This document provides an overview of the upper limb and pectoral region. It begins by introducing the upper limb, which develops from the anterior body wall and divides into the shoulder, arm, forearm, and hand. The muscles of the upper limb are arranged in anterior and posterior compartments. The pectoral region contains the pectoralis major, pectoralis minor, subclavius, and serratus anterior muscles. It describes the anatomy of the pectoralis major and minor muscles as well as the mammary gland, its parts, blood supply, and lymphatic drainage. Key bones, fascia, and neurovasculature of the pectoral region are also summarized.
Bones of the Foot: Tarsals, Metatarsals and Phalanges · The Femur · The Patella · The Tibia · The Fibula.
The femur is the only bone in the thigh and the longest bone in the body.
It acts as the site of origin and attachment of many muscles and ligaments, and can be divided into three parts; proximal, shaft and distal.
Bones of the Foot: Tarsals, Metatarsals and Phalanges · The Femur · The Patella · The Tibia · The Fibula.
The femur is the only bone in the thigh and the longest bone in the body.
It acts as the site of origin and attachment of many muscles and ligaments, and can be divided into three parts; proximal, shaft and distal.
Anatomy of ankle and foot is described briefly with clinical importance and photos.
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The tibiofibular joints are a set of articulations that unite the tibia and fibula. These two bones of the leg are connected via three junctions; The superior (proximal) tibiofibular joint - between the superior ends of tibia and fibula. The inferior (distal) tibiofibular joint - between their inferior ends.
Anatomy of ankle and foot is described briefly with clinical importance and photos.
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The tibiofibular joints are a set of articulations that unite the tibia and fibula. These two bones of the leg are connected via three junctions; The superior (proximal) tibiofibular joint - between the superior ends of tibia and fibula. The inferior (distal) tibiofibular joint - between their inferior ends.
Shoulder girdle and brachial plexus anatomyJunaid Ahmad
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A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
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June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
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Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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3. Introduction to upper limb
• Limbs are outgrowth of
anterior part of body wall
• Rotation occurs at 7th week
4. Introduction to upper limb
• Divided into
– Shoulder
• Pectoral
• Scapular
• Axilla
– Arm
– Forearm
– Hand
5. Arrangement of muscles
• Arranged in 2 groups
– Anterior compartment
– Posterior compartment
• A few muscles of
posterior compartment
occupy anterolateral
side in forearm
• No muscles in
posterior compartment
Hand
7. Pectoral region
• Surface landmarks
– Clavicle
– Jugular notch
– Sternal angle
– Epigastric fossa
– Midclavicular line
– Infraclavicular fossa
– Coracoid process
– Acromion process
– Nipple
– Midaxillary line
8. Skin
• Dermatome
– Area of skin supplied by
• An individual spinal nerve
– In trunk dermatome arranged
• Successive Horizontal strip
– Unusual in pectoral region
• In upper part of chest
– Upto sternal angle
• C3 & C4
– But below sternal angle
• T2
• Why this overlap
– Upper ;imb is developed from
C5-T1
13. Pectoral fascia
• Deep fascia of pectoral region
• Covers pectoralis major
• Attachment
– Medially
• Sternum
– Superorlaterally
• Deltoid fascia
– Inferiorly
• Merges with rectus sheath
– Laterally
• Axillary fascia
16. Pectoralis major
• Origin
– 2 heads
• Clavicular head
– From medial ½ of the front of the
clavicle.
• Sternocostal head
– Sternum
– Upper 6 costal cartilages.
• Aponeurosis of external oblique muscle
• Insertion
– Lateral lip of bicipital groove
• Upper fibres in lower part
• Lower fibres in upper part
17. Pectoralis major
• Deltopectoral groove
– Intermuscular groove
– Upper part of Pectoralis major is
near to Deltoid
– A gap between
• Deltoid & pectoralis major
• Structures traversing
– Cephalic vein
– Deltoid branch of
• Thoracoacromial artery
– Deltopectoral lymph node
• Drain lymph from
– Superficial tissue of upper limb along
cephalic vein (including thumb)
18. Pectoralis major
• Nerve supply
– Lateral pectoral
• Pierces clavipectoral fascia
– Medial pectoral nerve
• Pierces pectoralis major muscle
• Action
– Medial rotation & adduction of arm
19.
20. Pectoralis minor
• Origin
– 3rd, 4th & 5th ribs
• Close to their costal cartilages
• Insertion
– Coracoid process
• Nerve supply
– Medial pectoral nerve
• Action
– Depression of shoulder
• Draw the ribs upward and
outwards during deep
inspiration
21. Relations
• Anteriorly
– Pectoralis major
– Interpectoral nodes
• Posteriorly
– Axillary artery (2nd part)
– Axillary vein
– Cords of brachial plexus
• Lower border
– Lateral thoracic vessels
– Anterior group of axillary
lymph nodes
• Tail of breast
22. Subclavius
• Origin
– 1st rib
• At its junction with 1st costal cartilage
• Insertion
– Subclavian groove
• At middle 3rd of inferior surface of
clavicle
• Nerve supply
– Nerve to subclavius
• From upper trunk of brachial plexus
• Action
– Fixes the clavicle during
movement of shoulder joint
24. Clavipectoral fascia
• Location
– In anterior wall of axilla
• Deep to pectoralis major (clavicular
part)
• Vertical extent
– Above
• Clavicle
– Below
• Axillary fascia
• Suspensory ligament of axilla
– Clavipectoral fascia
• Below pectoralis minor
• Maintains concavity of axilla
• Encloses
– 2 muscles
• Subclavius
• Pectoralis minor
25.
26. Horizontal extent
• Medial
– Costoclavicular ligament
– First 2 external intercostal
membrane
• Lateral
– Coracoid process
– Coracoclavicular ligament
• Costocoracoid ligament
– Upper thickened part
– Extend
• First costochondral junction
• Coracoid process
27. Structures piercing
• Lateral pectoral nerve
– From lateral cord
• Thoraco- acromial artery
– Branch from 2nd part of axillary
• Cephalic vein
– Into axillary vein
• Few lymph vessels
– From
• Breast to apical group of axillary
lymph node
29. Serratus anterior
• Origin
– Upper eight ribs
• Insertion
– Medial border and inferior angle of
scapula
• Anterior aspect
• Nerve supply
– Long thoracic nerve
• Action
– Draws the scapula forward
(protrusion, in boxing)
8
6
4
2
30. Long thoracic nerve
• Otherwise
– Nerve of Bell
• Arises from
– Roots of brachial plexus
• Root value
– C5, C6 & C7
• Protected by
– Deep fascia
– Not injured during surgery at
axilla
31. Winging of scapula
• Paralysis of serratus anterior
• Medial margin of scapula
becomes prominent
• Why
– Protraction of scapula is by
serratus anterior
• In the absence of action of serratus
• Rhomboideus retract
• So medial margin prominent
43. Age changes
• Appearance of milk ridge – 7th week of IUL
• Nipple appears just before birth
• Lactiferous ducts without alveoli –till
puberty
• Deposition of fibrofatty tissue – puberty
• Proliferation of parenchyma –pregnancy
• Alveoli shrink – after lactation
• Atrophy of skin & fibrous tissue – old age
