 2CU2M Ulnar N Medial Pectoral N Medial root to Median N  intercosto-brachial nerve T2 spinal accessory nerve XI  Musclocutaneous N Radial N Mainly Median N Radial N Mainly Ulnar N All muscles of the anterior compartment of the forearm “Flexors” are innervated by Median N except FCU and Medial half of FDP All muscles of the Posterior compartment of the arm and forearm “Extensors” are innervated by Radial N All muscles of the Hand are innervated by Ulnar N except LOAF Lateral 2 lumbricals Opponens Pollicis Abductor Pollicis Brevis Flexor Pollicis Brevis Axillary Artery Start Outer border of 1st rib as a continuation of Subclavian artery. course Pass behind Pectoralis Minor Parts 1st part >> Above Pectoralis Minor 2nd Part >> behind Pectoralis Minor 3rd part >> Below Pectoralis Minor Branches end At the lower border of Teres Major Brachial Artery Start At the lower border of Teres Major as a continuation of Axillary artery. course Medial then anterior to humerus end At Cubital fossa where it divides into Radial and Ulnar arteries Clinical Blood Pressure measurment Radial Artery Start At the Cubital fossa as one of the two terminal branches of Brachial artery. course Anterolateral aspect of the forearm end In the palm as a deep Palmar arch Radial Pulsation Ulnar Artery Start At the Cubital fossa as one of the two terminal branches of Brachial artery. course Anteromedial aspect of the forearm end In the palm as a superficial Palmar arch Clinical Allen’s test  Digital veins Dorsal Venous arch Cephalic Vein Basilic Vein Radial side Ulnar side Axillary Vein Brachial Vein Subclavian Vein Median Cubital Vein