The Resting Arm… by Vinod More

Kaan Yücel M.D., Ph.D. 03.January.2014 Friday

2

UPPER LIMB

Radius Ulna

Wrist Carpals

%

1

1

2

1

8

5

14

Efficiency of hand function

ability to place it in the proper position by movements

at the

upper limb joints

3

UPPER LIMB

associated with lateral aspect of the lower portion of the neck thoracic wall

Suspended from the trunk by muscles & a small skeletal articulation between clavicle & sternum: sternoclavicular joint

4

UPPER LIMB

5

proximal segment of the limb overlaps parts of the trunk (thorax and back) and lower lateral neck

Shoulder

6

Pectoral (shoulder) gırdle

bony ring,

posteriorly formed by the scapulae and clavicles

anteriorly by formed by the manubrium of the sternum

7

ARM -BRACHIUM

First segment of the free upper limb & longest segment of the limb Between shoulder and elbow Anterior & posterior segments of the arm around the humerus

8

Second longest segment of the limb Between elbow wrist & Includes anterior & posterior regions overlying the radius and ulna

Forearm-AntebrachIum

9

part of the upper limb distal to the forearm

formed around the carpus, metacarpus, and phalanges. composed of the wrist, palm, dorsum of hand, and digits

Hand-manus

10

BONES OF THE PECTORAL GIRDLE

11

CLAVICLE

the only bony attachment between the trunk and the upper limb

12

CLAVICLE

the only bony attachment between the trunk and the upper limb

palpable along its entire length

S-shaped contour

forward-facing convex part medial

forward-facing concave part lateral

13

CLAVICLE

medial sternal end

articulates with manubrium

sternoclavicular joint

lateral end acromial end articulates with acromion of scapula

acromioclavicular joint

14

CLAVICLE

Inferior surface-near the acromial end conoid tubercle –medial part of- trapezoid line –lateral part of- coracoclavicular ligament Medial 1/3 of the clavicle’s shaft subclavian groove – subclavius muscle More medially impression for the costoclavicular ligament binding 1st rib to clavicle Limiting elevation of the shoulder

15

Functions of the Clavicle

A moveable, rigid support

limb has maximum freedom of motion.

A boundary of the cervico-axillary canal (passageway between

the neck and the arm), protection to the neurovascular bundle

supplying the upper limb.

Transmits shocks from the upper limb to the axial skeleton.

16

SCAPULA

large, flat triangular bone

lies on the posterolateral aspect of the thorax

between 2nd-7th ribs

17

SCAPULA

Anterior view

three angles

lateral, superior, and inferior three borders

superior, lateral, and medial two surfaces

costal and posterior three processes

Acromion

Spine

Coracoid process

18

SCAPULA

Posterior view

Acromion Supraspinous fossa Infraspinous fossa Spine of scapula Suprascapular notch

19

SCAPULA

Lateral view

Glenoid cavity Supraglenoid tubercle Infraglenoid tubercle Acromion Coracoid process

20

BONE OF THE ARM

21

HUMERUS

the largest bone in the upper limb

articulates w/

Scapula Glenohumeral (Shoulder) joint

Radius & Ulna

elbow joint

22

HUMERUS

In cross-section, shaft triangular with:

anterior, lateral, & medial

borders

anterolateral, anteromedial, posterior

surfaces

Intermuscular septa

attach to medial & lateral borders.

23

HUMERUS

proximal end

Head Neck

-Anatomical neck -Surgical neck

Greater tubercle Lesser tubercle Intertubercular groove

24

HUMERUS

shaft

Deltoid tuberosity

Medial and lateral supraepicondylar (supracondylar) ridges

Radial groove

25

HUMERUS

distal end

Anterior view Posterior view

Trochlea Capitilum

Olecranon fossa

Coronoid fossa

Medial epicondyle Lateral epicondyle

Radial fossa

27

BONES OF THE FOREARM

medial and longer of the two forearm bones lateral and shorter of the two forearm bones

MORE IMAGES

99-103

28

For articulation with the humerus 1) Olecranon

2) Coronoid process Radial notch @ the lateral surface articulation with head of radius

ULNA

proximal end

articulation with humerus proximally head of the radius laterally

Tuberosity of ulna Inferior to coronoid process

Trochlear notch Semilunar notch

29

ULNA

shaft

triangular in cross-section and has:

three borders anterior, posterior, and interosseous

three surfaces anterior, posterior, and medial

Supinator crest Inferior to radial notch @ lateral surface Supinator fossa On the lateral surface, under the radial notch

Broad superiorly, continuous with large proximal end Narrow distally to form a small distal head

Supinator muscle

30

ULNA

distal end

Head of the ulna Ulnar styloid process

Ulna does not reach and participate to

the radiocarpal (wrist) joint!

31

RADIUS

proximal end & shaft A short head

Neck

Radial tuberosity

Oblique line

The shaft of the radius

in contrast to that of the ulna

gradually enlarges

triangular in cross-section, with:

three borders

anterior, posterior, and interosseous three surfaces

anterior, posterior, and lateral

32

RADIUS

distal end

Dorsal tubercle of the radius

Radial styloid process

Ulnar notch

SHAFT triangular in cross-section, with:

three borders

anterior, posterior, and interosseous three surfaces

anterior, posterior, and lateral

33

BONES OF THE HAND

MORE IMAGES

104--108

34

BONES OF THE HAND

BONES OF THE HAND

Proximal row of carpal bones

lateral to medial Scaphoid Lunate Triquetrum Pisiform

Distal row of carpal bones

lateral to medial Trapezium Trapezoid Capitate Hamate

I am sailing with my little boat on a summer night The moon is crescent I am filling my three-cornered hat with beas falling off the sky

Table (Little)Head On a Hook

BONES OF THE HAND

Proximal row of carpal bones

lateral to medial Scaphoid Lunate SeLoTyP Triquetrum Pisiform

Distal row of carpal bones

lateral to medial Trapezium ToToCu Hasan Trapezoid Capitate Hamate

She Looks Too Pretty; Try To Catch Her

37

BONES OF THE HAND

Carpal arch The carpal bones do not lie in a flat plane; rather, they form an arch, whose base is directed anteriorly. lateral side of this base formed by tubercles of the scaphoid and trapezium. medial side formed by pisiform & hook of hamate.

base

head