6.Upper limbs.pdf

Upper limb

1. Human
Skeleton
The Free Upper Limbs
Assoc. Prof.Dr.Rusudan
Vadatchkoria

2. Upper Limbs skeleton-(30X2=60 bones):
1. Upper Arm (brachium)-Humerus -1(in each hand)
2. Forearm(antebrachium) –2:
Ulna -1
Raduis -1
3. Hand(manus):
3.1. Scaphoid -1
Trapezium-1
Capitale -1
Trapezoid -1
Lunate -1
Triquentum -1
Pisiform -1
Hamate -1
3.2. Metacarpals –5
3.3. Phalangies –14 (3X4+2) (three per digit, thumb has2)

3. Humerus
The humerusis the
longest bone of the
upper limb. It
articulates with the
scapula at the shoulder
joint and with the radius
and ulna at the elbow.
Humerushas:
The proximal end
Shaft
The distal end

4. Proximal End of Humerusconsists of:
thehead-hemispherical, faces
medial, superior, and posterior
the anatomical neck(collum
anatomicum)-neck is at the
periphery of the head
the greater tubercle -projects
laterally, beyond the acromion, is
covered by the deltoid muscle
(rounded contour of the shoulder)
thelesser tubercles-The
lesser tubercle projects
anteriorward
theintertubercular groove-
contains the tendon of the long
head of the biceps.
the surgical neck(collum
Chirurgicum)-is the point at
which the superior portion of the
bone meets the shaft-a common
site of fracture of the humerus.
Theaxillary nerve lies in contact
with the surgical neck

5. Shaft of Humerus
The shaft has:
tree surfaces:
anterolateral-
deltoid muscle is
inserted into a
tuberosityat about
the middle of the shaft
anteromedial
posterior-the radial
nerve runs inferiorward
and lateral on the
posterior surface in a
shallow, oblique
groove
thee borders:
lateral
anterior
medial

6. The distal end of Humerus
Upper part of fhaftis
cylindroid in form, the lower
part –triangularandends with
Condilushumeri.
It consists:
Capitulumhumeri
(medial)–articulates with
radius
Trochlea humeri(lateral)-
articulate with ulna
2 eminence: Lateral
epicondileand medial
epicondile;
3 fossa: coronoid and
olecranon, radialis;

7. Radius (1)
The forearm consists
radius and ulna.
Radiusor radial bone
is one of two large
bone of the forearm, it
is shorter than and
lateral to the ulna.
The proximal end
articulates with the
humerus,
the medial aspect with
the ulna,
thedistal end with the
carpus.
Radius has:
The proximal
end
Shaft
The distal end

8. Radius (2) -The proximal end
Consists of:
a head(caput radii) with
fovea articularis. The
superior, concave surface of
the head articulates with the
capitulum of the humerus.
The circumference
(circumferencia
articularis)of the head
articulates with the ulna
medially but is elsewhere
covered by the annular
ligament
neck-(collumradii)
Tuberosity(tuberositas
radii)-is situated distal to
the neck and serves to
attachment of M.biceps

9. Radius (2) -The distalend
Is wider than proximal end
and consists of:
On its medial side, Incisura
ulnarisor ulnar notchfor
articulation with the head of
the ulna;
Processulstiloideusfrom
the lateral side; Itis
palpable between the
extensor tendons of the
thumb. It gives attachment
to the radial collateral
ligament.
Faciesarticulariscarpalis,
divided into to part: for
articulation with scaphoid
and lunate bones

12. Radius (3) -Shaft
The shaft has:
three surface:
anterior,
posterior,
lateral
three
borders:
anterior,
posterior,
interosseous
-is attached
by the
interosseous
membrane to
a
correspondin
g border on
the ulna

14. Ulna (1)
Is longer than and
medial to the radius.
It articulates with the
humerus proximally,
the radius laterally, and
the articular disc
distally.
Ulna has:
The proximal
end
Shaft
The distal end

15. The proximal end of Ulna
includes:
thochlearnoch(incisura
trochlearis) with two
prominence: the olecranonand
the coronoid
process.(processus
coronoideus)
The lateral side hasradial noch
(incisuraradialis);
below it -the tuberositasulna
The superior aspect of the
olecranon receives the insertion of
the M.triceps.
The posterior aspect, covered by
a bursa, is subcutaneous.
The antierior partof the olecranon
forms a part of the trochlear notch,
which articulates with the trochlea
of the humerus.

16. Ulna (4) –the shaft
The shaft has:
three surface:
anterior,
posterior,
lateral
tree borders:
anterior,
posterior-is completely
subcutaneous and
readily palpable. It
separates the flexor from
the extensor muscles of
the forearm
interosseous

17. Carpus-8 bones (1)
usually eight in number, are
arranged in two rows of four
Their names are:
scaphoid,
lunate,
triquetrum (or
triquetral),
pisiform,
trapezium,
trapezoid,
capitate,
hamate.
The pisiform lies anterior
to the triquetrum,
whereas each of the
other carpals has several
facets for articulation with
adjacent bones.

18. Carpal Bone (2)
The posterior aspect of the
intact carpus is convexand
the anterior aspect is
concave,where it is bridged
by the flexor retinaculum to
form the carpal canal or
tunnel for the flexor tendons
and the median nerve.
The flexor retinaculum
extends between the
scaphoid and trapezium
laterally and the triquetrum
and hamate medially
The scaphoid has a tubercle
on its anterior side that can be
felt under cover of and lateral
to the tendon of the flexor
carpi radialis.

19. Carpal Bone (4)
The lunate is
broader on the
anterior than the
posterior
side.Anterior
dislocation of the
lunate is a fairly
common injury of the
wrist.
Inadduction of the
hand, the lunate
articulates with the
radiusonly,
whereasin the
neutral position or in
abduction, it
articulates with the
articular disc also.

20. Carpal Bone (5)
The pisiform, the
smallest of the
carpals and the
last to ossify, lies
anterior to the
triquetrum and
can be moved
passively from
side to side when
the flexor carpi
ulnaris is relaxed

21. Carpal Bone (6)
The trapezium
supports the thumb
by means of a
saddle-shaped
facet for the first
metacarpal.
Like the adjacent
scaphoid, it has an
anterior tubercle.
Thetrapezoid is
associated with the
index finger.

22. Carpal Bone (7)
The capitate-the
largest of the
carpals and the first
to ossify, is placed
centrally and is in
line with the third
metacarpal. It has a
prominent head on
its superior side.
The hamate sends
a marked hook
anteriorly, which
gives attachment to
the flexor
retinaculum.

23. Metacarpus –5 bones
They are numbered from 1 to 5, from
the thumb to the little finger. The first
is the shortest and the second the
longest. They contribute to the palm,
and their posterior aspects can be felt
under cover of the extensor
tendons.
Each metacarpal is technically a long
bone, consisting of:
a base-(proximally)-articulates with
the carpus and, except for that of the
first, with the adjacent metacarpal(s)
also. The base of the first metacarpal
has a saddle-shaped facet for the
trapezium
a shaft
a head (distally) -of each metacarpal
articulates with a proximal phalanx
and forms a knuckle of the fist.

24. Phalangies(14 X2=28 bones)
The thumb has two phalanges, whereas
each of the other fingers has three.
They are designated proximal, middle,
and distal.
Each phalanx is technically a long bone,
consisting of:
a base (proximally) -articulates with the
head of a metacarpal;
a shaft–;
a head (distally)-presents two
condyles for the base of a middle
phalanx.
Similarly, the head of a middle phalanx
presents two condyles for the base of a
distal phalanx. Each distal phalanx ends
in a rough expansion termed its
tuberosity.
Sesamoid bones are found related to
the anterior aspects of some of the
metacarpophalangeal and
interphalangeal joints.
Twolocated anterior to the head of the
first metacarpal are almost constant.

25. Note!!!

27. Q
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28. Q
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29. Reference
Frazer's Anatomy of the Human Skeleton, 6th ed., rev.
by A. S. Breathnach, Churchill, London, 1965. A
detailed, regional synthesis of skeletal and muscular
anatomy.
Pyle, S. I., Waterhouse, A. M., and Greulich, W. W.,
(eds.), A Radiographic Standard of Reference for the
Growing Hand and Wrist, Year Book Medical
Publishers, Chicago, 1971.
Keith Moore Clinically. Oriented Anatomy. VII edition.
WolterKluwer, 2011, p. 672 -687