Overview of upper limb Dr. Ashraf Hussain
Upper limb Associated with lateral aspect of the lower portion of neck and thoracic wall Suspended from the trunk by muscles and a small skeletal articulation between the clavicle and the sternum-the sternoclavicular joint. The upper limb is divided into Shoulder Arm Forearm Hand
Segments of upper limb Shoulder: pectoral, scapular, lateral supra clavicular Arm (L. brachium) : first and longest segment of the limb Forearm (L. antibrachium): second largest segment of the limb-extends between elbow and wrist Hand (L.manus): distal to the forearm-wrist, palm dorsum of hand, fingers
How do upper limb differs from lower limb?
Distinction from lower limb Not involved in weight bearing Pectoral girdle is attached to the axial skeleton only anteriorly via a very mobile joint Paired bones of the forearm are able to be moved relative to each other Hands have long, mobile fingers and an opposable thumb
Upper limb Mobility Ability to grasp Strike Conduct fine motor skills
Areas of Transition in upper linb
The glenohumeral joint The glenohumeral joint allows the arm to move around three axes with a wide range of motion. Movements of the arm at this joint are flexion extension abduction adduction medial rotation (internal rotation) lateral rotation (external rotation) circumduction
Hand Hand as a mechanical tool: grip Hand as a sensory tool: Touch - high density of somatic sensory receptors
Movements Scapulothoracic Glenohumeral Elbow Radioulnar wrist
Bones of upper limb Clavicle Scapula Humerus Ulna Radius Bones of hand: scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
Important features Muscles of upper limb Joints of upper limb Axilla Brachial plexus Brachial artery: ulnar, radial Nerves: musculocutaneus, radial, median ulnar Cubital fossa Compartments of the forearm: flexor, extensor Hand
Joints of upper limb Sternoclavicular Acromioclavicular Glenohumeral Elbow wrist
The deformity of shoulder dislocation.
Bones of upper limb
Danger of nerve injury in humeral fractures
The right carpus, metacarpus and phalanges.
Muscles
Four rotator cuff muscles
Principal muscles acting on the shoulder joint Abductors Adductors ◊◊supraspinatus ◊◊pectoralis major ◊◊deltoid ◊◊latissimus dorsi Flexors Extensors ◊◊pectoralis major ◊◊teres major ◊◊coracobrachialis ◊◊latissimus dorsi ◊◊deltoid (anterior fibres) ◊◊deltoid (posterior fibres) Medial rotators Lateral rotators ◊◊pectoralis major ◊◊infraspinatus ◊◊latissimus dorsi ◊◊teres minor ◊◊teres major ◊◊deltoid (posterior fibres) ◊◊deltoid (anterior fibres) ◊◊subscapularis
Relationship
Back and thoracic wall
The derivatives of the brachial plexus
Venous drainage
Lymphatic drainage
principal vessels and nerves in forearm
The structures on the anterior aspect of the wrist