Download 1 Anatomy - Upper Limb – Bones

Anatomy - Upper Limb – Bones
Clavicle Sternal end 2 facets, conoid tubercle inf/lat
Doubly curved long bone connecting upper limb to trunk
Articulations SC, AC
Acromial end, Sternal end + facets
Muscles
Clavicular head SCM → med 1/3 ant/sup
Pectoralis major → med 1/3 ant/inf
Deltoid → lat 1/3 ant
Trapezius → lat 1/3 post
Subclavius in subclavian groove inf/mid 1/3
Ligaments
Ant and post SC, Interclavicular, Costoclavicular ligaments
Coracoclavicular ligament, 2 parts:
Conoid ligament (medial) conoid tubercle to coracoid
Trapezoid ligament (lateral) trapezoid line to coracoid
Acromioclavicular ligament thickening AC capsule
Functions
Strut, Transmits shock, Elevation ribs deep insp, Protect brachial plexus
Relations medial clavicle
Med – SC, manubrium
Post – 1st rib, brachioceph/IJ/subclavian veins
Apical pleura, thoracic duct L
Ant/sup/inf – subcut tissue, skin, platysma
Scapula Spine post, glenoid lateral
Pectoral girdle bone, posterolat aspect thorax, over 2nd-7th ribs
Articulations AC, glenohumeral
Ligaments
Coracoclavicular – conoid, trapezoid
Acromioclavicular
Coracoacromial
Glenohumeral (weak)
Coracohumeral (strong)
Movement
Elevation – trap; depression – gravity; protraction – serr ant;
retraction – trap; rotation – trap/serr ant/lat dorsi
Landmarks
Medial, lateral, superior borders
Medial border → sup to inf:
Levator scap, Rhomb minor, major
Superior, lateral, inferior angles
Costal surface - Subscapular fossa
Subscapularis, Serratus anterior
Scapular notch
Dorsal surface – Supraspinous/infraspinous fossae
Spine → acromion (articulates with clavicle)
Supraspinatus, Infraspinatus, Teres major, minor,
Trapezius, Deltoid
Glenoid (articulates with head humerus), neck
Supraglenoid tubercle → long head biceps; Infra
→ long head triceps
Coracoid process anterolaterally, superior to glenoid
Pec minor, short head bicep, coracobrach to tip
Humerus Bicipital groove anterior
Proximal
Head, Lesser tuberosity - Subscap
Greater tuberosity
3 facets: sup – supraspin; mid – infraspin; low – teres minor
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Intertubercular groove - transverse humeral lig, tendon long head biceps
Anatomical neck articular margin; Surgical neck junction upper end/shaft
Articular surface 4x area glenoid
Capsule attached articular margin except med - down 2cm
Teres major inserts med lip
Lat dorsi in floor (A Lady between 2 Majors)
Pectoralis major inserts lat lip
Shaft
Triangular
Deltoid to deltoid tuberosity
Radial groove spirals post - radial nerve
Lat and med supracondylar ridges into epicondyles
Lat head triceps from lateral lip groove, Med head from whole shaft
Coracobrachialis into opposite side to deltoid tuberosity
Brachialis from flexor surface
Events occurring at mid-humerus
- insertion deltoid and coracobrachialis, origin brachialis
- radial nerve emerge from spiral groove, median nerve cross brachial art
- basilic vein perforates deep fascia, nutrient artery enters humerus
Distal
Med epicondyle - common flexor origin; Lat epicondyle - common extensor
Capitulum articulates with head radius
Trochlea articulates with ulna
Coronoid fossa above trochlea, radial fossa above capitulum
Olecranon fossa posterior
Capsule attached to margins capitulum/trochlea and shaft above
coronoid/radial/olecranon fossa
Ossification distal humerus - CRITOE Capitellum, Radial head, Int epicondyle, Trochlea, Olecranon, Ext epicondyle
Ulna Radial notch medially
Olecranon - Triceps into upper surface, FDP med surface, Anconeus lat surface
Coronoid process - medial lip forms sublime tubercle - FDS attach, MCL below, pron teres
Ulnar tuberosity - ant surface coronoid process roughened - Brachialis inserts
Radial notch for head radius - Annular ligament attached; Quadrate ligament just below notch
Trochlear notch fits trochlea of humerus
Capsule attached to margins trochlear notch and radial notch
Shaft
Supinator crest distally from post margin radial notch - supinator arises
Interosseous border - interosseous membrane
Extensor surface between interosseous/post borders: AbdPL (radius), EPL (ulna only), EI (ulna)
Flexor surface medial to interosseous border - Common aponeurosis arises and pronator quadratus
Head Articulates ulnar notch of radius and articular cartilage
Ulnar styloid
Radius Biceps tubercle medially, ant oblique line ant, styloid lat
Head Articulates capitulum; Neck enclosed annular ligament
Shaft Radial tuber project toward ulna - Biceps attach
Ant - Supinator, Pronator teres, Radial head FDS, FPL, Pron quad
Posterior attachments – AbdPL, EPL
Lower end Ulnar surface - ulnar notch for articulation with ulna
Radial styloid - Radial collat lig, Brachioradialis and ext retinac attach
Broad distal end articulates with scaphoid and lunate
Scaphoid prone to AVN due to relative ischaemia - blood supply via dorsal branch radial artery at waist → proximal
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