Download Upper limb - Wikispaces

UPPER LIMB
MUSCLES OF ARM, CUBITAL FOSSA,
AND ELBOW JOINT
Dr.Nivin Sharaf MD M.B.BCH
Objectives
-Identify the following structures: humerus (medial & lateral
epicondyles, lateral condyle (capitulum), medial condyle (trochlea),
radius (head, styloid process, tuborosity), ulna (olecranon, coronoid
process, styloid process)
-Describe the movements of flexion and extension of the elbow joint.
-Describe the articulation of the elbow joint with the radius and ulna.
-Explain where you would aspirate a joint effusion.
-Describe the course of neurovascular structures in the arm (brachial
artery and vein, nerves - medial, ulnar and radial), and their relation in
the cubital fossa
-Name and identify the anatomical region of the cubital fossa
(location, boundaries)
Surface
Anatomy
Surface anatomy
• .
Bony Skeleton
Humerus and Scapula (Ant)
Humerus and Scapula (Post)
Humeral Head
Supra scapular
Fossa
Infra scapular
Fossa
Humeral Neck
Anatomical
Humeral Neck
Surgical
Radial groove
Inferior
Angle
Medial epicondyle
Humerus and Scapula (Post)
Humeral Head
Supra scapular
Fossa
Infra scapular
Fossa
Humeral Neck
Anatomical
Humeral Neck
Surgical
Radial groove
Inferior
Angle
Medial epicondyle
Elbow joint
http://www.joint-pain-expert.net/images/elbow_joint_anatomy001.jpg
Ligaments of Elbow
ELBOW= hinge jt.
Humerus:
-medial & lateral epicondyles,
-lateral condyle (capitulum),
-medial condyle (trochlea)
-coronoid fossa
-olecranon fossa
Radius:
-head,
-tuborosity (biceps insertion)
Ulna:
-olecranon,
-coronoid process
- tuborosity (brachialis insertion)
Fibrous capsule of the elbow joint.
-Strong collateral ligaments on
each side.
- Annular ligament encircles radial
head
Triceps tendon
Cubital tunnel syndrome
Muscles
Anterior arm
Mainly Flexors
BBC
Brachialis
Biceps
Coraco brachialis
Nerve Supply!
Musculo Cutaneous Nerve
Posterior arm
Arm muscles
http://www.highfive.me.uk/Resources/Anatomy/UpperA
Cubital Fossa
Surface Anatomy
Roof of cubital fossa.
-superficial veins:
Median Cubital v.
Cephalic v.
Basilic v.
Cubital fossa.
– anterior to the elbow
Boundaries:
- Epicondyles *
(medial & lateral)
- Pronator Teres
- Brachioradialis
Contents:
- Brachial a
(radial / ulnar aa)
- Biceps tendon
& aponeurosis
- Median n
Floor of cubital fossa.
- Brachialis m
- Supinator m
- Radial nerve: deep branch
(muscular, articular)
superficial branch (cutaneous)
Cubital Fossa
Identify the
borders of the
cubital fossa:
Brachioradialis
m. laterally,
Pronator teres
medially and
Brachialis which
forms the floor of
the fossa.
Cubital Fossa
Contents
Lateral to medial, the Bicipital tendon, the
Brachial artery, and the Median nerve. The
Brachial veins may be removed. You should
look for the branching of the Brachial a. into
Radial and Ulnar aa. and the Superficial
branch of the Radial nerve running underside
Brachioradialis muscle
Course of nerves in anterior and posterior arm.
Brachial Plexus
Randy Travis Drinks Cold Tea
Axilallry N and Radial N
Axillary nerve supplies
Deltoid muscle
Teres Minor
Skin over deltoid
Axillary nerve
Radial Nerve
Radial Nerve
Supplies all the extensors
+
Brachio Radialis
Posterior View
Median
Nerve
•
•
•
•
Supplies all the flexors
of the arm except
Flexor Carpi Radialis
(Radial N)
Flexor Carpi Ulnaris
(Ulnar N)
Medial ½ of FDP
Radial Nerve
Brachial Plexus
Links
• http://www.bing.com/images/search?q=posterior+forarm&form=QBIR&qs=n
#focal=703fca7fd9d811d3076749b41e801de4&furl=http%3A%2F%2Fwww.anatom
yfacts.com%2FMuscle%2FMuscleBone_files%2Fimage019.gif
• http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/musculoske
•
•
letal_system/forearm_questions.html
www.getbodysmart.com
http://www.becomehealthynow.com/body/muscles/atlas/anconeus.shtml
References
•
•
•
•
•
•
•
•
•
•
Google images
Netter Anatomy Atlas
University of Washington website
Bing Images
Yahoo Images
http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/images/wrist_ant.jpg
http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/musculoskeletal_system/forearm_questions.html
http://iris3.med.tufts.edu/dentgross/labguide/SupHand2R.jpg
http://www.dasd.k12.pa.us/57592111818543/lib/57592111818543/Muscles_of_the_Posterior_Trunk,_Shoulder_and_Arm_Numbered.jpg
http://www.yamli.com/#t=image&q=axillary%20nerve&s=120&safe=1&isz=all&sm=ltr
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
1. Deltoid: scapula/clavicle to humerus- abducts arm
2. Levator scapulae: C-vertebrae to scapula- elevates scapula
3. Infraspinatus: lower scapular spine to humeral head- lateral rotation of humerus
4. Teres major: scapula to anterior humerus- medial rotation of humerus'
5. Teres Minor: scapula to posterior humerus- lateral rotaion of humerus
6. Supraspinatus: upper scapular spine to humeral head- abducts humerus
7. Trapeziues: Vertebrae/Occipital to scapula/clavicle- abduct arm, rotate, abduct scapula
8. Rhomboidius: T-vertebrae to scapula- raise/adduct scapula
9. Latissimus Dorsi: T-, L-, S- vertebrae to humerus- extend/adduct arm
10. Biceps: scapula to radius- flex elbow
11. Triceps: scapula/humerus to ulna- extend elbow
12. Pronator: Medial humerus to radius- medial rotation of forearm (pronation)
13. Flexor carpi radialis: medial humerus to 2nd/3rd metacarpal- flex/abduct hand
14. Flexor Digitorum: medial humerus/ulna to phalanges- flex fingers
15. Extensor carpi ulnaris: lateral humerus to 5th metacarpal- extend/adduct hand
16. Extensor digitorum: lateral humerus to phalanges- extend fingers
17. Extensor carpi radialis: lateral humerus to 2nd/3rd metacarpal- extend/adduct hand