This document describes how to mark the surface anatomy of arteries, nerves, and other structures of the upper extremity. It provides landmarks and guidelines for tracing the brachial, radial, and ulnar arteries. Landmarks are also given for marking the median, musculocutaneous, radial, and ulnar nerves in both the arm and forearm. Finally, points are identified for marking the flexor retinaculum of the wrist.

1. Surface Marking of Superior
Extremity
Dr. Mushfiqul Hoque
Lecturer
Dhaka National Medical College

2. Arteries
Superior Extremity

3. Brachial Artery
Corresponds to a line by joining
the following Points:
1. A Point at the junction of
anterior one-third and
posterior two thirds of the
lateral wall of axilla, where the
pulsation of the artery is felt.
2. A point at the cubital fossa 1cm
below the bend of the
elbow just medial to the
tendon of biceps brachii.

4. Brachial Artery
• A Point at the
junction of anterior
one-third
and posterior two
thirds of the lateral
wall of axilla, where
the pulsation of the
artery is felt.

5. Brachial Artery
• A point at the cubital
fossa 1cm below the
bend
of the elbow just
medial to the tendon
of biceps brachii.

6. Radial Artery
Corresponds to a line by
joining the following Points:
1. A point in front of the elbow at the
level of the neck of the radius
medial to the tendon of the biceps
brachii.
2. The second point at the wrist
between the anterior border of
the radius laterally and the tendon
of the flexor carpi radialis medially,
where the radial pulse is
commonly felt.

7. Radial Artery
1. A point in front of the
elbow at the level of
the neck of the radius
medial to the tendon
of the biceps brachii.

8. Radial Artery
2. The second point at the
wrist between the anterior
border of the radius
laterally and the tendon of
the flexor carpi radialis
medially, where the radial
pulse is commonly felt.

9. Ulnar Artery
Corresponds to a line by joining the
following Points:
1. A point in front of the elbow at the
level of the neck of the radius
medial to the tendon of the biceps
brachii
2. A second point at the junction of
the upper one-third and lower
two-thirds of the medial border of
the forearm (lateral to the ulnar
nerve)
3. The third point lateral to the
pisiform bone

10. Ulnar Artery
1. A point in front
of the elbow at
the level of the
neck of the
radius medial to
the tendon of the
biceps brachii

11. Ulnar Artery
2. A second point
at the junction of
the upper one-
third and lower
two-thirds of the
medial border of
the forearm (lateral
to the ulnar nerve)

12. Ulnar Artery
3. The third
point lateral to
the pisiform
bone

13. Superficial Palmer Arch
Corresponds to a line by
joining the following Points:
1. A point just lateral and
distal to the pisiform bone
2. The second point medial
to the hook of the hamate
bone.
3. The third point on the
distal border of the thenar
eminence in line with the
cleft between the index
and middle fingers.

14. Nerves
Superior Extremity

15. Musculocutaneous Nerve
Corresponds to a line by joining the
following Points:
1. A point lateral to the axillary artery
3 cm above its termination
2. A point lateral to the tendon of
the biceps brachii muscle 2 cm
above the bend of the elbow. Here
it pierces the deep fascia and
continues as the lateral cutaneous
nerve of the forearm

16. Median Nerve (In the arm)
1. Mark the brachial artery. The
nerve is then marked lateral to the
artery in the upper half, and
medial to the artery in the lower
half of the arm. The nerve crosses
the artery anteriorly in the middle
of the arm

17. Median Nerve (In the Forearm)
Corresponds to a line by joining the
following Points:
1. A point medial to the brachial
artery at the bend of the elbow
2. A point in front of the wrist, over
the tendon of the palmaris longus
or 1cm medial to the tendon of
the flexor carpi radialis

18. Radial Nerve (In the arm)
Corresponds to a line by joining the
following Points:
1. The first point is at the lateral wall
of the axilla at its lower limit
2. The second point is at the junction
of the upper one third and lower
two-thirds of a line joining the
lateral epicondyle with the
insertion of the deltoid
3. The third point is on the front of
the elbow just below the level of
the lateral epicondyle 1 cm lateral
to the tendon of the biceps brachii

19. Radial Nerve (In the arm)
1. The first point is at the lateral wall
of the axilla at its lower limit
2. The second point is at the junction
of the upper one third and lower
two-thirds of a line joining the
lateral epicondyle with the
insertion of the deltoid

20. Radial Nerve (In the arm)
1. The first point is at the lateral wall
of the axilla at its lower limit
2. The second point is at the junction
of the upper one third and lower
two-thirds of a line joining the
lateral epicondyle with the
insertion of the deltoid

21. Radial Nerve (In the arm)
3. The third point is on the front of
the elbow just below the level of the
lateral epicondyle 1 cm lateral to the
tendon of the biceps brachii

22. Radial Nerve (In the forearm)
Corresponds to a line by joining the
following Points:
1. A point 1 cm lateral to the biceps
tendon just below the level of the
lateral epicondyle
2. The second point at the junction
of the upper two-thirds and lower
one-third of the lateral border of
the forearm just lateral to the
radial artery
3. The third point at the anatomical
snuff box.

23. Radial Nerve (In the forearm)
1. A point 1 cm lateral to the biceps
tendon just below the level of the
lateral epicondyle
2. The second point at the junction
of the upper two-thirds and lower
one-third of the lateral border of
the forearm just lateral to the
radial artery
3. The third point at the anatomical
snuff box.

24. Ulnar Nerve (In the arm)
Corresponds to a line by joining the
following Points:
1. A point on the lateral wall of the
axilla at its lower limit (lower
border of the teres major muscle)
2. The second point at the middle of
the medial border of the arm
3. The third point behind the base of
the medial epicondyle of the
humerus.

25. Ulnar Nerve (In the forearm)
Corresponds to a line by joining the
following Points:
1. A point on the back of the base of
the medial epicondyle of the
humerus
2. The second point lateral to the
pisiform bone.

26. Flexor Retinaculum
Superior Extremity

27. Flexor Retinaculum
Flexor retinaculum is marked by
joining the following four points
1. Pisiform bone
2. Tubercle of the scaphoid bone
3. Hook of the hamate bone
4. Crest of the trapezium.