Transcript Document
The Resting Arm… by Vinod More Kaan Yücel M.D., Ph.D. 03.January.2014 Friday UPPER LIMB 1 % 1 1 Radius Ulna 2 Wrist Carpals 8 5 14 2 UPPER LIMB 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 Shoulder proximal segment of the limb overlaps parts of the trunk (thorax and back) and lower lateral neck 5 Pectoral (shoulder) gırdle bony ring, posteriorly formed by the scapulae and clavicles anteriorly by formed by the manubrium of the sternum 6 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 7 Forearm-AntebrachIum Second longest segment of the limb Between elbow wrist & Includes anterior & posterior regions overlying the radius and ulna 8 Hand-manus 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 9 BONES OF THE PECTORAL GIRDLE 10 CLAVICLE the only bony attachment between the trunk and the upper limb 11 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 12 CLAVICLE medial sternal end articulates with manubrium sternoclavicular joint lateral end acromial end articulates with acromion of scapula acromioclavicular joint 13 CLAVICLE Inferior surface-near the acromial end conoid tubercle –medial part oftrapezoid line –lateral part ofcoracoclavicular 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 14 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. 15 SCAPULA large, flat triangular bone lies on the posterolateral aspect of the thorax between 2nd-7th ribs 16 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 17 SCAPULA Posterior view Acromion Supraspinous fossa Infraspinous fossa Spine of scapula Suprascapular notch 18 SCAPULA Posterior view Acromion 19 SCAPULA Lateral view Supraglenoid tubercle Infraglenoid tubercle Acromion Coracoid process 20 SCAPULA Lateral view Supraglenoid tubercle Infraglenoid tubercle 21 BONE OF THE ARM 22 HUMERUS the largest bone in the upper limb articulates w/ Scapula Glenohumeral (Shoulder) joint Radius & Ulna elbow joint 23 HUMERUS In cross-section, shaft triangular with: anterior, lateral, & medial borders anterolateral, anteromedial, posterior surfaces Intermuscular septa attach to medial & lateral borders. 24 HUMERUS proximal end Head Neck -Anatomical neck -Surgical neck Greater tubercle Lesser tubercle Intertubercular groove 25 HUMERUS shaft Deltoid tuberosity Medialandlateralsupraepicondylar(supracondylar)ridges Radial groove 26 HUMERUS distal end Posterior view Anterior view Radial fossa Coronoid fossa Trochlea Medial epicondyle Olecranon fossa Capitilum Lateral epicondyle 27 BONES OF THE FOREARM medial and longer of the two forearm bones MORE IMAGES 99-103 lateral and shorter of the two forearm bones 29 ULNA proximal end articulation with humerus proximally head of the radius laterally For articulation with the humerus 1) Olecranon Trochlear notch Semilunar notch 2) Coronoid process Radial notch Tuberosity of ulna @ the lateral surface Inferior to coronoid process articulation with head of radius 30 ULNA shaft Broad superiorly, continuous with large proximal end Narrow distally to form a small distal head 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 Supinator muscle 31 ULNA distal end Ulna does not reach and participate to the radiocarpal (wrist) joint! Head of the ulna Ulnar styloid process 32 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 33 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 34 BONES OF THE HAND MORE IMAGES 104--108 35 BONES OF THE HAND 36 BONES OF THE HAND Distal row of carpal bones lateral to medial Trapezium Table Trapezoid (Little)Head Capitate On a Hook Hamate Proximal row of carpal bones lateral to medial Scaphoid Lunate Triquetrum Pisiform 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 BONES OF THE HAND Distal row of carpal bones lateral to medial Trapezium ToToCu Hasan Trapezoid Capitate Hamate Proximal row of carpal bones lateral to medial Scaphoid Lunate SeLoTyP Triquetrum Pisiform She Looks Too Pretty; Try To Catch Her 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. head base lateral side of this base formed by tubercles of the scaphoid and trapezium. medial side formed by pisiform & hook of hamate. 39