ANAT 5010 - unit 5

- medial brachial cutaneous nerve joined by the intercostobrachial nerve which is the lateral cutaneous branch of the second intercostal nerve

- medial antebrachial cutaneous nerve

what are the cutaneous nerves on the medial side of the upper limb?

- upper lateral cutaneous nerve of arm (branch of axillary nerve)

- lower lateral cutaneous nerve of arm (branch of radial nerve)

- lateral antebrachial cutaneous nerve (continuation of the musculocutaneous nerve)

what are the cutaneous nerves on the lateral side of the upper limb?

- posterior cutaneous nerve of arm (radial nerve)

- dorsal cutaneous nerve of forearm (radial nerve)

what are the cutaneous nerves on the dorsal side of the upper limb?

cephalic vein

goes from the dorsal venous arch on the dorsum of the hand at the radial side; ascends the forearm to the anterolateral aspect at the elbow, then goes to the deltopectoral triangle; pierces clavipectoral fascia to join the axillary vein

basilic vein

goes from the dorsal venous arch on the ulnar side of the dorsum of the hand; ascends to the antero-medial side at the elbow; shortly above the elbow, it pierces the deep fascia to join the brachial vein and from the axillary vein

median cubital vein

formed at the front of the elbow; connects the basilic and cephalic veins; separated from the brachial artery and median nerve by the bicipital aponeurosis

cephalic, basilic, and median cubital veins

what are the superficial veins?

deep fascia

tubular connective tissue investment of deeper structures of arm

brachial fascia

covers muscles of the arm

lateral and medial intermuscular septa

separates arm muscles into anterior and posterior compartments

origin: lateral 1/3 of clavicle, acromion process, and spine of the scapula

insertion: deltoid tuberosity

what is the origin and insertion of the deltoid muscle?

action: extends, adducts, and medially rotates the arm

innervation: thoracodorsal nerve (middle subscapular nerve)

what is the action and innervation of the deltoid muscle?

origin: inferior angle and axillary border of the scapula

insertion: crest of lesser tubercle of the humerus

what is the origin and insertion of the teres major muscle?

action: adducts and medially rotates the arm at the shoulder joint

innervation: inferior subscapular nerve

what is the action and innervation of the teres major muscle?

- supraspinatus

- infraspinatus

- teres minor

- subscapularis

what muscles make up the rotator cuff?

origin: supraspinatus fossa of the scapula

insertion: greater tubercle of the humerus

what is the origin and insertion of the supraspinatus?

origin: infraspinatus fossa of the scapula

insertion: greater tubercle of the humerus

what is the origin and insertion of the infraspinatus?

action: abducts the arm and assists the deltoid muscle in its full movement

innervation: suprascapular nerve

what is the action and innervation of the supraspinatus?

action: laterally rotates the arm

innervation: suprascapular nerve

what is the action and innervation of the infraspinatus?

origin: lateral border of the scapula

insertion: greater tubercle of the humerus

what is the origin and insertion of the teres minor?

action: laterally rotates the arm

innervation: axillary nerve

what is the action and innervation of the teres minor?

origin: costal surface of scapula

insertion: lesser tubercle of the humerus

what is the origin and insertion of the subscapularis?

action: medially rotates and adducts the arm

innervation: superior and inferior subscapular nerves

what is the action and innervation of the subscapularis?

- humerus

- long head of the triceps muscle

- teres major

- teres minor

what forms the quadrangular space?

posterior humeral circumflex vessels and axillary nerve

what passes through the quadrangular space?

- teres minor

- teres major

- long head of the triceps muscle

what forms the triangular space?

branches of the scapular circumflex vessels

what can be seen through the triangular space?

- long head of triceps muscle

- lateral head of triceps muscle

- teres major

what makes up the triangular interval?

radial nerve and deep brachial vessels

what can be seen through the triangular interval?

- coracobrachialis

- biceps brachii

- brachialis

what muscles make up the anterior compartment of the arm?

origin: coracoid process

insertion: half way down the medial aspect of the humerus

what is the origin and insertion of the coracobrachialis?

action: adducts and flexes the arm

innervation: musculocutaneous nerve

what is the action and innervation of the coracobrachialis?

origin: supraglenoid tubercule (long head) and coracoid process (short head)

insertion: radial tuberosity

what is the origin and insertion of the biceps brachii?

action: flexes shoulder, flexes forearm at elbow, supinates forearm

innervation: musculocutaneous nerve

what is the action and innervation of the biceps brachii?

origin: lower anterior half of humerus

insertion: ulnar tuberosity

what is the origin and insertion of the brachialis?

action: flexes forearm at elbow

innervation: musculocutaneous nerve

what is the action and innervation of the brachialis?

triceps brachii

what muscle is in the posterior compartment of the arm?

origin: long head -> infraglenoid tubercule of scapula, medial head -> lower half of humerus, upper head -> upper half of the humerus

insertion: olecranon process of ulna

what is the origin and insertion of the triceps brachii?

action: extends forearm at elbow and shoulder

innervation: radial nerve

what is the action and innervation of the triceps brachii?

brachial artery

direction continuation of the axillary artery; begins at the lower border of the teres major muscle; ends by dividing into radial and ulnar arteries

- deep brachial artery

- superior ulnar collateral artery

- inferior ulnar collateral artery

what are the branches of the brachial artery?

deep brachial artery

travels with the radial nerve in the arm and ends by dividing into the radial collateral artery and the middle collateral artery

radial collateral artery

runs with the radial nerve; anastomoses with the radial recurrent artery; anterior to lateral epicondyle between brachioradialis and brachialis muscles

middle collateral artery

runs with the radial nerve to the anconeus muscle; anastomoses with the interosseous recurrent artery behind the elbow joint

superior ulnar collateral artery

travels with the ulnar nerve posterior to the medial epicondyle

inferior ulnar collateral artery

runs anterior to the medial epicondyle

brachial vein and axillary vein

what are the deep veins?

brachial veins

formed at the elbow by the union of the radial and ulnar veins; paired set of veins that accompany the brachial artery; contain valves and make frequent cross anastomoses with each other

axillary vein

formed at the lower border of either the teres major or subscapularis muscles; lateral brachial vein crosses the axillary artery to join the medial brachial vein to form this

sternoclavicular joint

a synovial joint between the medial end of the clavicle and the manubrium; represents the bony articulation between the upper limb and the axial skeleton

fibrocartilaginous disk

separates the cavity of the sternoclavicular joint into two

articular capsule

surrounds the medial end of the clavicle, disk, and other articular surfaces of the manubrium

interclavicular ligament

extends from one clavicle to the other; strengthens the superior surface of the joint capsule

anterior and posterior sternoclavicular ligaments

found on the anterior and posterior surfaces of the capsule of the sternoclavicular joint to strengthen it

costoclavicular ligament

a strong accessory ligament which joins the clavicle to the first rib

permits movement in anteroposterior and vertical planes and some rotation about the long axis of the clavicle

what does the sternoclavicular joint allow?

acromioclavicular joint

a plane synovial join between the lateral end of the clavicle and the medial surface of the acromion process of the scapula

- acromioclavicular ligament

- coracoclavicular ligament

what reinforces the capsular ligament of the acromioclavicular joint?

coracoclavicular ligament

an accessory ligament joining the coracoid process of the scapula to the undersurface of the clavicle and consists of the conoid ligament (medial) and the trapezoid ligament (lateral)

superior transverse scapular ligament

converts the superior scapular notch into a foramen for passage of the suprascapular nerve; suprascapular vessels pass over the ligament

coracoacromial ligament

passes from lateral margin of the coracoid process to the acromion process

glenohumeral joint

articulation between the glenoid fossa of the scapula and the head of the humerus; a ball and socket synovial joint exhibiting the greatest motility and least stability of the major joints of the body

glenoid labrum

a fibrocartilaginous ridge at the margins of the glenoid fossa which slightly deepens the fossa

transverse humeral ligament

attaches to the greater and lesser tubercles of the humerus, bridging over the intertubercular sulcus; crosses anterior to the tendon of the long head of the biceps brachii

coracohumeral ligament

from coracoid process to greater tubercle of the humerus

- superior glenohumeral ligament

- middle glenohumeral ligament

- inferior glenohumeral ligament

what are the three anterior thickenings of the shoulder joint capsule?

superior glenohumeral ligament

located above the communication between the joint cavity and the subscapular bursa

middle glenohumeral ligament

located immediately below the communication between the joint cavity and the subscapular bursa

inferior glenohumeral ligament

located inferior to the middle glenohumeral ligament

tendon of the long head of the biceps brachii

- passes under the transverse humeral ligament and enters the shoulder joint cavity

rotator cuff

major strength of the glenohumeral joint comes from the -