Upper limb musclessssssssssssssssssssssss

Dr NAMANI SATYANARAYANA
UPPER LIMB
Muscles of the Upper Limb, Cubital Fossa &
Carpal Tunnel

Learning outcomes
At the end of the lecture, students should be able to:
2.1 Describe the pectoral, scapular and shoulder
muscles.
2.2 Describe the boundaries and contents of
quadrangular space. List and explain the muscles of
anterior and posterior compartments of the arm.
2.3 Define cubital fossa and describe its boundaries &
contents. List and describe the muscles of the flexor
and extensor compartment of the forearm.
2.4 Explain the formation, contents of carpal tunnel and
its clinical significance.
2.5 List and explain the muscles of hand-thenar,
hypothenar, lumbricals and interossei.

Upper Limb: Muscles
• The upper limb is divided into shoulder, arm,
forearm, and hand.

Upper Limb: Shoulder Muscles
Muscles of the shoulder can be grouped into :
1. Muscles connecting the thoracic wall (axial skeleton)
with scapula, clavicle or to the proximal end of the
humerus - pectoralis major, pectoralis minor,
subclavius, serratus anterior
2. Muscles connecting the vertebral column (axial
skeleton) with scapula and clavicle (pectoral girdle) or
with proximal end of humerus- trapezius, levator
scapulae, rhomboids, latissimus dorsi
3. Muscles connecting the scapula and clavicle to the
humerus - the 4 rotator cuff muscles: subscapularis,
supraspinatus, infraspinatus, teres minor along with
teres major & deltoid

Group 1: Muscles connecting the thoracic wall (axial skeleton) with scapula,
clavicle or to the proximal end of the humerus

Group 2: Muscles connecting the vertebral column (axial skeleton) with
scapula and clavicle (pectoral girdle) or with proximal end of humerus

Group 3: Muscles connecting the scapula and clavicle to the humerus

Upper Limb: ROTATOR CUFF
• The rotator cuff is a group
of tendons and muscles in
the shoulder, connecting
the humerus to the
scapula.
• The rotator cuff tendons
provide stability to the
shoulder.
Muscles in the rotator cuff :
• Supraspinatus
• Infraspinatus
• Teres minor
• Subscapularis

Upper Limb: Quadrangular Space
Located in the axilla, the quadrangular space is bordered by:
• Medial: Long head of triceps
• Lateral: Humeral shaft
• Superior: Teres minor
• Inferior: Teres major
Contents
• Axillary nerve
• Posterior humeral circumflex artery

Upper Limb:
Quadrangular Space, triangular Space and
triangular interval

MUSCLES OF ARM
ANTERIOR / FLEXOR
Coracobrachialis
Biceps brachii
Brachialis
POSTERIOR / EXTENSOR
Triceps
Upper Limb: Muscles of Arm

 It’s a triangular space in
front of the elbow
 Boundaries
• Medially : by lateral border
of pronator teres
• Laterally : by medial
border of brachioradialis
• Base – by imaginary line
joining both epicondyles of
humerus
• Apex directed downwards
• Floor – formed by
brachialis and supinator
• Roof – skin, superficial
fascia, medial cubital vein
in the superficial fascia,
deep fascia and bicipital
aponeurosis
Upper Limb: Cubital Fossa

Boundary of Cubital Fossa

Contents of Cubital Fossa
• Contents : arranged from
medial to lateral –
median nerve / brachial
artery / tendon of biceps
/ radial nerve
• Importance: Blood
pressure, intravenous
injection

Upper Limb: Muscles of Forearm

FLEXOR (ANTERIOR)
COMPARTMENT
Superficial group:
• Pronator teres
• Flexor carpi radialis
• Palmaris longus
• Flexor carpi ulnaris
• Flexor digitorum
superficialis
Deep group:
• Flexor digitorum profundus
• Flexor pollicis longus
• Pronator quadratus
EXTENSOR (POSTERIOR)
COMPARTMENT
Superficial group:
• Brachio radialis
• Extensor carpi radialis longus
• Extensor carpi radialis brevis
• Extensor digitorum
• Extensor digiti minimi
• Extensor carpi ulnaris.
• Anconeus
Deep group:
• Supinator
• Abductor pollicis longus
• Extensor pollicis brevis
• Extensor pollicis longus
• Extensor indicis

Flexor: Superficial group

Flexor: Superficial & Deep group

Insertion/Tendon of FDS & FDP

Extensor: Superficial group

Extensor: Deep group

Arteries & nerves in the extensor compartment of forearm

 The anterior concavity of the carpal bones is converted
into tunnel by flexor retinaculum.
 Flexor retinaculum is a fibrous band. Its attached-
◦ Medially - pisiform and hook of hamate
◦ Laterally - tubercle of scaphoid and crest of trapezium
 Structures passing through the tunnel
◦ Tendons of long flexor muscles of forearm
◦ Median nerve – clinically important
 Clinical importance – carpal tunnel syndrome
◦ The synovial sheath surrounding the long flexor
tendons gets inflamed and swelling occurs, this leads
to the compression of median nerve causing pain and
weakness of muscle supplied by median nerve
Upper Limb: CARPAL TUNNEL

Upper Limb: Muscles of Hand
Thenar Muscles

Hypothenar Muscles

Thenar & Hypothenar Muscles

Intrinsic muscles of Hand

It’s a modified deep fascia of palm
and degenerated tendon of the
palmaris longus
• It has 3 parts
➢ Central
➢ Medial
➢ Lateral
• Functions
➢Prevents bow stringing of long
flexor tendons
➢Improves grip
➢Gives septa which sub -
divides the palm into surgical
spaces
• Clinical importance
➢ Dupuytren’s contracture
Upper Limb: Palmar Aponeurosis

 It’s a triangular depression on the radial side of wrist
 Seen clearly when the thumb is extended
 Boundaries
◦ Anteriorly – abductor pollicis longus and extensor pollicis
brevis
◦ Posteriorly – extensor pollicis longus
◦ Roof – skin, fascia, beginning of cephalic vein. The roof is
crossed by superficial branch of radial nerve
◦ Floor – styloid process of radius, scaphoid
 Content – Radial artery
Upper Limb: Anatomical Snuff Box

Upper limb musclessssssssssssssssssssssss

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