Introduction to the Upper Limb 2024 Student Version PDF

INTRODUCTION TO THE UPPER LIMB James Dunn [email protected] LEARNING OBJECTIVES Lecture Practical Appreciate that in anatomy structure and function Appreciate the layering and compartmentalisation should be studied together Gain rudimentary knowledge of the upper limb of muscles of the...

INTRODUCTION TO THE UPPER LIMB James Dunn [email protected] LEARNING OBJECTIVES Lecture Practical Appreciate that in anatomy structure and function Appreciate the layering and compartmentalisation should be studied together Gain rudimentary knowledge of the upper limb of muscles of the upper limb Describe generalised origins, insertions and functions of muscular components of the upper limb Locate and describe surface landmarks, bones and joints of the upper limb Locate and describe the major vascular and nerve supply of the upper limb OVERVIEW Regions of the upper limb Function of the upper limb movements Bones and bony landmarks Muscle groups Blood vessels of the upper limb -brachid Nerve supply - - Moore’s Clinically Oriented Anatomy, 8 th Ed. Regions of the upper limb 1. Shoulder 2. Arm - - daric , spacula between the shoulder & & abou proximal hamerus joints 3. Forearm 4. Hand - , phalangs metacarpals carples , Moore’s Clinically Oriented Anatomy, 8 th Ed. Transitional regions of the upper limb Vessel) or Blood armpit region (may Brachial plexus The neve thatentire innovates the Thorax to arm limb Axilla - = - upper Cubital Fossa Transition : Arm to forearm * Venous access ANATOMICAL POSITION aspect of limb tendons - numerous passage of muscles from of Forearm to hand/wrist = upper the. Carpal Tunnel X. elbow front he of - culterior. travele Bloostsupply carpal ↳ Why tunnel the anterior forearm down to the ita hand inflammationinthisaogy.. se Gray’s Anatomy for Students 3 rd Ed. Function of the upper limb 1. Movement of the hand in space Gripping objects Feeling objects Tactile and sensory functions Mechanical function A variety of individual movements Communication -highly mobile Movements of the shoulder flexing the shoulder used the upper Limb. direction in an to move / Large Pectoralis Major - = found on Torso the. anterior - - ↳ moving upper limb in a lateral position away from the. midline AntagonistMorementimptoAbdudioedit packmidline toward the. L is shoulder Largeeirula mon extension" "combine elements of- flexion - - Abduction Adduction Gray’s Anatomy for Students 3 rd Ed. joint Movements at the elbow Flexion and extension of the arm muscles (anterior and posterior groups) Pronation vs supination ↓ Gray’s Anatomy for Students 3 rd Ed. *sup is up* Movements of the hand Abduction vs adduction of the hand/wrist Remember the anatomical position Muscles for these movements are located primarily in the forearm Gray’s Anatomy for Students 3 rd Ed. Movements of the phalanges/fingers Gray’s Anatomy for Students 3 rd Ed. What you need to know - function Understand the primary function of the upper limb Movement of hand in space Become familiar with terms relating to movement Flexion vs. extension Abduction vs. adduction Protraction vs. retraction Pronation vs. supination The bones The shoulder/pectoral girdle Scapula Clavicle The arm Humerus The forearm Radius Ulna The hand Carpals Metacarpals Phalanges Moore’s Clinically Oriented Anatomy, 8 th Ed. The clavicle S-shaped bone acting as strut and shock absorber Superior surface – smooth Inferior surface – grooved Conoid tubercle Gray’s Anatomy for Students 3 rd Ed. Subclavian The clavicle made SUPERIOR vein/artery surfac. Due to ↑ large a af passage blood Vessel under more bumps &. landmarks · INFERIOR The scapula ↳ shoulder bland Triangular Broad, flat bone Glides across post. thorax I Acromion Anchored Coracoid process by Misch Glenoid cavity by me - Frase Gray’s Anatomy for Students 3 rd Ed. of I Spine scapula muscular The scapula /superior Coracoid process d Superoanterior Muscular. attachments projection Subscapular fossa the Supraspi n ous fossa Importantattachment ↑ L. in involvedbetween joint the Acromion the scapular process - a rice. > - see in e ntrepi e dese ↳ & Luperior. maid intersection (lateral & Joints of the pectoral girdle Sternoclavicular joint Ant. Post. Motion Elevation and depression Acromioclavicular joint Gliding movements Glenohumeral joint Ball and socket Many movements Image Copyright, John Wiley & Sons Inc. ~ long bone of the Famount of. Proximal landmark arm landmarks &. The humerus S (Bicepital groove). most site for. fracture ↑ extensor musulo head >. articulation with radius site of articulation with the 'ulna , flexor (MORE muscles FORCE) Netter’s Clinical Anatomy 3 rd Ed. u The radius and ulna a attachmentofmusclecald shape - man flexor. elbow or of bicipital Radius is lateral Ulna has the olecranon Radial tuberosity Biceps brachii Ulnar tuberosity Brachialis Netter’s Clinical Anatomy 3 rd Ed. The elbow joints Humero-ulnar joint (elbow joint Uni-axial hinge Flex and extend Humeroradial joint Limited ball and socket Flex and extend Proximal radio-ulna joint Uni-axial pivot Pronation and supination Gray’s Anatomy for Students 3 rd Ed. The bones of the hand distalproximal 8 carpals Thumb has (C) phalanges I. Scaphoid, lunate, triquetrum 5 metacarpals G 14 phalanges E ↳- articulating radius the underneath Netter’s Clinical Anatomy 3rd Ed. What you need to know – the bones Consult the practical guide This has an extensive list of bony features You do not need to name every individual bone of the hand Appreciate the different types of bone know carpal metacarpals , & phalange. The muscles Shoulder region Ant. & post. Thorax Rotator Cuffs Deltoids Arm Anterior and posterior Forearm Anterior and posterior Netter’s Clinical Anatomy 3rd Ed. wrohed The anterior thorax * The anterior muscles are responsible ; Flexion, adduction, protraction BONUS Pectoralis Major - for Clavicular head in of shoulder the flexion Sternocostal head 2 heads Thorax to arm Pectoralis Minor Ribs to scapula Netter’s Clinical Anatomy 3 rd Ed. The posterior thorax will antagonistic thorax anterior have functions to the. Trapezius Extension, adduction and retraction BONUS Trapezius Latissimus Dorsi Rhomboids Major and Minor retotain) Teres Major - Levator Scapula Levator Scapula Rhomboid Minor Rhomboid Major Teres Major extension E Latissimus Dorsi Netter’s Clinical Anatomy 3 rd Ed. The rotator cuff Spine of scapula Supraspinatus Supraspinatus Infraspinatus Teres Minor Subscapularis 3 Responsible the medial lateral of for the Infraspinatus rotation shoulder Teres minor Rotation Moore’s Clinically Oriented Anatomy, 8 th Ed. Netter’s Clinical Anatomy 3 rd Ed. The deltoid -Lateral arm compartment ( Abduction Triangular shaped shoulder cap Overall - abduction Anterior part Flex Middle part Abduct Posterior part Extend Netter’s Clinical Anatomy 3 rd Ed. corocoid process ↑ The anterior arm Flexion at the elbow Musculocutaneous nerve Inrorates ↳ all the muscles of the anterior arm compartment musculocutaneous neme -. Biceps Brachii Attach to radius Brachialis (MVP) -primary flexor Attach to ulnar Coracobrachialis Netter’s Clinical Anatomy 3 rd Ed. The posterior arm 4 work antagonistically to the anterior asm Elbow extension Radial nerve Triceps Brachii Gray’s Anatomy for Students 3 rd Ed. The anterior forearm -KNOW hiscommon ea (flexion) Wrist and finger flexion, wrist adduction flexi carpi ulnaris Anterior muscles – medial epicondyle attachment romounced Median (90%) and ulnar nerve ~ - move the rap on a a 8 muscles 3 layers Netter’s Clinical Anatomy 3 rd Ed. The posterior forearm Wrist and finger extension Posterior muscles – lateral attachment Radial nerve 11 muscles 2 layers Netter’s Clinical Anatomy 3 rd Ed. What you need to know – the muscles Only need to know broad muscle groups Joints they cross Know the collective function of muscle groups and innervation Start to recognise some of the bony landmarks and their importance to muscles broad musds * * Muscles of the rotater etc , d which they originate- named after the fossa of the scapula + know the bicepital - functions f ↳ Ther. Innovation / which the tuberotig ↳ group collective on the radius biceps will attack. Blood vessels of the upper limb We point underneath insertion pectoralis me ↑ sits at the of point major - of the armpit. right of↓ the aorta Subclavian artery & Axillary artery BRANCHES / reaching anticlbica a Brachial artery Rundownthemee L - BIFURCATES Radial & Ulnar artery Travels underneath clavicle the - towards & we - fossa. > - the along following into & following along the ula Netter’s Clinical Anatomy 3rd Ed. Blood vessels of the upper limb Radial & Ulnar vein Brachial vein Axillary vein Subclavian vein Netter’s Clinical Anatomy 3rd Ed. Blood vessels of the upper limb mone later e SURFACE VEINS Cephalic Vein Basilic Vein -medially Median Cubital Vein Intermediate Antebrachial Vein The Two Come major veins will al veice together& anastomosiscubital. Gray’s Anatomy for Students 3rd Ed. Netter’s Clinical Anatomy 3rd Ed. Innervation of the upper limb * Moore’s Clinically Oriented Anatomy The musculocutaneous nerve - will innovate anterior arm compartment. & Part then for. flexion / - travel to the responsible I - ↑ Brachis is Providing cutare our sensation to the later al & anterior aspects of the. forearm Netter’s Clinical Anatomy 3rd Ed. Behind it. or of umpingement ing my illay neve he an - & facture of y important clinical. observation & S/N The axillary nerve Then surgical neck of We - ened of the behindto & - & numen & --- We ~ humerous Supply the deltoids > - To the latesee muscles ↓ Responsible for. Abduction Travels posterior to surgical neck of humerus Supplies deltoids Netter’s Clinical Anatomy 3rd Ed. The radial nerve Runs along the posterior arm Innervates posterior muscle compartments Netter’s Clinical Anatomy 3rd Ed. The median nerve Course: midline of arm and forearm Supplies anterior forearm and some intrinsic hand muscles for / Median nerve Thumb movements. Netter’s Clinical Anatomy 3rd Ed. The ulnar nerve Course: medial side of arm and forearm Supplies some anterior forearm but mostly intrinsic hand muscles Netter’s Clinical Anatomy 3rd Ed. Cutaneous innervation Netter’s Clinical Anatomy 3rd Ed. Innervation summary 1 Musculocutaneous nerve KNOW * 5 terminal branches of compartments. Muscle 2 etc ; Axillary nerve muscular cutaneous ↳ Deltoids Anterior Median Elbow flexes for the name the shoulder Radial Anterior forearm ↳ d neve posterior arm/forearm compartments Ulnar nerve Some anterior forearm and hand groups they innovate Deltoids/Abductors of Median Nerve muscles what nems axillary L Neme Posterior arm and posterior forearm hypofemoral -> arm ↳ L Radial nerve brachia. plexm Anterior arm ↳ the in hard. = Extension movements What you need to know – upper limb This lecture will guide you through the practical Bones and bony landmarks are important Muscle groups and collective function Basics of venous supply Innervation to muscle groups * Gnatory practical - complete.