Bones of upper limb.pdf

 ‫‪Lectures of the Upper limb.‬‬ ‫ا‪.‬د ‪/‬مرسي عبد الفتاح مرسي‪.‬‬ ‫أستاذ‪/‬التشريح واألجنة‪ /‬كلية الطب‪/‬‬ ‫جامعة طنطا‪.‬‬ ❑ Objectives: By the end of this lecture the students will be able to: ❖Identify the bones of upper limb. ❖Describe the clavicle. ❖Describe the scapula. ❖...

 ‫‪Lectures of the Upper limb.‬‬ ‫ا‪.‬د ‪/‬مرسي عبد الفتاح مرسي‪.‬‬ ‫أستاذ‪/‬التشريح واألجنة‪ /‬كلية الطب‪/‬‬ ‫جامعة طنطا‪.‬‬ ❑ Objectives: By the end of this lecture the students will be able to: ❖Identify the bones of upper limb. ❖Describe the clavicle. ❖Describe the scapula. ❖Describe the humerus. ❖Describe the radius and ulna. ❖Identify the bones of the hands Bones of upper limb: Clavicle ❑ Clavicle: It composed of two ends and shaft. Its medial end (quadrilateral) and lateral end (Flat). The medial 2/3 of the shaft convex anterior and cylinder has 4 surfaces (anterior, posterior, superior and inferior). The lateral 1/3 of the shaft is concave anterior and convex posterior and has 2 surfaces ( superior and inferior ) and 2 borders (anterior and posterior). The lateral (acromial end) articulate with acromion process to form acromioclavicular joint (plane-synovial). The medial (sternal end) articulates with manubrium to form sternoclavicular joint (compound synovial). The anterior surface of medial 2/3 of the shaft gives origin to clavicular head of pectoralis major muscle. The medial ½ of superior surface gives origin to the clavicular head of sternomastoid muscle. The smooth concave posterior surface gives room for passage of axillary artery and cords of the brachial plexus. Lateral end. flattened Posterior Medial 2/3 Medial end. convex ant. Quadrilateral Lateral 1/3 concave ant. Anterior  Conoid tubercle for conoid ligament Rough area for costoclavicular ligament Trapezoid line for Groove for insertion trapezoid ligament. of subclavius muscle Scapula ❑ Scapula: ✓ The scapula is a flat triangular bone. ✓ It has three borders (Superior, medial and lateral),3 angles (superior, Inferior and lateral),3 processes( spine, acromion and coracoid process) and two surfaces (anterior and posterior). ✓ It lies on the posterior chest wall between the 2nd and the 7th ribs. ✓ On its posterior surface, the spine of the scapula projects backward. ✓ The lateral end of the spine is free and forms the acromion process, which articulates with the clavicle to forms acromioclavicular joint (plane synovial joint). ✓ The superolateral angle of the scapula forms the pear-shaped glenoid cavity, or fossa, which articulates with the head of the humerus at the shoulder joint. ✓ The coracoid process projects upward and forward above the glenoid cavity and provides attachment for muscles and ligaments. ✓ Medial to the base of the coracoid process is the suprascapular notch. ✓ The anterior surface of the scapula is concave and forms the shallow subscapular fossa. ✓ The posterior surface of the scapula is divided by the spine into the supraspinous fossa above and infraspinous fossa below. ✓ The inferior angle of the scapula can be palpated easily in the living subject and marks the level of the 7th rib and the spine of the 7th thoracic vertebra.  Suprascapular notch. Superior angle Upper Coracoid process. border Facet for articulation with clavicle Supraspinous fossa. Acromion Medial border. Spinoglenoid Spine of notch scapula. Glenoid cavity Infraspinous fossa. Infraglenoid tubercle. Lateral border Inferior angle Dorsal aspect of the scapula.  Articular surface for clavicle. Superior Acromian border process. Superior angle. Coracoid process. Glenoid Medial border cavity. Infraglenoid Subscapular fossa. tubercle. Lateral border. Inferior angle. Scapula (Anterior aspect).  Superior angle Supraglenoid Acromion procss tubercle Coracoid process Glenoid Cavity Spinous Infraglenoid process tubercle Lateral border. Inferior angle Lateral aspect of the scapula Humerus ❑ Humerus : It is a long bone which is formed of : *Upper end (head,2 necks and 2 tubercles). ✓ The head is less than ½ of sphere and is directed upward ,backwards and medially. ✓ The necks are anatomical and surgical. ✓ Tubercles are lesser (small & anterior) and greater (large and lateral) between them there is intertubercular groove. *The shaft: ✓ The upper ½ cylindrical and lower ½ triangular. ✓ It has 3 borders (anterior, medial and lateral). ✓ It has 3 surfaces ( anteromedial, anterolateral and posterior). ✓ It has one tuberosity on the anterolateral surface (deltoid tuberosity). ✓ It has radial groove (spiral groove) on the back of the middle 1/3 of the shaft. *The lower end: ✓ It consists of medal and lateral epicondyles, trochlea for articulation with ulna, capitulum for articulation with head of the radius, 3 fossae (radial , coronoid fossa anterior and olecranon fossa posterior). ✓ Two supracondylar ridges which are the lower sharp part of the medial and lateral borders of the shaft. ❑Anterior surface of the Humerus: ▪ Head. ▪ Anatomical neck. ▪ Bicipital groove. ▪ Surgical neck. ▪ Lesser tubercle. ▪ Greater tubercle. ▪ Deltoid tuberosity. ▪ Lateral supracondylar ridge. ▪ Medial supracondylar ridge. ▪ Medial epicondyle. ▪ Lateral epicondyle. ❑ Anterior surface of lower end: ▪ Medial epicondyle. ▪ Trochlea. ▪ Capitulum. ▪ Coronoid fossa. ▪ Radial fossa. ▪ Medial supracondylar ridge. ▪ Lateral supracondylar ridge. ❑ Posterior aspect of the Humerus: Greater Head tubercle. Spiral groove Lateral epicondyle. Olecranon fossa Trochlea. Medial epicondyle. ❑ Posterior surface of the shaft: Medial epicondyle. Olecranon fossa. Groove on the back of medial epicondyle for ulnar nerve Radius and Ulna ❑ Radius is a long bone composed of: ✓ Upper end: is formed of head ,neck and radial tuberosity. ✓ Shaft is formed of: A- 3 borders (anterior. medial or Interosseus and posterior). B- 3 surfaces (anterior ,lateral and posterior). ✓ lower end: is larger than upper end and has 5 surfaces (anterior ,posterior, medial, lateral and inferior). The lateral surface extends downwards to form styloid process of radius. On its medial surface there is ulnar notch for inferior radioulnar joint. On its posterior surface dorsal tubercle is present. ❑ Ulna is long bone composed of: ✓ Upper end: is formed of two processes (olecranon superiorly and coronoid anteriorly). two notches (trochlear notch anterior and radial notch lateral). ✓ Shaft: It has 3 surfaces two convex (medial and posterior) and one concave (anterior).It has 3 borders two rounded (anterior and posterior) and one sharp (Lateral or Interosseus). ✓ Lower end: it has small head anterior and styloid process posterior. ▪ Head. ▪ Neck. ▪ Radial tuberosity. ▪ Anterior border. ▪ Anterior surface. ▪ Lateral surface. ▪ Styloid process. ▪ Interosseus border. ❑ Anterior aspect of the ulna: ▪ Olecranon process. ▪ Coronoid process. ▪ Trochlear notch. ▪ Styloid process. ▪ Radial notch. ▪ Anterior surface. ▪ Ulnar tuberosity. ▪ Interosseus border. ▪ Anterior border. ▪ Posterior surface of radius. ▪ Interosseus border of radius. ▪ Post. border of ulna. ▪ Med. surface of ulna. ▪ Styloid process of ulna. ▪ Posterior border of radius. ▪ Posterior border of ulna. ▪ Interosseus border of ulna. ▪ Posterior surface of ulna. ▪ Lateral surface of radius. ▪ Dorsal tubercle. ▪ Head of ulna. ▪ Styloid process of ulna. Bones of the hand ❑ Carpal bones: composed of two rows (Posterior view): A-Proximal row: 1-Scaphoid. 2-Lunate. 3-Triquaterl. 4-Pisiform (not appears). B-Distal row: 1-Trapezium. 2-Trapezoid. 3-Capitate. 4-Hamate. ❖ Carpal bones (8): Anterior view: Proximal row: 1-Scaphoid. 2-Lunate. 3-Triquateral. 4-Pisiform.(Appear in this view). Distal row: 1-Trapezium. 2-Trapezoid. 3-Capitate. 4-Hamate. ❑ Metacarpal bones 5 in number composed of head , shaft and base. They are: ▪ 1st. ▪ 2nd. ▪ 3rd. ▪ 4th. 3rd ▪ 5th. 2nd 1st 4th 5th  MCQ 1-Which one of the following carpal bones lies at the distal row of the hand? a. Lunate b. Scaphoid c. Capitate d. Triquetral 2-Which one of the following is present at the distal end of ulna? a. Ulnar notch b. Ulnar tuberosity c. Styloid process d. Olecranon process 3-Which one of the following represents the anterior surface of scapula? a. Supraspinous fossa b. Subscapular fossa c. Infraspinous fossa d. Olecranon fossa. 4- Which one of the following is present at the lower end of humerus? a. Trochlea. b. Greater tubercle c. Lesser tubercle. d. Surgical neck. 5-Which one of the following nerves is present in the groove on the back of medial epicondyle of humerus? a. Radial b. Ulnar c. Axillary d. Musculocutaneous Thanks, with the best wishes. Pr.Dr/Morsy Abdelfattah.