1. Posterior region of upper limb
Regional anatomy of upper limb
Posterior region of upper limb
Ling Shucai

2. Parts and regions Scapular region 肩胛区 Posterior region of the arm 臂后区
Posterior region of the elbow 肘后区
Posterior region of the forearm 前臂后区
Dorsum of wrist and hand 腕背及手背

3. The Posterior Region of the Upper Limb
1. Surface anatomy 表面解剖
2. The superficial structures 浅层结构
Superficial veins 浅淋巴管
Superficial lymph vessels 浅静脉
Cutaneous nerves 皮神经
3. The deep structures 深层结构
The deep fascia 深筋膜
The muscles 肌肉
The vessels 血管
The nerves 神经
4. Regional anatomy 局部解剖
Trilateral and quadrilateral foramina 三边孔和四边孔
Humeromuscular tunnel 肱骨肌管

4. Surface anatomy

6. Trapezium
Deltoid
Triangle of ausculation
Latissimus dorsi
Thoracolumbar fascia
Levator scapular
Rhomboideus

8. C A B A 肱骨内上髁 Medial epicondyle B 尺骨鹰嘴 Olecranon C 肱骨外上髁
Lateral epicondyle

9. 肱骨外上髁
桡骨头
尺骨鹰嘴
肘外侧三角

10. The superficial structures

11. Cutaneous n. and superificial v.

12. The deep structures

13. The muscles of upper limb2 4 3
Muscles of shoulder
Deltoid 三角肌
Supraspinatus 冈上肌
Infraspinatus 冈下肌
Teres minor 小圆肌
Teres major 大圆肌
Subscapularis 肩胛下肌 5 1 6 1

14. Myotendinous Cuff (Rotator cuff) 肌腱袖

15. Myotendinous Cuff (Rotator cuff) 肌腱袖

16. Muscles of arm
（posterior view)
Triceps brachii
肱三头肌

17. Muscles of forearm （posterior view) Posterior group (10)
Superficial layer (5)
Extensor carpi radialis longus 桡侧腕长伸肌
Extensor carpi radialis brevis 桡侧腕短伸肌
Extensor digitorum 指伸肌
Extensor digiti minimi 小指伸肌
Extensor carpi ulnaris 尺侧腕伸肌 1 2 2 4 3 5 3 5 4

18. Deep layer (5) Supinator旋后肌 Abductor pollicis longus拇长展肌
Extensor pollicis brevis 拇短伸肌
Extensor pollicis longus拇长伸肌
Extensor indicis 示指伸肌 1 4 2 5 3 4 2 5 3

19. Arteries of the scapular region 肩胛区的动脉
Suprascapular a 肩胛上动脉
Dorsal scapular a. 肩胛背动脉
Circumflex scapular a 旋肩胛动脉

20. Innervation 神经支配 Posterior cord axillary n. 腋神经 radial n. 桡神经
thoracodorsal n. 胸背神经

21. Axillary nerve 腋神经
Distribution: Deltoid and teres minor muscle; skin over deltoid and upper posterior aspect of arm
Injury: result in deltoid and teres minor paralysis (loss of shoulser abdution and weel external rotation) with loss of sensation over the deltoid

22. Radial nerve 桡神经
Distribution: Extensor muscles of arm and forearm, brachioradialis; skin on back of arm, forearm, and radial side of dorsum of hand and radial two and one-half fingers
Injury: Wristdrop 垂腕

23. Radial nerve injury: Wristdrop 垂腕

24. Nerves of hand
Median n.－thenar except adductor pollicis, first two lumbricals; skin of thenar, central part of palm, palmar aspect of radial three and one-half fingers, including middle and distal fingers on dorsum
Ulnar n.－hypothenar muscles, interossei, 3rd and 4th lumbricals and adductor pollicis; skin of hypothenar, palmar surface of ulnar one and one-half fingers
Median n.
Ulnar n.
Radial n.

25. Radial n.－skin of radial side of dorsum of hand and radial two and one-half fingers
Median n.
Ulnar n.
Radial n.

26. Regional anatomy

27. Trilateral and quadrilateral foramina 三边孔和四边孔
Between the subscapularis and teres major, there is a long triangular space whose lateral side is surgical neck of humerus. The long head of triceps brachii subdivides this space into a medial trilateral foramen and a lateral quadrilateral foramen.
The posterior humeral circumflex a. and axillary n. pass through the quadrilateral foramen.
The circumflex scapular a. passes through the triangular space to reach the dorsum of the scapula.

28. Trilateral and quadrilateral foramina
Axillary n.
Posterio humeral circumflex a.
Deep brachial a.
Radial n.
Suprascapular n.& a.
Supraspinatus
Infraspinatus
Teres minor
Teres major

29. Humeromuscular tunnel 肱骨肌管
Radial n.
Deep brachial a.

30. Posterior interosseous a.
Posterior interosseous n.

31. Dorsum of wrist and hand 腕背和手背

32. Fascia of the dorsal hand
The superficial fascia
Deep fascia－the dorsal fascia of hand
Superficial layer (dorsal aponeurosis) 手背腱膜
Deep layer (dorsal interosseous fascia) 骨间背侧筋膜

33. Anatomical snuff box 解剖鼻烟壶
When the thumb is abducted and extended, a triangular hollow appears between the tendon of the extensor pollicis longs medially and the tendons of the extensor pollicis brevis and abductor pollicis longus laterally.
The floor of the snuff box is the scaphoid and trapezium bones and crossed by the radial a..

34. Extensor retinaculum 伸肌支持带
Thickening of deep faxcia of forearm a wrist
Attached laterally to radius and medially to styloid process of ulna and triquetrum
Forms six fibrous compartments for extensor tendons passing from forearm into hand:

35. Radius 桡骨
Ulna 尺骨
1. tendons of abductor pollicis longus and extensor pollicis brevis and their synovial sheaths;
2. tendons of extensor carpi radialis longus and brevis and their synovial sheaths;
3. tendon of pollicis longus and its synovial sheath;
4. tendons of extensor digitorum, extensor indicis and their synovial sheaths;
5. tendon of extensor digiti minimi and its synovial sheaths;
6. tendon of extensor carpi ulnaris and its synovial sheaths

36. Skin incisions

37. The muscles of back Superficial group Deep group Trapezius 斜方肌
Latissimus dorsi 背阔肌
Levator scapulae 肩胛提肌
Rhomboideus菱形肌
Deep group
Erector spinae 竖脊肌
Splenius 夹肌
Thoracolumbar fascia 胸腰筋膜 6 3 1 4 5 2 7

38. Major muscles of the trunk
Trapezius
Origin: superior nuchal line, external occipital protuberance, ligamentum nuchae and spinous processes of seventh cervical and all thoracic vertebrae
Insertion: lateral third of clavicle, acromion, and spine of scapulartery
Acton: upper fibers elevate scapula, lower fibers depress scapula; if scapula is fixed, one side acting along, draws head toward the same side, and turn face to opposite side; both sides together, draw head directly backward

39. Latissimus dorsi
Origin: spinous processes of lower six thoracic and all lumbar vertebrae, median sacral crest, and posterior part of iliac crest.
Insertion: floor of intertubercular groove of humerus.
Action: trunk fixed, extends, adducts and medially rotates arm ; arm fixed, elevates trunk.