UPPER LIMB

1. Shoulder

2. Arm

3. Elbow

4. Forearm

5. Wrist

6. Hand

6 parts of the upper limb region

Shoulder

Complex region connecting the trunk with the upper limb

1. Pectoral

2. Scapular

3. Axilla

What are the thre parts of the shoulder?

Arm

Proximal segment of the upper limb from the shoulder to the elbow

Elbow

Area connecting the arm with the forearm

Cubital fossa

A depression across the front of the elbow, the distal end of the upper limb

Forearm

Segment of the upper limb from the elbow to the wrist

Wrist

• AKA Carpus

• Complex of small bones connecting the forearm and hand

Hand

• AKA manus

• a very important organ, it is located at the distal end of the upper limb

Pectoral region

• Anterior aspect of the shoulder

• Houses the breasts

Breast

• Specialized accessory glands of the skin that secrete milk

Sexes

Breast is present in both ______.

Areola

Colored area of skin that surrounds the nipples

Arterial blood supply

Perforating branches of the internal thoracic artery and the intercostal arteries

Axillary nerve

Other than the arterial nerve supply, this also supplies the gland via its lateral thoracic and thoracoacromial branches

Pectoral group of nodes

Where does the lateral quadrants of the breast drain?

Internal thoracic group of nodes

Where does the medial quadrants of the breast drain?

Scapular region

• Part of the back

• Posterior thoracic wall

Quadrangular space

• Intermuscular space; located immediately below the glenohumeral joint

Axillary nerve, Posterior circumflex humeral vessels

The significance of quadrangular space is that the _____ and _____ emerge through this space to reach their terminal destinations in the shoulder.

Axilla

Pyramid-shaped space between the upper part of the arm and the side of the chest

Apex

• Upper end of the axilla

• Directed into the root of the neck and is bounded in front by the clavicle

Base

• Lower end

• Bounded in front by the anterior axillary fold, behind by the posterior axillary fold, and medially by the chest wall

1. Anterior wall

2. Posterior wall

3. Medial wall

4. Lateral wall

What are the 4 axillary walls?

1. Pectoralis major

2. Subclavius

3. Pectoralis minor

What are the 3 components of the anterior axillary wall?

1. Subscapularis

2. Latissimus dorsi

3. Teres major

What are the 3 components of the posterior axillary wall?

1. Upper 4/5 ribs

2. Intercostal spaces

3. Serratus anterior

What are the 3 components of the medial axillary wall?

1. Coracobrachialis

2. Biceps brachii

3. Bicipital groove

What are the 3 components of the lateral axillary wall?

Osseofascial compartment

• Sheath of deep fascia enclosing the arm

Fascial intermuscular septa

Two _______, one on the medial side and one on the lateral side, extend inward from this sheath

1. Musculocutaneous nerve

2. Median nerve

3. Ulnar nerve

4. Brachial artery

5. Basilic vein

6. Radial nerve

What are the 6 structures that passes through anterior osseofacial compartment?

1. Radial nerve

2. Ulnar nerve

3. Profunda brachii vessels

What are the structures that passes through posterior osseofacial compartment?

Interosseous membrane

• Strong ligamentous band that unites the shafts of the radius and the ulna

• Provides additional surface area for the attachments of neighboring muscles

Flexor retinaculum

• Thickening of deep fascia that holds the long flexor tendons in position at the wrist

Extensor retinaculum

• Thickening of deep fascia that stretches across the back of the wrist and holds the long extensor tendons in position

Carpal tunnel

The long flexor tendons to the fingers and thumb pass through the tunnel and are accompanied by the median nerve

1. Supraspinatus

2. Infraspinatus

3. Teres minor

4. Subscapularis

What are the muscles that composes the rotator cuff?

SITS

• Tendons are fused to the underlying capsule of the shoulder joint

• Plays a very important role in stabilizing the glenohumeral joint

• The tone of these muscles assists in holding the head of the humerus

Biceps brachii

• Powerful flexor of the elbow & weak flexor of the shoulder joint

• Powerful supinator

1. Superficial

2. Intermediate

3. Deep

What are the groups of anterior osseofacial compartment muscles?

1. Flexor carpi ulnaris

2. Palmaris longus

3. Flexor carpi radialis

4. Pronator teres

Components of the Superficial group

Flexor digitorum superficialis

Intermediate group of anterior osseofacial compartment

1. Flexor digitorum profundus

2. Flexor pollicis longus

3. Pronator quadratus

What are the muscles that composes of the deep group?

Palmaris brevis

• Small muscle that arises from the flexor retinaculum and palmar aponeurosis and inserted into the skin of the palm

Lumbrical muscle

• Arises in the hand from the four tendons of the flexor digitorum profundus

• Inserts into digits 2 through 5

1. 4 palmar interossei

2. 4 dorsal interossei

8 Interosseous muscles

Palmar interossei

Interosseous muscles that adduct digits

Dorsal interossei

Interosseous muscles that abduct digits

Thenar muscles

What kind of muscle does the thumb has?

1. Abductor pollicis brevis

2. Flexor pollicis brevis

3. Opponens pollicis

4. Adductor pollicis

4 intrinscic muscles of the thumb

Hypothenar eminence

What is the kind of muscle that the little finger has?

1. Abductor digiti minimi

2. Flexor digiti minimi brevis

3. Opponens digiti minimi

3 muscles under hypothenar eminence

Opponens digiti minimi

only muscle capable of rotating the fifth metacarpal bone to a slight degree

Subclavian artery

It supplies the upper limb as the axillary artery

Axillary sheath

The axillary artery is encolosed in a connective tissue called _____.

Highest thoracic artery

It runs along the upper border of the pectoralis minor to reach the area of the first 2 ribs

Thoracoacromial artery

It divides into 4 terminal branches that supply the pectoral muscles and the acromioclavicular region

Lateral thoracic artery

Runs along the lower (lateral) border of the pectoralis minor along the lateral chest wall

Suprascapular artery

Distributed to the supraspinous and infraspinous fossae of the scapula

Superficial cervical artery

Gives off a deep branch that runs down the medial border of the scapula

Ulnar artery

• Larger of the 2 terminal branches of the brachial artery

• Begins in the cubital fossa at the level of the neck of the radius

Radial artery

• Smaller of the 2 terminal branches of the brachial artery

• Begins in the cubital fossa at the level of the neck of the radius and descends through the lateral aspect