Download - NP Upper Extremity Grays
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The Upper Extremity
Bones,
Muscles,
Vessels,
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Bones 30 bones!!!! Appendicular skeleton ectoral irdle
"lenoid ca#ity
Allo$s %or mobility Attachments
Upper extremity& Arm
humerus
'orearm (adius, ulna )interosseous
membrane*
+and arpals, metacarpals, phalanes
(e#ie$ bones and landmarksstudied in lab!!!
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-oints o% Upper Extremity
.ternocla#icular .yno#ial/saddle iarthrosis
Acromiocla#icular .yno#ial/plane iarthrosis
"lenohumeral 1oint
.yno#ial/ball2socket iarthrosis Many liaments Muscle rein%orcement
"reat Mobility
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-oints o% Upper Extremity
roximal (adioulnar 1oint .yno#ial / pi#ot
iarthrosis
istal (adioulnar 1oint .yno#ial pi#ot
iarthrosis Allo$s pronation and
supination o% %orearm
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(e#ie$ o% :amin;
:amin 'lexor carpi ulnaris 'lexor diitorum super%icialis 'lexor pollicis lonus
ronator ?uadratus Extensor carpi radialis bre#is
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.capula Muscles
5% the insertionis
on the scapula
mo#es the scapula (homboids
Trape8ius
ectoralis Minor
.erratus Ventralis 4e#ator .capulae
Use location of Insertion to determine movement
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.capula 5nner#ation
@riin on scapula .ubscapularis and
teres ma1or
.ubscapular .upraspinatus and5n%raspinatus .uprascapular
Teres Minor Axillary
4atissimus orsi Thoracodorsal
oracobrachialis Musculocutaneous
5nsertion on scapula (homboids and 4e#ator
.capulae
orsal scapular Trape8ius Accessory
ectoralis Minor Medial and 4ateral
.erratus Ventralis 4on thoracic
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Arm Muscles
ross elbo$, mo#e
%orearm
6 compartments Anterior
'lexors o% %orearm
osterior Extensors o% %orearm
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Arm Muscles
Anterior
compartment
Brachialis Biceps brachii
oracobrachialis
Bracioradialis
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Arm Muscles
osterior
compartment Triceps brachii
Anconeus
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Arm Muscle 5nner#ation
Anterior compartment (adial ner#e
Bracioradialis
Musculocutaneous ner#e oracobrachialis Brachialis Biceps brachii
osterior compartment (adial ner#e
Triceps brachii Anconeus
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'orearm Muscles
ross elbo$, $rist and%iner 1oints
Mo#ement o% hand and%iners ross =rist
%lex, extend, abduct,adduct hand
ross 'iners %lex, extend %iners
roximally are %leshy
istally ha#e lon tendons 'lexor and extensor
retinacula $ristbands Ceep tendons %rom
1umpin out$ards $hen
tensed
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'orearm Muscles
Anterior %lexor
compartment .uper%icial and eep
Most %lexors ha#e
common tendon on
medial epicondyle
ontains 6 pronators
osterior extensorcompartment .uper%icial and eep
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Anterior ompartment o% 'orearm
Muscles :er#es .uper%icial
'lexor diitorum super%icialis Median 'lexor carpi radialis Median ronator teres Median almaris lonus Median 'lexor carpi ulnaris (adial
eep 'lexor pollicis lonusMedian 'lexor diitorum pro%undus Ulnar )med 9D6*
Median )lat 9D6*
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Anterior ompartment
'orearm
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osterior ompartment o% 'orearm
Muscles :er#es .uper%icial
Extensor carpi radialis lonus (adial Extensor diitorum (adial
Extensor carpi ulnaris (adial
eep .upinator (adial
Abductor pollicis lonus (adial
Extensor pollicis lonus bre#is (adial
Extensor indicus (adial
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osterior ompartment o% 'orearm
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+and Bones
arpus )F* True $rist
istal to radiusDulna Metacarpus )7*
istal to carpus
halanes )9G* istal to
metacarpus
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5ntrinsic Muscles o% the +and
Muscle :er#e inky )little %iner*
All diiti minimi Ulnar
)'lexor, Abductor, @pponens* Thumb
Abductor pollicis bre#is Median 'lexor pollicis bre#is Median @pponens pollicis Median Adductor pollicis Ulnar
@ther 5ntrinsic Muscles almar orsal 5nterossei Ulnar 4umbricals Median, Ulnar
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5ntrinsic Muscles o% the +and
5nterossei Muscles 4umbrical Muscles
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Blood .upply / Veins
eep #eins eep palmar #enous arches (adial / %orearm Ulnar / %orearm Brachial armDelbo$ .ubcla#ian / neck Axillary axilla
.uper%icial Veins ephalic armD%orearm
Basilic armD%orearm Median cubital elbo$
Blood dra$s!! Median / %orearm .uper%icial palmar #enous
arches
iital
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Blood .upply / Arteries
.ubcla#ian )neck* Axillary )armpit*
.ubscapular ircum%lex humeral arteries
Brachial )arm* eep brachial
(adial )%orearm* Ulnar )%orearm*
ommon 5nterosseous
.uper%icial 2 eep almararches iital
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Axilla
Armpit!! =here axillary hairs ro$ Boundaries
Ventral ectoral muscles
orsal 4atissimus dorsi, teres ma1or,
subscapularis Medial
.erratus #entralis 4ateral
Bicipital roo#e o% humerus
ontents Axillary lymph nodes, Axillary
#essels, brachial lexus
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.ur%ace Anatomy o% Arm
Biceps brachii
Triceps brachii
@lecrenon rocess
Medial Epicondyle
4ateral Epicondyle
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.ur%ace Anatomy o% Elbo$
ephalic #ein ubital 'ossa
Anterior sur%ace elbo$
ontents Median ubital Vein Brachial Artery Median :er#e
Boundaries MedialH ronator teres 4ateralH Brachioradialis .uperiorH 4ine bet$een epicondyles
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.ur%ace Anatomy o% +and
arpal Tunnel arpals conca#e anteriorly arpal liament co#ers it
ontains& lon tendons, Medianner#e
5n%lammation o% tendons Hcompression o% Median ner#e
Anatomical .nu%%box
4ateral H E
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Brachial lexus
:er#e plexus :et$ork o% ner#es %ormed by
#entral rami
4ies partly in neck and partly
in axilla
"i#es rise to almost all
ner#es that supply upper limb
'ormed by intermixin o%
#entral rami o% spinal ner#es
7/F and T9 .mall contributions %rom G and
T6
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Ventral (ami
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Brachial lexus
Really Tired> Drink !o%%ee "uddy!
( H (AM5 )#entral* )7* T H T(U:C. )3* H 5V5.5@:. )6* H @(. )3* B H B(A:+E. )Many!!*
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(ami 1oin to %orm Trunks! )in neck*
#entral Rami Trun$s
7 Upper Trunk
I
J Middle Trunk
F T9 4o$er Trunk
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Trunks .plit to %orm i#isions! )in neck*
Trun$s Divisions
Upper Anteriorosterior
Middle Anteriorosterior
4o$er Anteriorosterior
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i#isions -oin to %orm ords! )in axilla*
Trun$s Division !ords
U A 4ateral
M A Medial
4 A osterior
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ords "i#e o%% Branches!! )in axilla*
4ateral Musculocutaneous
Median
Medial Ulnar
osterior (adialAxillary)thoracodorsal*)subscapular*
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ut it all toether;;
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Brachial lexus ords and Branches
4ateral Musculocutaneous Median
Medial Ulnar
osterior
(adial Axillary Thoracodorsal .ubscapular
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Both Medial and 4ateral ords
Median ner#e ourse&
Middle o% brachial plexus )%rom lateral and medial cords*
oes not branch in arm
istal to elbo$ pro#ides many branches to most %orearm %lexors
asses throuh carpal tunnel to hand to lateral palmar intrinsics
5nner#ates& Anterior %orearm )motor*
Most %lexors, some intrinsics )thumb*
6D3 4ateral palm )sensory*
orsum o% %iners 6 and 3 )sensory*
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osterior ords
(adial ner#e 4arest branch o% brachial plexus omes %rom posterior cord ourse&
Throuh arm Around humerus Around lateral epicondyle )then di#ides*
5nner#ates& osterior muscles o% arm and %orearm
Triceps brachii, anconeus, supinator, brachioradialis
i#ides in %orearm& .uper%icial
.kin o% arm and dorsolateral sur%ace o% hand eep
Extensor muscles o% %orearm )e E< carpi radialis 4 B*
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osterior ord
Axillary ner#e Branches o%% posterior cord ourse&
(uns posterior to humerus (uns $ith caudal humeral circum%lex artery
5nner#ates& eltoid and teres minor )motor* apsule o% shoulder, skin o% shoulder )sensory*
.ubscapular ner#e 5nner#ates&
.ubscaplaris, Teres ma1or
Thoracodorsal ner#e ourse&
(uns $ith thoracodorsal artery and ner#e 5nner#ates&
4atissimus dorsi
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