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This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. Bones of the Upper Limb The Clavicle o o o The clavicle is an S-shaped long bone, which forms part of the pectoral girdle It articulates proximally with the sternum and distally with the acromion of scapula Bony features include: Acromial facet Sternal facet Impression for costoclavicular ligament Subclavian groove Conoid tubercle Trapezoid line o Right clavicle Smooth superior surface of the shaft, under the platysma muscle Deltoid tubercle: attachment of the deltoid Acromial facet Conoid tubercle, attachment of the conoid ligament which is the medial part of the coracoclavicular ligament Sternal facet Subclavian groove: site of attachment of the subclavius muscle Acromial facet Impression for the costoclavicular ligament which binds the clavicle to the first rib Rough inferior surface of the shaft, over the first rib Trapezoid line, attachment of the trapezoid ligament which is the lateral part of the coracoclavicular ligament FACTOIDS - - Its occasionally pierced by a branch of the supraclavicular nerve thicker and more curved in manual workers weakest part is the junction of the middle and lateral thirds: most commonly fractured; more common in children after a fracture, the sternocleidomastoid elevates the medial fragment of the clavicle, and the shoulder drops. The lateral fragment of the clavicle gets pulled medially by the arm adductors, eg. pectoralis major THE CLAVICLE IS THE FIRST LONG BONE TO OSSIFY in the embryo (5th-6th week) Protects the neurovascular bundle supplying the upper arm, forming a bony boundary of the cervical canal Transmits traumatic impact force from the upper limb to the axial skeleton Contains NO MEDULLARY CAVITY This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. The Scapula o o o The clavicle is a triangular flat bone which lies on the posterolateral surface of the thorax Proximally, it is curved to move over the chest wall, and distally it articulates with the clavicle at the acromioclavicular joint, and with the head of humerus at the glenohumeral joint Bony features include: Subscapular fossa Spine of scapula, Delotid tubercle on the spine of scapula Acromion process of the spine of scapula Facet for articulation with the clavicle Supraspinous fossa Infraspinous fossa Coracoid process Suprascapular notch Glenoid cavity Right Scapula Suprascapular notch Supraspinous fossa Spine of the scapula Head of scapula Infraspinous fossa Facet for the clavicle Superior border: THINNEST bone Acromion Body of scapula (forms the head) Coracoid process Supraglenoid tubercle: For attachment of long head of biceps This whole surface is the subscapular fossa Glenoid cavity: 4cm by 2-3 cm; Faces anterolaterally and slightly superiorly Infraglenoid tubercle: For attachment of long head of triceps Lateral border: a thick bar of bone, the stress-bearing region of the scapula Medial (vertebral)border: Thin bone This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. The Humerus o o o the humerus is a long bone, the largest in the upper limb it articulates proximally with the scapula at the scapulohumeral (glenohumeral) joint it articulates distally with the ulna at the elbow joint Bicipital groove Greater tubercle The humerus is in direct contact with a bunch of important nerves: The Right Humerus Lesser Tubercle The anatomical neck is formed by a groove distal to the head but proximal to the tubercles The Axillary Nerve At the surgical neck The surgical neck is the narrow part past the tubercles The Deltoid Tuberosity is where the deltoid attaches The Radial Nerve The Radial groove is where the radial nerve and deep artery of the arm pass next to the humerus At the radial groove The sharp lateral supracondylar ridge The Median Nerve The sharp medial supracondylar ridge The Lateral Epicondyle : attachment for EXTENSORS At the distal humerus The Medial Epicondyle : attachment for FLEXORS The Ulnar Nerve At the medial epicondyle Olecranon Fossa : receives the olecranon process of ulna Trochlea articulates with the trochlear notch of the ulna Coronoid Fossa : receives the coronoid process of the ulna Capitulum : articulates with the head of radius Radial Fossa: receives the head of radius Bony features include: - The head of humerus The anatomical neck The greater tubercle The lesser tubercle Intertubercular groove – bicipital groove The surgical neck The deltoid tuberosity - The radial groove The medial and lateral supracondylar ridges The medial and lateral epicondyles The olecranon fossa The trochlea The coronoid fossa The radial fossa The capitulum This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. The Humerus common fracture sites and the position of the nerves relative to these o o o o COMMONEST fracture site: the SURGICAL NECK AXILLARY NERVE is injured by this MID-SHAFT fracture: either transverse, from a direct blow, or spiral, from a fall on an outstretched arm RADIAL NERVE is injured this way as it runs in the radial groove INTERCONDYLAR FRACTURE: fall on a flexed elbow; the olecranon is driven into the olecranon fossa, shattering it; MEDIAN NERVE is damaged by this ULNAR NERVE may be damaged by this The greater tubercle can get avulsed, but there are no nerves around to be harmed by this This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. The Radius o o o o o o o the humerus is a long bone, the largest in the upper limb it articulates proximally with the scapula at the scapulohumeral (glenohumeral) joint it articulates distally with the ulna at the elbow joint the radius is a long bone, the shorter of the two in the forearm proximally, the head of radius articulates with the capitulum of the humerus the head also articulates with the radial notch of the ulna the radial tuberosity separates the neck of radius from the body The head of radius The neck of radius Radial tuberosity Bony features include: The body of radius head of radius neck of radius radial tuberosity body of radius radial styloid process Dorsal markings on the distal radius, ulnar notch groove for extensor digitorum and extensor indices groove for extensor pollicis longus dorsal tubercle of radius groove for extensor carpi radialis groove for extensor carpi radialis longus and brevis Ulnar notch: this is where the head of the ulna articulates Posterior oblique line Groove for extensor pollicis longus Dorsal tubercle of radius: “Listers tubercle” Groove for extensor carpi radialis longus and brevis Groove for extensor digitorum and extensor indices Radial styloid process: MUCH LARGER than the ulnar. It extends further distally by about 1 fingers breadth. This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. Markings on the Dorsal Radius o o o the humerus is a long bone, the largest in the upper limb it articulates proximally with the scapula at the scapulohumeral (glenohumeral) joint it articulates distally with the ulna at the elbow joint extensor CARPI RADIALIS LONGUS and BREVIS Dorsal tubercle of radius extensor POLLICIS LONGUS extensor DIGITORUM and extensor INDICES Ulnar notch ULNA RADIUS This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. The Ulna o o o the ulna is a medial long bone, the longer of the two in the forearm. Proximally, it articulates with the capitulum and trochlea of the humerus; At the radial notch, it articulates with the head of radius It stabilizes the forearm The HEAD LIES DISTALLY. The Olecranon The Trochlear Notch The Coronoid Process The Radial Notch where the head of the radius goes The Tuberosity of the Ulna is where the Brachialis attaches Supinator fossa Supinator crest The deep part of the supinator attaches here Bony features include: - The head of ulna The ulnar styloid process Humerus and ulna: landmarks and articulations o o o the humerus is a long bone, the largest in the upper limb it articulates proximally with the scapula at the scapulohumeral (glenohumeral) joint it articulates distally with the ulna at the elbow joint o o the ulna and humerus articulate at the elbow joint the articulations include: articulation between the trochlea of the humerus and the trochlear notch of the ulna articulation of the olecranon process and the olecranon fossa during extension articulation of the coronoid process and the coronoid fossa during flexion the surface landmarks include the medial and lateral epicondyle the olecranon the posterior border of the ulna o Olecranon Trochlear notch Coronoid process Radial notch Tuberosity of ulna Supinator fosa Supinator crest Head of ulna Ulnar styloid process This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. The Articulated Carpus o o o the humerus is a long bone, the largest in the upper limb it articulates proximally with the scapula at the scapulohumeral (glenohumeral) joint it articulates distally with the ulna at the elbow joint o o o the carpals are eight bones arranged in two rows the carpus is convex anteriorly and concave posteriorly these bones glide on each other, as well as the two rows gliding on each other, as well as gliding along the radiocarpal joint. Some Lovers Try Positions That They Cant Handle: - o Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate. The scaphoid, linate and triquetrum articulate with the radius. Capitate Articulates with the 3rd metacarpal Largest bone in the carpus Trapezoid Articulates with the 2nd metacarpal Hamate Articulates with the 4th and 5th metacarpal Tubercle of trapezium Hook of Hamate Trapezium Articulates with the 1st and 2nd metacarpals Tubercle of scaphoid Pisiform Scaphoid Largest bone in the proximal row Articular disk Triquetrum Lunate 5th 4th 3rd Hamate 2nd 1st Capitate Trape trapezium zoid 1st References: Moore’s Clinically Oriented Anatomy 5th edition 1st 1st 1st