This ppt includes the description of fascial compartment, intermuscular septum, gross structures of humerus, ulna and radius, muscle attachments of upper limb, their ossification centres, important radiological lines, importance of ossification centre and radiological line, mock test. here visible human project can be harvested from the YouTube.

1. Visible human project

2. Arm and ForearmArm and Forearm
with Elbow Jointwith Elbow Joint
Dr. Zobayer Mahmud Khan
Resident, Phase- B

3. Objectives

4. • Mention the compartments of the arm
and forearm
• Define fascial compartment
• Describe the lateral and medial
intermuscular septum
• Explain the development of limbs
• Identify the gross structures of
Humerus, radius, ulna and elbow joint
• Name the muscles of the arm,
forearm
Objectives

5. • Identify the cross and longitudinal sections
through the arm, forearm
• Know the anterior humeral line and
radiocapitellar line and their importance
• Enumerate the ossification centres of
humerus, around elbow joint
• Explain the importance of knowing
ossification centres
• Participate in a mock test
Objectives

6. The arm
Anterior compartment
(Flexor compartment)
Posterior compartment
(Extensor compartment)
The forearm
Anterior compartment
(Flexor compartment)
Posterior compartment
(Extensor compartment)

7. Compartment
A fascial compartment is a section within the body
that contains muscles and nerves, vessels and is
separated from other by intermuscular septum.

8. Intermuscular septum

9. • Lateral intermuscular septum
• Medial intermuscular septum

10. Extends from the lower part of the crest of the
greater tubercle of the humerus, along the lateral
supracondylar ridge, to the lateral epicondyle.
Blended with the tendon of the deltoid muscle,
gives attachment to the triceps brachii behind,
and to the brachialis, brachioradialis, and
extensor carpi radialis longus muscles in front.
Perforated by the radial nerve and profunda
branch of the brachial artery.
Lateral Intermuscular septum

11. • Extends from the lower part of the crest of the lesser
tubercle of the humerus below the teres major, and
passes along the medial supracondylar ridge to the
medial epicondyle; it is blended with the tendon of the
coracobrachialis, and gives attachment to the triceps
brachii behind and the brachialis in front.
• It is perforated by the ulnar nerve, the superior ulnar
collateral artery, and the posterior branch of the
inferior ulnar collateral artery.
Medial Intermuscular septum

12. Limb Development

13. At the end of the fourth week
Limb buds
Specific Spinal Segment
(upper limb, C5-T2: lower limb, L2-S2)
Apical Ectodermal Ridge (APR)
Progressive region
Zone of polarizing activity
Rotation
Limb Development

14. Bones form by endochondral Ossification.
Muscle cell migrate from somites in a
segmental fashion and segregate into dorsal
and ventral muscle group. Later Fusion and
splitting of these groups into different muscles
distorts the original segmental pattern.
Limb Development

15. Digits form when apoptosis occurs in the AER to
separate this structure into five separate ridges.
Final separation of the digits is achieved by
additional apoptosis in the interdigital spaces.
Limb Development

16. Bone and X-ray

21. Muscles

22. ?Biceps brachii

23. ?Brachialis

24. Opposite
view
?Brachioradialis

25. ?Triceps brachii

26. Coracobrachialis

29. Ossification Centre

30. Ossified from eight centers,
One primary and seven secondary centres.
Number Site Time of
appearance
Time of
Fusion
One Body Eighth week
of fetal life
twentieth
year
One Head First year Six year
One Greater
Tubercle
Second year Six year
One Lesser
Tubercle
Fifth year Six year
one for the capitulum, the trochlea, and
one for each epicondyle.

31. ForearmForearm

32. Bone and X-ray

35. Muscles

36. Opposite
view
?Supinator

37. ?Pronator teres

38. ?Pronator quadratus

39. ?Flexor carpi radialis

40. ?Flexor carpi ulnaris

41. ?Palmaris longus

42. Opposite
view
?Extensor carpi radialis longus

43. **Repeat Muscle**
?Brachioradialis

44. ?Extensor carpi radialis longus

45. ?Extensor carpi radialis brevis

46. ?Extensor carpi ulnaris

47. ?Extensor digitorum

49. Flexor Digitorum Superficialis

52. Elbow Joint

53. Bone and X-ray

57. A line drawn down the
neck of the radius should
intersect the capitullum.
A line drawn down the
anterior surface of the
humerus should
intersect the middle
third of the capitullum.

58. Importance

59. • If the radiocapitellar line does not intersect the
capitellum, there is radial head dislocation.
• If the anterior humeral line does not intersect the
capitellum, there is subtle supracondylar fracture..

60. Ossification Centre

61. C R I T O E

62. Elbow ossification centres Age at appearance
(years)
Age at closure
(years)
Capitulum 1-2 14
Radius 3 16
Internal (medial) Epicondyle 5 15
Trochlea 7 14
Olecrenon 9 14
External (lateral) Epicondyle 11 16

68. Importance

69. • If you can see a trochlea but no internal epicondyle,
then you need to look very hard for the avulsed
ossification center.
• If the trochlear center is present, but there is no
medial epicondyle then you are most likely looking
at a medial epicondylar fracture where the
ossification center has been avulsed and displaced.

70. Mock test

71. Dislocated
Humerus

72. Fracture of shaft

73. Isolated Ulnar Fracture
(Proximal)

74. Isolated Ulnar Fracture
(Distal)

75. Isolated Radial
Fracture (Distal)

76. Fracture of
Radial Head

77. Capitulum Fracture

78. Ulna Fracture (Proximal)

79. Olecranon
Fracture

80. Fat Pad

81. Mass of
closely
packed fat
cells
surrounded
by fibrous
tissue septa.
They are
extensively
supplied with
capillaries
and nerve
endings.

82. Fat Pad Sign

83. Sail sign

84. https://radiopaedia.org/
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