Muscle and blood vessel Upper Limb Flashcards
what function muscle UL and what are the muscle
Muscles of the upper limb
• Function of the upper limb. • Grasping [prehension]
• Upper limb is divided into regions
• Pectoral region
• Axilla
• Shoulder & Back
• Arm
• Forearm
• Hand
muscle for pectoral region
- Pectoralis major 2. Pectoralis minor 3. Subclavius
- Serratus Anterior
muscle of the shoulder
This group of muscles consists of
1. Deltoid
2. Supraspinatus
3. Infraspinatus
4. Teres minor
5. Subscapularis
6. Teres major
• All are supplied by C5, C6
what is rotator cuff muscle
This group of muscles are:
• 1. Supraspinatus
• 2. Infraspinatus
• 3. Teres minor
• 4. Subscapularis
• The tendons of these muscles are fused with capsule of shoulder joint and mantain its stability
what origin an insertion deltoid
• ORIGIN – from clavicle, acromion & spine.
• INSERTION – into deltoid tuberosity of humerus.
• Nerve supply – Axillary nerve
• Action – powerful abductor of the arm
muscle of the back
Trapezius muscle
Trapezius Origin ➡️superior nuchal line, ext. occipital protruberance, ligamentum nuchae &spines of CV 7 to TV 12
Insertion➡️Lateral 3rd ofclavicle, acromion & spine of scapula
Nerve supply ➡️11th cranial nerve [aka Acessory Nerve]
Action ➡️
1. Superior fibers – elevate scapula
2. Middle fibers – retract scapula
3. Inferior fibers – depress scapula 4. Superior fibers + Inferior fibers ➡️ lateral rotation of scapula
latissimus dorsi
• Attachment. Thoracolumbar vertebrae and lumbar fascia - humerus but a small portion of it attaches to inferior angle of scapula
• Action - Swimming Muscle & involves in scapula rotation.
• Nerve- Nerve to latissimus dorsi
• Levator scapulae
• Attachment.Transverse process of
C1-C4 - Vertical border of scapula • Action Elevate/adduct scapula
• Rhomboids Minor:
• Spinal processes C7-T1
• Major: Spinal processes T2-T6 - Medial border of scapula - Retract scapula
what is axilla
Axilla:
• The cavity beneath the junction of the arm and the body, better known as the arm pit.
•It contains principal arterial trunk & nerves
• It has an apex, a base and 4 walls
what walls of the axilla -anterior
Formed by:
1. pectoralis major
2. subclavius
3. pectoralis minor muscles
what wall of axilla -posterior
- subscapularis,
- latissimus dorsi,
- teres major muscles from above down
medial wall axilla
• upper 5 ribs and intercostal spaces covered by serratus anterior muscle
lateral wall axilla
- Lateral wall:
• formed by inter-tubercular groove of humerus,
• biceps brachii and Coracobrachialis muscle
contents of axilla
Contents of axilla
1. the cords and branches of the brachial plexus
2. axillary artery and its branches
3. axillary vein and its tributaries
4. axillary lymph nodes
axillary lymph nodes
• Axillary lymph node (20-30) drain not only lymphatics of breast, but also those of pectoral region, upper abdominal wall and upper limb and are arranged in five groups.
• There are 5 groups of axillary lymph nodes.
• Anterior – lying deep to pectoralis major along the lower
border of pectoralis minor
• Posterior – along the subscapular vessels
• Lateral – along the axillary vein
• Central - in the axillary fat.
• Apical - at apex of axilla behind the clavicle
the muscle of free upper limb
• Muscles of Free Upper limb is divided into
• Muscles of the arm
• Muscles of the forearm
• Muscles of the hand
flexors (anterior compartment ) of the arm
- Biceps brachii
- Coracobrachialis
- Brachialis
The flexor muscles of the arm are supplied by the musculocutaneous nerve
biceps
origin- short head of bicep
action of flexor muscle of arm
- Biceps brachii
- Flexion of shoulder joint & elbow joint
- Strong supinator of forearm [turning of screw with slightly flexed elbow] - Brachialis
- Flexor of elbow joint - Coracobrachialis
- Flexor of shoulder joint
extensor (posterior compartment) of the arm
- Triceps brachii 2. Anconeus
The extensor muscles of the arm are supplied by radial nerve. Action
- Extension of shoulder (long head)
- Extension of elbow joint
quadrangular space
Bounded by –
Above ➡️ Teres minor
Below ➡️Teres major
Medially ➡️ Long head of
triceps
Laterally ➡️Humerus
Passes through ➡️
1. Axillary nerve
2. Posterior Circumflex
humeral vessels
posterior compartment of arm
- triceps
action – extension
nerve – radial nerve
origin tricep:
long head – infra-glenoid tubercle
Medial head- medial to spiral
groove
Lateral head- lateral to spiral groove
insertion
olecranon process of ulna
muscle of anterior compartment (flexor) of the forearm
Superficial group
1. Pronator teres
2. Fl. Carpi radialis
3. Palmaris longus
4. Fl. carpi ulnaris
5. Fl. Digitorum superficialis
6. Fl. Pollicis longus
Deep group
7. Fl. Digitorum Profundus
8.. Pronator quadratus
medial epicondyle
origin of superficial flexor and pronator muscle
anterior forearm
All the flexor muscles of the
forearm are supplied by the median nerve except flexor carpi ulnaris and medial half of flexor digitorum profundus which is supplied by the ulnar nerve.
muscle lateral compartment of the forearm
- Brachioradialis
2.Extensor Carpi radialis longus
All the lateral compartment muscles of the forearm are supplied by the radial nerve ( C 5 67)
muscle posterior compartment of the forearm
- Extensor carpi radialis brevis
- Extensor digitorum
- Extensor digiti minimi
- Extensor carpi ulnaris
- Supinator
- Abductor pollcis longus
- Extensor pollicis brevis
- Extensor pollicis longus
- Extensor indicis
All the extensor muscles of the arm & forearm are supplied by radial nerve
cubital fossa
• Definition
• It is the triangular hollow area on the anterior surface of the elbow with the apex directed distally.
• Boundaries
• Base
an imaginary line joining 2 epicondyles of humerus.
• Medial border
pronator teres muscle.
• Lateral border
brachioradialis muscle.
• Apex
- formed by meeting of the pronator teres and brachioradialis.
contents ( medial to lateral)
- Median nerve.
- Brachial artery and its vene comitantes
- Biceps tendon.
- Radial nerve (at most lateral part)
muscle of the hand
Muscles of the Hand
1. Smallmusclesofthehand
2. Short muscles of the thumb
3. Short muscles of the little finger
small muscle of the hand
- Palmaris brevis
- Lumbricals
- Interossei
short muscle of the thumb( thenar muscle)
- Flexor pollicis brevis
- Abductor pollicis brevis
- Opponens pollicis
- Adductor Pollicis
They are supplied by the median nerve except Adductor pollicis which is supplied by deep branch of ulnar nerve
short muscle of the little finger ( hypothenar muscle)
- Abd. Digiti minimi
- Flexor digiti minimi
- Opponens digiti minimi
They are supplied by the deep branch of ulnar nerve
lumbricals muscle
Lumbricals
Medial 2 lumbricals ➡️supplied by ulnar nerve
Lateral 2 lumbricals ➡️supplied by median nerve
Action ➡️Flexion of metacarpophalangeal joints & extension of interphalangeal joints
(writing position of hand)
interossei muscle- The interossei muscles are intrinsic muscles of the hand located between the metacarpals
- Dorsal interossei
- 4 in number; bipennate [larger]
- Action ➡️Dab** [nemonics]– abduction of
fingers - Palmarinterossei
- 4 in number; unipennate
- Action ➡️Pad** [nemonics]– adduction of
fingers
All interossei are supplied by ulnar nerve
arteries of upper limb sequences
Arteries of Upper limb
Sublavian artery ➡️Axillary artery ➡️Brachial artery divide 2 :
1.Radial artery ➡️ Superficial palmar arch➡️digital artery
2.Ulnar artery➡️Deep palmar arch ➡️digital artery
axillary artery
The axillary artery is the continuation of
subclavian artery
Begins – lateral border of 1st. rib.
Ends lower border of Teres major
axillary artery divide by 3
It is divided into 3 parts by pectoralis minor which passes infront of it.
1st part ➡️above the muscle
2nd part ➡️behind the muscle
3rd part ➡️below the muscle
branches axillary nerve
Branches
1st. Part
Highest thoracic artery (Supreme thoracic )
2nd. Part-
Thoracoacromial artery Lateral thoracic artery 3rd.part
Subscapular artery
Ant. Circumflex humeral
artery Posterior circumflex
humeral artery
Nemonics- S,TL, SAP
applied anatomy of axillary nerve
- The axillary artery can be palpated in the lateral wall of the axilla.
- Rupture of axillary artery can occur in reducing old dislocations in which the artery has become fixed to the capsule.
brachial artery
Brachial artery
Continuation of axillary art.
Begins – at lower border of teres major
Ends - at the level of neck of radius
Divides into – radial and ulnar arteries
[ulnar is the larger branch]
branches of brachial artery
- Muscular branches
- Nutrient artery to humerus
- Profunda Brachii artery –arises near the beginning & follows the radial nerve into the spiral groove of humerus.
- Superior ulnar collateral artery- arises near the middle of humerus & follows the ulnar nerve.
- Inferior ulnar collateral artery- arises near the termination & takes part in the anastomosis around the elbow joint.
arteries of forearm
Ulnar artery - Larger of two terminal branches of brachial artery.
Begins – in the cubital fossa at the level of the neck of the radius.
Descends through the ant. Compartment of the forearm.
Enters the palm in front of flexor retinaculum with ulnar nerve.
ulnar artery
Ulnar artery
Enters the hand superficial to flexor
retinaculum on lateral side of ulnar nerve and pisiform bone.
Ends by forming the superficial palmar arch with superficial palmar branch of radial artery
radial artery
Radial artery
Smaller br. of brachial art.
Begins – in the cubital fossa at the level of neck of radius
Course – passes downward & laterally, beneath the brachioradialis & on deep muscle of forearm.
The radial artery leave the forearm – by
winding around the lateral aspect of the wrist to reach the posterior surface.
It then leaves the dorsum of the hand by
turning forward between two heads of dorsal interosseous muscles.
On entering the palm it continues as
deep palmar arch
deep palmar arch
Is a direct continuation of the radial artery.
-Curves medially beneath the long flexors.
- is completed by deep branch of ulnar artery.
-Surface anatomy- at a level of proximal border of extended thumb
-Branches – digital branches
- arteria radialis indicis
- arteria princeps pollicis
venous drainage of upper limb
2 sets of veins
Superficial veins- lie in subcutaneous tissue.
Deep veins- accompany the arteries and have similar names.
Blood from hand __ dorsal venous network
Cephalic vein – continuation of radial side of the dorsal network –ascends along the lateral side of UL, to delto- pectoral groove & pierce the clavipectoral fascia to end in axillary vein.
cephalic vein
Cephalic vein – pierces the clavipectoral fascia & ends in axillary vein
basilic vein
Begins – continuation of ulnar side of dorsal network
Pierces – the deep fascia at the middle of arm
Ends – joins the venae comitantes of brachial artery and becomes the axillary vein.
median cubital vein
-An anastomosing channel that runs upward and medially from the cephalic to the basilic
axillary vein
Begins –at the lower border of Teres major by the union of the venae comitantes of the brachial artery and the basilic vein.
Course – runs upward on the medial side of the axillary artery.
Ends – at the lateral border of the first rib by becoming the subclavian vein.
Tributaries –cephalic vein
- branches corresponding to the branches of axillary artery
clinical application injuries
- Injuries- the arteries of Upper Limb can be damaged by penetrating wounds or require
ligation in amputation operation
clinical app pulsation felt
Axillary artery – 3rd part – in axilla
- Brachial artery – in cubital fossa on brachialis
- Radial artery - in distal part of forearm on the lateral side of Flexor Carpi Radialis Longus [FCRL].
- Ulnar artery – in front of flexor retinaculum lateral to pisiform bone
clinical app brachial artery
- Brachial artery over the cubital fossa for taking blood pressure [BP].
clinical app median cubital vein
- Median cubital vein
– separated from the brachial artery by bicipital aponeurosis. Use for taking blood sample and intravenous injection
clinical app basilic vein
- Basilic Vein
-Use in central venous catherization in angiogram because of its increasing diameter and join axillary vein not in right angle.
