The Resting Arm… by Vinod More The Resting Arm… by Vinod More Kaan Yücel M.D., Ph.D. 03. January Friday

2 UPPER LIMB RadiusUlna WristWrist Carpals %

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

6 Pectoral (shoulder) g ı rdle bony ring, posteriorly formed by the scapulae and clavicles anteriorly by formed by the manubrium of the sternum

7 ARM -BRACHIUM F irst 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 S econd longest segment of the limb B etween elbow wrist & I ncludes anterior & posterior regions overlying the radius and ulna Forearm-AntebrachIumForearm-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 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-manusHand-manus

10 BONES OF THE PECTORAL GIRDLE

11 CLAVICLECLAVICLE the only bony attachment between the trunk and the upper limb

12 CLAVICLECLAVICLE 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 CLAVICLECLAVICLE medial sternal end articulates with manubrium sternoclavicular joint lateral end acromial end articulates with acromion of scapula acromioclavicular joint

14 CLAVICLECLAVICLE 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 Transmits shocks from the upper limb to the axial skeleton. 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 Transmits shocks from the upper limb to the axial skeleton.

16 SCAPULASCAPULA large, flat triangular bone lies on the posterolateral aspect of the thorax between 2nd-7th ribs

17SCAPULA Anterior view SCAPULA 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 SCAPULA Acromion Supraspinous fossa Infraspinous fossa Spine of scapula Suprascapular notch

19 SCAPULA Lateral view SCAPULA Glenoid cavity Supraglenoid tubercle Infraglenoid tubercle Acromion Coracoid process

20 BONE OF THE ARM

21 HUMERUSHUMERUS the largest bone in the upper limb articulates w/ Scapula Glenohumeral (Shoulder) joint Radius & Ulna elbow joint

22 HUMERUSHUMERUS 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 HUMERUS Head Neck -Anatomical neck -Surgical neck Greater tubercle Lesser tubercle Intertubercular groove

24 HUMERUSshaftHUMERUSshaft Deltoid tuberosity Medial and lateral supraepicondylar (supracondylar) ridges Radial groove

25 HUMERUS distal end HUMERUS Anterior view Posterior view Trochlea Capitilum Olecranon fossa Coronoid fossa Medial epicondyle Lateral epicondyle Radial fossa

27 BONES OF THE FOREARM lateral and shorter of the two forearm bones

28 For articulation with the humerus 1)Olecranon 2)Coronoid process Radial the lateral surface articulation with head of radius ULNA proximal end ULNA articulation with humerus proximally head of the radius laterally articulation with humerus proximally head of the radius laterally Tuberosity of ulna Inferior to coronoid process Trochlear notch Semilunar notch

29 ULNAshaftULNAshaft triangular in cross-section and has: three borders anterior, posterior, and interosseous three surfaces anterior, posterior, and media l Supinator crest Inferior to radial 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 ULNA Head of the ulna Ulnar styloid process Ulna does not reach and participate to the radiocarpal (wrist) joint!

31 RADIUS proximal end & shaft RADIUS A short head Neck Radial tuberosity Oblique line 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 RADIUS Dorsal tubercle of the radius Radial styloid process Ulnar notch 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

34 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