Upper Limb Anatomy

Name the missing anatomical features of the proximal humerus

1 - Surgical neck

2 - Greater tuberosity

3 - Anatomical neck

4 - Humeral head

5 - Intertubercular Groove

6 - Lesser tuberosity

7 - Deltoid tuberosity

Name the missing anatomical features of the distal humerus

1 - Olecranon Fossa

2 - Lateral epicondyle

3 - Trochlea

4 - Medial epicondyle

5 - Capitulum

6 - Radial fossa

7 - Coronoid fossa

Name the joint shown

Acromioclavicular joint

Name the joint shown

Sternoclavicular joint

What kind of joint is the sternoclavicular joint

Synovial, saddle joint

Name the sternoclavicular joint ligaments

Quite easy to remember

Interclavicular ligament - in between the right and left clavicles

Costoclavicular ligament - in between costal cartilage of first rib and clavicle

Sternoclavicular ligament - in between manubrium of the sternum and clavicle

Briefly discuss the movements allowed in the sternoclavicular joint with reference to wider movements of the shoulder/upper limb

Elevation and depression - as per the same with the scapula and overall shoulder

Anterior and posterior movement - as the scapula protracts and retracts

Posterior rotation - as upper limb going into flexion and scapula upward rotates

Name the joint highlighted

Acromioclavicular joint

What type of joint is the acromioclavicular joint

Synovial, plane joint

Name the ligaments of the acromioclavicular joint

1 & 2 combined are known as the coracoclavicular ligaments

3 - Acromioclavicular ligament. Easy one, goes between acromion of scapula and the clavicle

Briefly discuss the movements allowed in the acromioclavicular joint with reference to wider movements of the shoulder/upper limb

The AC joint moves passively and glides during movements of the scapula. Typically they are described as a scapular movement with respect to the clavicle.

• Upward / downward rotation - the scapula moves into upwards rotation in relation to the clavicle

• Internal / external rotation - the scapula internally rotates with protraction, and externally rotates with retraction, in relation to the clavicle

• Anterior / posterior tilting - as the scapula tilts around the clavicle.

Name the missing scapula parts on this anterior view

1 - Inferior angle

2 - Lateral border

3 - Infraglenoid tubercle

4 - Glenoid cavity

5 - Lateral angle

6 - Supraglenoid tubercle

7 - Acromion

8 - Coracoid process

9 - Scapula notch

10 - Superior border

11 - Superior angle

12 - Subscapular fossa

13 - Medial Border

14 - Neck

Name the missing scapula parts on this posterior view

1 - Medial Border

2 - Supraspinous fossa (where the supraspinatus originates)

3 - Superior angle

4 - Superior border

5 - Scapular notch

6 - Scapular spine

7 - Coracoid process

8 - Acromion process

9 - Acromion angle

10 - Glenoid cavity

11 - Infraglenoid tubercle (inferior of the glenoid cavity)

12 - Infraspinous fossa (where the infraspinatus originates)

13 - Lateral border

Demonstrate movements of the scapula and how they relate to movements of the shoulder as a whole

Upward and downward rotation - when arm goes into flexion and extension respectively.

Anterior and posterior tilt of - Elevation and depression of the scapula respectively, as the scapula moves around the curvature of the rib cage

External and internal rotation - As the scapula moves around the side of the rib cage in retraction and protraction respectively.

Discuss some key features of the scapulothoracic joint

• Not a true anatomical joint, no union by synovial, cartilaginous or fibrous tissues

• Refers to the relationship between the scapula and rib cage

• The anterior face of the scapula is slightly concave, which sits on the slightly convex superolateral thoracic wall

• The scapula is separated from the rib cage by the subscapularis muscle

Identify the key parts of the humerus

1 - Intertubercular groove (in between tubercles)

2 - Greater tubercle

3 - Lesser tubercle

4 - Lateral supracondylar ridge (above later epicondyle)

5 - Radial Fossa

6 - Coronoid Fossa

7 - Capitulum

8 - Head of radius

9 - Head of humerus

10 - Anatomical neck

11 - Surgical neck

12 - Deltoid Tuberosity

13 - Shaft

14 - Medial supracondylar ridge

15 - Medial epicondyle

16 - Trochlea

17 - Coronoid process of ulna

18 - Greater tubercle

19 - Radial groove

20 - Olecranon fossa

21 - Lateral epicondyle

22 - Head of radius

Compare the terms tubercle and tuberosity

They are both bony prominences that are used as attachment sites for tendons and ligaments

A tubercle is smaller

A tuberosity is larger

Explain the function of the glenoid labrum

The labrum effectively depends the ‘socket’ of the glenohumeral joint, providing extra support and stability

Name the components of the rotator cuff

Supraspinatus

Infraspinatus

Teres Minor

Subscapularis

(SITS)

Name the missing ligaments

1 - Coracoacromial ligament - between coracoid process of the scapula and acromion

2 - Coracohumeral ligament - between coracoid process of the scapula and humerus

3 - Glenohumeral ligaments - between glenoid fossa of the scapula and humerus. Three components - superior, middle and inferior

Name the highlighted ligament, and it’s function

Transverse humeral ligament, which attaches between the greater and lesser tuberosities of the humerus. It covers the intertubercular groove, preventing displacement of the biceps brachii tendon

Name the highlighted bursa, and why it’s often troublesome

Subacromial bursa. This bursa sits in the narrow gap between the acromion and humeral head. It is a common cause of shoulder pain as it can get inflamed from repetitive overhead movements.

Briefly discuss how the coraco-acromial arch aids with shoulder stabiity

The combination of the coracoid process, acromion process and coracoacromial ligament aids in preventing upward dislocation of the glenohumeral joint.

Briefly discuss how the rotator cuff aids with shoulder stability

The group of four muscles originate from the scapula and insert onto the head of the humerus, pulling it into the glenoid fossa.

State the prime movers of shoulder flexion

Anterior portion of deltoid

Clavicular origin component of pectoralis major

State the prime movers of shoulder extension

Latissimus dorsi

Posterior portion of deltoid

State the prime movers of adduction

Pectoralis Major

Latissimus dorsi

State the prime movers of abduction

0 - 15 degrees - Supraspinatus

15 - 90 degrees - Medial Deltoid

90 - 180 degrees - Serratus anterior, upper and lower trapezius

State the prime movers of protraction

Serratus anterior

Pectoralis major and minor

State the prime movers of internal rotation

Pectoralis major

Teres Major

Latissimus Dorsi

Subscapularis

State the prime movers of external rotation

Teres minor

Infraspinatus

State the prime movers of retraction

Rhomboid major and minor

Mid trapezius

Explain the cause of adhesive capulitis

A.K.A frozen shoulder, is caused by inflammation of the ligaments (forming the capsule) surrounding the glenohumeral joint, resulting in pain and reduced range of motion.

Briefly explain what is meant by shoulder impingement syndrome

A.K.A painful arc syndrome is caused when the subacromial space narrows, causing pain especially when lifting arm above head

Name the three joints that make up the elbow joint complex

Humeroulnar

Humeroradial

Proximal radioulnar

Name the missing parts of the ulna

1 - Olecranon process (main prominence of the elbow)

2 - Trochlea notch (articulates with the trochlea of the humerus)

3 - Coronoid process (proximal, anterior bony prominence)

4 - Styloid process (distal bony prominence, radius has one too)

5 - Ulnar Tuberosity

6 - Olecranon process (main prominence of the elbow)

7 - Trochlear notch

8 - Coronoid process

9 - Styloid process (again!)

10 - Head of ulna (the smaller end)

11 - Radial notch - articulates with the radius

Name the two joints within the elbow joint and the parts of bone which make them

Humeroradial joint - made up of the capitulum of the humerus and head of radius

Humeroulnar joint - made up of the trochlea of the humerus and trochlear notch of the ulnar (lego hand)

Which joint allows for pronation and supination of the forearm, and what’s actually happening in this movement?

Proximal radioulnar joint.

When pronating the head of the radius will rotate, and the radius itself will rotate around the ulna

What are the three main ligaments in the elbow complex

Ulnar collateral ligament - between humerus and ulna

Radial collateral ligament - between humerus and radius

Annular ligament - around the radial head, from the radial notch

What is nursemaids elbow

This is when the annular ligament gets displaced as the radius is pulled distally, trapping it in between the radius and humerus. Most common in children.

What type of joint is the distal radioulnar joint?

Synovial, pivot joint

Name the muscles that produce flexion at the elbow

Biceps Brachii

Brachialis

Brachioradialis

Identify the unknown muscles shown

1 - Biceps Brachii

2 - Brachioradialis

3 - Brachialis

Identify the unknown parts of the tricep

Triceps Brachii:

1 - long head

2 - lateral head

3 - medial head

Name the unknown muscles shown

1 - Pectoralis major

2 - Pectoralis minor

What is the origin and insertion of pectoralis major

Clavicular head, origin = clavicle, insertion = greater tubercle of humerus

Sternocostal head, origin = sternum and costal cartilage, insertion = greater tubercle of humerus

What is the origin and insertion of rhomboid major and minor

The rhomboid minor originates at C7 and T1

The rhomboid major originates at T2 to T5

Both muscles insert onto the medial border of the scapula

State the origin and insertions of the three parts the trapezius

Upper, Origin = Occipital, nuchal ligament, Insertion = clavicle

Middle, Origin = T1 - T4 spinous processes, Insertion = spine of scapula

Lower, Origin = T4 - T12 spinous processes, Insertion - medial end of spine of scapula

What is the origin and insertion of latissimus dorsi

The latissimus dorsi originates at T7-T12, the illium (pelvis), ribs 9 - 12 and the thoracolumbar fascia

It inserts onto the intertubercular groove of the humerus

What is the origin and insertion of Teres Major

Origin - inferior angle of scapula

Insertion - intertubercular groove of the humerus

What is the origin and insertion of Teres Minor

Origin = lateral border of the scapula

Insertion = greater tubercle of humerus

What is the origin and insertion of infraspinatus

Origin - infraspinatus fossa

Insertion - posterior aspect of greater tuberosity of humerus

What is the origin and insertion of supraspinatus

Origin - supraspinatus fossa of the scapula

Insertion - greater tuberosity of humerus

State the name of the hidden hand bone groups

1 - Distal Phalanges

2 - Intermediate Phalanges

3 - Proximal Phalanges

4 - Metacarpals

5 - Carpals

Name the carpal bones

Way to remember this, from lateral to medial, proximal to distal
Simply Learn The Parts That The Carpus Has

1 - Scaphoid

2 - Lunate

3 - Triquetrum (tri-kwet-trum)

4 - Pisiform

5 - Trapezium (um, thumb)

6 - Trapezoid

7 - Capitate

8 - Hamate

What is the formal name for the wrist joint

Radiocarpal joint

State the components of the radiocarpal joint

Radius bone

Articular disc

Scaphoid

Lunate

Triquetrum

What movements are facilitated by the radiocarpal joint

Flexion

Extension

Radial deviation

Ulnar deviation

What type of joint is the wrist joint

Synovial, condyloid

Name the muscles hidden in the image

1 - Flexor carpi radialis (inserts on radial side)

2 - Palmaris longus (is long and thin!)

3 - Flexor carpi ulnaris (inserts on the ulna side)

4 - Flexor digitorum superficialis

5 - biceps brachii

6 - Brachioradialis

7 - Pronator Teres

What is meant by golfers elbow

A chronic inflammation of the tendons attaching to the medial epicondyle and proximal wrist flexors, a.k.a medial epicondylitis

Name the muscles hidden in the image

1 - Extensor carpi radialis (on the radial side)

2 - Extensor digitorum

3 - Extensor digiti minimi (extends little finger)

4 - Extensor carpi ulnaris (on the ulnar side)

5 - Anconeus (small stabilizing muscle)

What is meant by tennis elbow

A chronic inflammation of the tendons attaching to the lateral epicondyle and proximal wrist extensors, a.k.a lateral epicondylitis

Where is, and what is the function of, flexor retinaculum

Ret-in-ack-ulum

Proximal, anterior hand. Ligament that forms the carpal tunnel and stabilises the carpal bones.

What is the function of the the flexor carpi radialis

flexion of the wrist

What is the function of the flexor carpi ulnaris

Wrist flexion and ulnar deviation

What is the function of the brachioradialis

elbow flexion

What is the function of pronator teres

pronation of the forearm

Identify the muscle highlighted

Coracobrachialis

Describe the function of the coracobrachialis muscle

Shoulder flexion and adduction

State the insertion and origin of the coracobrachialis

Origin: coracoid process

Insertion: shaft of humerus

Name the highlighted muscle, and it’s insertion and origin

Supinator

Origin: ulna, lateral epicondyle of humerus, radial collateral ligament

Insertion: radius

What is the insertion and origin of the subscapularis

Origin: subscapular fossa

Insertion: lesser tuberosity of humerus

What movement does the subscapularis produce upon contraction

Internal rotation of the humerus

State where the nuchal ligament is found, and it’s function.

On the posterior face of the cervical spine. It attaches onto all cervical vertebrae C1-C7 and the occipital. It supports the cervical spine and prevents excessive movement