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Anatomy - Upper Limb – Bones

Clavicle Sternal end 2 facets, conoid tubercle inf/lat

Doubly curved long bone connecting upper limb to trunk

Articulations SC, AC

Acromial end, Sternal end + facets

Muscles

Clavicular head SCM → med 1/3 ant/sup

Pectoralis major → med 1/3 ant/inf

Deltoid → lat 1/3 ant

Trapezius → lat 1/3 post

Subclavius in subclavian groove inf/mid 1/3

Ligaments

Ant and post SC, Interclavicular, Costoclavicular ligaments

Coracoclavicular ligament, 2 parts:

Conoid ligament (medial) conoid tubercle to coracoid

Trapezoid ligament (lateral) trapezoid line to coracoid

Acromioclavicular ligament thickening AC capsule

Functions

Strut, Transmits shock, Elevation ribs deep insp, Protect brachial plexus

Relations medial clavicle

Med – SC, manubrium

Post – 1st rib, brachioceph/IJ/subclavian veins

Apical pleura, thoracic duct L

Ant/sup/inf – subcut tissue, skin, platysma

Scapula Spine post, glenoid lateral

Pectoral girdle bone, posterolat aspect thorax, over 2nd

-7th

ribs

Articulations AC, glenohumeral

Ligaments Coracoclavicular – conoid, trapezoid

Acromioclavicular

Coracoacromial

Glenohumeral (weak)

Coracohumeral (strong)

Movement

Elevation – trap; depression – gravity; protraction – serr ant;

retraction – trap; rotation – trap/serr ant/lat dorsi

Landmarks

Medial, lateral, superior borders

Medial border → sup to inf:

Levator scap, Rhomb minor, major

Superior, lateral, inferior angles

Costal surface - Subscapular fossa

Subscapularis, Serratus anterior

Scapular notch

Dorsal surface – Supraspinous/infraspinous fossae

Spine → acromion (articulates with clavicle)

Supraspinatus, Infraspinatus, Teres major, minor,

Trapezius, Deltoid

Glenoid (articulates with head humerus), neck

Supraglenoid tubercle → long head biceps; Infra

→ long head triceps

Coracoid process anterolaterally, superior to glenoid

Pec minor, short head bicep, coracobrach to tip

Humerus Bicipital groove anterior

Proximal

Head, Lesser tuberosity - Subscap

Greater tuberosity

3 facets: sup – supraspin; mid – infraspin; low – teres minor

2

Intertubercular groove - transverse humeral lig, tendon long head biceps

Anatomical neck articular margin; Surgical neck junction upper end/shaft

Articular surface 4x area glenoid

Capsule attached articular margin except med - down 2cm

Teres major inserts med lip

Lat dorsi in floor (A Lady between 2 Majors)

Pectoralis major inserts lat lip

Shaft Triangular

Deltoid to deltoid tuberosity

Radial groove spirals post - radial nerve

Lat and med supracondylar ridges into epicondyles

Lat head triceps from lateral lip groove, Med head from whole shaft

Coracobrachialis into opposite side to deltoid tuberosity

Brachialis from flexor surface

Events occurring at mid-humerus

- insertion deltoid and coracobrachialis, origin brachialis

- radial nerve emerge from spiral groove, median nerve cross brachial art

- basilic vein perforates deep fascia, nutrient artery enters humerus

Distal Med epicondyle - common flexor origin; Lat epicondyle - common extensor

Capitulum articulates with head radius

Trochlea articulates with ulna

Coronoid fossa above trochlea, radial fossa above capitulum

Olecranon fossa posterior

Capsule attached to margins capitulum/trochlea and shaft above

coronoid/radial/olecranon fossa

Ossification distal humerus - CRITOE Capitellum, Radial head, Int epicondyle, Trochlea, Olecranon, Ext epicondyle

Ulna Radial notch medially

Olecranon - Triceps into upper surface, FDP med surface, Anconeus lat surface

Coronoid process - medial lip forms sublime tubercle - FDS attach, MCL below, pron teres

Ulnar tuberosity - ant surface coronoid process roughened - Brachialis inserts

Radial notch for head radius - Annular ligament attached; Quadrate ligament just below notch

Trochlear notch fits trochlea of humerus

Capsule attached to margins trochlear notch and radial notch

Shaft

Supinator crest distally from post margin radial notch - supinator arises

Interosseous border - interosseous membrane

Extensor surface between interosseous/post borders: AbdPL (radius), EPL (ulna only), EI (ulna)

Flexor surface medial to interosseous border - Common aponeurosis arises and pronator quadratus

Head Articulates ulnar notch of radius and articular cartilage

Ulnar styloid

Radius Biceps tubercle medially, ant oblique line ant, styloid lat

Head Articulates capitulum; Neck enclosed annular ligament

Shaft Radial tuber project toward ulna - Biceps attach

Ant - Supinator, Pronator teres, Radial head FDS, FPL, Pron quad

Posterior attachments – AbdPL, EPL

Lower end Ulnar surface - ulnar notch for articulation with ulna

Radial styloid - Radial collat lig, Brachioradialis and ext retinac attach

Broad distal end articulates with scaphoid and lunate

Scaphoid prone to AVN due to relative ischaemia - blood supply via dorsal branch radial artery at waist → proximal