Osteology,Myology, of upper limb

1. UPPER LIMB..
Dr MEHWISH
LECTURER

2. ANATOMY OF THE UPPER LIMB
1-Bones of the upper limb.
2-Joints of the upper limb.
3- Muscles of the upper limb.
4- Vessels of the upper limb.
5- Nerves of the upper limb.
.

3. ANATOMY OF THE UPPER LIMB
Surface anatomy of the upper limb.
The upper limb divided to
1- The Shoulder
2- The arm
3- The forearm
4- The hand
5- The axilla & the breast
6-Cubital fossa

4. Osteology of upper
limb.

5. Bones of the upper limb.

6. SHOULDER
 THE SHOULDER
 It contains THE
SCAPULA & THE
CLAVICLE which
articulate with the
sternum & humerus.

7. THE SCAPULA

8. THE SCAPULA
 It is a triangle flat bone with
lies on the posterlateral
aspect of the thorax.
 2 surfaces (ventral& dorsal).&
 3 angles (superior, lateral&
inferior).&
 3 borders (medial ,lateral &
superior).
 It has a spine , acromial
process & coracoid process.

9. THE SCAPULA
• The scapula (shoulder blade) is a triangular flat bone that lies
on the posterolateral aspest of the thorax, overlying the 2nd-7th
ribs.
• The spine of the scapula starts medially.
• Extend laterally where be wider to form acromial process
• Articulate with the lateral end of the clavicle.
• At the lateral end of the superior border is the coracoid process.
• The lateral angle forms the glenoid cavity.(SHOULDER JOINT)

10. Articulation of the scapula
 There are 2 synovial & 2 fibrous joints.
 The synovial joints
 The glenoid cavity with the head of the humerus to form the shoulder joint
 Acromio-clavicular joint
 The fibrous joints
 coraco- clavicular joint (strong joint covered with strong ligament)
 coraco- acromial joint (strong joint covered with strong ligament)

11. Anastamosis around the scapula
 It is an important anastamosis between branches of the first
part of the subclavian artery.& the third part of axillary artery.
 Branches of the first part of the subclavian artery.
 The supra scapular artery. which distributed to the supraspinous & the
infraspinous fossa.
 Deep branch of the transverse cervical artery. which go down along the
medial border of the scapula.

12. Anastamosis around the scapula
 The branches of the third part of axillary artery.
 The sub scapular artery. which go down along the lateral border of the scapula
 The circumflex scapular artery. which arise from the sub scapular artery
& go to the infraspinous fossa.

14. THE CLAVICLE

15. THE CLAVICLE
 It lies horizontally in the root of the neck.
 It covers the flat 1st rib
 its medial 2/3 are curved forward to give room for the passage of the
large vessels & nerves which leave the neck & pass behind & below
the clavicle on their way to upper limb.
 It has 2 important functions:
 To transmit forces from the upper limb to the bones of the axial
skeleton (sternum)
 To act as support, holding the arm free from the trunk.

16. THE CLAVICLE
 It is along bone with 2 ends:
 The sternal end articulate with the manuberium of the sternum forming the
Sterno- clavicular joint.
 The acromial end articulate with the acromial process of the scapula forming the
Acromio- clavicular joint.
 The body is convex in medial 2/3 concave in lateral 1/3.

17. THE CLAVICLE
Important relations of the clavicle
 The subclavian artery &vein &the trunk of the brachial pluxes pass behind the
middle /3 of the clavicle.
 The common carotid artery lies behind the left sternoclavicular joint
 The brachio-cephalic artery. divided & its branches behind the right sternoclavicular
joint.
 The internal jugular vein lies a little laterally on either side.

18. THE HUMERUS

19. THE HUMERUS
 It is a tubular long bone composed of upper end ,
body (shaft ) & lower end.
 The upper end formed.
 The head
 The neck ( anatomical &surgical )
 The tubercles (greater & lesser )

20. THE HUMERUS
 The head : which is less than ½ ball directed medially ,upward &
posteriorly .
 It is separated from the greater & lesser tuberosities by a shallow
groove called the anatomical neck .
 The greater tuberosity is a importance which projects posteriorly in
rest position.
 The lesser tuberosity is a small importance which project anteriorly.
 The greater & lesser tuberosities & head are separated from the
shaft by the surgical neck.
 There is small groove below them called the bicipital groove .

21. THE HUMERUS
 The anterior aspect :medial epicondyle , trochlea ,capitulum &
lateral epicondyle .
 2 fossae (coronoid & radial ) .
 The posterior aspect: medial epicondyle , trochlea & lateral epicondyle with
one fossa (olecranon) .The medial epicondyle is larger , more prominent &
extend downward more than the lateral .It carries a shallow groove in the
posterior surface for the ulner nerve .

22. THE HUMERUS
• Nerves related to the humerus :
• The circumflex (axillary) nerves may be injured in fracture of surgical
neck
• The radial nerves. (which lies in the spiral groove ) may be injured in
fracture of the middle of the shaft .
• The ulnar nerves may be injured in fracture of the lower end (the
medial epicondyle)

23. Bone of forarm

24. Bone of forarm.
• THE RADIUS
 The radius bone is the lateral and shorter bone.
 The lower end which is the styloid process laterally &
ulnar notch medially
• THE ULNA
 The ulna is the stabilizing bone of forearm and it is medial and longer bone
of forearm.

25. THE RADIUS
 The radius is the lateral bone of the forarm ,and
homologus with the tibiaof the lower limb. it has 2
end and shaft
Above:
 Upper end is having disc-shaped head while lower end
is styloid process.
 Shaft: 3borders,3 surface
BORDERS SURFACES
Anterior border anterior ,
Posterior border posterior,
Medial or interosseous border lateral
Below
 The lower end is the wides part of the bone.
it has 5 surfaces
 Anterior surfaces.
 Posterior surfaces.
 Medial surfaces.
 Lateral surface
 Inferior surfaces

26. THE ULNA
 The ulna is the bone of forearm,its
homologous with the fibula of the lower limb
its thas 2 end and shaft.
ABOVE:
 upper end is hook-like, upper end presented
the olecranon and coronoid processes, and
trochlear and radial notches.
 5 surfaces.(olecranon processes)
Anterior, Posterior, Medial, Lateral, Superior,
 4 surface.(coronoid processes)
Superior, Anterior, Lateral,medial
 Shaft 3 borders,3surfaces
Borders surfaces
Lateral Anterior
Anterior Medial
Posterior Posterior

27. THE ULNA
BELOW
lower end of ulna is made up of
head and styloid process..
 The head : small rounded articulating
with the medial side of the lower end of the
radius forming the inferior radio – ulnar
joint.
 The styloid process : projects
medially & below the head .

29. Ulna bone with border and surfaces

31. The interosseous membrane
 The radius & ulna are also joined by a fibrous membrane which
stretches between the interosseous borders of the 2 bones..
 It run obliquely downwards &medially from radius to ulna.
 It is pierce by the ant: Interosseous membrane .
Its function is
 Increase the area of origin of forearm.
 transmits forces received by the lower end of radius to ulna.

34. BONES OF HAND

35. The bones of the hand

36. The bones of the hand
 They consist of :carpus , metacarpus & phalanges
bones
 The carpus bones : they are 8 arrange in 2 rows
( proximal & distal ).
From lateral to medial:
 The proximal row : scaphoid ,lunate , triquetral &
pisiform
 The distal row : trapezium , trapezoid , capitate &
hamate .

37. The bones of the hand
• The Metacarpal bones : are 5 . One for each finger .
• Each metacarpal bone has : base ,shaft & head .
• The phalanges : all the fingers have 3 phalanges
• ( proximal , middle & distal )
• Each phalanx has base , shaft & head
• except the thumb has only 2 (proximal & distal ).

38. The articulation of the carpal bones
 The proximal row is convex toward the lower end of radius & ulna .
 The scaphoid & lunate articulate with the lower end of the radius
 The triquetral articulates with the lower end of the ulna .
 The bones of the proximal row articulate with the bones of the distal row in
mid carpal (transverese carpal) joint.

39. The bones of the distal row articulate with the base of the
metacarpals by
 The trapezium articulate with the1st metacarpal bone
 The trapazoid articulate with the 2nd metacarpal .
 The capitate articulate with the 3rd metacarpal .
 The hamate articulate with the 4th & 5th metacarpals..

42. MYOLOGY THE MUSCLES OF
THE
UPPER LIMB

43. THE MUSCLES OF THE UPPER LIMB
In general they divided to
Muscle attached the upper limb to axial
skeleton .
Muscles of the upper limb proper .

44. Muscle attached the upper limb to axial
skeleton .
 THE FRONT Mm.
Pectoralis major , Pectoralis minor & subclavius Muscles.
 AT SIDE Mm.
serratus ant Muscles.
 THE BACK Mm.
Latissmus dorsi , trapezius , levator scapulae , rhomboideus minor
& rhomboideus major muscles.
Only the pect: Major & latissmus dorsi are inserted in the humerus while all
the others are inserted in the shoulder girdle( scapula & clavicle) .

45. MOVEMENTS OF THE SHOULDER
GIRDLE
1- ELEVATION: by upper of trapezius & levator scapulae Mm
.2-DEPRETION: by pect.major , pect.minor &latissmus dorssi Mm.
3- RETRACTION: by middle of trapezius, rhomboideus major & minor Mm
.4- PROTRACTION: by serratus ant:,levator scapulae & pect. Minor.
5- ROTATION UP : by upper &lower of trapezius &serratus anterior Mm.
6-ROTATION DOWN :levator scapulae,rhomboideus major & rhom.minor Mm.

46. MUSCLES OF THE SHOUlDER REGION
• They are 6 Mm.: deltoid , teres major , teres minor ,supraspinatus ,
infraspinatus& subscabularis Mm.
• The Rotator cuff M. ,supraspinatus , infraspinatus& subscabularis.
teres minor
• Arise from the scapula ( all from the dorsal surface except subscapularis
M. from the anterior surface )
• Inserted in the tuberosities of humerus .They rotate the arm(medially or
laterally) & adduct the arm (except the deltoid &supraspinatus Mm.) all
suplied by C5, C6 Nn.

47. MUSCLES OF THE BACK OF THE ARM.:
Triceps Brachii: The triceps
brachii muscle “three-headed muscle
of the arm” is the large muscle on the
Posterior Compartment of the upper
limb. Triceps Brachii muscle is
principally responsible for extension of
the elbow joint.
• Attachments of the triceps brachii
muscle
• Origin:
• Long head – originates from the
infraglenoid tubercle
• Medial head – originates from
the humerus, inferior to the radial
groove
• Lateral head – originates from the
humerus, superior to the radial groove

48. • Insertion:
Distally, the heads converge onto
one tendon and insert into the
olecranon of the ulna.
• Actions of the
triceps brachii
muscle
• Extension of the arm
at the elbow

49. THE FOREARM MUSCLES THE FLEXOR –PRONATOR GROUP
 They divided to 2 groups:
1- The flexor- pronator group.
2- The extensor- supinator group.
*They divided to superficial & deep groups.
*The superficial group arise from the front of medial epicondyle of humerus,
pass in front of the forearm& the wrist to inserted in bones of the hand .

50. THE FLEXOR –PRONATOR GROUP
Anterior compartment of forearm
 They are :Pronator teres , Fl. Carpi-
radialis , Fl. Carpi-ulnaris ,Fl. Digitorum
superficialis &palmaris longus Mm .
 The deep group arise from the
front of interosseous membrane
of radius & ulna.
 They are : Fl.digitorum profundus ,
Fl.pollicis longus & pronator quadratus
Mm.

51. THE FLEXOR –PRONATOR GROUP :
• The pronators; are Pronator teres & Pronator quadratus Mm.
where inserted in the radius & pronate the forearm .
• The flexors of the wrist are ;Fl.carpi-radialis ,Fl. carpi-ulnaris &
Palmaris longus where inserted in the metacarpal bones .
• The flexor of the fingers; are Fl. digitorum superficialis & Fl. Digitorum
profundus where inserted in the phalanges.
• The flexor of the thumb; is Fl. Pollicis longus& inserted in phalanges of
the thumb .

54. THE EXTENSOR - SUPINATOR GROUP.
Posterior compartment of forearm
• *They extend the wrist & fingers & supinate the forearm .
• * They divided in to superficial & deep :
• The superficial group arise from the back of the lateral epicondyle of
humerus to pass on the back of the forearm
• inserted in the bones of the hand .
• There are 7 ; Brachio-radialis , extensor carpi – radialis longus ;ext.calpi-
radialis brevis ;ext.digitorum ; ext. digiti- minimi ;ext. carpi –ulnaris &
anconeus Mm.

55. THE EXTENSOR - SUPINATOR GROUP.
Posterior compartment of forearm

56. THE EXTENSOR - SUPINATOR GROUP.

57. THE EXTENSOR - SUPINATOR GROUP
Muscles of the thumb
 Muscles of the thumb are :
 Abductor pollicis longus ,
 Ext. pollicis brevis
 Ext. pollicis longus Mm.
 Inserted in the thumb bones

58. RETINACULUM
 Two types of
retinaculum
 Flexor retinaculum
 Extensor retinaculum

59. THE FLEXOR RETINACULUM
 They are the band of
deep fascia of the wrist.
 Attachments
Medially
 The pisiform bone &
 The hook of the hamate.
Laterally
 The tubercle of the scaphoid
 The crest of the trapezium
Function
 Hold the long flexor and extensor
 Tendons in positions at the wrist.

60. RELATIONS..

61. THE EXTENSOR RETINACULUM
 They are the band of deep fascia of
the wrist.
 Attachments
Medially
 Medially pisiform &triquterum
Laterally
 Distal end of radius
 Function
 Hold the long flexor and extensor
 Tendons in positions at the wrist.

62. RELATIONS..

64. CARPAL TUNNEL SYNDROME
• The Carpal Tunnel in your wrist.
• It is made up of the carpal bones
and the flexor retinaculum
(transverse carpal ligament).
Carpal Bones
•

65. Carpal tunnel syndrome
• Carpal tunnel syndrome is a common
condition that causes pain, numbness, and
tingling in the hand and arm.
• The condition occurs when one of the
major nerves compressed
• The median nerve; is squeezed or
compressed as it travels through the
wrist.

67. THENAR & HYPOTHENAR

68. HYPOTHENAR
• The hypothenar eminence is a group
of three muscles found at the base of
the little finger, on the ulnar side of the
palm.
• Similarly to the thenar muscles with
the thumb, these muscles control
movement in the little finger.
• This group consists of the following
three muscles:
• abductor digiti minimi,
• the flexor digiti minimi brevis
• opponens digiti minimi.

69. Thenar
 Thenar Eminence
Group of three short muscles located
at the base of the thumb.
This group of muscles forms a “fleshy
mass” on the lateral side of the palm
which is responsible for the thumb’s
fine movements.
• This group consists of the following
three muscles:
• Opponens Pollicis.
• Abductor Pollicis Brevis.
• Flexor Pollicis Brevis.

70. MOVEMENT OF THUMB

71. REFERENCES
B D CHURASIA’S HUMAN ANATOY.
SNELL
 THANK YOU