Download 2 Upper Limb

The Upper Limb
Anatomage Table
Instructors Guide- Upper Limb
Table of Contents
Upper Limb 1- The Skeletal System.........................................................................................................3
1: Clavicle..............................................................................................................................................3
2: Scapula..............................................................................................................................................5
3: Shoulder (Glenohumeral) and Proximal Humerus............................................................................7
4: Distal Humerus and Elbow...............................................................................................................9
5: Wrist................................................................................................................................................11
6: Hand................................................................................................................................................14
Suggested Clinical Correlates (CC): ..............................................................................................16
Upper Limb 2- The Muscular System.....................................................................................................17
1: Anterior Axioappendicular (Pectoral) Muscles...............................................................................17
2: Posterior Axioappendicular Muscles...............................................................................................19
3: Scapulohumeral Muscles.................................................................................................................21
4: Arm Muscles...................................................................................................................................23
5: Anterior Forearm.............................................................................................................................25
6: Posterior Forearm............................................................................................................................27
7: Hand................................................................................................................................................29
Suggested Clinical Correlates (CC): ..............................................................................................31
Upper Limb 3- The Cardiovascular System ...........................................................................................32
1: Arterial Supply to the Axilla and Arm.............................................................................................32
2: Arterial Supply to the Forearm and Hand.......................................................................................34
3: Venous Return of the Upper Limb..................................................................................................36
Suggested Clinical Correlates (CC): ..............................................................................................38
Appendix..................................................................................................................................................39
Upper Limb 1- The Skeletal System
1: Clavicle
•
Name the bones comprising the shoulder girdle and discuss the difference between a separated
and dislocated shoulder
1st and 2nd Rib
Clavicle
Humerus
Manubrium
Scapula
Sternum (body)
1. a. Shoulder Girdle
Acromial end of clavicle
Acromioclavicular (AC) joint
Acromion
Clavicle
Deltoid tubercle
Manubrium
Sternal end of clavicle
Sternoclavicular (SC) joint
1. b. Vertebral Arch (Superior)
1st and 2nd Rib
Acromial end of clavicle
Acromioclavicular (AC) joint
Acromion process
Clavicle
Humerus
Manubrium
Scapula
Sternal end of clavicle
Sternoclavicular (SC) joint
1. c. Intervertebral Joint
Acromial end of clavicle
Acromioclavicular (AC) joint
Acromion angle
Clavicle
Coracoid process
Deltoid tubercle
Humerus
Scapula
1. d. Zygopophyseal Joint (Low Visibility)
2: Scapula
•
Describe the features of the scapula and list the various processes and fossa
Acromion process
Coracoid process
Glenoid cavity
Inferior angle
Lateral (axillary) border
Medial (vertebral) border
Subscapular fossa
Superior angle
Suprascapular notch
2. a. Subscapular Fossa
Acromion angle
Acromion process
Coracoid process
Head of scapula
Medial (vertebral) border
Neck of scapula
Spine of scapula
Superior angle
Suprascapular notch
Supraspinous fossa
2. b. Supraspinous Fossa
Acromion process
Head of scapula
Inferior angle
Infraspinous fossa
Lateral (axillary) border
Medial (vertebral) border
Neck of scapula
Spine of scapula
2. c. Infraspinous Fossa
Acromion process
Coracoid process
Glenoid fossa (cavity)
Head of scapula
Inferior angle
Infraglenoid tubercle
Lateral (axillary) border
Neck of scapula
Subscapular fossa
Supraglenoid tubercle
Suprascapular notch
2. d. Glenoid Fossa
Acromion process
Coracoid process
Glenoid cavity
Inferior angle
Lateral (axillary) border
Medial (vertebral) border
Spine of scapula
Subscpular fossa
Superior angle
Suprascapular notch
2. e. Subscapular Fossa
3: Shoulder (Glenohumeral) and Proximal Humerus
•
Identify the component parts and features that stabilize the shoulder joint
•
Describe the proximal humerus and explain the difference between the surgical and anatomical
necks of the humerus
Anatomical neck of humerus
Glenoid fossa( cavity)
Head of humerus
Infraglenoid tubercle
Supraglenoid tubercle
Surgical neck of humerus
3. a. Glenohumeral Joint
Compact (cortical) bone
Epiphyseal line
Glenoid fossa (cavity)
Head of humerus
Marrow (medullary) cavity
Spongy (Cancellous) bone
3. b. Spongy and Compact Bone (Coronal Cut)
Anatomical neck of humerus
Greater tubercle
Head of humerus
Intertubercular groove
Lesser tubercle
Surgical neck of humerus
3. c. Intertubercular Groove (Anterior)
Acromion process
Anatomical neck of humerus
Deltoid tuberosity
Glenoid fossa (cavity)
Greater tubercle
Head of humerus
Surgical neck of humerus
3. d. Proximal Humerus (Posterior)
Acromial end of clavicle
Acromion process
Anatomical neck of humerus
Clavicle
Coracoid process
Glenoid fossa (cavity)
Greater tubercle
Head of humerus
Humerus
Lateral (axillary) border
Scapula
3. e. Shoulder X-ray (Anterior)
4: Distal Humerus and Elbow
•
Classify the elbow joint and identify the sites of articulation between the various bones
Deltoid tuberosity
Greater tubercle
Head of humerus
Intertubercular groove
Lateral epicondyle
Lesser tubercle
Medial epicondyle
Radial groove
Shaft of the humerus
4. a. Humerus (Anterior)
Capitulum
Coronoid fossa
Lateral epicondyle
Lateral supracondylar ridge
Medial epicondyle
Medial supracondylar ridge
Radial fossa
Radius
Shaft of humerus
Ulna
4. b. Coronoid Fossa (Anterior)
Capitulum
Head of radius
Lateral epicondyle
Lateral supraepicondylar ridge
Medial epicondyle
Medial supraepicondylar ridge
Olecranon fossa
Olecranon process
Shaft of humerus
Trochlea
4. c. Olecranon Fossa (Posterior)
Coranoid fossa
Coranoid process
Olecranon fossa
Olecranon process
Shaft of humerus
Trochlea
Trochlear notch
Ulna
Ulnar tuberosity
4. d. Humeroulnar Joint (Medial)
Capitulum
Head of radius
Lateral epicondyle
Lateral supraepicondylar ridge
Neck of radius
Radial fossa
Radial tuberosity
4. e. Humeroradial Joint (Anterior)
Coranoid fossa
Coranoid process
Head of radius
Neck of radius
Olecranon fossa
Olecranon process
Shaft of humerus
Trochlea
Trochlear notch
4. f. Elbow X-ray (Medial)
5: Wrist
•
Describe the articulation of the bones at the wrist and review the bones involved both directly
and indirectly with this joint
Coronoid process
Head of radius
Neck of radius
Radial notch
Radial tuberosity
Radius
Ulna
Ulnar tuberosity
5. a. Proximal Radioulnar Joint (Anterior)
Anterior compartment of forearm
Interosseous border of radius
Interosseous border of ulna
Location of interosseous
membrane
Posterior compartment of
forearm
Shaft of radius
Shaft of ulna
Skin
Superifical v.
5. b. Interosseous Borders (Axial Slice)
Distal radioulnar joint
Head of ulna
Shaft of radius
Shaft of ulna
Styloid process of radius
Styloid process of ulna
Ulnar notch of radius
5. c. Distal Radioulnar Joint (Anterior)
Lunate
Pisiform
Radiocarpal joint
Scaphoid
Styloid process of radius
Styloid process of ulna
Triquetrum
Tubercle of scaphoid
Ulnar notch of radius
5. d. Wrist (Radioulnar) Joint (Anterior)
Capitate
Hamate
Hook of hamate
Lunate
Pisiform
Scaphoid
Styloid process of radius
Trapezium
Trapezoid
Triquetrum
Tubercle of scaphoid
Tubercle of trapezium
5. e. Carpal Bones (Anterior)
Lunate
Pisiform
Radiocarpal joint
Scaphoid
Styloid process of radius
Styloid process of ulna
Triquetrum
Ulnar notch of radius
5. f. Carpal Bones (Posterior)
Capitate
Distal radioulnar joint
Hamate
Head of ulna
Lunate
Pisiform
Radiocarpal joint
Scaphoid
Styloid process of radius
Styloid process of ulna
Trapezium
Trapezoid
Triquetrum
5. g. Wrist X-ray (Posterior)
6: Hand
•
Name the bones and joints in the hand
1st-5th Metacarpals
Capitate
Carpometacarpal joint
Hamate
Midcarpal joint
Trapezium
Trapezoid
6. a. Carpometacarpal Joint (Posterior)
1st-5th Metacarpals
Intermetacarpal joints
Sesamoid bones
6. b. Metacarpals (Anterior)
1st-5th Metacarpals
1st-5th Proximal phalanx
Metacarpophalangeal (MP) joint
6. c. Metacarpophalangeal (MP) Joint (Posterior)
1st distal phalanx
1st Metacarpal
1st Proximal phalanx
Carpometacarpal (CMC) joint
Interphalangeal (IP) joint
Metacarpophalangeal (MP) joint
Sesamoid bones
Trapezium
6. d. Thumb
2nd-5th Distal phalanx
2nd-5th Middle phalanx
2nd-5th Proximal phalanx
Base, shaft, head of middle
phalanx
Base, shaft, head of proximal
phalanx
Base, shaft, tubersotiy, and head
of distal phalanx
6. e. Phalanges
5th Distal phalanx
5th Metacarpal
5th Middle phalanx
5th Proximal phalanx
Distal interphalangeal (DIP) joint
Metacarpophalangeal (MP) joint
Proximal interphalangeal (PIP)
joint
6. f. Interphalangeal Joints X-ray (Posterior)
Suggested Clinical Correlates (CC):
Anteroinferior Dislocation with Hill-Sachs
Impaction Fracture of Greater Tuberosity
Luxation Erecta Positioning of Arm
Case 0106 Shoulder Dislocation
Distal Radial Ulnar Joint with TFCC
Perforation or Tear
Scapholunate and/or a Lunotriquetral
Perforation or Tear
Case 0092 Scapholunate Tear
Comminuted Frx of 3rd and 4th Metacarpal
Metaphysis, Comminuted Frx of Base and
Proximal Shaft of 5th Metacarpal
Comminuted Mildly Displaced Hamate Frx
Mildly Displaced Frx of Base of 2nd Metacarpal
Case 0321 Metacarpal Fractures
Upper Limb 2- The Muscular System
1: Anterior Axioappendicular (Pectoral) Muscles
•
Name the attachments for the muscles of the anterior chest wall
•
Describe the dominant actions for pectoralis major and serratus anterior
•
Explain the clinical significance of “winging of the scapula” and identify the primary muscle
involved
Body of sternum
Clavicle
Clavicular head of pectoralis
major
Lateral lip of intertubecular
groove
Manubrium
Sternocostal head of pectoralis
major
1. a. Pectoralis Major (Anterior)
Cephalic v.
Clavicle
Clavicular head of pectoralis
major
Deltoid
Deltopectoral groove
Deltopectoral triangle
1. b. Deltopectoral Triangle (Superior)
3rd -4th Rib
Medial border of scapula
Pectoralis major
Pectoralis minor
Serratus anterior
1. c. Serratus Anterior (Inferior)
2nd -3rd Rib
Axillary a.
Axillary v.
Coracoid process
Pectoralis major
Pectoralis minor
Spine of scapula
1. d. Pectoralis Minor (Sagittal Cut Lateral)
2: Posterior Axioappendicular Muscles
•
Identify and describe the sites of attachment for the extrinsic muscles of the back
•
Review the associated actions of these muscles on the scapula and upper limb
Acromial end of clavicle
C7, T1-T4 spinous process
Exteranl occipital protuberance
Inferior fibers of trapezius
Medial border of scapula
Middle fibers of trapezius
Spine of scapula
Superior fibers of trapezius
2. a. Trapezius (Posterior)
Acromial end of clavicle
Inferior fibers of trapezius
Intertubucular groove of humerus
Latissimus dorsi
Medial border of scapula
Middle fibers of trapezius
Spine of scapula
2. b. Latissimus Dorsi (Posterolateral)
Levator scapulae
SCM
Superior border of scapula
Superior fibers of trapezius
2. c. Levator Scapulae (Low Visibility)
Medial border of scapula
Rhomboid major
Rhomboid minor
Spine of scapula
Trapezius
2. d. Rhomboids (Sagittal Cut Low Visibility)
3: Scapulohumeral Muscles
•
Identify and describe the muscles that comprise the rotator cuff
•
Discuss the clinical consequence of damaging the various muscles of the rotator cuff
Acromial end of clavicle
Acromion process
Anterior fibers of deltoid
Deltoid tuberosity
Middle fibers of deltoid
Posterior fibers of deltoid
Spine of scapula
3. a. Deltoid (Posterior)
Anterior axillary fold
Latissimus dorsi
Lymph nodes
Pectoralis major
Pectoralis minor
Posterior axillary fold
Teres major
3. b. Axillary Fossa (Anterior)
1st and 2nd Rib
Axillary a.
Axillary v.
Body of scapula
Deltoid
Glenoid cavity
Head of the humerus
Pectoralis major
Pectoralis minor
Serratus anterior
Subscapularis
3. c. Axillary Borders (Inferior)
Acromion process
Body of scapula
Deltoid
Glenoid cavity
Head of humerus
Infraspinatus
Spine of scapula
Subscapularis
Supraspinatus
3. d. Rotator Cuff (Sagittal Cut Lateral)
4: Arm Muscles
•
Identify the compartments of the arm and list the muscles located within each compartment
•
Describe the attachments and function of each muscle within the anterior and posterior
compartments of the arm
Anterior compartment of arm
Brachial a.
Cephalic v.
Deep artery of arm
Huermus
Posterior compartment of arm
4. a. Arm Compartments (Axial Cut)
Brachialis
Coracobrachialis
Long head of biceps brachii
Short head of biceps brachii
Tendon of biceps brachii
4. b. Anterior Compartment of Arm
Brachioradialis
Brachialis
Long head of biceps brachii
Short head of biceps brachii
4. c. Elbow Flexors (Lateral)
Brachioradialis
Lateral head of triceps brachii
Long head of triceps brachii
4. d. Posterior Compartment of Arm (Lateral)
Lateral head of triceps brachii
Long heado f triceps brachii
Medial head of triceps
Olecranon process of ulna
4. e. Triceps (Medial)
5: Anterior Forearm
•
Describe the boundaries and contents of the cubital fossa
•
Name the muscles that comprise the three layers of the forearm and describe their attachments
and functions
•
Explain the consequence of injury to the common flexor and extensor attachments
Biceps brachii tendon
Brachialis
Brahioradialis
Medial epicondylesBrachial a.
Median cubital v.
Pronator teres
5. a. Cubital Fossa (Anterior)
Flexor carpi radialis
Flexor carpi radialis tendon
Flexor carpi ulnaris tendon
Medial epicondylesFlexor carpi
ulnaris
Pronator teres
5. b. Superficial Forearm Flexors (Anterior)
Flexor digitorum superficialis
Flexor digitorum superficialis
tendon
Flexor digitorum superficialis
tendon
Radius
Ulna
5. c. Intermediate Forearm Flexors
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
Radius
Ulna
5. d. Deep Forearm Flexors (Axial-cut Low-visibility)
5. e. Carpal Tunnel Contents (Axial-cut Low-visibility)
Capitate
Flexor digitorum profundus
tendons
Flexor digitorum superficialis
tendons
Flexor pollicis longus tendon
Hook of hamate
Lunate
Pisiform
Radial a.
Superficial palmar branch of
ulnar a.
Trapezium
Trapezoid
Triquetrum
6: Posterior Forearm
•
Review the muscles in the extensor group and describe their attachments and action
•
Describe the anatomical snuffbox, including its boundaries and contents
Extensor carpi radialis brevis
Extensor carpi radialis brevis
tendon
Extensor carpi radialis longus
Extensor carpi radialis longus
tendon
Extensor carpi ulnaris
Extensor carpi ulnaris tendon
Extensor digiti minimi tendon
Extensor digitorum
Extensor digitorum tendons
6. a. Superficial Layer Posterior Forearm
Abductor pollicis longus tendon
Extensor indicis tendon
Extensor pollicis brevis
Extensor pollicis brevis tendon
Extensor pollicis longus tendon
6. b. Deep Layer Posterior Forearm
Crest of ulna
Neck of radius
Supinator
6. c. Supinator (Axial-cut- Low-visibility)
Abductor pollicis longus tendon
Extensor carpi radialis brevis
tendon
Extensor carpi radialis longus
tendon
Extensor pollicis brevis tendon
Extensor pollicis longus tendon
Radial a.
Scaphoid
6. d. Anatomical Snuff Box (Posterolateral)
7: Hand
•
Review the intrinsic muscles of the hand and discuss the actions of these muscles
•
Describe the structural and functional relationship between the long tendons from the forearm
and the intrinsic muscles of the hand
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
7. a. Thenar eminence
Abductor digiti minimi
Flexor digiti minimi brevis
7. b. Hypothenar eminence
1st-4th Dorsal interossei
2nd-5th Metacarpal
7. c. Dorsal Interossei (Low-visibility)
1st-3rd Palmar interossei
2nd-5th Metacarpal
7. d. Palmar Interossei (Anterior Low-visibility)
1st -4th Lumbricals
Adductor pollicis
FDP tendon
7. e. Lumbricals (Anterior Low-visibility)
Adductor pollicis
Hypothenar eminence
Thenar eminence
7. f. Adductor Pollicis (Low-visibility)
Suggested Clinical Correlates (CC):
Ill-defined Hypoattenuation in Triceps, Deltoid,
Teres Major
Case 0240 Axilla Tumor Post Mastectomy
Partial Tearing of Subscapularis Tendon
Partial Thickness and Pinhole Thickness
Tearing of Supraspinatus and Infraspinatus
Tendons
Case 0239 Shoulder Arthritis
Upper Limb 3- The Cardiovascular System
1: Arterial Supply to the Axilla and Arm
•
Describe the arteries and their branching patterns within the axilla and arm
•
Identify the boundaries of the major vessels in the axilla and arm and review the points of name
change
Arch of the Aorta
Axillary a.
Brachiocephalic trunk
Clavicle
Lateral border of 1st Rib
Subclavian a.
1. a. Axillary Artery (Anterior)
Axillary a.
Circumflex scapular a.
Internal thoracic a.
Lateral thoracic a.
Pectoral a.
Subscapular a.
Subscapular a.
Thoracoacromial trunk
Thoracodorsal a.
1. b. Branches of Axillary Artery
Axillary a.
Brachial a.
Circumflex scapular a.
Deep artery of the arm
Dorsal scapular a.
Posterior circumflex humeral a.
Subscapular a.
1. c. Proximal Arm Vasculature (Anterior)
Axillary a.
Brachial a.
Circumflex scapular a.
Deep artery of the arm
Posterior circumflex humeral a.
Radial a.
Subscapular a.
Thoracodorsal a.
Ulnar a.
1. d. Arteries in the Arm
2: Arterial Supply to the Forearm and Hand
•
Describe the arteries and their branching patterns within the forearm and hand
•
Review the collateral circulation of the elbow
Brachial a.
Radial a.
Ulnar a.
2. a. Cubital Fossa (Medial)
Anterior ulnar recurrent a.
Brachial a.
Inferior ulnar collateral a.
Posterior ulnar recurrent a.
Radial a.
Superior ulnar collateral a.
Ulnar a.
2. b. Elbow Collateral Circulation (Medial)
Anterior interosseous a.
Posterior interosseous a.
Radial a.
Ulnar a.
2. c. Arteries in the Forearm (Anteromedial)
Deep palmar arterial arch
Radial a.
Superficial palmar arterial arch
Superficial palmar branch of
radial a.
Ulnar a.
2. d. Superficial Palmar Arterial Arch (Anterior)
Common palmar digital a.
Proper palmar digital a.
Superficial palmar arterial arch
2. e. Digital Arteries (Anterior)
Deep palmar arterial arch
Radial a.
2. f. Radial a. and Deep Arch (Lateral)
3: Venous Return of the Upper Limb
•
Describe the branching patterns and path of venous return for the veins of the upper limb
Basilic v.
Cephalic v.
Dorsal venous network
3. a. Dorsal Venous Network (Posterior)
Basilic v.
Cephalic v.
Ulnar a.
Venae commitantes
3. b. Venae Commitantes (Anterior)
Basilic v.
Cephalic v.
Median cubital v.
3. c. Median Cubital Vein (Anterior)
Axillary a.
Axillary v.
Basilic v.
Brachial a.
Cephalic v.
Deep v.
3. d. Axillary Vein
Suggested Clinical Correlates (CC):
Extensive Convoluted Vessels in Palmar
Surface of Right Hand Over First Through
Third Metacarpals
Hypertrophy of Radial, Ulnar, and Interossei
Arteries
Hypertrophy of Superficial and Deep Palmar
Arch
Prominant Earlyfilling Veins
Case 0155 Complex AV Formation
Metacarpals To 1st/2nd-2nd/3rd Intermetacarpal
and 5th Metacarpal Artery Moderately
Attenuated
Case 0015 Thoracic Outlet Syndrome
Appendix
Upper Limb 1-The Skeletal System
Library Case: 0082 (Topics 1-3), 0186 (Topics 4-6)
Goal(s):
Identify, describe structures, and discuss clinical correlates of (1) the osteology of the shoulder,
humerus, and hand, and (2) explain the basis for the classification of surrounding joints
Annotated Anatomy:
1: Clavicle
1st and 2nd Rib, Acromial end of clavicle,
Acromioclavicular (AC) joint, Acromion,
Acromion angle, Acromion process, Clavicle,
Coracoid process, Deltoid tubercle, Humerus,
Manubrium, Scapula, Sternal end of clavicle,
Sternoclavicular (SC) joint, Sternum (body)
2: Scapula
Acromion angle, Acromion process, Coracoid
process, Glenoid cavity, Glenoid fossa (cavity),
Head of scapula, Inferior angle, Infraglenoid
tubercle, Infraspinous fossa, Lateral (axillary)
border, Medial (vertebral) border, Neck of scapula,
Spine of scapula, Subscapular fossa, Superior
angle, Supraglenoid tubercle, Suprascapular notch,
Supraspinous fossa
3: Shoulder (Glenohumeral) and
Proximal Humerus
Acromial end of clavicle, Acromion process,
Anatomical neck of humerus, Clavicle, Compact
(cortical) bone, Coracoid process, Deltoid
tuberosity, Epiphyseal line, Glenoid fossa (cavity),
Greater tubercle, Head of humerus, Humerus,
Infraglenoid tubercle, Intertubercular groove,
Lateral (axillary) border, Lesser tubercle, Marrow
(medullary) cavity, Scapula, Spongy (Cancellous)
bone, Supraglenoid tubercle, Surgical neck of
humerus
4: Distal Humerus and Elbow
Capitulum, Coranoid fossa, Coranoid process,
Coronoid fossa, Deltoid tuberosity, Greater
tubercle, Head of humerus, Head of radius,
Intertubercular groove, Lateral epicondyle, Lateral
supracondylar ridge, Lateral supraepicondylar
ridge, Lesser tubercle, Medial epicondyle, Medial
supracondylar ridge, Medial supraepicondylar
ridge, Neck of radius, Olecranon fossa, Olecranon
process, Radial fossa, Radial groove, Radial
tuberosity, Radius, Shaft of humerus, Trochlea,
Trochlear notch, Ulna, Ulnar tuberosity
5: Wrist
Anterior compartment of forearm, Capitate,
Coronoid process, Distal radioulnar joint, Hamate,
Head of radius, Head of ulna, Hook of hamate,
Interosseous border of radius, Interosseous border
of ulna, Location of interosseous membrane,
Lunate, Neck of radius, Pisiform, Posterior
compartment of forearm, Radial notch, Radial
tuberosity, Radiocarpal joint, Radius, Scaphoid,
Shaft of radius, Shaft of ulna, Skin, Styloid process
of radius, Styloid process of ulna, Superifical v.,
Trapezium, Trapezoid, Triquetrum, Tubercle of
scaphoid, Tubercle of trapezium, Ulna, Ulnar notch
of radius, Ulnar tuberosity
6: Hand
1st-5th Metacarpals, 1st-5th Proximal phalanx, 1st-5th
Distal phalanx, 2nd-5th Middle phalanx, Base, shaft,
head of middle phalanx, Base, shaft, head of
proximal phalanx, Base, shaft, tubersotiy, and head
of distal phalanx, Capitate, Carpometacarpal
(CMC) joint, Distal interphalangeal (DIP) joint,
Hamate, Intermetacarpal joints, Interphalangeal
(IP) joint, Metacarpophalangeal (MP) joint,
Midcarpal joint, Proximal interphalangeal (PIP)
joint, Sesamoid bones, Trapezium, Trapezoid
Upper Limb 2-The Muscular System
Library Case: 0155 (Topics 1-4), 0238 (Topics 5-7)
Goal(s):
Identify, describe structures, attachments, functions and discuss clinical correlates of (1) the shoulder,
axilla, rotator cuff, (2) forearm, and hands.
Annotated Anatomy:
1: Anterior Axioappendicular
(Pectoral) Muscles
2nd-4th Rib, Axillary a., Axillary v., Body of sternum
Cephalic v., Clavicle, Clavicular head of pectoralis
major, Coracoid process, Deltoid, Deltopectoral
groove, Deltopectoral triangle, Lateral lip of
intertubecular groove, Manubrium, Medial border
of scapula, Pectoralis major, Pectoralis minor,
Serratus anterior, Spine of scapula, Sternocostal
head of pectoralis major
2: Posterior Axioappendicular
Muscles
Acromial end of clavicle, C7, T1-T4 spinous
process, Exteranl occipital protuberance, Inferior
fibers of trapezius, Intertubucular groove of
humerus, Latissimus dorsi, Levator scapulae,
Medial border of scapula, Middle fibers of
trapezius, Rhomboid major, Rhomboid minor,
SCM, Spine of scapula, Superior border of scapula,
Superior fibers of trapezius, Trapezius
3: Scapulohumeral Muscles
Clavicle, Ribs (1-2), Head of humerus, Deltoid
tuberosity, Superior border of scapula, Spine of
scapula, Acromion process, Body of scapula,
Glenoid cavity, Anterior and Posterior axillary fold,
Axillary a. and v., Lymph nodes, Anterior, Middle
and Posterior fibers of Deltoid, Pectoralis major,
Pectoralis minor, Serratus anterior, Teres major,
Latissimus dorsi, Deltoid, Subscapularis,
Supraspinatus, Infraspinatus
4: Arm Muscles
1st and 2nd Rib, Acromial end of clavicle, Acromion
process, Anterior axillary fold, Anterior fibers of
deltoid, Axillary a., Axillary v., Body of scapula,
Deltoid, Deltoid tuberosity, Glenoid cavity, Head of
humerus, Infraspinatus, Latissimus dorsi, Lymph
nodes, Middle fibers of deltoid, Pectoralis major,
Pectoralis minor, Posterior axillary fold, Posterior
fibers of deltoid, Serratus anterior, Spine of
scapula, Supraspinatus, Teres major
5: Anterior Forearm
Biceps brachii tendon, Brachial a., Brachialis,
Brahioradialis, Capitate, Flexor carpi radialis,
Flexor carpi radialis tendon, Flexor carpi ulnaris,
Flexor carpi ulnaris tendon, Flexor digitorum
profundus, Flexor digitorum profundus tendons,
Flexor digitorum superficialis, Flexor digitorum
superficialis tendon, Flexor pollicis longus, Flexor
pollicis longus tendon, Hook of hamate, Lunate,
Medial epicondyle, Median cubital v., Pisiform,
Pronator quadratus, Pronator teres, Radial a.,
Radius, Superficial palmar branch of ulnar a.,
Trapezium, Trapezoid, Triquetrum, Ulna
6: Posterior Forearm
Abductor pollicis longus tendon, Crest of ulna,
Extensor carpi radialis brevis, Extensor carpi
radialis brevis tendon, Extensor carpi radialis
longus, Extensor carpi radialis longus tendon,
Extensor carpi ulnaris, Extensor carpi ulnaris
tendon, Extensor digiti minimi tendon, Extensor
digitorum, Extensor digitorum tendon, Extensor
indicis tendon, Extensor pollicis brevis, Extensor
pollicis brevis tendon, Extensor pollicis longus
tendon, Neck of radius, Radial a., Scaphoid,
Supinator
7: Hand
1st -4th Lumbricals, 1st-3rd Palmar interossei, 1st-4th
Dorsal interossei, 2nd-5th Metacarpal , Abductor
digiti minimi, Abductor pollicis brevis, Adductor
pollicis, FDP tendon, Flexor digiti minimi brevis,
Flexor pollicis brevis, Hypothenar eminence,
Opponens pollicis, Thenar eminence
Upper Limb 3- The Cardiovascular System
Library Case: 0155 (Topic 1), 0015 (Topic 2-3)
Goal(s):
Identify, describe structures, and discuss clinical correlates of the artereis and veins of the arm
Annotated Anatomy:
1: Arterial Supply to the Axilla and
Arm
Arch of the Aorta, Axillary a., Brachial a.,
Brachiocephalic trunk, Circumflex scapular a.,
Clavicle, Deep artery of the arm, Dorsal scapular
a., Internal thoracic a., Lateral border of 1st Rib,
Lateral thoracic a., Pectoral a., Posterior circumflex
humeral a., Radial a., Subclavian a., Subscapular a.,
Thoracoacromial trunk, Thoracodorsal a., Ulnar a.
2: Arterial Supply to the Forearm
and Hand
Anterior interosseous a., Anterior ulnar recurrent a.,
Brachial a., Common palmar digital a., Deep
palmar arterial arch, Inferior ulnar collateral a.,
Posterior interosseous a., Posterior ulnar recurrent
a., Proper palmar digital a., Radial a., Superficial
palmar arterial arch, Superficial palmar branch of
radial a., Superior ulnar collateral a., Ulnar a.
3: Venous Return of the Upper
Limb
Axillary a., Axillary v., Basilic v., Brachial a.,
Cephalic v., Deep v., Dorsal venous network,
Median cubital v., Ulnar a., Venae commitantes