1. Upper Limb Topography

2. Fossa axillaris Between arm and chest Boundaries
Anteriorly – mm. pectorales
Dorsally = latissimus dorsi, teres major, subscapularis
Medially = serratus anterior
Laterally = sulcus bicipitis
Content
Lymph nodes, vessels, pl. brachialis

3. Foramen axillare laterale et mediale

4. Posterior of the arm Surface anatomy M. triceps brachii
caput longum, medialis, lateralis
Surface elements
Skin thick and movable
Subcutaneous tissue well expressed
n. cutaneus brachii posterior
n. cutaneus brachii lateralis inferior
n. cutaneus antebrachii posterior

5. Deep structures А. Fascia brachialis B. Neurovascular bundles
- Thick, thins distally
B. Neurovascular bundles
1. Upper - in canalis humero-muscularis, between:
- sulcus n. radialis
- medial and lateral head of m. triceps brachii
1.1. n. radialis – lies on the humerus
- n. cutaneus brachii lateralis inerior
- n. cutaneus antebrachii posterior
- rr. musculres
1.2. a. profunda brachii
- a. collateralis media
- collateralis radialis

6. Lower neurovascular bundle
behind medial epicondyle
n. ulnaris
a. collateralis ulnaris inferior

8. Elbow region

9. Anterior elbow Surface anatomy Elements Three eminences Two grooves
Lateral groove - v. cephalica, n. cutaneus antebrachii lateralis
Medial groove – v. basilica, n. cutaneus antebrachii medialis
V. mediana cubiti

10. Deep structures А. Muscles Flexors of forearm – medial eminence
Extensors of forearm – lateral eminence
Brachial muscles, mm. biceps, brachialis – middle eminence

11. Deep structures B. Vessels and nerves C. Cubital fossa Boundaries
Medial bundle - between m. biceps brachii and pronator teres
- a.v. brachialis, n. medianus
Lateral bundle - between m. brachialis and brachioradialis
- n. radialis, a. collateralis radialis, a. recurrens radialis
C. Cubital fossa
Boundaries
- m. brachioradialis (lateral), m. pronator teres (medial)
Content
- tendo m. brachialis, m. biceps brachii, bursa bicipitoradialis

12. Layers of the elbow Venous 1 v. cephalica 2 v. basilica
3 v. mediana cubiti
Apponeurotic
1 aponeurosis bicipis
2 tendo m. biceps brachii

13. Neurovascular Muscle Bone 1 a. brachialis 2 n. medianus 1 m. supinator
2 m. brachialis
3 tendo m. biceps brachii
Bone
1 humerus
2 radius
3 ulna

16. The palm

17. Surface Anatomy of Upper Limb
Carpal Tunnel
Carpals concave anteriorly
Carpal ligament covers it
Contains: long tendons, Median nerve
Inflammation of tendons = compression of Median nerve
Anatomical Snuffbox
Lateral = E.pollicis brevis
Medial = E. pollicis longus
Floor = scaphoid, styloid of radius
Contains Radial Artery (pulse)
pg 306, 788

18. Muscles of the Wrist Extensor muscles Extensor Retinaculum
What’s its function?
Muscles innervated by radial nerve
There are 8
Name them…

19. Muscles of the Wrist Flexor Muscles
Flexor retinaculum (transverse carpal ligament)
Two compartments
Superficial – 4
Deep – 3
Name them…
Innervated by median and ulnar nerve

20. Wrist and Hand Anatomy Nerves/Vessels Radial & ulnar artery and veins
Radial, ulnar, & median nerves
Carpal Tunnel
Flexor Tendons - 9
Median Nerve

21. - Medial and lateral eminence and middle depression
Surface anatomy
- Medial and lateral eminence and middle depression
- Flexion grooves
- Commissural pads
Surface elements
Skin- thick, hairless
- Attached to palmar aponeurosis – in the middle
- Loose connective tissue in the eminences
- r. palmaris (n. medianus), r. cutaneus palmaris (ulnaris)
- small veins
Aponeurosis palmaris – thick fibrous tissue
- superficial layer – tendinous fibers of m. palmaris longus,
- deep layer – transverse fibers, lig. metacarpeum transversum superficiale
- commissural openings

22. Lateral (thenar) compartment
Deep compartments
Intermuscular septae and
Palmar interosseous fascia form
- Three fascial compartments
Lateral (thenar) compartment
Muscle - 4 layers
- M. abductor pollicis brevis
- M. opponens pollicis, m. flexor pollicis brevis (caput superfic.)
- M. flexor pollicis brevis (caput profundus)
- M. adductor pollicis
Nerves - r. muscularis n. medianus
Vessels - r. palmaris superficialis a. radialis
Two connective tissue spaces – above and below m. adductor pollicis

23. Medial (hypothenar) compartment
Muscles - 2 layers
- Superficial - m. abductor digiti minimi,
m. flexor digiti minimi
- Deep - m. opponens digiti minimi
Nerves – superficial and deep branches of n. ulnaris
Vessels - superficial and deep branches of a. ulnaris
M. palmaris brevis - proximal

25. Middle compartment Muscular tendinous layer: Two spaces
- mm. flexores digitorum superficialis & profundus
- mm. lumbricales
- vagina synovialis communis flexorum
Two spaces
а. Superficial – below palmar aponeurosis
- arcus palmaris superficialis - aa. digitales palmares communes
- n. medianus - nn. digitales palmares communis
- r. palmaris n. ulnaris - n. digitalis palmaris communis IV & n. digitalis palmaris proprius V
Interfascial canals - distal
- mm. lumbricales, a.n. palmares digitales comm. et propriae

28. Middle compartment b. Deep space - below palmar interosseous fascia
- communications:
forearm - trough carpal canal
superficial space – interfascial canals
- arcus palmaris profundus - a. radialis + r. profundus a. ulnaris
- aa. metacarpales palmares - aa. digitales palmares communes
- deep branch of r. palmaris n. ulnaris supplying -
- mm. hypothenari, mm. interossei, m. adductor pollicis и mm. lumbricales II - IV.