The arm plus forearm contain two regions-anterior and posterior surfaces
In between are cubital regions-anterior and posterior
Below the forearm-carpal region
3. Learning objectives
1.List the main regions of the upper limb
2.Name the important terms, describe various
parts
3. List bones, nerves, vessels, and muscles of
upper limb
11/21/2022 3
SG OBAJE
4. GENERAL INTRODUCTION OF
UPPER LIMB
◦Let us look in details the main bones, muscles
vessels, and nerves
11/21/2022 4
SG OBAJE
5. Regions of the upper limb
◦Upper limb (UL) divides into-4 main parts
i. Shoulder
ii. Arm
iii. Forearm
iv. Hand
◦Two regions
i. Deltoid region
ii. Axillary region
11/21/2022 5
SG OBAJE
6. Regions of the upper limb
◦The arm plus forearm contain two regions-anterior and
posterior surfaces
◦In between are cubital regions-anterior and posterior
◦Below the forearm-carpal region
i. Connects the hands
◦Hand consists-palm (anterior) and dorsum (posteriorly)
i. Further divides into-metacarpal and digit regions
ii. Digits numbered-1 to 5 from thumb to little finger
11/21/2022 6
SG OBAJE
7. Upper of the upper limb
◦ Only 5 bones-clavicle, scapula, humerus, radius, and ulna
◦ Forearm bones-radius and ulna
◦ Hand bones-27 bones known as carpal, metacarpal, and
phalanges
i. Carpal bones-scaphoid, lunate, triquetral, pisiform,
trapezium, trapezoid, capitate, hamate
ii. Metacarpal (1-5)
iii. Phalanges-proximal (5) middle (4), and distal (5)
11/21/2022 7
SG OBAJE
8. Main joints of UL
◦Acromioclavicular
◦Glenohumeral
◦Elbow
◦Wrist
◦Carpal
◦Carpometacarpal
◦Metacarpophalangeal
◦interphalangeal
11/21/2022 8
SG OBAJE
10. Carpal tunnel
◦Narrow osteo-fibrous canal
i. Located in the palmar side of wrist
ii. Roof-found deep to flexor retinaculum/transverse
carpal ligament
iii. Floor composed of carpal bones
iv. Serves as passage way for structures between
forearm and hand
v. Transmits median nerve and 4 tendons of flexors-
11/21/2022 10
SG OBAJE
12. Carpal tunnel
◦Structures that refused to pass through the carpal tunnel
are;
◦Tendons of carpal radialis
◦ . Passing though its synovial sheath (tubular
compartment)
◦II. Ulnar artery
◦ .passing through Guyon canal
11/21/2022 12
SG OBAJE
13. Carpal tunnel
◦ III. Ulnar nerve
◦ .passing through Guyon canal
◦ IV. Palmaris longus
◦ ……GUYON CANAL
◦ .LOCATED superficial to flexor retinaculum
11/21/2022 13
SG OBAJE
15. Carpal tunnel syndrome
◦Group of signs an symptoms
i. Compression of median nerve
ii. Factors-narrow tunnels, fracture, trauma, swollen of
tendons/lig
iii. Risk factors
i. .diabetes
11/21/2022 15
SG OBAJE
16. Carpal tunnel syndrome
◦Pregnancy
◦Obesity
◦Occupational activity/biomechanical
◦Symptoms
◦Pain on the skin of palm except radial aspect being
supplied by palmar cutaneous branch of median
nerve that travel superficially.
11/21/2022 16
SG OBAJE
17. Flexor retinaculum
◦Also called transverse carpal ligament
◦Strong and fibrous
◦Rectanular ligt
◦Attaches bones near wrist
. Ulnar ide, FR attached to pisiform and hook of
hamate
.Radial side, FR attached to tubercle of scaphoid
bone
11/21/2022 17
SG OBAJE
19. Palmar aponeurosis
◦Continuation of flexor retinaculum
◦Consist of sheet of connective fibers
◦Located near the distal wrist and radiate to fingers
◦PA attaches to muscles, ligaments, digital sheaths, and
forearm tendon
11/21/2022 19
SG OBAJE
20. Palmar aponeurosis
◦Function
◦Gives firm attachment to skin of palm and strength
◦Protects underlying structures
◦Clinical
◦ .Dupuytren’s contracture-hyperflxed proximal and
distal phalanx of fingers (3rd and 4th fingers)
◦ .terminal phalanx remans unaffected
11/21/2022 20
SG OBAJE
21. Forearm
◦Class work
.muscles in the compartment of forearm, arm,
and hands
◦students are classified into 10 groups
◦Discusses muscles and graded in class
11/21/2022 21
SG OBAJE
23. Sciatic nerve
◦Largest nerve in human body
◦Arises from the lumbosacral plexus in lower back (L4-
S3)
◦Travels through buttock, pelvis, piriformis, posterior
thigh, knee, leg, ankle, and foot
◦Divisions-common fibular nerve and tibial nerve
11/21/2022 23
SG OBAJE
24. Sciatic nerve
◦Tibial nerve supplies posterior part of leg, heel, and
plantar surface of foot
◦Common fibular nerve wraps around the head of
fibular bones, dividing into;
◦I. superficial branch
◦II. Deep branch
◦Both supply anterior and lateral compartments of
leg, ankle, and dorsum of foot
11/21/2022 24
SG OBAJE
25. Sciatic nerve
◦Supply at levels:
◦Posterior thigh-innervation of hip joint, hamstring
muscles, and ischio-condylar part of adductor
11/21/2022 25
SG OBAJE
27. Sciatica
◦Pain going down the leg from the lower back
◦Symptoms
I. Pain going down the leg from the lower back
II. Weakness or numbness of the affected leg
III. Loss of bowel or bladder control
11/21/2022 27
SG OBAJE
