Lab 3 - Upper Appendicular II PDF

LAB 3 – Upper Appendicular II YOU MUST BE ABLE TO IDENTIFY ALL BONES, BONE CHARACTERISTICS, AND LIGAMENTS FROM THE FOLLOWING LIST. AS WELL BE ABLE TO TELL WHETHER THE BONE IS FROM THE LEFT OR RIGHT SIDE OF THE BODY. 3.1 Bones of the Forearm and Hand The elbow is a hinge joint formed by the...

LAB 3 – Upper Appendicular II YOU MUST BE ABLE TO IDENTIFY ALL BONES, BONE CHARACTERISTICS, AND LIGAMENTS FROM THE FOLLOWING LIST. AS WELL BE ABLE TO TELL WHETHER THE BONE IS FROM THE LEFT OR RIGHT SIDE OF THE BODY. 3.1 Bones of the Forearm and Hand The elbow is a hinge joint formed by the bones called the humerus, ulna, and radius and works in conjunction with the proximal and distal radioulnar joints. Although the movements of the upper extremity are quite complex as a unit, the movements found at the elbow are relatively simple. At the elbow we either pull things toward us as in wrestling, or push things away from us as in throwing or striking. The elbow is quite stable and compared to other major joints, sustains far fewer injuries. The elbow acts as an intermediary between the arm and the forearm. The humerus is the long bone of the arm and the radius and ulna are the bones of the forearm. The trochlea of the humerus forms a deep articulation with the trochlear notch of the ulna, and the head of the radius articulates with the capitulum of the humerus. The articulation between the wrist and the forearm occurs as the radius contacts two of the eight carpal bones (scaphoid and lunate). The carpal bones all have distinctive shapes and form two rows, proximal and distal. The proximal row joins the wrist to the forearm, and the distal row joins the wrist to the hand. Ulna Be able to identify: A. Olecranon process - triceps brachii attaches distally at this structure Always Superior B. Coronoid process Fits into Coronoid fossa lateral side C. Radial notch - receives head of radius Next to platform of trocklear notch (can beused to differentiate sides) Always on D. Trochlear notch -articulates with trochlea of humerus Big open notch Opens Anteriorly E. Ulnar tuberosity Below the coronoid process F. Body G. Head Distal H. Styloid process - surface landmark On head of ulna Lies distally Note: The ulna tapers from the proximal end distally. Whereas the ulna is the primary bone of the forearm at the elbow, it is of second importance at the wrist joint. Orientation: The ulna is the medial bone in the forearm. The proximal end contains the olecranon process and radial notch. The head of the ulna is distal. Grasp proximal end with the trochlear notch facing anterior. Hold as the medial bone in the forearm with the radial notch facing lateral towards the radial bone (lateral). Radius Be able to identify: A. Head - articulates with capitulum of humerus Proximal and ulna ring Wraps around radius B. Neck - held to ulna by annular ligament Below head in a C. Radial tuberosity - biceps brachii inserts here Rough area below neck D. Body E. Ulnar notch - receives head of ulna Points medially  F. Styloid process - surface landmark Most prominent end distally G. Carpal articular surface - articular surface located at the distal most aspect of the radius and located between the ulnar notch and the styloid process. Smooth concave end points anteriorly Note: The radius is larger at its distal end. Orientation: The head of the radius is proximal. To orientate the radius it is the lateral bone of the forearm. Hold with ulnar notch facing medially. The radial tuberosity and the concave surface of the distal end should face in the anterior direction. Carpal (Wrist) Bones (8) Be able to identify: Proximal Row Distal Row A. Scaphoid (navicular) E. Trapezium B. Lunate F. Trapezoid C. Triquetrum (triquetral, triangular) G. Capitate D. Pisiform H. Hamate (Hook) Note: The scaphoid and the lunate articulate with the radius in the wrist joint, and are therefore the most commonly fractured carpals. Make a MNEMONIC to help you learn the carpal bones. Be creative. Ask your TA for help. Suzie Likes To Play, Try To Catch Her Some lovers Try Positions That They Can't Handle s comehen traight line i i he pinky Here to a  Metacarpals Numbered 1-5 from radial side to ulnar side (lateral to medial in anatomical position). Each has a base (proximal), body, and head (distal). Note: The difference in position of the thumb joint. Phalanx Numbered as are the metacarpals. Digit one (1) has only two phalanx (proximal and distal) while the other four digits (2-5) have proximal, middle, and distal phalanges. 3.2 Elbow and Wrist Joint More lecture Elbow joint: There are two synovial joints sharing a common joint cavity and surrounded by an articular capsule. 1. Humeroulnar - a hinge joint - trochlea of humerus fits into trochlear (semilunar) notch 2. Humeroradial - gliding joint - capitulum of humerus articulates with superior surface of the head of the radius What movement(s) is/are possible at the elbow? Radioulnar: 3 joints: 1. Proximal radioulnar - a pivot synovial joint  - the head of the radius rotates within the annular ligament which holds the radial head tightly against the radial notch of the ulna, allowing pronation and supination of the palm of the hand. 2. Middle radioulnar - a type of fibrous joint called a syndesmosis. The sheet of fibers is called an interosseous membrane. 3. Distal radioulnar - a synovial, pivot joint - distal end of the ulna pivots against the ulnar notch of the radius, allowing the radius to cross over the ulna in pronation. Wrist joint 1. Radiocarpal joints: The ulna is excluded from articulation by an articular disc, so the only active joint is that between the radius and the two carpals, the scaphoid and lunate bones. - a condyloid joint reinforced by several ligaments - allows flexion/extension, adduction/abduction, and circumduction 2. Intercarpal joints - between all the carpal bones - gliding joints What functional advantage is created by having many small interconnected bones versus only a couple of larger bones? Joints of the Hand - note the shape of the articular surfaces 1. 1st Metacarpal-carpal - saddle type of synovial joint 2. #2-5, Metacarpal-carpal - gliding type of synovial 3. #2-5, Metacarpophalangeal (your knuckles) - condyloid synovial joints 4. 1st Metacarpophalangeal - hinge synovial joint 5. Interphalangeal - hinge synovial joints, so allow only flexion/extension YOU MUST BE ABLE TO IDENTIFY THE ORIGIN AND INSERTION OF ALL MUSCLES FROM THE FOLLOWING LIST AND THEREFORE THE RESULTANT ACTIONS PRODUCED BY THE MUSCLES. 3.4 Muscles of the Forearm and hand Muscles that move the Forearm at the Elbow Joint The arm is the region between the shoulder and elbow. The muscles of the arm function at either/both the shoulder (as above) and/or the elbow. Be able to identify: A. Triceps Brachii: one of its three heads has a proximal attachment on the scapula, while the other two heads are on the shaft of the humerus. B. Biceps Brachii: the heads have separate proximal attachments and a common distal attachment. C. Brachialis: “true” flexor of the forearm Deep to biceps brachi:  D. Brachioradialis 20 E. Anconeus Muscles that act on the Forearm, Wrist and Hand Extensors occupy the posterior compartment of the forearm; flexors occupy the anterior compartment; contraction of an extensor and a flexor on the same side results in abduction/adduction of the wrist. FLEXOR ASPECT OF THE FOREARM: The muscles of the flexor forearm are neatly arranged in four layers. In general, as you proceed from superficial to deep, the muscles of each layer act more distally in the limb; this is not so for the deepest (fourth) layer: Be able to identify: Superficial group (first layer) - The four muscles of the superficial group all have complete or partial attachment off the medial epicondyle of the humerus: A. Pronator teres 12 short medial side on B. Flexor carpi radialis 13 Toward thumb side C. Palmaris longus 14 Toward middle of palm D. Flexor carpi ulnaris 1 3 Toward pinky Second Layer - Only one muscle is found in the second layer: E. Flexor digitorum superficialis Ill below superficial group Exam tip: There are 5 muscles on the Third Layer - Two muscles occupy this layer: big arms that are not labelled with F. Flexor digitorum profundus Rest of this layer numbers but that you can still G. Flexor pollicis longus Thumb side before nerve distinguish and name. Fourth Layer - Only one muscle is found in the fourth layer: H. Pronator quadratus Where you would watch strap wear a EXTENSOR ASPECT OF THE FOREARM: The muscles of the extensor forearm are also arranged in layers, although this arrangement is complicated somewhat by a group of "outcropping muscles" that act on the thumb. Be able to identify: Superficial group (first layers) - All of these muscle have complete or partial attachment off the lateral epicondyle of the humerus. Again, as with the flexor forearm, the muscles lying deeper have their action on more distal portions of the limb. I. Extensor carpi radialis longus 19 To carpal bones radial side on J. Extensor carpi radialis brevis 18 Shorter K. Extensor digitorum (communis): This muscle splits into four tendons, prominently visible on the dorsum of the hand, which attach via an intricate arrangement known as the extensor expansion. 17 L. Extensor carpi ulnaris 16 Una side M. Extensor digiti minimi: The tendon of this muscle may arise from the belly of the extensor digitorum communis. Between extensor carpi radialis brevis and extensor carpi unaris Second layer - This layer includes the "outcropping muscles" which form a bulge on the posterolateral surface of the inferior forearm. These muscles have their proximal attachments on the radius and interosseous membrane and distal attachments, via prominent tendons, onto the thumb. These tendons form the boundaries of an area at the base of the thumb called the "anatomical snuff box", where the radial artery passes through and the pulse can be felt here by pressing the artery against the deeper lying trapezium and scaphoid. Be able to identify: N. Extensor Pollicis Longus 21 O. Abductor Pollicis Longus 23 P. Extensor Pollicis Brevis 22 Q. Extensor Indicis: as noted above the extensor digitorum communis is characterized by several intertendinous connections, limiting independent extension of the involved digits. The index finger (second digit) is provided with a second extensor, the "proper extensor of the index finger". Thus the second digit is usually the only one capable of independent extension. Can't see on model Tendon second digit , on R. Supinator 25 Deep to brachioradial is TAKE HOME STUDY RESOURCES Using key choices; identify the bone names or markings according to the descriptions on the following page. Insert the appropriate letter in the answer blanks and identify each bone or marking on the skeletons. KEY CHOICES A. Acromion process F. Coronoid fossa K. Olecranon fossa P. Scapula B. Capitulum G. Deltoid tuberosity L. Olecranon process Q. Sternum C. Carpals H. Glenoid fossa M. Phalanges R. Styloid process D. Clavicle I. Humerus N. Radial tuberosity S. Trochlea E. Coracoid process J. Metacarpals O. Radius T. Ulna 1. Raised area on lateral surface of humerus to which deltoid muscle attaches 2. Upper arm bone 3. 4. Bones composing the shoulder girdle 5. 6. Forearm bones 7. Point where scapula and clavicle connect 8. Shoulder girdle bone that has no attachment to the axial skeleton 9. Shoulder girdle bone that articulates anteriorly with the sternum 10. Socket in the scapula for the upper arm bone 11. Process above the glenoid fossa that permits muscle attachment 12. Commonly called the collarbone 13. Distal medial process of the humerus; joins the ulna 14. Medial bone of the forearm in anatomic position 15. Rounded knob on the humerus that articulates with the radius 16. Anterior depression, superior to the trochlea, which receives part of the ulna when the forearm is flexed 17. Forearm bone involved in formation of elbow joint 18. 19. Bones that articulate with the clavicle 20. Bones of the wrist 21. Bones of the fingers 22. Heads of these bones form the knuckles Study the bones involved in the joints of the upper limb. What bones articulate at the shoulder, elbow, wrist, and metacarpal-phalangeal joint of the thumb? What movements are allowed at each of these joints? Which joints of the upper limb are designed for mobility and which for stability? Match the following: a. Extensor carpi radialis longus and g. Flexor digitorium profundus brevis h. Flexor digitorium superficialis b. Extensor carpi ulnaris i. Flexor pollicis longus c. Extensor digitorium j. Pronators teres and quadratus d. Extensor pollicis longus and brevis k. Palmaris longus e. Flexor carpi radialis l. Abdcutor pollicis longus f. Flexor carpi ulnairs m. Supinator 1. Flexes the wrist and middle phalanges 2. Pronates the forearm 3. Flexes the distal Interphalangeal joints 4. Extends the thumb 5. May not be present in some of us 6. Powerful wrist flexors that also stabilize the wrist during finger extension 7. Flexes the distal phalanx o f the thumb 8. Extends and abducts the wrist 9. These muscles form the anatomical snuff box 10. Extends the fingers 11. Supinates the forearm