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Upper Limb Anatomy Slides forearm , arm,
- 1. Anatomy Block The UpperLimb 1. Wrist & Hand 2. Elbow 3. Shoulder Complex SP7057 Kirsten Wing Sem 1, Week 2
- 2. 2 Housekeeping reminder InPerson Breaks *Scheduled brain break after each joint Kit (activity) Please wear the appropriate clothing. You will be asked to leave/change if you do not. So have a look around the room…. Questions Yes great! Either raise your hand, ask me in a break or e-mail me after a session. Do not disrupt others by interrupting. General, non personal questions must go into the discussion forum. Protocols Please be ontime. You must do the attendance register.
- 3. 3 Schedule Elbow 1. Bone 2. Softtissue Shoulder 1. Bone 2. Soft Tissue Wrist & Hand 1. Bone 2. Soft Tissue 1st 9.15am 2nd 10.30 3rd 13.15 break lunch Bring all together
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- 5. 5 Basic Bony UpperLimb Anatomy Ulna Radius Carpals Phalanges Metacarpals
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- 7. 7 Basic Upper LimbAnatomy Radius Ulna
- 8. Carpal bones To rememberthe carpals (lateral to medial, proximal row first) use the rhyme: 1 Scaphoid 2 Lunate 3 Triqutrium 4 Pisiform 5 Trapezium 6 Trapezoid 7 Capitate 8 Hamate 1 2 3 4 5 6 7 8 Right hand: Posterior view Silly Little Tommy Pushes Through The Car Hole Can you come up with your own???
- 9. Metacarpals and phalanges Metacarpals I-V Proximal phalangesIntermediat e phalanges Distal phalanges Distal phalanx
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- 13. 13 To remember thecarpals (lateral to medial, proximal row first) use the rhyme: 1 Scaphoid 2 Lunate 3 Triqutrium 4 Pisiform 5 Trapezium 6 Trapezoid 7 Capitate 8 Hamate Remember to include your metacarpals and phalanges This should include: Metacarpals 1-5 Proximal phalanges Intermediate phalanges Distal phalanges
- 14. 14 Bony Landmarks- Palpation • Radialstyloid • Ulna styloid • Scaphoid • Pisiform • Hook of Hamate Radial Styloid Process Ulna Styloid Process
- 15. 15 Bony Landmarks- Palpation • Bases,shafts and heads of metacarpals • Bases, shafts and heads of phalanges • 1st carpometacarpal joint • Radio-carpal joint line • RCL • UCL
- 16. 16 Key Wrist andHand Muscles Wrist Flexion Wrist Extension Wrist Ulnar Deviation Wrist Radial Deviation Flexor carpi radialis Extensor carpi radialis longus Flexor Carpi Ulnaris Flexor Carpi Radialis Flexor carpi ulnaris Extensor carpi radialis brevis Extensor Carpi Ulnaris Extensor Carpi Radialis Extensor digitorum muscle Finger Flexion Finger Extension Finger Adduction Finger Abduction Thumb opposition flexor digitorum profundus extensor digitorum interossei muscles (4) interossei muscles (4) opponens pollicis flexor digitorum superficialis extensor indicis lumbricals extensor digiti minimi lumbricals
- 17. Wrist Extension 1. ECRL 2.ECRB 3. ECU Wrist Flexion 4. FCR 5. FCU Wrist UD 1. ECU 2. FCU Wrist RD 3. ECRL 4. ECRB 5. FCR Muscles that produce the movement
- 18. Wrist Flexion +UD Flexor Carpi Ulnaris Origin Medial epicondyle of humerus, olecranon and posterior border of ulna Insertion Pisiform bone, hamate bone, base of metacarpal bone 5 Action Wrist joint: Wrist flexion, wrist adduction 18
- 19. Wrist Flexion +RD Flexor carpi radialis Origin Medial epicondyle of humerus Insertion Bases of metacarpal bones 2-3 Action Wrist joint: Wrist flexion, wrist abduction 19
- 20. Wrist Extension &UD Extensor Carpi Ulnaris Origin Lateral epicondyle of humerus, posterior border of ulna Insertion Base of metacarpal bone 5 Action Wrist joint: Hand extension and adduction 20
- 21. Wrist Extension +RD Extensor carpi radialis longus Origin Lateral supracondylar ridge of humerus, lateral intermuscular septum of arm Insertion Posterior aspect of base of metacarpal bone 2 Actions Wrist joints: Hand extension, hand abduction (radial deviation) 21
- 22. Wrist Extension +RD Extensor carpi radialis brevis Origin Lateral epicondyle of humerus (common extensor tendon) Insertion Posterior aspect of base of metacarpal bone 3 Action Wrist joints: Hand extension, hand abduction (radial deviation) 22
- 23. Wrist Extension Extensor digitorummuscle Origin Lateral epicondyle of humerus (common extensor tendon) Insertion Extensor expansions of digits 2-5 Action Metacarpophalangeal / Interphalangeal joints 2-5: Finger extension 23
- 24. 24 Remember… in orderto palpate you need to… 1. Effectively observe 2. Move the muscle if needed 3. Know where the muscle starts and ends (theory bit) 4. Only then can you be hands on!
- 25. Wrist Flexion +UD Flexor Carpi Ulnaris 25 Flex the wrist to expose the tendons
- 26. Wrist Flexion +RD Flexor carpi radialis 26 Flex the wrist to expose the tendons
- 27. Wrist Extension &UD Extensor Carpi Ulnaris 27
- 28. Wrist Extension +RD Extensor carpi radialis longus and brevis 28
- 29. Wrist Extension Extensor digitorummuscle 29
- 30. Ligament Radial Collateral Carpal Ligament Origin Radialstyloid Insertion Scaphoid tuberosity Action Limits ulna deviation
- 31. Origin Ulna styloid Insertion Palmar –Pisiform Dorsal – Triquetrium Action Limits radial deviation Ligament Ulnar Collateral Carpal Ligament
- 32. Ligament Radial (thumb side)Collateral Carpal Ligament
- 33. Ligament Ulnar (little fingerside) Collateral Carpal Ligament
- 34. Nerves Three major nervesof the area Median Nerve (Palmar branch, recurrent branch, common palmar digital branches) Ulnar Nerve (Dorsal branch, dorsal digital branches, palmar branch, superficial branch) Radial Nerve (Superficial branch) 1. Example of Median Nerve (think middle) 2. Example of Ulnar Nerve (think little finger) 3. Example of Radial Nerve (think thumb side)
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- 37. Articulations of theShoulder 4 articulations to consider at the “shoulder” 1 - Glenohumeral joint (G/H) 2 - Acromioclavicular joint (AC) 3 - Sternoclavicular joint (SC) 4 - Scapulothoracic joint All need to work in conjunction “girdle” 1 2 3 4
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- 41. 41 Scapula Palastanga, 2019 Post-lateralaspect of thorax 2nd to 7th ribs. Triangular in shape.
- 42. 42 Clavicle Palastanga, 2019 S-Shaped,curved to allow passage of blood vessels & nerves. Lateral 1/3 concave anteriorly. Medial 2/3 convex anteriorly.
- 43. 43 Sternum Palastanga, 2019 Daggershaped Manubrium- clavicular notch. Body- 2-7 ribs. Xiphoid Process.
- 44. Ligaments Sternoclavicular joint • Anteriorand posterior Sternoclavicular ligaments • Interclavicular ligament • Costoclavicular ligament Acromioclavicular joint • Superior and inferior acromioclavicular ligaments • Coracoclavicular ligament Glenohumeral joint • Glenohumeral ligaments • Transverse humeral ligament • Coracohumeral ligament • Coracoacromial ligament Other stabilising structures Glenoid labrum Long head of biceps Rotator cuff muscles
- 45. Glenohumeral joint Other stabilisers– Glenoid labrum
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- 47. 47 Clavicle Palpation 1 -Sternal notch 2 - SC joint 3 - Clavicle 4 - A-C joint 5 - Acromian process
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- 49. 49 Scapula Palpation 6 -Spine of scapula 7 - Medial border of scapula 8 - Inferior angle of scapula 9 - Lateral border of scapula
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- 51. 51 Humerus Palpation 10 -Greater tuberosity of humerus 11 - Lesser tuberosity of humerus 12 - Intertubercular (bicipital) groove 13 - Coracoid process 14 - Gleno-humeral joint line
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- 53. 53 The key musclesand what they do… Flexion Extension Adduction Abduction Medial Rotation Lateral Rotation Clav. fibres of Pec. Major. Posterior Deltoid Latissimus Dorsi Ant & Mid Deltoid Latissimus Dorsi Teres Minor Anterior Deltoid Teres Major Coracobrachi alis Supraspinatu s Coracobrachiali s Post. Deltoid Coracobrachialis Latissimus Dorsi Teres Major Rotator Cuff Teres Major Infraspinatus Biceps Brachii Pectoralis Major (sternal fibres) Pectoralis Major Pectoralis Major Triceps brachii Subscapularis Anterior Deltoid
- 54. Serratus Anterior Origin External surfacesof the upper eight (nine or ten) ribs and intercostal fascia Insertion Costal surface of the medial border of the scapula Action Protraction of scapula
- 55. Supraspinatus Origin Supraspinous fossa ofscapula Insertion Upper facet of greater tubercle of humerus Action Initiates abduction
- 56. Infraspinatus Origin Medial 2/3rds of infraspinous fossaof scapula Insertion Middle facet of greater tubercle of humerus Action Lateral rotation of humerus
- 57. Teres Minor Origin Upper 2/3rds oflateral border of the scapula Insertion Lower facet of greater tubercle of humerus Action Lateral rotation and adduction of humerus
- 58. Subscapularis Origin Medial 2/3rds of subscapularfossa Insertion Lesser tubercle of humerus Action Medial rotation, and assists adduction, of humerus
- 59. Deltoid Origin: Anterior border oflateral third of clavicle, the lateral border of acromion and the lower lip of scapular spine Insertion: Deltoid tuberosity, ½ way down the lateral aspect of the shaft of humerus Action: Abduction of humerus, also anterior fibres aid flexion and posterior fibres aid extension
- 60. Pectoralis Major Origin: Clavicular headfrom medial half of anterior surface of the clavicle. Sternal head arises from anterior surface of manubrium, sternum, upper six costal cartilages and anterior aspect of rectus sheath. Insertion: Lateral lip of the intertubercular groove Action: Flexion, Horizontal Adduction and internal rotation of humerus
- 61. Latissimus Dorsi Origin: Spinous processesand supraspinous ligaments of T7 to T12, spines of all lumbar and sacral vertebrae via thoracolumbar fascia, posterior part of the iliac crest and the lower four ribs Insertion: floor of the intertubercular groove of humerus Action: Extension, adduction and medial rotation of humerus
- 62. Triceps Origin: Long head -infraglenoid tubercle of the scapula Medial head - posterior surface of the humerus Lateral head - lateral border of the humerus Insertion: Upper surface of olecranon process of ulna Action: Elbow extension and long head assists extension of humerus at the shoulder
- 63. Biceps Brachii Origin Short head- Tip of the coracoid process Long head - Supraglenoid tubercle Insertion Posterior aspect of the radial tuberosity Action Forearm flexion and supination, long head assists shoulder flexion Short head Long head
- 64. Trapezius Origin Medial-third of thesuperior nuchal line,, the ligamentum nuchae and the tips of the spinous processes and intervening supraspinous ligaments from C7 to T12 Insertion superior fibers attach to posterior border of the lateral-third of the clavicle; the middle fibers pass horizontally to attach to the crest of the scapular spine; the inferior fibers attach to a tubercle at its lateral apex Action Retraction, elevation and depression of scapula, also cervical extension and side flexion
- 65. Rhomboids Origin spinous processes andintervening supraspinous ligaments of T2 to T5. Insertion Medial border of the scapula between base of spine and inferior angle Action Medial rotation and retraction of the scapula
- 66. Pectoralis Minor Origin: Outer surfaceof the 3rd, 4th and 5th ribs Insertion: Tip of coracoid process Action: Protraction and depression of scapula
- 67. Teres Major Origin: Inferior angleand the adjacent lateral border of the scapula Insertion: Medial lip of the intertubercular groove Action: Extension, adduction and medial rotation of the humerus
- 68. Coracobrachialis Origin: tip of thecoracoid process Insertion: medial aspect of the mid shaft of the humerus Action: Flexion and horizontal adduction of humerus
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- 77. Radius and Ulna(antero- medial view) Head Radial Tuberosity RADIUS Ulna Tuberosity Coronoid Process Olecranon Process Anterior Border Anterior Border Trochlea Notch Neck ULNA Interosseous Border Styloid process Styloid process Head
- 78. Radius and Ulna(postero- lateral view) Supinator Crest Posterior Border Ulna Notch Posterior Border Head RADIUS Olecranon Process Neck ULNA Interosseous Borders Styloid process Styloid process
- 79. 79 Radius and Ulna Head Radial Tuberosity RADIUS UlnaTuberosity Coronoid Process Olecranon Process Trochlea Notch ULNA
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- 81. Elbow Joint(s) 3 articulationsmake up the elbow complex 1- Humero-ulna Joint 2 - Humero-radial Joint 3 - Superior Radio-Ulna Joint 1 2 3
- 82. 82 Joint Capsule Continuous withSuperior Radio- Ulnar Joint. Thin anteriorly & posteriorly but reinforced by Collateral ligaments. Anteriorly: Coronoid & Radial Fossa to Cornoid Process & Annular ligament. Posteriorly: Olecranon process to Annular ligament. (Palastanga & Soames, 2012)
- 83. Humero-ulna joint • Synovialhinge joint • Troclea of humerus articulates with trochlea notch of ulna • Allows flexion and extension
- 84. Humero-radial joint • Synovialhinge joint • Capitulum of humerus articulates with head of radius • Allows flexion and extension • Often not considered a “true” joint
- 85. Radio-ulna joint (s) •Synovial Joint • Articulation between head of radius and radial notch on of ulna • Annular ligament forms ring around head of radius, attaches to ant & post of radial notch • Allows pronation and supination
- 86. 86 Elbow Ligaments Ulnar CollateralLigament: Thick triangular band. Anterior, Medial Epicondyle to Coronoid Process. Posterior, Medial Epicondyle to Medial Olecranon Process. Both united by intermediate band. (Palastanga & Soames, 2012)
- 87. 87 Elbow Ligaments (Palastanga &Soames, 2012) Radial Collateral Ligament: Strong, triangular. Inferior Lateral Epicondyle (deep to extensor tendons) to Annular ligament. Less distinctive than UCL.
- 88. 88 Radio-Ulna Ligament Annular Ligament: Strong,triangular. Inferior Lateral Epicondyle (deep to extensor tendons) to Annular ligament. Less distinctive than UCL.
- 89. 89 The key musclesand what they do… Flexion Extension Supination Pronation Biceps (already covered) Triceps (already covered) Biceps (already covered) Pronator teres Brachioradialis Anconeus Supinator Pronator quadratus FCR Brachioradialis Brachioradialis FCU Palm Long Pronator Teres Brachilais
- 90. Brachioradialis Origin Upper 2/3rds of thelateral supracondylar ridge of the humerus Insertion base of the styloid process of radius Action Elbow flexion
- 91. Brachialis Origin Anterior surface ofthe distal half of the humerus Insertion Anterior surface of the coronoid process Action Elbow Flexion
- 92. Anconeus Origin Distal facet onthe lateral epicondyle of humerus Insertion Proximal quarter of the posterio lateral aspect of the ulna Action Assists elbow extension
- 93. Pronator teres Origin Humeral head- Immediately proximal to the medial epicondyle Ulnar head - Medial aspect of the coronoid process Insertion Half way along the lateral surface of the radial shaft Action Pronation of forearm and assists elbow flexion
- 94. Pronator quadratus Origin Anterior aspectof the distal quarter of the ulna Insertion Anterior aspect of the distal radius Action Pronation of forearm
- 95. Supinator Origin Superficial head -lateral epicondyle, radial collateral and annular ligaments of elbow Deep head - from the supinator crest and fossa of ulna Insertion Lateral aspect of proximal 1/3 of radius Action Supination of the forearm
- 96. 96 Other Structures Nerve Supply Musculocutane ous, median, radial & ulnar nerves (C5,6,7,8) Blood Supply Brachial Artery and branches.
- 97. 1) Lateral SupracondylarRidge 2) Medial Supracondylar Ridge 3) Olecranon Fossa 4) Medial Epicondyle 5) Lateral Epicondyle 6) Capitulum 7) Olecranon 8) Trochlea 9) Coronoid Process of Ulna 10) Superior Radioulnar Joint 11) Head of Radius 12) Neck of Radius 13) Tuberosity of Radius 14) Ulna
- 99. Remember position forpalpations…
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- 102. Pronator teres Pronatorquadratus
- 103. Ligaments and jointlines UCL (medial) RCL (lateral) Annular (inferior lateral epicondyle) Proximal and distal!
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- 106. 106 Lunate (the big oneon the pinky side) Scaphoid (the big one on the thumb side) Trapezium (the big one that i9s next to the thumb) Pisiform (the sticky out one)
- 107. Metacarpals and phalanges • Digitsare described (from lateral to medial) • Each metacarpal and phalanx has a base, shaft and head • Thumb has proximal and distal phalanges • Other digits have proximal, intermediate and distal phalanges Base Shaft Head B S H B S H B S H
- 108. Movements at thewrist
- 109. Movements of theMidcarpal Joint
- 110. Radiocarpal and Midcarpaljoint Combine to give following ranges: Movement Radiocarpal joint Midcarpal joint Total Flexion 50° 35° 85° Extension 35° 50° 85° Abduction (Radial dev.) 7° 8° 15° Adduction (Ulna dev.) 30° 15° 45°
- 111. Movements of theThumb Combined movements allow approximately: Movement Range Flexion 0 (+90° at IP) Extension 80° (+10° at IP) Abduction 80° Adduction 0° Opposition Touch 5th MCP
- 112. Muscles of thethumb
- 113. Nerves Three major nervesof the area Median Nerve (Palmar branch, recurrent branch, common palmar digital branches) Ulnar Nerve (Dorsal branch, dorsal digital branches, palmar branch, superficial branch) Radial Nerve (Superficial branch) 1. Example of Median Nerve (think middle) 2. Example of Ulnar Nerve (think little finger) 3. Example of Radial Nerve (think thumb side)
- 114. How to rememberthe flexors
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- 116. References Cael, C. (2010) FunctionalAnatomy Philadelphia: Lippincott Williams & Wilkins Drake, R.L, Vogl, W. and Mitchell, A.W.M. (2005) Gray’s Anatomy for Students Philadelphia; Elsevier Primal Pictures CD-Rom (2003) Palastanga, N. and Soames, R. (2012) Anatomy and Human Movement (6th Ed) Edinburgh; Butterworth Heinemann.
- 117. Anterior View- findme on a skeleton? Head Anatomical Neck Lesser Tuberosity Shaft Medial Supracondylar Ridge Medial Epicondyle Greater Tuberosity Intertubercular Groove Surgical Neck Deltoid Tuberosity Radial Fossa Lateral Epicondyle Capitulum Coronoid Fossa Troclea
- 118. Posterior View Head Anatomical Neck Shaft Lateral Supracondylar Ridge MedialEpicondyle Greater Tuberosity Surgical Neck Deltoid Tuberosity Radial Groove Lateral Epicondyle Olecranon Fossa
- 119. Anterior View- findme on a skeleton? Acromion Glenoid Fossa Glenoid Margin Subscapular Fossa Coracoid Process Superior Border Lateral Border Medial Border Inferior Angle Neck of Glenoid Supraglenoid Tubercle
- 120. Posterior View Spine Superior Angle Supraspinous Fossa Lateral BorderMedial Border Angle of Acromion Neck of Glenoid Infraglenoid Tubercle Inferior Angle Infraspinous Fossa Glenoid Margin
- 121. The Clavicle- AnteriorView Acromion Articular Facet Trapezoid Line First Rib Articular Facet Deltoid Tubercle Anterior Border Sternal Articular Facet Inferior Surface Superior Surface Impression for Costoclavicular ligament
- 122. Medial View Deltiod Tubercle Superior Surface Posterior Border First RibArticular Facet Sternal Articular Facet Groove for Subclavius Muscle
- 123. Glenohumeral joint Dynamic Stability RotatorCuff Muscles • Supraspinatus • Infraspinatus • Teres Minor • Subscapularis Rotator cuff interval Supported by ligaments and tendons
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- 127. Movement Pure ROM (approx) ROM (approx) Muscles Flexion90o-100o 180o Clav. fibres of Pec. Major. Anterior Deltoid, Coracobrachialis Extension 70o 90o Posterior Deltoid Teres Major, Latissimus Dorsi Abduction 120o 180o Ant & Mid Deltoid Supraspinatus, Rotator Cuff Adduction 50o-75o Latissimus Dorsi Coracobrachialis, Teres Major Medial Rot. Lateral Rot. 60o-100o 80o-90o Subscapularis Teres Major, Pectoralis Major Latissimus Dorsi Infraspinatus Teres Minor, Post. Deltoid
- 128. Muscles acting overthe shoulder Scapula Stabilisers - Serratus Anterior - Trapezius (upper, middle and lower fibres) - Rhomboids Rotator cuff - Supraspinatus - Infraspinatus - Teres minor - Subscapularis Other Key Movers Deltoids (anterior, posterior and middle) Pectoralis major (sternal and clavicular fibres) Latissimus dorsi Teres Major Triceps (working over the shoulder) Biceps (Long head) Coracobrachialis Pec Minor
- 129. Sternoclavicular joint Costoclavicular ligament Origin Inferiorsurface of proximal end of clavicle Insertion Superior surface of 1st rib and costal cartilage Action Limits elevation of clavicle Supports inferior joint capsule
- 130. Acromioclavicular joint Superior &inferior acromioclavicular ligaments Origin Superior and inferior surfaces of distal clavicle Insertion Superior and inferior surfaces of medial acromion Action Strengthen joint capsule
- 131. Acromioclavicular joint Coracoclavicular ligament Origin Coracoidprocess Insertion Inferior surface of clavicle 2 parts Conoid & Trapezoid Action Limit superior translation of clavicle against scapula (at AC joint) Conoid Trapezoid
- 132. Glenohumeral joint Superior glenohumeralligament Origin upper pole of glenoid cavity and base of coracoid process Insertion superior to lesser tuberosity Action prevent posterior and inferior translation of humeral head
- 133. Glenohumeral joint Middle glenohumeralligament Origin glenoid labrum and scapular neck Insertion anterior aspect of anatomic neck of the humerus Action Limits external rotation
- 134. Glenohumeral joint Inferior glenohumeralligament Origin Inferior part of glenoid rim Insertion Lower part of anatomical neck of humerus Action Limits abduction of humerus
- 135. Glenohumeral joint Coracohumeral ligament Origin Lateralaspect of base of coracoid process Insertion Greater tuberosity of humerus Action Strengthens joint capsule in rotator cuff interval
- 136. Glenohumeral joint Coracoacromial ligament Origin Coracoidprocess Insertion Acromion process Action Prevent superior translation of humerus
- 137. Glenohumeral joint Transverse humeralligament Origin Greater tuberosity Insertion Lesser tuberosity Action Turns inter-tubercular groove into a tunnel to accommodate biceps tendon
- 138. Movements of theshoulder complex Flexion Pectoralis Major (Clavicle fibres) Anterior fibres deltoid Coracobrachiarlis Biceps Brachii (+ lateral rotator of the scapula) Extension Posterior fibres of the deltoid Teres Major Latissimus Dorsi Pectoralis Major (sternal fibres) Triceps brachii (+ medial rotators of scapula)
- 139. Movements of theshoulder complex Abduction Supraspinatus (initiates abduction) Deltoid (+lateral rotators of the scapular) Adduction Pectoralis Major Latissimus Dorsi Teres Major Coracobrachiarlis (+medial rotators of scapula)
- 140. Movements of theshoulder complex Medial Rotation Pectoralis Major Teres Major Latissimus Dorsi Subscapularis Anterior Deltoid Lateral Rotation Infraspinatus Teres Minor Posterior Deltoid
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- 142. 142 Humerus Medial/Lateral Epicondyle. Radial/Coronoid Fossa Capitulum (radius) Trochlea (ulna)
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- 144. 144 Cael, 2010 Ligaments ofthe Elbow Region: Anterior View
- 145. 145 Ligaments of theElbow Region: Posterior View Cael, 2010
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- 147. 1) Lateral SupracondylarRidge 2) Medial Supracondylar Ridge 3) Olecranon Fossa 4) Medial Epicondyle 5) Lateral Epicondyle 6) Capitulum 7) Olecranon 8) Trochlea 9) Coronoid Process of Ulna 10) Superior Radioulnar Joint 11) Head of Radius 12) Neck of Radius 13) Tuberosity of Radius 14) Ulna
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- 149. 149 Carrying Angle Line ofHumerus & Forearm are not the same. Forearm abducted at angle, why? Medial edge of Trochlea projects approx. 6mm below the lateral edge. Typically Females have larger angles. Masked in full flexion & in pronation of the extended forearm.
- 150. References Cael, C. (2010) FunctionalAnatomy Philadelphia: Lippincott Williams & Wilkins Drake, R.L, Vogl, W. and Mitchell, A.W.M. (2005) Gray’s Anatomy for Students Philadelphia; Elsevier Primal Pictures CD-Rom (2003) Palastanga, N. and Soames, R. (2012) Anatomy and Human Movement (6th Ed) Edinburgh; Butterworth Heinemann.
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- 154. Please complete thefollowing two diagrams and bring a permanent marker (something that will stick to a rubber glove) All the bones of the hand remember your marker 154 Anatomy
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- 157. 157 The key musclesof the hand. Mix and Match Task (11) Metacarpal muscles Thenar muscles Hypothenar muscles
- 158. 158 The key musclesof the hand. Mix and Match Task (11) Metacarpal muscles Thenar muscles Hypothenar muscles Dorsal interossei Abductor pollicis brevis Abductor digiti minimi Palmar interossei Adductor pollicis Flexor digiti minimi Lumbricals Flexor pollicis brevis Opponens digiti minimi Opponens pollicis Palmaris brevis
- 159. 159 The ligaments… Ligament AttachmentsFunction Notes Glenohumeral ligaments Coracoclavicular ligament Coracoacromial ligament
- 160. 160 The key musclesand what they do… Flexion Extension Adduction Abduction Medial Rotation Lateral Rotation Clav. fibres of Pec. Major. Posterior Deltoid Latissimus Dorsi Ant & Mid Deltoid Latissimus Dorsi Teres Minor Anterior Deltoid Teres Major Coracobrachi alis Supraspinatu s Coracobrachiali s Post. Deltoid Coracobrachialis Latissimus Dorsi Teres Major Rotator Cuff Teres Major Infraspinatus Biceps Brachii Pectoralis Major (sternal fibres) Pectoralis Major Pectoralis Major Triceps brachii Subscapularis Anterior Deltoid
Editor's Notes
- #25 https://www.youtube.com/watch?v=LfTb0MP7e-8
- #26 https://www.youtube.com/watch?v=LfTb0MP7e-8
- #28 https://learnmuscles.com/blog/2016/12/06/causes-tennis-elbow/
- #42 S-Shaped, curved to allow passage of blood vessels & nerves. Lateral 1/3 concave anteriorly. Medial 2/3 convex anteriorly. Inferiorly: Costoclavicular Ligament. Subclavian Groove Coracoclavicular Ligament
- #43 Dagger shaped Manubrium- clavicular notch. Body- 2-7 ribs. Xiphoid Process.
- #72 We can’t directly palpate subscap
- #82 Collateral= outside...medial and lateral ANTERIORLY: blends with some fibres of brachialis (flexes elbow POSTERIORLY: reinforced by RCL, encircles head of radius, allows radius to rotate (pro/sup)
- #85 Proximal and distal
- #86 UCL- fans out from medial epicondyle reinforces med/lat aspects of the joint capsule
- #89 Ant. View: Medial Epicondyle common flexor tendon origin important muscles are FCR + FCU + FDS (Palmaris longus absent in about 14% of population – hook hand and wrist/grip – medial epicondyle to distal half flexor retinaculum and palmar aponeurosis) FCU – two heads humeral attachment at medial epicondyle of the humerus and ulnar head at olecranon and posterior border of proximal 3rd of ulna pisiform, hook of hamate and base of 5th metacarpal FCR – Medial epicondyle of humerus base of 2nd metacarpal FDS – two heads: humeroulnar head from medial epicondyle of humerus, UCL and coronoid process + radial head from superior half of ant. Radius to bodies of 2nd-4th phalanges (THESE ACT OVER THE WRIST) Over the elbow: Biceps Brachii – Two heads – Long head from superior glenoid tubercle and short head from tip coracoid process radial tuberosity. Brachialis ant. Distal half of humerus anterior surface of coronoid process Brachioradialis Upper 2/3rds of the lateral supracondylar ridge of the humerus styloid process of distal radius Pronator Teres Humeral head - Immediately proximal to the medial epicondyle + Ulnar head - Medial aspect of the coronoid process Half way along the lateral surface of the radial shaft Supinator Lateral epicondyle of humerus RCL/AL + supinator fossa lateral aspect of proximal 3rd of radius
- #96 ROM of elbow flexion 150 degrees limiting factors bicep
- #127 This will help with SP4041
- #142 Medial epicondyle larger than lateral Trochlea- medial aspect/more extensive Capitulum- rounded surface Fossas on the olecranon and cornoid
- #149 5-15 degrees
- #151 Sternal and clavicular heads of sternomastoid Clavicular and acromial attachments of trapezius Sternal and clavicular heads of pectoralis major, and laterally to outer lip of bicipital groove. Clavicular and acromial attachments of deltoid: distally to midshaft humerus. Pectoralis minor Coracobrachialis: distally to medial humeral midshaft Short head of biceps Supraspinatus Subscapularis Long head of triceps Latissimus dorsi: rotates around teres major to floor of bicipital groove Teres major Brachioradialis Brachialis Extensor carpi radialis longus Common extensor origin Pronator teres: distally to lateral radial midshaft Common flexor origin Flexor digitorum superficialis: distal split onto middle phalanx Supinator: from lateral ulna around posterior aspect of upper radius Ulnar head of pronator teres Radial attachment of biceps Flexor digitorum profundus: to distal phalanx Flexor pollicis longus: to base of distal phalanx Pronator quadratus: between adjacent radius and ulna Flexor carpi ulnaris Abductor pollicis longus Tendons of extensor carpi radialis longus and brevis Extensor pollicis brevis Extensor pollicis longus
- #152 Sternal and clavicular heads of sternomastoid Trapezius Brachial plexus Subclavian artery Sternal and clavicular heads of pectoralis major Deltoid Axillary artery Biceps, short head Biceps, long head Serratus anterior Median nerve Radial nerve Brachial artery Common flexor origin Brachioradialis Pronator teres Biceps tendon and aponeurosis Flexor carpi ulnaris Flexor carpi radialis Ulnar artery Radial artery Palmaris longus, overlying median nerve at wrist Ulnar nerve Thenar muscles Hypothenar mus
- #154 Stickers session
- #157 Match the words into the table Abductor pollicis brevis: Thumb abduction Adductor pollicis: Thumb adduction Abductor digiti minimi: Abduction, flexion and extension of little finger Flexor digiti minimi: Flexion, lateral rotation and opposition of little finger Opponens digiti minimi: Flexion, lateral rotation and opposition of little finger Palmaris brevis: Tightens palmar aponeurosis, tightens grip Dorsal interossei: flexion and extension of fingers 2-4 Palmar interossei: flexion and extension of fingers 2, 4 & 5 Lumbricals: flexion and extension of fingers 2-5 Flexor pollicis brevis: Thumb flexion Opponens pollicis: Thumb opposition
- #158 Match the words into the table Abductor pollicis brevis: Thumb abduction Adductor pollicis: Thumb adduction Abductor digiti minimi: Abduction, flexion and extension of little finger Flexor digiti minimi: Flexion, lateral rotation and opposition of little finger Opponens digiti minimi: Flexion, lateral rotation and opposition of little finger Palmaris brevis: Tightens palmar aponeurosis, tightens grip Dorsal interossei: flexion and extension of fingers 2-4 Palmar interossei: flexion and extension of fingers 2, 4 & 5 Lumbricals: flexion and extension of fingers 2-5 Flexor pollicis brevis: Thumb flexion Opponens pollicis: Thumb opposition