Introduction to limbs Sanjaya Adikari Department of Anatomy
Introduction to limbs Sanjaya Adikari Department of Anatomy
Main topics covered • Skeleton • Superficial nerves/veins – only the important ones • Dermatomes • Muscle compartments – attachment & action of muscle groups and their innervation • Brachial plexus & lumbosacral plexus
Main topics…. • Special regions: axilla, cubital fossa, carpal tunnel, snuff box, femoral triangle, cubital fossa, gluteal region etc. • Joints with ligaments • Arterial anastomoses • Lymph drainage
Skeleton • Axial • Skull • Vertebral column & ribs • Appendicular • Limb girdles • Bones of the limbs
Upper limb
Skeleton Shoulder/pectoral girdle Arm (humerus) Fore arm (radius, ulna) Wrist (carpal bones) Hand (metacarpals, phalanges)
Superficial veins & nerves
Dermatomes
Muscles of the shoulder • Flexors • Extensors • Internal/medial rotators • External/ lateral rotators • Abductors • Adductors
Compartments of the right arm • Anterior Coracobrachialis Biceps brachii Brachialis N: musculocutaneous C 5, C 6 • Posterior Triceps N: Radial nerve C 7, C 8
Contents of the right arm compartments
Compartments of the right forearm Pronator teres………. Flexor digitorum superficialis Flexor pollicis longus Flexor digitorum profundus Pronator quadratus
Brachial plexus
Axilla Transverse section Anterior wall Posterior wall Medial wall Lateral wall Apex Floor
Cubital fossa
Anterior aspect of wrist • Median and ulnar nerves • Radial and ulnar arteries • Tendons of flexor muscles • Flexor retinaculum
Carpal tunnel Palmar branch of median nerve
Anatomical snuffbox
Hand • Dorsum • Palm
Joints with ligaments
Arterial anastomoses Anastomosis around the elbow Scapular anastomosis
Axillary lymph nodes To thoracic duct or right lymphatic duct supraclavicular apical central posterior anterior lateral
Lower limb
Skeleton Pelvic girdle Thigh (femur) Leg (tibia, fibula) Ankle (tarsal bones) Foot (metatarsals, phalanges)
Skeleton of the foot
Superficial veins & nerves
Posterior arch vein
Adductor canal perforator Below knee perforator Lateral perforator Upper medial perforator Middle medial perforator Level of medial malleolus Lower medial perforator
Dermatomes
Fascia Lata
Femoral sheath
Compartments of the right thigh Fascia lata
Innervation Anterior compartment Femoral nerve Medial compartment Obturator nerve Posterior compartment Sciatic nerve
Compartments of the right leg
Innervation Anterior compartment Deep peroneal nerve Lateral compartment Superficial peroneal nerve Posterior compartment Tibial nerve
Lumbosacral plexus
Femoral triangle
Gluteal region
Popliteal fossa Right Se. Mem Se. Tend Gastroc Biceps Popliteal surface of femur Gastroc Popliteus muscle
Foot • Dorsum • Sole
Arches of the foot Medial longitudinal arch Lateral longitudinal arch Transverse arch:
Joints with ligaments Ligaments at the knee joint Ligaments at the ankle
Trochanteric & Cruciate anastomoses
Inguinal lymph nodes • Deep inguinal nodes • Superficial inguinal nodes ‐ Vertical group ‐ Horizontal group
- Slides: 44