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Anatomy of the arm (detailed)
- 2. Subject of the presentation: Anatomy-of-the-Arm Prepared by:Prepared by: Dr. RasekhDr. Rasekh Ms ortho, senior consultantMs ortho, senior consultant Date :13/12/2015
- 3. The Humerus The humerus bone has two parts: 1-Upper part(All are insertion) 2-Lower part(All are origins) Attachments on the Humerus
- 4. Upper part 1-Inter tubercular sulcus 2-Greater tubercle 3-Lesser tubercle 4:Deltoid tuberosity
- 7. A-Inter tubercular sulcus 1-pectoralis major(Lateral lip) 2-Latissimus dorsi(Floor) 3-Teres major(Medial lip) Mnemonic: ( lady between two majors)
- 8. Mnemonic: ( Lady between two majors)
- 9. B:Greater tubercle: 1:Supraspinatus(in upper impression) 2:Infraspinatus(in middle impression) 3:Teres minor(in lower impression) Mnemonic: (Minor sit)
- 16. E:Medial aspect of shaft of humerus Coracobrachialis muscle
- 18. Lower part(All are origins) Medial • A:Pronator teres (lower 1/3 of supracondylar ridge) • B:common flexor origin • (Epicondyle) Lateral • A:brachioradialis(upper 2/3 Of supracondylar ridge) B:extensor carpi radialis longus(lower 1/3 of supracondylar ridge) C:Anconeus(posterior surface of epicondyle) D:common extensor origin (epicondyle)
- 19. A:Pronator teres (lower 1/3 of supracondylar ridge)
- 20. A:Pronator teres
- 21. Common flexor origin (med.Epicondyle(5) – 1:Pronator teres – 2:Flexor carpi radialis – 3:Palmaris longus – 4:Flexor carpi ulnaris • 5:flexor digitorum superficials
- 24. Flexor Digitorum Superficialis is deep to other flexors pg 302 Brachioradialis Anterior View
- 25. Extensor carpi radialis longus(lower 1/3 of supracondylar ridge)
- 29. – 1:Extensor carpi radialis longus – 2:Extensor digitorum – 3:Extensor carpi ulnaris – 4:Supinator – 5: Extensor carpi radialis brevis 6:Extensor digiti minimi Common extensor origin (lat.epicondyle(8)
- 30. Brachialis
- 31. Triceps muscle
- 34. Biceps
- 35. Fascial Septa • Divide arm into anterior and posteriorDivide arm into anterior and posterior compartments.compartments.
- 36. Medial Intermuscular Septum • From subcutaneous sheath to humerus. • Separates muscles of anterior arm from medial side of triceps complex.
- 37. Lateral Intermuscular Septum • From subcutaneous sheath to humerus. • Separates muscles of anterior arm from lateral side of triceps complex.
- 39. Arteries • Subclavian • Axillary • Brachial • Radial • Ulnar • Profundus Brachii • Ant/Post Interosseus
- 41. Arch of the aorta Ascending aorta Descending aorta
- 42. Arch of the aorta Left subclavian artery Left common carotid artery Brachiocephalic artery
- 47. Pectoralis minor
- 48. Subclavian
- 49. Internal thoracic artery Thyrocervical trunk Transverse cervical artery Suprascapular artery Vertebral artery VIST Turkey Mnemonic
- 52. Axilary artery • Continuation of subclavian artery at lateral border of first rib • Becomes brachial artery at lower border of teres major • Divided into three parts by overlying pectoralis minor – A:First portion, above muscle － gives rise to 1:highest thoracic artery – B:Second portion, behind muscle － gives rise to – 1:thoraco acromial artery – 2:lateral thoracic artery. – C:Third portion, below muscle － gives rise to 1:subscapular artery – 2: posterior and anterior humeral circumflex artery 1:Hi 2:Tell Laila 3:Samad Passed Away! Mnemonic
- 56. Brachial Artery • Direct continuation of axillary artery. • Begins at inferior border of teres major. • Main branch is deep brachial artery. • Other branches: Superior ulnar collateral: To posterior ulnar recurrent. Inferior ulnar collateral: To anterior ulnar collateral.
- 57. Brachial artery
- 58. Radial Nerve
- 60. Brachial artery Pronator teres Brachialis tendon
- 62. Radial artery
- 64. Cephalic Vein • Lateral continuation of dorsal venous arch. • Ascends in superficial fascia along lateral aspect of forearm and arm. • Passes through deltopectoral triangle. • Empties into axillary vein.
- 66. Basilic Vein • Medial continuation of dorsal venous arch. • Ascends in superficial fascia along medial aspect of forearm and arm to middle of arm. • Pierces deep fascia and ascends in upper aspect of arm in deep fascia. • Joins venae comitantes to form axillary vein: Usually near inferior border of teres major.
- 67. Vein Cephalic Vein Basilic Vein Anti cubital Vein
- 68. Median Cubital Vein • Connects cephalic and basilic vein. • Extends diagonally across bicipital aponeurosis. • Receives blood from median antebrachial vein. • Drains blood from palmar hand.
- 70. Venae Comitantes • Veins that parallel arteries: • Usually two per artery.
- 77. Right brachiocephalic Vein left brachiocephalic Vein Superior vena cava Subclavian Vein
- 85. Nerves • Principle Nerves are – Radial Nerve (C5-C8, T1) – Median Nerve (C6-C8, T1) – Ulnar Nerve (C7, C8, T1) – Musculocutaneous Nerve (C5-C7)
- 86. Radial Nerve Musculocutaneous Median Nerve Ulnar Nerve Auxiliary artery pectoralis minor
- 87. Below pectoralis minor muscle Auxiliary artery
- 88. Musculocutaneous
- 89. Radial Nerve
- 90. Median Nerve Ulnar NerveAuxiliary artery
- 92. Musculocutaneous Nerve • Pierces coracobrachialis in upper half or third of brachium. • Innervates muscles of anterior brachial compartment. • Pierces fascia lateral to biceps tendon: Continues as lateral cutaneous nerve of the forearm. Supplies skin on lateral forearm as far as wrist.
- 95. Biceps
- 97. Lateral cutaneous nerve of forearm
- 98. Radial Nerve • . • Descends posterior to the axillary artery: Spirals around the posterior surface of the humerus in the spiral (radial) groove. Accompanied by deep brachial artery.
- 99. Radial Nerve • Pierces lateral intermuscular septum distal to deltoid insertion. • Passes into forearm: Between the brachialis medially and the brachioradialis laterally. • Divides into superficial and deep branches near lateral epicondyle.
- 100. Radial Nerve • Branches in the distal third of the arm: Branch to brachioradialis. Branch to extensor carpi radialis longus (brevis?) Articular branches to elbow joint.
- 104. Latissimus dorsi
- 106. After removing the long head of triceps lateral head Medial head Bone
- 108. lateral epicondyle Brachioradialis Deep branch(motor) Superficial branch (sensory)
- 110. Median Nerve • Supplies flexor muscles on the radial side of the forearm. • Travels with the brachial artery: Lateral to artery in upper half of brachium. Medial to artery in lower half of brachium. • Crosses cubital fossa superficially: With brachial artery Deep to bicipital aponeurosis
- 111. Median Nerve Brachial Artery Cubital Fossa
- 112. Radial recurrent a. Radial a. Radial n. Median n. Ulnar n. Ulnar a. Ulnar recurrent a. Ulnar n. Brachial a.
- 113. Median Nerve Ulnar Nerve Brachial artery
- 114. Median Nerve Ulnar Nerve Brachial artery
- 115. Brachial artery Pronator teres Brachialis tendon
- 117. Ulnar Nerve • Supplies flexor muscles on the ulnar side of the forearm. • Starts in anterior brachial compartment: Medial to brachial artery Runs with superior ulnar collateral artery.
- 118. Ulnar Nerve • Pierces medial intermuscular septum: Enters posterior compartment of the brachium. Passes around (superficial) medial epicondyle. Passes into forearm between two heads of flexor carpi ulnaris muscle.
- 119. Ulnar nerve Fibrous tunnelFlexor carpi ulnaris Triceps
- 120. Musculocutaneou s n. Median n. Ulnar n. Medial antebrachial cutaneous n. Superior ulnar coleteral a. Deep brachial a.
- 121. Median n. Axillary a. Brachial a. Medial antebrachial cutaneous n. Superior ulnar coleteral a. & Ulnar n. Inferior ulnar coleteral a.
- 123. Nerves in the Brachium • Medial brachial cutaneous nerve: Direct branch from medial cord. • Medial antebrachial cutaneous nerve: Direct branch from medial cord.
- 124. CUBITAL FOSSA
- 125. Cubital Fossa Boundaries • Lateral: Brachioradialis muscle • Medial: Pronator teres muscle • Superior base: Line between two humeral epicondyles • Floor: Supinator and brachialis muscles
- 126. Cubital Fossa Contents • Lateral to medial: Biceps TTendon Brachial AArtery Median NNerve Mnemonic TAN
- 128. Articulations: The site where 2 or more bones meet. Joints are the weakest part of the skeleton. Classification Functional: Amount of movement allowed 1). Synarthroses: Immovable joints 2). Amphiarthrosis: Slightly movable joint 3). Diarthroses: Fully movable joints
- 130. Fibula Tibia Ligament (b) Syndesmosis Joint held together by a ligament. Fibrous tissue can vary in length, but is longer than in sutures. Classification Structural: based on material binding the bone. 1). Fibrous: Bone ends united by collagenic fibers a). Sutures b). Syndesmoses c). Gomphoses
- 131. Classification 2). Cartilaginous Joints Bones are united by cartilage a). Synchondrosis b). Symphyses
- 132. Immovable Joints (synarthrosis) • Bones united by ligament suturesuture
- 133. Immovable Joints (synarthrosis) • Bones united by ligament (syndesmosis)
- 134. Immovable Joints (synarthrosis) • Bones united by ligament Interosseous membrane (syndesmosis)
- 135. • Ligaments hold tooth in bony socket • Immovable joint enamel dentin gum root of tooth pulp Socket of alveolar process Peridontal ligament (membrane)
- 136. Slightly Movable (ampharthrosis) and Immovable (synarthrosis) Joints • Lacks a synovial cavity • Bones connected by fibrocartilage or hyaline cartilage • 2 types - synchondrosis - symphyses
- 138. Slightly Movable Joint (ampharthrosis) pubic symphysispubic symphysis symphysis
- 146. Shoulder joint
- 150. Ankle Joint
- 152. • Planar Joint • Hinge Joint • Pivot Joint • Saddle Joint • Ball & Socket Joint • Condyloid or Ellipsoid Joint
- 154. • Convex surface of bone fits in concave surface of 2nd bone • Unixlateral like a door hinge • Examples: - Knee, elbow, ankle, interphalangeal joints • Movements produced: - flexion - extension - hyperextension
- 155. • Bone surfaces are slightly curved • Side to side movement only • Rotation prevented by ligaments • Examples: - intercarpal to intertarsal joints - sternoclavicular joint - vertebrocostal joints
- 156. • Rounded surface of bone articulates with the ring formed by the 2nd bone & ligament • Monoaxial since it only allows rotation around longitudinal axis • Examples: - proximal radioulnar joint - supination - pronation - atlanto-axial joint - Turning head side to side “no”
- 157. • One bone saddle-shaped, other bone fits like a person riding on the saddle • Biaxial - circumduction allows the tip of the thumb to travel in a circle - Opposition allows thumb to touch tip of other fingers • Examples: - Trapezium of carpus and metacarple of thumb
- 158. • Ball fitting into a cup-like depression • Multiaxial - flexion/extension - abduction/adduction - rotation • Examples: - shoulder joint - hip joint
- 159. • Oval-shaped depression fits into oval depression • Biaxial= flex/extend or adduct/abduct is possible • Examples: - Wrist and metacarpophelangeal joints for 2 to 5 digits
- 160. Figure 8.5a Movements allowed by synovial joints. Gliding (a) Gliding movements at the wrist
- 161. Figure 8.5b Movements allowed by synovial joints. (b) Angular movements: flexion, extension, and hyperextension of the neck Hyperextension Extension Flexion
- 162. Figure 8.5c Movements allowed by synovial joints. Hyperextension Flexion Extension (c) Angular movements: flexion, extension, and hyperextension of the vertebral column
- 163. Figure 8.5d Movements allowed by synovial joints. Extension Extension Flexion Flexion (d) Angular movements: flexion and extension at the shoulder and knee
- 164. Figure 8.5e Movements allowed by synovial joints. Abduction Adduction (e) Angular movements: abduction, adduction, and circumduction of the upper limb at the shoulder Circumduction
- 165. Figure 8.5f Movements allowed by synovial joints.Lateral rotation Medial rotation Rotation (f) Rotation of the head, neck, and lower limb
- 166. Figure 8.6a Special body movements. Supination (radius and ulna are parallel) (a) Pronation (P) and supination (S) Pronation (radius rotates over ulna)
- 167. Figure 8.6b Special body movements. Dorsiflexion Plantar flexion (b) Dorsiflexion and plantar flexion
- 168. Figure 8.6c Special body movements. EversionInversion (c) Inversion and eversion
- 169. Figure 8.6f Special body movements. (f) Opposition Opposition
- 170. Type of joint movement: • Flexion- bent knee • Extension- extend knee • Hyperextension- bring leg back • Dorsi flexion- heal • Plantar flexion- toe • Abduction- leg out • Adduction-leg in • Rotation- twisting • Circumduction- circular motion • Supination- palm up • Pronation- palm down • Eversion- foot out • Inversion- foot in • Protraction- chin forward • Retraction- chin back • Elevation- shoulders up • Depression- shoulders down
- 171. Questions?
- 172. Thanks for your kind attention
Editor's Notes
- Synarthrotic joints These joints offer no mobility. "Syn-" means together, and "arthr-" stands for joint. So, this is a joint that is stuck together. It doesn't move. The sutures in your skull are an example of this type of joint. Amphiarthrotic joints These joints of some mobility. "Amphi-" means both or dual, and you may remember this term from when you learned about how phospholipids were amphipathic (both hydrophilic and hydrophobic). The term amphiarthrotic means then, that these joints offer both a bit of mobility and a bit of sturdiness. An example of an amphiarthrotic joint is found in your vertebral column. Every vertebra can move against the next vertebra through their joint together which contains an intervertebral disk. This offers the vertebrae limited mobility. You should realize, though, that your entire vertebral column allows for pretty good movement (like when you go to bend down and touch your toes)... that is because you have many of these limited-movement joints along the entire vertebral column, so all of them combined total up to a fair amount of movement. Diarthrotic joints These joints are considered to be freely movable. The term diarthrotic means (I would guess) that the joint acts as if there are two ("di-") separate bones within the one joint. However, keep in mind that just because a joint is diarthrotic does not mean that it can move in any direction or that it can bend completely. All synovial joints are diarthrotic joints.
- A syndesmosis is a joint where the rough edges of two bones are held together by thick connective ligaments. The connection of the lower leg bones, the tibia and fibula, is a syndesmosis. The tibia is the main bone of the lower leg. The fibula is the small, thin bone that runs down the outer edge of the tibia. Only a few joints in the body are syndesmosis joints. In addition to the ankle syndesmosis (the connection of the tibia and fibula), syndesmosis joints are also located in the lower spine, where the top of the triangular-shaped sacrum bone fits between the pelvis bones. Most joints in the body are synovial joints. Synovial joints are enclosed by a ligament capsule and contain a fluid, called synovium, that lubricates the joint. The ankle syndesmosis sits next to the ankle synovial joint, where the tibia meets the talus bone. The ankle syndesmosis is supported and held together by three main ligaments. The ligament crossing just above the front of the ankle and connecting the tibia to the fibula is called the anterior inferior tibiofibular ligament (AITFL). The posterior fibular ligaments attach across the back of the tibia and fibula. These ligaments include the posterior inferior tibiofibular ligament (PITFL) and the transverse ligament. The interosseous ligament lies between the tibia and fibula. (Interosseous means between bones.) The interosseus ligament is a long sheet of connective tissue that connects the entire length of the tibia and fibula, from the knee to the ankle. The syndesmosis ligaments hold the bottom ends of the tibia and fibula in place. This arrangement forms the upper surface of the ankle joint. The ankle joint is a hinge joint. The hinge is formed where the tibia and fibula sit above the talus bone. This connection is called a mortise and tenon, a stable connection that woodworkers and craftsmen routinely use to create strong and stable constructions. A syndesmosis is an articulation in which adjacent bones are bound together by a ligament. The syndesmosis of the ankle is made up of anterior tibiofibular ligament, interosseous ligament, and posterior-fibular ligaments.
- Where the connecting medium is cartilage, a joint is termed a synchondrosis. An example of a synchondrosis joint is the sternocostal joint (where the ribs meet the sternum). In this example, the rib will join up with the sternum via the costal cartilage.
- sutures of the skull are fibrous joints with very short connecting fibers
- - Symphyses - adjoining bones are interconnected by a disk of fibrocartilage (e.g.: pubic symphysis and intervertebral joints) - Synchondroses - cartilaginous joints with hyaline cartilage between the articulating bones (e.g.: epiphyseal plate and costochondral articulations bet. ribs & sternum)
- Synchondrosis Joint This type of immovable joint is a cartilaginous joint in which the connecting tissue is hyaline cartilage. (eg. epiphyseal plate).
- Symphysis JointA symphysis occurs where there is much more cartilage present than in a synchondrosis. Adjacent bones are separated by, and fused to, a fibrocartilaginous pad.
- Talocrural (ankle) joint - the 2 articulations within the ankle are: The medial malleolus of the tibia articulates with the tallus The lateral malleolus of the fibula articulates with the tallus These are synovial, hinge joints that allow dorsiflexion and plantar flexion
- The temporomandibular joint is one of the most complex joints in the body. The healthy TMJ opens and closes like a hinge but also allows the lower jaw to slide forward. There are two TMJ’s, located right in front of each ear. The temporomandibular joint is affected by physical and emotional stress. What’s more, the joint is constantly affected by the mechanics of your bite and your jaw movements. Stress, fatigue, jaw muscle tension, and changes in your bite can all affect the TMJ. Many people have problems with the TMJ. These include clicking and popping noises, limited mouth opening, locking, and pain. Common causes include bruxism (grinding the teeth), occlusal (bite) problems, and injuries. Stress or tension in the muscles of the jaw can also cause similar symptoms. These problems with the TMJ are collectively called TMD—Temporomandibular Disorder.