Osteology and Circulation of the upper limb Flashcards
Identify all of the bones of the upper limb
1) Clavicle
2) Scapula
3)Humerus
4) Radius
5) Ulna
6) Carpals
7) Metacarpals
8) Phalanges
Describe the shape of the clavicle
S shaped - It curves anteriorly and then posteriorly before coming to its distal end where it attaches to the acromion of the scapula
Describe the superior and inferior surface of the clavicle
- Smooth superior surface
- Rough inferior surface- roughened by the attachments of ligaments
What are the facets on the clavicle?
Facets for articulation:
- Round proximal end(sternal end) - Sternal facet
- Flat distal end (Acromial end (of the scapula)) - Acromial facet
Describe the sternoclavicular joint
- Sternoclavicular joint at the medial end: ( only junction between the upper limb and the axial skeleton) where the clavicle articulates with the sternum
- Very strong ligaments
- Fibrocartilage lined joint
- Articular disc
- Interclavicular ligament
Describe the acromioclavicular joint
- Acromioclavicular joint at the lateral end where the clavicle articulates with the scapula
- Coracoclavicular ligament :
- Trapezoid Ligament
- Conoid ligament
- Acromioclavicular ligament
- Coracoclavicular ligament :
Where is the clavicle most likely to fracture?
In the middle third of the clavicle
Name the angles of the scapula
- Superior
- Inferior
- Lateral
Name the fossae of the scapula
- Supraspinous
- Infraspinous
- Subscapular
Name the three borders of the scapula
- Medial
- Lateral
- Superior
Describe the proximal humerus
- Head
- Two tubercles
- Two necks
- Anatomical neck: Where the epiphyseal plate was
- Surgical neck: Where many fractures occur
- Lumps and bumps for muscle attachment
Describe the humerus
- Two tubercles at which muscle attach
- Inter-tubercular sulcus
- Medial and lateral lips
- Lumps, bumps and lines for muscle attachment
- Fractures: Closely associated neurovascular structures
- Mid shaft
- Spinal Groove- radial nerve
- Surgical Neck
- Axillary neve
- Supracondylar
- Median nerve
- Mid shaft
Describe the distal humerus
- Condyles
- Trochlea
- Capitulum
- Epicondyles
- Medial: articulates with the ulna and is an attachment point for flexor muscles in the forearm
- Lateral: articulates with the radius and is an attachment point for extensor muscles in the forearm
- Supracondular ridges
Describe the Radius
Proximal radius:
- Head: articular disc for the capitulum of the humerus at the elbow joint
- Neck
- radial tuberosity serves as the attachment site for the biceps brachii tendon. The biceps brachii muscle, which is located in the upper arm, attaches to the radial tuberosity to facilitate forearm flexion and supination (the act of rotating the forearm to turn the palm upward).
Distal radius:
- Styloid process
- Dorsal tubercle
Describe the ulna
- Trochlear notch articulates with the trochlea of the humerus which forms the main part of the flexion extension movement in the elbow
- Coronoid process fits into the coronoid fossa of the humerus when the elbow is flexed
How many carpal bones are there?
8
Name the bones of the proximal row of the carpals
- S-Scaphoid
- Lunate
- Triquetrum
- Pisiform
Name the bones of the distal row of the carpals
- Trapezium
- Trapezoid
- Capitate
- Hammate
List the vessels involved in the arterial supply of the hand
- The subclavian artery
- Axillary artery
- Brachial artery
- Radial and Ulnar arteries
- Interosseous Arteries
- Superficial and deep arteries of the hand
Describe the subclavian artery
- Start at the brachiocephalic trunk (right) and Aortic arch
- Finish at Lateral border of 1st Rib - The Axillary artery
- 2 Relevant branches: Dorsal Scapular and Suprascapular
Describe the axillary artery
- From lateral border of 1st Rib to inferior border of Teres major
- Becomes the brachial artery
- Crosses posterior to Pectoralis Minor
- Minor
- Split to 3 parts
- 1st before Pec. minor
- 2nd behind Pec. minor
- 3rd after Pec. minor
- Part 1 has 1 branch
- Part 2 has 2 branches
- Part 3 has 3 branches
Describe the brachial artery
- Starts at the lower border of Teres Major
- Ends at its bifurication anterior to the elbow (variable) to Ulnar and Radial
- 3 branches
- Profunda Barachii
- Superior Ulnar collateral
- Inferior Ulnar collateral
Describe the Radial and Ulnar arteries in the forearm
- Variable bifurcation
- Ulnar larger and deeper than Radial
- Both have recurrent branches - Elbow anastamosis
- Radial, anterior in the forearm
- Dorsally at the wrist
- Ulnar remains anterior into the hand
- Harder to palpate - buried in muscles
Describe the Radial and Ulnar arteries in the wrist
- Both radial and ulnar palpebral at the
- Radial>Ulnar
- Neither enters Carpal tunnel
- Radial passes posteriorly to carpal bones
- Ulnar passes anterior to the flexor retinaculum
- Guyon’s Canal
- Allen’s Test
- Both radial and ulnar branch into palmar and dorsal
Describe interserosseous arteries
- Ulnar quickly gives a branch
- Common interosseous
- Anterior interosseous
- Posterior interosseous
Describe the superficial arteries of the hand
- Ulnar enters hand and gives of the deep branch
- Continues as superficial branch
- Creates the superficial palmar arc
- Meets superficial palmar branch of radial
- Arch gives off Common palmar digital arteries
- Each divides into two proper palmar digital arteries
Describe the deep arteries of the hand
- Radial artery passes posteriorly on the scaphoid and trapezium
- Re-enters palmar surface through the 1st dorsal interosseous muscles
- Forms deep palmar arch-anastomosing with deep branch of ulnar
- Palmar arteries
- Anastamose with common palmar arteries
Describe the central venous system of the upper limb
- In the axilla
- Veins more numerus and variable than arteries
- Closely but not exactly follow arterial routes and nomenclature
- Frequent anastamoses
- Axillary vein also recieves some body wall veins from lower abdomen
Describe the superficial veins of the upper limb
- Dorsal venus network
- Gives Cephalic and Basilic veins
Describe the deep veins of the upper limb
- Deep veins
- Follow arterial supply as Venae comitantes
- Brachial veins coalesce into Axillary veins
- Joined by basilic vein at lower border of Teres Major
Describe the lymphatic drainage of the upper limb and the lymph nodes of the axilla
- Superficial drainage
- Basilic > Lateral
- Cephalic > Apical
- Deep drainage
- Deep veins > Lateral
What joints are involved in the elbow joint?
- Humero-ulnar joint
- Humero-radial joint
Where does pronation and supination occur?
Proximal radio-ulnar joint which shares a capsule with elbow joint
Describe the capsue of the elbow joint
Capsule is lax anteriorly and posteriorly with collateral ligaments
What is present in the fossae of the elbow joint
In each of the fossae Fat pads are present to absorb the shock of extension and flexion
Describe the bursae of the elbow joint
- Olecranon bursae
- Deep intratendinous bursa
- Superficial subcataneous bursa
Describe the distal radio-ulnar joint
- Middle radio- ulnar joint
- Syndesmosis - fibrous joint
- Fibrous disc
- Anterior and posterior radio-ulnar ligament
- Synovial Memebrane
- Sacciform recess to aid movement
Name the 3 glenohumeral ligaments
- Superior
- Middle
- Inferior
Name the ligaments of the glenohumeral joint
- Glenohumeral ligaments x3
- Coroaco-acromiol ligament
- Coraco-humeral ligament
- Transverse humeral ligament
Describe the coraco-acromial ligament
between the coracoid process of the scapula and acromion; prevents superior dislocation (extrinsic from the joint capsule)
Describe the coraco-humeral ligament
runs from the coracoid process (on the scapula) to the greater tuberosity of the humerus; prevents inferior dislocation
Describe the transverse humeral ligament
runs across the intertubercular groove of the humerus, connecting the greater and lesser tuberosities; helps hold the tendon of the long head of the biceps brachii muscle in place within the groove and contributes to stabilizing the biceps tendon.
What muscles are involved in the movement of the glenohumeral joint
1) Rotator cuff muscles:
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
2) Deltoid
3) Long head of the bicep
4) Long head of the tricep
Name the bursae of the glenohumeral joint
- Subacromial
- Subscapular
- Subcoracoid
- Coracobrahial
