BONES OF THE UPPER LIMB OBJECTIVES To learn
BONES OF THE UPPER LIMB
OBJECTIVES To learn the bones of the upper limb Identify the bone Gross features of each bone Muscles attached to each bone Joints formed by each bone Clinical conditions associated with each bone.
Clavicle: Shape Sigmoid Convex anteriorly Concave posteriorly
Clavicle: Ligament Attachments Sternal end of clavicle to first costal cartilage: Costoclavicular ligament Conoid tubercle: Conoid portion of coracoclavicular ligament Trapezoid line: Trapezoid portion of coracoclavicular ligament
Clavicle: Muscle Attachments Deltoid Pectoralis major Trapezius Sternocleidomastoid Subclavius
CLAVICLE LONG BONE –HORIZINTALLYARTICULATES MEDIALLY –STERNUM LATERALLY --- ACROMIAN PROCESS --- SCAPULA Curved –medial 2/3 and lateral 1/3. IT HELPS IN WEIGHT TRANSMMISION CONNECTS STERNUM-----UPER LIMB KEEP THE ARM AWAY FROM THE BODY
CLAVICLE Left clavicle
OSSIFICATION (SPECIAL FEATURES) The clavicle is the first bone to ossify -- 5 th and 6 th last bones to finish ossification -21 -25 years It forms by intra membranous ossification
CLAVICLE –GROSS FEATURES Medial 2/3 and Lateral 1/3. Surface Borders
APPLIED Clavicles are the most common broken bone in the human body. It is most often fractured in the middle third of its length. Fall onto an outstretched upper extremity, direct trauma Pain on movements, swelling Shoulder droops as the muscles can not support. Infants – fracture ---difficult delivery.
FRACTURE Right clavicle -
APPLIED Compression of the brachial plexus. Mal union –---ossification centers
SCAPULA It a flat bone –triangular, overlies---2 nd 7 th vertebra Surfaces– costal – sub scapular fossa - dorsal– infra spinous , supra spinous fossa Borders – medial –parallel---5 cm. from spines. --lateral --superior Processes— acromian --- coracoid --- spine
FUNCTIONS Forms the mobile base –for upper limb Triangular, flat, curved –shape of the scapula conforms –thoracic cage. Large surface area for muscular attachment. Coraco clavicular ligament ---support the limb and helps in weight transmission
SCAPULA Left scapula
SCAPULA costal surface
APPLIED Fracture – direct trauma Winging of scapula –paralysis of serratus anterior muscle – injury to long thoracic nerve.
PARTS OF HUMERUS Head neck Shaft Lower end
PARTS Proximal end -- Head - Neck----surgical , anatomical neck Tubercle ---greater , lesser Biccipital groove
PARTS Shaft Elongated part— Deltoid tuberosity Radial groove Inferior end –widened –medial &lateral supracondylar ridges.
HUMERUS Left Humerus Anterior & posterior aspect
HUMERUS Posterior view
PARTS Distal end Trochlea , capitulum Olecranon , coronoid, radial fossa
Humerus: Anterior Surface Greater tubercle (tuberosity): Superior facet (for supraspinatus muscle) Middle facet (for infraspinatus muscle) Inferior facet (for teres minor muscle) Lesser tubercle (tuberosity): For subscapularis muscle Intertubercular groove: For latissimus dorsi muscle
Humerus: Anterior Surface Crest of greater tubercle (lateral lip): For pectoralis major muscle Crest of lesser tubercle (medial lip): For teres major muscle Radial fossa Coronoid fossa Capitulum Trochlea
ARTICULATIONS Gleno humeral joint ---scapula Elbow------radio ulnar joint.
NEURO VASCULAR BUNDLE Axillary artery Brachial artery Anterior circumflex humeral artery Posterior circumflex humeral artery Profunda brachi artery
NERVES Axillary Radial Median Ulnar
HUMERUS
NEUROVASCULAR BUNDLE Cubital fossa
AXILLARY NERVE Axilla
ELBOW JOINT Ulnar nerve
MEDIAN NERVE Supra condylar fracture
APPLIED Fracture –surgical head of the humerus (older people) Fracture of the shaft – trauma Supra condylar fracture –trauma
APPLIED Fracture –shaft
RADIUS –PROXIMAL END Lateral , shorter bone – Proximal end –head –articulates -capitulum of humerus Radial notch of ulna – Radial tuberosity
RADIUS --SHAFT Cylindrical Expands distally
RADIUS
RADIUS –DISTAL END Four sided – Ulnar notch –medial side Styloid process—lateral aspect Dorsal tubercle –dorsal aspect
RADIUS –ULNA
ULNA Medial , longer , does not participate in wrist joint. Olecranon process—articulates with Olecranon fossa Coronoid process. Tuberosity of ulna Shaft ---thick Head –small , small Styloid process. Attached with radius interosseous membrane
APPLIED—RADIUS Fracture –distal end of radius – colle’s fracture
RADIUS Colle’s fracture
Carpus Proximal row of bones (radial to ulnar): Scaphoid: Tubercle of scaphoid Lunate Triquetral Pisiform: Sesamoid bone in tendon of flexor carpi ulnaris
Carpus Distal row of bones (radial to ulnar): Trapezium Trapezoid Capitate Hamate: Hook of hamate (hamulus) Carpometacarpal joint (CMC) Metacarpals
BONES OF HAND Carpal Meta carpal Phalanges
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