Download of the upper limb

BONES
AND
JOINTS
OF THE UPPER LIMB
UPPER LIMB – BONES AND JOINTS
UPPER LIMB
consists of 4 major segments:
SHOULDER:
•  ovelaps parts of thorax, trunk and lower lateral neck
•  includes: pectoral scapular, deltoid regions
•  the pectoral (shoulder) girdle:
- incomplete posteriorly by scapulea
- complete anteriory by clavicules and manubrium of the sternum
ARM:
•  longest part of the upper limb
•  consists of anterior and posterior regions of the arm
FOREARM:
•  between the elbow and wrist
•  inculdes anterior and posterios regions of the forearm
HAND:
•  is formed around the carpus, metacarpus and phalanges
•  is composed of the wrist, palm, dorsum od the hand and digits
UPPER LIMB – BONES AND JOINTS
BONES
MUSCLES
JOINTS
Clavicle
Scapula
Humerus
Radius
Ulna
Carpal bones
Metacarpals
Phalanges
Pectoralis major and minor muscle
Trapezius muscle
LaTssimus dorsi muscle
Scapulohumeral muscles
Subclavius muscle
Levator scapulae muscle
Rhomboids
Glenohumeral joint
Elbow joint
Wrist joint
Sternoclavicular joint
Acromioclavicular joint
Proximal and distal radio-ulnar joint
Intercarpals joints
Carpometacarpal joints
Intermetacarpal joints
Metacarpohalangeal joints
Interphalangeal joints
OTHERS
Axilla
Axillary artery
Axillary vein
Axillary lymph nodes
UPPER LIMB – BONES AND JOINTS- CLAVICLE
HOW TO RECOGNIZE LEFT – RIGHT CLAVICLE
BONE?
CLAVICLE (COLLAR BONE)
•  long bone
•  has not medullary (marrow) cavity
Consists of:
•  the shaU of clavicle – has double
curve in a horizontal plane
•  the sternal end
•  the acromial end
STERNAL END:
•  arTculates with the mandibrium of the sternum
•  is rather plumb
•  is enlarged and traingular
•  the medial 2/3 of the shaU are convex anteriorly
ACROMIAL END:
•  arTculates with the acromion of the scapula
(acromioclavicular joint – AC joint)
•  is more pointed
•  the lateral 1/3 is concave anteriorly
SUPERIOR SURFACE OF THE CLAVICLE:
•  is smooth
INFERIOR SURFACE OF THE CLAVICLE:
•  is rough, because of the ligaments bind it
•  the subclavian groove in the medial third
•  medially posiToned is the conoid tubercle
•  and lateral the trapezoid line
UPPER LIMB – BONES AND JOINTS- SCAPULA
SCAPULA (SHOULDER BLADE)
•  flat bone
•  triangular shape – 3 margins and
3 angles
•  lies on the posterolateral aspect
of the thorax
•  overlying the 2nd to 7th ribs
•  body, head, neck
STRUCTURES OF THE SCAPULA
POSTERIOR SURFACE:
•  is unevenly divided and convex
•  divided by the spine of the scapula into:
- infraspinous and infraspinous fossa
•  the spine conTnues laterally as the
expanded acromion
•  the acromion arTculates with the acromial
end of clavicle – (acromioclavicular joint –
AC joint)
•  AC joint is superior to the shoulder joint
•  the spine of scapula is the
point of a]achment of the
deltoid muscle
UPPER LIMB – BONES AND JOINTS- SCAPULA
STRUCTURES OF THE SCAPULA
ANTERIOR SURFACE:
•  anterior surface = costal surface
•  physiological scapulothoracic joint
•  subscapular fossa
UPPER LIMB – BONES AND JOINTS - SCAPULA
•  the spine and the acromion are places for
the a]ached muscles, parTculary the
trapezius
SCAPULA (SHOULDER BLADE)
STRUCTURES OF THE SCAPULA
LATERAL BORDER:
•  superolaterally surface has the glenoid cavity
•  the glenoid cavity is on the head of the
scapula
•  oval and concave glenoid cavity arTculates
with the head of the humerus (glenohumeral
joint)
•  anterolaterally, superior to the glenoid cavity
is the coracoid process
•  the coracoclavicular ligament a]aches the
coracoid process
SCAPULA (SHOULDER BLADE)
STRUCTURES OF THE SCAPULA
SUPERIOR BORDER:
•  the suprascapular notch is where the superior border joins the base of the coracoid
process
•  the suprascapular nerve passes through the suprascapular notch, which is bridge by
superior transverse scapular ligament
•  ossificaTon of this ligament can result in compression of the nerve with weekening of the
dependent muscles: supra- and infraspinatus
MEDIAL BORDER:
•  called the vertebral border
•  runs parallel to and approximately 5cm lateral to the spinous processes
LATERAL BORDER:
•  thickest part of the bone
•  bears the broadened head of the scapula
•  called the axillary border
UPPER LIMB – BONES AND JOINTS - HUMERUS
HUMERUS (ARM BONE)
HUMERUS
•  PROXIMAL HUMERUS
•  SHAFT OF HUMERUS
•  DISTAL HUMERUS
The humerus is the largest bone in the upper limb, arTculates with
the scapula (the glenohumeral joint) and the radius and ulna (the
elbow joint)
The proximal humerus has:
•  HEAD
•  ANATOMICAL NECK
•  SURGICAL NECK
•  GREATER TUBERCLE
•  LESSER TUBERCLE
UPPER LIMB – BONES AND JOINTS - HUMERUS
HUMERUS (ARM BONE)
PROXIMAL HUMERUS
THE HEAD OF HUMERUS:
•  arTculates with the glenoid cavity of the scapula (the glenohumeral joint)
THE ANATOMICAL NECK:
•  is formed by the groove circumscribing the head and separaTng it from the greater and the
lesser tubercles
•  provides a]achment for fibrous joint capsule
THE SURGICAL NECK:
•  proximal end of shaU
•  is a narrow part distal to the head and tubercles
•  a common site of fractures
THE GREATER TUBERCLE:
•  is at the lateral margin of the humerus
•  provides inserTon for supraspinatus infraspinatus and teres minor muscles
UPPER LIMB – BONES AND JOINTS - HUMERUS
HUMERUS (ARM BONE)
PROXIMAL HUMERUS
THE LESSER TUBERCLE:
provides inserTon for subscapularis muscle
THE INTERTUBERCULAR SULCUS (BICIPITAL GROOVE):
•  separates the tubercles
•  transmits tendon of the long head of the biceps muscle
•  bridged by transverse humeral ligament
UPPER LIMB – BONES AND JOINTS - HUMERUS
•  DISTAL HUMERUS
HUMERUS
•  PROXIMAL HUMERUS
•  SHAFT OF HUMERUS
HUMERUS (ARM
BONE)
The humerus is the largest bone in the upper limb,
arTculates with the scapula (the glenohumeral
joint) and the radius and ulna (the elbow joint)
The shaU of the humerus has two prominent features:
•  the deltoid tuberosity (laterally)
•  the radial groove (posteriorly)
DELTOID GROOVE (SPIRAL GROOVE):
•  separates origins of lateral and medial heads of triceps brachii muscle
•  contains radial nerve and profunda brachii artery
UPPER LIMB – BONES AND JOINTS - HUMERUS
HUMERUS (ARM BONE)
SHAFT OF HUMERUS
•  the radial nerve may be injured during fractures in the shaU
area
•  resulTng in a clinically obvious lesion of the radial nerve
(radial nerve paralysis)
•  the nerve may also be damaged by compression (“park
bench paralysis” or “saturday night palsy”) – main effect:
WRIST DROP
The inferior end of the humerus:
•  widens as the sharp medial and lateral supraepicondylar ridges form