Introduction to human anatomy for ms student

1
JIMMA UNIVERSITY
Prepared by: Diriba Erko
Submitted to: Mr. Mangistu A (MSC IN C. Anatomy)
Institute of Health Science
Department of Biomedical Science
course: anatomy of upper extremities

outlines
 History of Anatomy
 Definition of Anatomy
 Approaches to Studying Anatomy
 Anatomical Terminology
 Bony skeleton of upper extremities
 Joints of upper extremities
2

History of Anatomy
 Hippocrates (460-377 B.C.) was a
famous Greek physician who is
regarded as the father of medicine.
 The field of medicine at the time of
Hippocrates held to the notion of four
fluids, or humors.
 This so-called humoral theory
suggested that, if blood, bile, black bile,
and phlegm were balanced, the person
would be healthy and have an even
disposition.
3

Aristotle (384-332 B.C.)
 He wrote the first known account of
embryology, in which he described the
development in a chick embryo.
 Despite his tremendous
accomplishments, Aristotle perpetuated
some erroneous theories regarding
human anatomy.
 For example, he disagreed with Plato,
who had described the brain as the seat
of feeling and thought, and proclaimed
the heart to be the seat of
intelligence.
 Aristotle thought that the function of the
brain, which was bathed in fluid, was to
cool the blood that was pumped from the
heart, and thus maintain body
4

Erasistratus (300-350 B.C.)
 He was more interested in
body functions than structure,
and is therefore frequently
referred to as the father of
physiology.
 Erasistratus authored a book
on the causes of diseases, in
which he included observations
on the heart, vessels, brain and
cranial nerves.
 Erasistratus was the first who
had differentiated the motor
and sensory nerves.
 After studying the contraction
of muscles, he developed the
theory of movement which was
5

HEROPHILUS (about 325BC)
 Great teacher of anatomy in
Alexandria
 performed -vivi-sections
(dissections of living humans)
- -dissections of human
cadavers
 regarded brain as seat of
intelligence
 described cerebrum, cerebellum ,
fourth ventricle
 first to identify nerves as
sensory or motor.
 He is credited with the discovery
of ovum
6

ROMAN PERIOD
CLAUDIUS GALEN(AD132-201).
 most influential writer on medical
subjects
 theorized on many medical
subjects like anatomy ,
physiology , pathology ,
symptomatology and treatment
 identified veins and arteries
containing blood
 For 1500 years his writings were
unquestionable .
 He studied the functions of
kidneys & spinal cord.
7

Middle Ages
 The Middle Ages (Dark Ages 5th -17th centuries) came with the
fall of Roman Empire in A.D.
 Dissections of cadavers were totally prohibited during this
period
 If mysterious death occurred, examination by inspection and
palpation were allowed.
 During the plague epidemic in the sixth century, however a few
necropsies and dissections were performed in hopes of
determining the cause of dread disease.
8

Ibn Sina, or Avicena (980-1037)
 He was the author of more than one hundred works, the most
prominent of which is the Canon of Medicine (c. 1000).
 This book contains valuable anatomical and physiological
information adopted from Hippocrates, Aristotle, and Galen to
which Ibn Sina added his own belief that the organism is
controlled not by three organs (Plato's tripod) but four, namely
the heart, brain, liver and testis (Avecena's quadrangle).
 Ibn Sina study of the structure of eye is also original.
 The Canon of Medicine was the best medical work produced in
the feudal age and served as the source of knowledge for
physicians of the East and West until the seventeenth century.
9

RENAISSANCE PERIOD
Period characterised by rebirth of science
 lasted from 14th century through 16th century
It was a transitional period from the
middle . ages (referred to as Dark ages) to
the modern ages . of science.
Canon remained the most important text book on
Anatomy
Series of authors dissected cadavers
10

Leonardo da Vinci (1452-
1519)
 He was the genius of Renaissance, a
painter, engineer, philosopher, and
scientist including anatomy.
 He was one of the first scholars to
dissect human cadavers and was a
genuine innovator in the study of the
human organism..
 He dissected human cadavers, sawed and
analyzed bones, and prepared models, to
produce three-dimensional images of the
organs. These drawings were the first
correct representations of various organs
of the human body.
11

SIXTEENTH CENTURY
VESALIUS(1514- 1654)
 Professor of anatomy at the
University of Padua in Italy
 His work De humani corporis
fabrica written in 7 volumes
 revolutionised the teaching of
anatomy
 Challenged hundreds of Galen’s
erroneous concepts
 Father of Modern Anatomy
 ‘Reformer of Anatomy’
12

William Harvey (1578-1657),
• William Harvey was the first who
provided a true picture of blood
circulation.
• In 1628, he published his
pioneering work “Anatomical
Treatise on the Movement of the
Heart and Blood in Animals”.
• This brilliant work proved the
continuous circulation of blood
within vessels and provided a
classic example of the scientific
investigation.
.
13

SEVENTEENTH and EIGHTEENTH CENTURY
ANTONIE VAN LEEUWENHOEK
( 1578-1657)
 Improved the microscope
 His many contributions
include-
-development of
techniques for examining
tissues
- description of blood cells,
spermatozoa and skeletal
muscle
14

NINTEENTH and TWEENTEENTH CENTURY
GREGORY JOHANN MENDEL (1822- 1844)
 performed experiments on plant’s hybridization
 ‘Father of Genetics’
WILHELM KONARD VON ROENTGEN (1845-1923)
 First used X-rays to detect bone fractures and assess
extent of Tuberculosis
De GRAF : described ovaries
SPALLAN ZANI : showed sperm and ovum
FRANCIS GLISSON :described liver, gall bladder, stomach,
intestine
THOMAS WILLIS : published summary of nervous system
15

NINETEENTH CENTURY
 ROBERT HOOKE -Coined the term ‘cell’
 JEAN BAPTISTE LAMARCK – observed gel like substance
with in the cell
 SCHLEIDEN and SCHWANN - put forth the cell theory
 RUDOLF VIRCHOW – worked on a book titled ‘cell pathology’
 JOHANNES MULLER – applied physics , chemistry and
psychology to the study of human body
 Henry Gray in 1858 published Gray’sAnatomy;Descriptive
and surgical. At the age of 34 he published second edition
and died of small pox.
16

HUMAN ANATOMY AND ITS MODERN
CONTENT
 Modern anatomy attempts to explain not only how the body is
formed, but to find out, why it is so formed.
 The human organism changes continuously from the time of
birth to the moment of death.
 The human species is the product of prolonged evolution.
 Anatomy, therefore, studies not only the structure of the modern
adult man, but discovers the regularities governing the structure
and development of the human body and investigates the
human organism in its historical development.
17

cont…
 There are three main points of historical
development of the human organism:
1. The development of the human genus in relations to
the evolutionary process of the lower life forms is called
phylogenesis (Gk phylon – genus, genesis –
development).
 Thus appeared comparative anatomy, which
compares the structure of various animals and man.
18

2. The formation and development of the human being
in relations to the development of society is called
anthropogenesis (Gk anthropos –human being).
3. The process of the development of individual
organism throughout life is called ontogenesis (Gk
onthos –being) and
 it is concerned with intrauterine and extrauterine
periods of development.
Cont..
19

Anatomy:
• is the science of body structures and the
relationships among them.
• The word anatomy is derived from Greek (ana- up;
-tomy- process of cutting) and
• means “to cut up” or “to cut open.”
20

Approaches to Studying Anatomy:
Three main approaches to study human gross
anatomy: regional, clinical (applied) and systemic.
1. Regional anatomy is based on the organization of
the body into parts.
2. Clinical (applied) anatomy: It deals both the
regional and the systemic approaches to
studying anatomy and stresses clinical
application.
3. Systemic anatomy is an approach to anatomical
study organized by organ systems that work
together to carry out complex functions:
21

Anatomical position - refers to
body position as if the person were
standing upright with the:
Head, eyes, and toes directed
anteriorly (forward).
Arms adjacent to the sides with
the palms facing anteriorly,
and
Lower limbs close together
with the feet parallel.
22
Anatomical Terminology

Median plane is the vertical plane passing
longitudinally through the center of the body,
dividing it into right and left halves.
Sagittal planes are vertical planes passing
through the body parallel to the median plane.
23
Planes and Sections of the Body

Frontal (coronal) planes are vertical planes passing
through the body at right angles to the median plane
– dividing it into anterior (front) and posterior (back)
portions.
Transverse planes are planes passing through the body
at right angles to the median and frontal (coronal)
planes.
– A transverse plane divides the body into superior
(upper) and inferior (lower) parts.
24
Cont…

Superior refers to a structure that is nearer the vertex,
the top most point of the cranium.
Inferior refers to a structure that is situated nearer the
sole of the foot.
Cranial relates to the cranium and is a useful
directional term, meaning toward the head or cranium.
Caudal means toward the feet or tail region,
represented in humans by coccyx.
26
Directional Terms

Posterior (dorsal) denotes the back surface of the body
or nearer to the back.
Anterior (ventral) denotes the front surface of the body.
Medial is used to indicate that a structure is nearer to the
median plane of the body.
Lateral indicates that a structure is farther away from
the median plane.
– For example, the 5th digit of the hand (little finger) is
medial to the other digits.
– The 1st digit of the hand (thumb) is lateral to the other
digits.
28
Directional Terms

Proximal means that a body part is closer to the point of
attachment or closer to the trunk. The elbow is proximal to
the hand.
Distal means that a body part is farther from the point of
attachment or farther from the trunk or torso. The hand is
distal to the elbow.
Superficial & deep describe the position of structures
relative to the surface of the body or the relationship of one
structure to another underlying or overlying structure.
29
Directional Terms

Bilateral- paired structures having right and left members
(e.g., kidneys, lungs)
Unilateral those occurring on one side only (e.g., the
spleen).
Ipsilateral - Something occurring on the same side of body
as another structure.
– E.g., the right thumb and right great toe are ipsilateral.
Contralateral means occurring on the opposite side of the
body relative to another structure.
– E.g., the left biceps brachii muscle and the right rectus
femoris muscle are contralateral.
30
Terms of Laterality

Abduction means moving
away from the median
planeAdduction means
moving toward median
plane.
– Abduction of the digits
means spreading them
apart.
–Adduction of the
digits is bringing the
spread fingers or toes
together. 31
Terms of Movement

Circumduction:
–Circular motion
without rotation
32
Terms of Movement

Pronation is a medial rotation of
forearm and hand so that the
palm faces posteriorly.
Supination is a lateral rotation of
the forearm and hand so that the
palm faces anteriorly
34
Cont…

Inversion:
– Twists sole of foot medially
Eversion:
– Twists sole of foot laterally
Dorsiflexion:
– Flexion at ankle (lifting toes)
Plantar flexion:
– Extension at ankle (pointing
toes)
35
Cont…

Flexion indicates bending or
decreasing the angle b/n the
bones or parts of the body.
Extension indicates straightening
or increasing the angle b/n the
bones or parts of the body.
36
Cont…

Protraction:
– Moves anteriorly
Retraction:
– Opposite of protraction
– Opposition:
 Thumb movement toward fingers or palm (grasping)
37
Cont…

Protrusion is a movement
anteriorly (forward) as in
protruding the mandible (chin),
lips, or tongue.
Retrusion is a movement
posteriorly (backward), as in
retruding the mandible, lips, or
tongue.
38
Cont…

Elevation:
– Moves in superior
direction (up)
Depression:
– Moves in inferior
direction (down)
39
Cont…

The upper limb consists of four segments:
1.Shoulder:
 proximal segment of the limb that overlaps
parts of the trunk
 includes the pectoral, scapular, and lateral
supra-clavicular regions
 is built on half of the pectoral girdle.
 The pectoral (shoulder) girdle is a bony
ring, incomplete posteriorly, formed by
the scapulae and clavicles and completed
anteriorly by the manubrium of the
sternum (part of the axial skeleton).

CONT…
2. Arm (L. brachium):
first segment of the free upper limb
the longest segment of the limbs
It extends between and connects the shoulder
and the elbow and is centered around the
humerus.
42

Cont…
3. Forearm
• The second longest segment of the limb.
extends between elbow and the wrist
contains the ulna and radius.
43

Cont…
4.Hand:
part of the upper limb distal to the forearm that
is formed around the carpus, metacarpus, and
phalanges.
composed of the wrist, palm, dorsum of hand,
and fingers (including an opposable thumb)
 is richly supplied with sensory endings for
touch, pain, and temperature
44

Bones of the Upper Limb contains:
 pectoral girdle
 Humerus
 Ulna and radius
 Carpal bones
 Metacarpals
 Phalanges

Bones of the Pectoral Girdle
1.The Clavicle
extends laterally and almost horizontally across
the root of the neck
extends from the manubrium of the sternum to
the acromion of the scapula.
The clavicle (collar bone) connects the upper
limb to the axial skeleton and the trunk
These curvatures increase the resilience of the
clavicle and give it the appearance of an
elongated capital “S”. 49

• has two halves:
medial half which is convex anteriorly,
lateral half is concave anteriorly
• has two ends: Medial (sternal) end
 is enlarged and triangular where it articulates
with the manubrium of the sternum at the
sternoclavicular (SC) joint.
Acromial end:
 is flat where it articulates with the acromion of
the scapula at the acromioclavicular (AC) joint

Cont…
The medial two thirds of the shaft of the clavicle
are:
Convex anteriorly
Cylinderical in crossection
Has four surfaces ( anterior, posterior, superior
and inferior)
52

Cont…
The lateral third is flattened and concave
anteriorly having:
twTo surfaces (superior and inferior)
Two borders (anterior and posterior)
1.Superior surface
–Is smooth and subcutanoues
–Is crossed by supraclavicular nerve
2.Inferior surface
•Is rough at both end 53

 The rough impression at sternal end gives
attachment to costoclavicular ligament
 The middle third of the inferior surface presents a
groove known as subclavian groove – groove for
subclavius muscle
 The lateral 3rd of the inferior surface presents conoid
tubercle and trapezoid line
 The conoid tubercle gives attachment to conoid
ligament
 The trapezoied line gives attachment trapezoid

Fracture of Clavicle
• commonly fractured bone even in the body
• caused by an indirect force transmitted from
an outstretched hand through the bones of
the forearm and arm to the shoulder during a
fall.
• The weakest part of the clavicle is at the
junction of its middle and lateral thirds.
• After fracture of the clavicle, the
sternocleidomastoid (SCM) muscle
elevates the medial fragment of bone

Cont…
• After fracture of the clavicle, the
sternocleidomastoid (SCM) muscle elevates
the medial fragment of bone
• The trapezius muscle is unable to hold up the
lateral fragment owing to the weight of the
upper limb, and thus the shoulder drops
• A fracture of the clavicle is often incomplete in
younger children
• it is a greenstick fracture
58

2. Scapula (shoulder blade)
•is a triangular flat bone that lies on the
posterolateral aspect of the thorax, overlying
the 2nd to 7th ribs and has
 Two surfaces: costal (ventral) and dorsal
 Three borders: lateral, medial and superior
borders
 Three angles: inferior, superior and lateral angles
 Three processes: spine, acromion and coracoid
processes
 Three fossae: supraspnous, infraspnous and
subscapular fossae 59

Surfaces of the scapula
 The ventral surface of the scapula is concave,
forming subscapular fossa
 The dorsal surface of the scapula is divided by the spine
into two parts (fossae):
supraspinous fossa
Infraspnous fossa
 The two fossae communicate together through
spinoglenoid
notch
61

2. Borders:
1.Medial border ( vertebral border):
 runs parallel to and approximately 5cm lateral to the
spinous processes of the thoracic vertebrae
 is the longest of the three, and extends from the
superior to the inferior angle
1. Lateral border (the axillary border)
 It begins above at the lower margin of the glenoid
cavity, and inclines obliquely downward and backward
to the inferior angle
 is made up of a thick bar of bone that prevents buckling
of this stress-bearing region of the scapula.
 is the thickest of the three
 The glenoid cavity is the primary feature of the
head.

Cont…
The shallow constriction between the head and the body
defines the neck of the scapula.
3.The superior border
 extends from the medial angle to the base of the
coracoid process
 is marked near the junction of its medial two
thirds and lateral third by the suprascapular
notch, which is located where the superior border
joins the base of the coracoid process.
64

3. The phalanges
 Each digit has three phalanges except for the first
(the thumb)
 Each phalanx has a base proximally, a shaft
(body), and a head distally
 The proximal phalanges are the largest,
 the middle ones are intermediate in size
65

Cont…
suprascapular notch is converted into a
foramen by the superior transverseligament,
and serves for the passage of the
suprascapular nerve; sometimes the ligament
is ossified
The superior border is the thinnest and
shortest of the three borders.
66

3. Angles of the scapula
1.The superor angle
 formed by the junction of the superior and vertebral
borders
 is thin, smooth, rounded, inclined somewhat
lateralward,
 gives attachment to a few fibers of the Levator
scapulæ
67

Cont…
2. The inferior angle
 thick and rough, is formed by the union of the
vertebral medial and axillary (lateral) borders
 its dorsal surface gives attachment to the Teres
major and frequently to a few fibers of the
Latissimus dorsi
68

3.The lateral angle
 is the thickest part of the bone
 sometimes called the head of the scapula.
 Has a shallow piriform, articular surface, the
glenoid cavity, which is directed lateralward
and forward and articulates with the head of
the humerus to form shoulder joint
 The surface is covered with cartilage in the fresh
state

Cont…
 its margins, slightly raised, give attachment to a
fibrocartilaginous structure, the glenoidal labrum,
which deepens the cavity
 The prominance on the upper part of glenoid
cavity is called supraglenoid tubercle- gives
origin to the long head of biceps brachii
 The rough impression below the glenoid cavity
is said to be infraglenoid tubercle - gives origin
to the long head of triceps brachii
70

3. Humerus
 the longest and largest bone of the upper
extremity
 divisible into a shaft and two ends( proximal
and distal end) Proximal end
 consists of a large rounded head joined to the
shaft by a constricted portion called the neck,
and two eminences, the greater and lesser
tubercles
72

Cont…
The Head - nearly hemispherical in form
 is directed upward, medialward, and a little
backward
 The circumference of its articular surface is
slightly constricted and is termed the
anatomical neck
 a constriction below the tubercles called
the surgical neck which is frequently the
sit of fracture
 The surgical neck is related to axillary
nerve, anterior and posterior circumflex
humeral vessels
73

The Anatomical Neck
 obliquely directed, forming an obtuse angle with
the body.
 best marked in the lower half of its circumference
 in the upper half, it is represented by a
narrow groove separating the head from
the tubercles.
 It affords attachment to the articular capsule of
the shoulder joint,
 is perforated by numerous vascular foramina.
75

The Greater Tubercle
• situated lateral to the head and lesser tubercle.
• Its upper surface is rounded and marked by
three flat impressions (SIT):
• the highest of these gives insertion to the
Supraspinatus (S)
• the middle to the Infraspinatus (I)
• the lowest to the Teres minor (T)
• The lateral surface of the greater tubercle is
convex, rough, and continuous with the lateral
surface of the body.
76

The Lesser Tubercle
 The lesser tubercle, although smaller, is more
prominent than the greater
 it is situated in front, and is directed
medialward and forward.
 Above and in front of it presents an
impression for the insertion of the tendon
of the Subscapularis
 The tubercles are separated from each other by
a deep groove, the intertubercular groove
(bicipital groove) 77

Intertubercular groove has:
A lateral lip - receives insertion of pectorals
major
A medial lip – receives insertion of teres major
The floor – receives insertion of latissimus dorsi
2. The Body or Shaft
almost cylindrical in the upper half of its
extent, prismatic and flattened from the below
 has three borders ( anterior, lateral and
medial)
 three surfaces (anterolateral, anteromedial and
posterior 78

The shaft also
has two prominent features:
 the deltoid tuberosity laterally
 the oblique radial groove (groove for radial
nerve, spiral groove) posteriorly.
 The inferior end of the humeral shaft widens as
the sharp medial and lateral supraepicondylar
(supracondylar) ridges form and then end
distally in the especially prominent medial
epicondyle and the lateral epicondyle,
providing for muscle attachment.
79

3.The distal end:
The distal end of the humerus includes:
 the trochlea
 the capitulum
 the olecranon,
 coronoid, and radial fossae, makes up the
condyle of the humerus
80

Cont…
 The condyle has two articular surfaces:
 a lateral capitulum - for articulation with the
head of the radius
 a medial, spool-shaped or pulley-like trochlea
for articulation with the proximal end
(trochlear notch) of the ulna.
81

Cont…
The following parts of the humerus are in direct
contact with the indicated nerves:
 Surgical neck: axillary nerve.
 Radial groove: radial nerve.
 Distal end of humerus: median nerve.
 Medial epicondyle: ulnar nerve.
84

Cont…
N.B. These nerves may be injured when the
associated part of the humerus is fractured
• Humeral fractures are often result in one
fragment being driven into the spongy bone of
the other fragment (impacted fracture)
85

Cont…
1.Ulna:
 a long bone, prismatic in form
 placed at the medial side of the forearm, parallel
with the radius.
 divisible into a body and two ends (proximal
and distal)
 Its upper end, of great thickness and strength,
forms a large part of the elbow-joint
87

Proximal end:
 presents two
curved processes
1.the olecranon which projects proximally
from its posterior aspect (forming the
point of the elbow) and serves as a
short lever for extension of the elbow,
2. the coronoid process is a triangular
eminence projecting forward from the
upper and front part of the ulna
88

Cont…
 two concave (articular cavities)
1.the trochlear notch:
 is a large depression, formed by the
olecranon and the coronoid process
 resembles the jaws of a crescent wrench
as it grips the trochlea of the humerus
 serves for articulation with the trochlea
of the humerus.
89

Cont…
2. Radial notches
 is a smooth, rounded concavity on the lateral side
of the coronoid process
 receives the broad periphery of the head of the
radius
 Inferior to the radial notch on the lateral surface of
the ulnar shaft is a prominent ridge, the supinator
crest
 Between it and the distal part of the coronoid
process is a concavity, the supinator fossa 90

The Body or Shaft
• is prismatic in form, and curved so as to be
convex behind and lateralward
• its central part is straight
• its lower part is rounded, smooth, and bent a
little lateralward.
• It tapers gradually from above downward, and
has three borders and three surfaces
91

The distal end
 is small, and presents two eminences
 the lateral and larger is a rounded, articular
eminence, termed the head of the ulna
 the medial, narrower and more projecting, is a
non-articular eminence, the styloid process.
92

2. Radius
• is the lateral and shorter of the two forearm
bones
• Its proximal end includes a short head,
neck, and medially directed tuberosity
• Proximally, the smooth superior aspect of
the discoid head of the radius is concave for
articulation with the capitulum of the
humerus during flexion and extension of the
elbow joint
• The head also articulates peripherally with
the radial notch of the ulna

Cont…
• the head is covered with articular cartilage.
• The neck of the radius is a constriction distal to
the head
• The oval radial tuberosity is distal to the medial
part of the neck and demarcates the proximal
end (head and neck) of the radius from the shaft
94

The distal end of the radius
• is essentially four sided when sectioned
transversely.
• Its medial aspect forms a concavity, the ulnar
notch, which accommodates the head of the
ulna.
• Its lateral aspect becomes increasingly ridge-like,
terminating distally in the radial styloid process.
• The radial styloid process is larger than the
ulnar styloid process and extends farther
distally. 96

Fractures of the radius and ulna
• Fracture of the distal end of the radius is a common
fracture in adults > 50 years of age
• occurs more frequently in women because their bones
are more commonly weakened by osteoporosis.
• A complete transverse fracture of the distal 2 cm of
the radius, called a colles fracture, is the most common
fracture of the forearm
• The distal fragment is displaced dorsally and is often
comminuted (broken into pieces). 98

Cont…
• The fracture results from forced dorsiflexion of
the hand, usually as the result of trying to ease a
fall by outstretching the upper limb.
• Often the ulnar styloid process is avulsed (broken
off).
• The fracture results from forced dorsiflexion of
the hand, usually as the result of trying to ease a
fall by outstretching the upper limb.
99

4.Bones of the hand
is composed of:
1. 8 carpal bones (carpals) arranged in two
rows (proximal and distal)
2. 5 metacarpal bones
3. 14 phalanges
101

1. Carpal bones
The proximal row of carpals (4) are the:
1. Scaphoid :
 a boat-shaped bone that articulates proximally
with the radius
 has a prominent scaphoid tubercle
 is the largest bone in the proximal row of
carpals.
102

Cont…
2. Lunate:
 a moon-shaped (semilunar) bone
between the scaphoid and the triquetral
bones
 it articulates proximally with the radius
 is broader anteriorly than posteriorly.
 is one of the most frequently dislocated bones
of the wrist region
3. Triquetrum (L. triquetrus, three-cornered):
 a pyramidal bone on the medial side of the
carpus 103

4. Pisiform (L. pisum, pea):
 a small, pea-shaped bone that lies on the
palmar surface of the triquetrum
 also known as the lentiform bone
 is a sesamoid bone since it is located within a
tendon
104

Cont…
 The distal row of carpals are:
1.Trapezium (G. trapez a four-sided bone on the
lateral side of the carpus
 it articulates with the 1st and 2nd
metacarpals, scaphoid, and trapezoid bones.
2. Trapezoid:
 a wedge-shaped bone that resembles the
trapezium
 it articulates with the 2ndmetacarpal, trapezium,
capitate, and scaphoid bones e, table): 105

Cont…
• 3.Capitate(L. caput, head):
 a head-shaped bone with a rounded extremity
and the largest bone in the carpus
 articulates primarily with the 3rd
metacarpal distally, and with the
trapezoid, scaphoid, lunate, and hamate.
106

Cont…
4.Hamate (L. hamulus, a little hook):
 a wedge-shaped bone on the medial side of
the hand
 articulates with the 4th and 5th
metacarpal, capitate, and triquetral bones
 has a distinctive hooked process, the hook
of the hamate, that extends anteriorly.
107

Fracture of the scaphoid
• The scaphoid is the most frequently fractured
carpal bone
• It often results from a fall on the palm when the
hand is abducted
• the fracture occurring across the narrow part
(waist) of the scaphoid
• Pain occurs primarily on the lateral side of the
wrist, especially during dorsiflexion and
abduction of the hand.
• Radiographs taken 10 -14 days later reveal a
fracture because bone resorption has occurred
there.
108

• Owing to the poor blood supply
to the proximal part of the
scaphoid, union of the fractured
parts may take at least 3 months.
• Avascular necrosis of the
proximal fragment of the
scaphoid (pathological death of
bone resulting from inadequate
blood supply) may occur and
produce degenerative joint
disease of the wrist
109

Cont…
 the distal ones are the smallest.
 The shafts of the phalanges taper distally.
 The terminal phalanges are flattened and
expanded at their distal ends, which underlie
the nail beds
110

2.The metacarpus:
 forms the skeleton of the palm of the hand
between the carpus and the phalanges.
 composed of five metacarpal bones
 Each consists of a base, shaft, and head.
 The proximal bases of the bone articulate with
the carpal bones
111

Cont…
 the distal heads of the bones articulate
with the proximal phalanges
 The 1stmetacarpal (of the thumb) is the thickest
and shortest of these bones.
 The 3rdmetacarpal is distinguished by a styloid
process on the lateral side of its base.
112

Joint of upper limb
• The upper limb consists of various joints that
allow for a wide range of movements, facilitating
activities such as reaching, grasping, and
manipulating objects.
• The major joints of the upper limb include the
• shoulder joint,
• elbow joint, and
• wrist joint.
114

Cont…
1. Shoulder Joint (Glenohumeral Joint):
• is a ball-and-socket joint
• formed by the head of the humerus and the
glenoid cavity of the scapula .
• It allows flexion, extension, abduction,
adduction, medial and lateral rotation, and
circumduction.
116

CONT…
2. Elbow Joint:
• The elbow joint is a hinge joint formed by
the humerus, radius, and ulna bones.
• It primarily allows for flexion and extension
of the forearm.
• The joint is supported by various
ligaments, including the ulnar collateral
ligament and radial collateral ligament.
117

CONT….
3. Wrist Joint (Radiocarpal Joint):
• is a condyloid joint formed by the radius and the
articular disc proximally, and the carpal bones
distally.
• It allows for flexion, extension, abduction, and
adduction of the hand at the wrist.
• Ligaments, such as the radial and ulnar
collateral ligaments, contribute to the stability of
the wrist joint
118

CONT…
4. Radioulnar Joints:
• There are two radioulnar joints – the proximal
radioulnar joint and the distal radioulnar joint.
• The proximal radioulnar joint allows for rotation
of the radius around the ulna, contributing to
supination and pronation of the forearm.
• The distal radioulnar joint allows for rotation of
the ulna on the radius, supporting pronation and
supination of the hand.
119

CONT..
5. Acromioclavicular Joint:
This joint is formed by the acromion process of
the scapula and the clavicle.
It allows for limited movement and plays a role
in the mobility of the shoulder complex.
6. Sternoclavicular Joint:
1.This joint is formed by the sternum and the
clavicle.
2.It allows for movement of the clavicle in
various directions, including elevation,
depression, protraction, and retraction.
120

CONT…
7. Interphalangeal Joints of the Hand:
– These joints are found between the
phalanges of the fingers and thumb.
– There are proximal interphalangeal (PIP)
joints and distal interphalangeal (DIP) joints
in each finger, allowing for flexion and
extension.
8. Metacarpophalangeal Joints:
– These joints are located between the
metacarpal bones of the hand and the
proximal phalanges.
– They allow for flexion, extension, abduction,121

Reference
• Netter F.H Atlas of human anatomy 3rd
edition.
• Moore clinically oriented human anatomy 7th
edition.
122

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