Upper Limb

the upper limb is characterized by its

mobility and ability to grasp, strike, and conduct fine motor skills (manipulation)

synchronized interplay occurs between the

joints of the upper limb

synchronized interplay occurs between the joints of the upper limb coordinate the intervening segments to perform

smooth, efficient motion at the most workable distance or position required for a specific task

efficiency of hand function results in large part form the ability to place it in the proper position by movements at the

scapulothoracic, glenohumerla, elbow, radioulnar, and wrist joints

shoulder

proximal segment of the limb that overlaps parts of the trunk (thorax and back) and lower neck

shoulder includes

pectoral, scapular, and deltoid regions of the upper limb, and the lateral part (greater supraclavicular fossa) of the lateral cervical region. It overlies half of the pectoral girdle

the pectoral girdle (shoulder girdle) is a

bony ring

the pectoral girdle posteriorly is

incomplete, formed by the scapulae and clavicles

the pectoral girdle anteriorly

completed by the manubrium of the sternum

arm is

first segment of the free upper limb (more mobile part of the upper limb independent of the trunk) and the longest segment of the limb

arm extends between and connects the

shoulder and elbow

arm consists of

antieror and posterior regions of the arm, centered around the humerus

forearm

second longest segment of the limb

forearm extends between and connects the

elbow and wrist

forearm includes anterior and posterior regions of forearm

overlying the radius and ulna

radius

lateral

ulna

medial

hand is

part of the upper limb

hand is distal to

the forearm

hand is formed around

the carpus, metacarpus, and phalanges

hand is composed of the

wrist, palm, dorsum of hand, digits

hand is richly supplied with

sensory endings for touch, pain, and temperature

the clavicle is fist bone to

ossify

clavicle is highly variable in

shape and size

clavicle is most commonly

fractured

clavicle fracture is evident by the

palpable elevation of the medial portion from action of the sternocleiodomastoid and dropping of the shoulder from the unsupported weight of the upper limb

clavicular fracture are common in

children, caused by indirect force

a clavicular fracture may also result from

fall directly on the shoulder

the weakest part of the clavicular is

the junction of its middle and lateral thirds

sternocleidomastoid

muscle that flexes and rotates the head, attaches to the sternum and clavicle.

in clavicular fracture sternocleidomastoid

elevates inner 3rd of clavicle, shoulder drops

acromion

the bony process on the scapula that forms the highest point of the shoulder.

coracoid process

projection on the scapula that serves as an attachment point for ligaments and muscles.

glenoid cavity

the socket in the scapula that receives the head of the humerus, forming the shoulder joint.

fracture of the scapula is usually the result of

severe trauma

fracture of scapula requires

little treatment because it is covered in muscles

scapula is covered in

muscles that provide support and protection.

most humeral fractures occur at

surgical neck

humeral fractures usually result in

impacted fractures due to falls

impacted fractures

one bone fragment is driven into another

humerus head is separated by

tubercles

biceps tendons run through

inter tubercular sulcus (bicipital groove)

lateral epicondyle

point of attachment of extensor

medial epicondyles

point of attachement for flexor

trochlea

hinge - articulates with the ulna at the elbow joint.

a direct blow to the arm may result in a (abusive relationship)

transverse or spiral fracture of the shaft

a fall on a flexed elbow may cause

intercondylar fracture

transverse or spiral fracture

that occurs when a bone is broken in a twisting or lateral motion, often due to excessive force.

intercondylar fracture

occurs between the condyles of the humerus

olecranon

connects with trachea to form hinge/elbow joint

radius is

thicker, shorter

ulna is

thinner, longer

interosseous membrane

a fibrous sheet connecting the radius and ulna, providing stability and support.

radius does not

contribute to the elbow

a colles fracture is a

transverse fracture of the distal radius

colles fracture is often accompanied by an

avulsed styloid process of the ulna

a colles fracture is a result of

a fall on an outstretched hand

the colles formation result is

posterior angulation of the forearm just proximal to the wrist : a dinner fork deformity

avulsed

seperation

scaphoid

most commonly fractured carpal bone

scaphoid healing is slow because

poor blood supply

fracture of 5th metacarpal

referred to as a "boxer's fracture"

sesamoid bones

a bone embedded within a tendon, commonly found in the hands and feet.

fracture of the hamate may result in

disunion of the fractured parts

why does fracture of hamate result in disunion

because of the traction of the attached musculature and may involve the ulnar nerve and artery

metacarpal fractures are

relatively stable and heal quickly

boxer’s fracture

when an unskilled person punches someone, causing the head of the bone to rotate over the distal shaft

pectorals major attaches

to the humerus, clavicle, and sternum, allowing for arm movement.

the pectorals minor attaches to

the coracoid process of the scapula and ribs 2-5 aiding in scapular movement and stabilization.

Poland syndrome

absence of the pectoralis and absence of the nipple, congenital

serrates anterior attaches to

scapula and 1-8 rib

serrates anterior function

helps grab or reach

trapezius

muscle that stabilizes and moves the scapula, aids in shoulder elevation, and extends the neck.

latissimus dorsi

large muscle of the back that helps with arm movement and stabilizes the shoulder

triangle of auscultation

allows for better listening to lung sounds because less tissue

injury to the thoracodosal nerve occurs during

surgery on scapular lymph nodes of the axilla

thoracodorsal nerve injury causes

paralysis of the latissimus doors

thoracodorsal nerve innervates

the latissimus dorsi muscle, allowing for arm extension, adduction, and internal rotation.

triangle of auscultation border - trapezius

lateral/medial portion

triangle of auscultation border - scapula

medial

triangle of auscultation border - latissimus dorsi.

superior border

if person has injury to the thoracodorsal nerve then they are

unable to raise the trunk with the upper limb or use an axillary crutch

supraspinatus innervation

suprascapular nerve

supraspinatus main action

abducts arm

infraspinatus innervation

supra scapular nerve

infraspinatus main action

laterally rotates arm

teres minor innervation

axillary nerve

teres minor main action

laterally rotates arm

subscapularis innervation

upper and lower subscapular nerves

subscapularis main action

medially rotates and adducts arms

rotator cuff muscles

supraspinatus, infraspinatus, teres minor, subscapularis

calcific supraspinatus tendonitis is caused by

inflammation and calcification of the subacrominal bursa and the tendon of supraspinatus

calcification supraspinatus tendonitis causes

pain and limitation of movement

the musculotendinous rotator cuff is commonly injured in

sports

the musculotendinous rotator cuff causes

shoulder pain and instability of the joint

rotator cuff acronym

SITS

deltoid proximal attachment

clavicle, acromion and spine of scapula

deltoid distal attachement

detolid tuberosity

deltoid innervation

axillary nerve

deltoid main action

anterior part flexes and medially rotates arm; middle part abducts arm; posterior part extends and laterally rotates arm