RT 211: The Upper Limb - Bones and Joints Study Notes

RT 211: THE UPPER LIMB - BONES AND JOINTS


Reference: Handbook of Anatomy and Physiology For Students of Medical Radiation Technology by M. Mallet

LEARNING OUTCOMES

  • To discuss the bone that makes up the upper limb and shoulder girdle.

  • To identify and describe the joints present in the upper limb and shoulder girdle.

  • To identify landmarks and prominences of the upper limb.

  • To identify and describe some congenital anomalies of the upper limb.

  • To identify some considerations for the radiography of the upper limb.

BONES OF THE UPPER LIMB OR MEMBER

1. Shoulder Girdle

  • Scapula

    • Also known as the shoulder blade.

  • Clavicle

    • Also known as the collar bone.

2. Arm or Brachium

  • Humerus

    • Long bone of the arm, also referred to as the arm bone.

3. Forearm or Antebrachium

  • Radius

    • Lateral bone of the forearm.

  • Ulna

    • Medial bone of the forearm.

4. Hand
A. Wrist or Carpus

  • Scaphoid

    • Navicular bone of wrist, also described as os scaphoideum.

  • Lunate

    • Semilunar bone, referred to as os lunatum.

  • Triquetral

    • Triangular bone, known as os triquetrum.

  • Pisiform

    • Also referred to as os pisiforme.

B. Distal Row of Carpal Bones

  • Trapezium

    • Greater multangular bone, os trapezium.

  • Trapezoid

    • Lesser multangular bone, os trapezoidum.

  • Capitate

    • Also known as os magnum or os capitatum.

  • Hamate

    • Referred to as os hamatum.

C. Palmar or Metacarpus

  • First to Fifth metacarpal bones:

    • First metacarpal bone

    • Second metacarpal bone

    • Third metacarpal bone

    • Fourth metacarpal bone

    • Fifth metacarpal bone

D. Digits

  • Thumb (Pollex):

    • Composed of 2 phalanges - proximal and distal.

  • Fingers:

    • Each composed of 3 phalanges - proximal, middle, and distal.

JOINTS OF THE UPPER LIMB

A. Major Joints

  • Sternoclavicular Joint (2):

    • Formed by the sternum and the clavicle.

  • Acromioclavicular Joint (2):

    • Formed by the scapula and clavicle.

  • Shoulder Joint (2):

    • Formed by the scapula and humerus.

  • Elbow Joint (2):

    • Composed of humerus, radius, and ulna.

    • Subcategories of the Elbow Joint:

    • Humeroradial

    • Humeroulnar

  • Proximal Radioulnar Joint (2):

    • Formed by radius and ulna.

  • Distal Radioulnar Joint (2):

    • Also formed by radius and ulna.

  • Wrist or Radiocarpal Joint:

    • Formed by radius and carpals.

  • Intercarpal Joints:

    • Occur between adjacent carpals.

  • Carpometacarpal Joints:

    • Formed between carpals and metacarpals.

  • Metacarpophalangeal Joints:

    • Formed between metacarpals and phalanges.

  • Interphalangeal Joints:

    • Formed between adjacent phalanges.

    • Subcategories of Interphalangeal Joints:

    • Proximal

    • Distal

IMPORTANT PARTS - BONES OF THE UPPER LIMB

1. Scapula

  • Description:

    • A flat triangular bone lying against the upper posterolateral chest wall.

  • Key Features:

    • Body:

    • Main part of the scapula.

    • Borders:

    • Medial or vertebral border

    • Lateral or axillary border

    • Superior border

    • Angles:

    • Superior or medial angle

    • Inferior angle

    • Lateral angle

    • Spine:

    • Acromion - the flat rounded lateral end of the spine.

    • Head:

    • Glenoid cavity - an oval depression on the lateral surface of the head of the scapula.

    • Neck:

    • Narrow section under the head.

    • Coracoid Process:

    • A beaklike projection from the anterior border of the neck of the scapula.

2. Clavicle

  • Description:

    • A long bone resembling an old-fashioned key.

  • Key Features:

    • Acromial Extremity:

    • The end that articulates with the acromion of the scapula.

    • Sternal Extremity:

    • The end that articulates with the sternum.

    • Conoid Tubercle:

    • Rough prominence on the inferior surface of the clavicle towards the acromial end.

3. Humerus

  • Description:

    • A long cylindrical bone extending from the shoulder to the elbow.

  • Key Features:

    • Proximal Extremity:

    • Head, anatomical neck, greater tubercle, lesser tubercle, intertubercular groove, surgical neck.

    • Body (Shaft):

    • Includes the deltoid tubercle.

    • Distal Extremity (Condyle):

    • Capitulum, trochlea, and various fossae (coronoid, radial, olecranon).

    • Includes medial epicondyle, lateral epicondyle, and ulnar groove.

4. Radius

  • Description:

    • The lateral bone of the forearm.

  • Key Features:

    • Proximal Extremity:

    • Head, neck, radial tuberosity.

    • Body (Shaft) and Distal Extremity:

    • Styloid process, carpal articular surface, and ulnar notch.

5. Ulna

  • Description:

    • The medial bone of the forearm.

  • Key Features:

    • Proximal Extremity:

    • Olecranon, coracoid process, trochlear notch, and radial notch.

    • Body (Shaft) and Distal Extremity:

    • Head and styloid process.

6. Carpal Bones

  • Wrist (Carpus):

    • Features eight small carpal bones, each with unique shapes:

    1. Scaphoid: Boat-shaped, lateral side of the wrist.

    2. Lunate: Crescent-shaped, resembling a half-moon.

    3. Triquetral: Triangular shape.

    4. Pisiform: Lies anterior to the triquetral bone.

    5. Trapezium:

    6. Trapezoid:

    7. Capitate: Largest bone of the wrist.

    8. Hamate: Characterized by a hook-like process called the hamulus.

CARPAL TUNNEL

  • Description:

    • Formed anterior to the wrist by a transverse carpal ligament attached to the scaphoid and trapezium laterally and to the pisiform and hook of the hamate medially.

  • Function:

    • Together with the anterior curved surfaces of the carpal bones, it forms a tunnel for tendons, blood vessels, and nerves to pass from the forearm into the hand.

CONGENITAL ANOMALIES OF THE UPPER LIMB

  • Description:

    • Anomalies may include conditions where one or both arms are absent, or Brachium Fusion:

    • A condition characterized by the joining together of the upper ends of the radius and ulna, resulting in an inability to supinate or pronate the hand.

  • Ospresngel's Deformity:

    • A condition involving elevation and deformity of the scapula.

LANDMARKS AND PROMINENCES OF THE UPPER LIMB

  • Key Landmarks:

    • Spine and Inferior Angle of the Scapula

    • Coracoid Process

    • Clavicle

    • Deltoid Tubercle

A. Shoulder

  • Key Features:

    • Epicondyles and olecranon process.

    • Head of the radius.

B. Elbow

  • Key Features:

    • Styloid process of the radius, head of the ulna, styloid process of the ulna, pisiform bone.

C. Wrist, Metacarpals, and Digits

  • Features Related to Joints:

    • Metacarpophalangeal joints.

RADIOGRAPHY OF THE UPPER LIMB

  • Key Areas for Radiography:

    • Scapula

    • Shoulder joint

    • Elbow joint and forearm

    • Wrist

    • Metacarpals

    • Digits

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