Forearm and hand a brief presentation.pptx

Here's a brief overview of the development of the upper limb:

*Embryological Development (Weeks 4-12)*

1. Upper limb buds appear as swellings on the lateral body wall (Week 4)
2. Buds elongate and differentiate into:
- Shoulder (scapula and humerus)
- Arm (humerus, radius, and ulna)
- Forearm (radius and ulna)
- Hand (carpal bones, metacarpals, and phalanges)
3. Upper limb rotation (Weeks 6-8): Limbs rotate 90° laterally, palms face forward
4. Hand plate formation (Week 7): Fingers and thumb develop from a single plate
5. Finger separation (Weeks 8-10): Interdigital tissue regresses, forming individual fingers

*Fetal Development (Weeks 12-38)*

1. Muscle and tendon development
2. Bone ossification and growth
3. Nerve and blood vessel formation
4. Skin and soft tissue differentiation

*Postnatal Development*

1. Neonatal reflexes (grasping, sucking)
2. Infant motor skills (reaching, grasping, releasing)
3. Toddler fine motor skills (pincer grasp, finger isolation)
4. Childhood and adolescent growth and refinement

*Key Milestones*

- 12 weeks: Upper limb buds visible
- 16 weeks: Fingers separated
- 20 weeks: Hand functional, can grasp
- 28 weeks: Neonatal reflexes present
- 6-12 months: Infant motor skills develop
- 1-3 years: Toddler fine motor skills refine

This brief overview highlights the major stages and milestones in upper limb development.

1. Forearm and Hand By: Dr Anita Rani Anatomy Lecture 7 th November 2016

2. Lesson Plan Identify skeleton and joints Muscles : attachments and location Action of Muscles on joints Nerves: course and branches Arteries : course and branches Fascia Applied Revision Questions

3. Skeleton and Joints

4. Muscles: Forearm 8 Superficial : cross elbow 1.Pronator teres 2. Flexor carpi radialis 3. Palmaris longus 4. Flexor carpi ulnaris Intermediate 5. Flexor digitorum superficialis Deep: 6. Flexor Pollicis Longus 7. Flexor digitorum Profundus 8. Pronator Quadratus 9. Supinator 10. Brachioradialis

5. Muscles : Hand 20 Thenar muscles: 4 Abductor pollicis brevis Flexor pollicis brevis Opponens pollicis Adductor pollicis Hypothenar muscles: 4 Abductor Digiti minimi Flexor digiti minimi Opponens digiti minimi Palmaris brevis Interossei : Palmar 4 Dorsal 4 Lumbricals : 4 with tendons of FDP

6. Supinator

7. Pronator Quadratus

8. Flexor pollicis longus

9. Flexor Digitorum Profundus

10. Flexor digitorum superficialis

11. Pronator teres

12. Palmaris longus

13. Flexor carpi ulnaris & radialis

14. B rachioradialis

15. Thenar & Hypothenar muscles

16. Thenar & Hypothenar M uscles

17. lumbricals

18. Interossei dorsal palmar

19. Actions Elbow: Flexion : muscle crossing front of elbow BR, PT FCR, FCU, PL, FDS

20. Actions Radio- ulnar joints Pronation : PT, PQ Supination : Supinator

21. Actions at wrist joint Flexion: all muscles except…. Abduction: FCR Adduction: FCU

22. Actions at carpometacarpal joints: Ist : Abduction: APB Adduction: Adductor pollicis Flexion: Flexor pollicis longus , flexor pollicis brevis Opposition: opponens pollicis

23. Actions Metacarpo-phalangeal joints: Flexion: FDS, FDP, lumbricals , PI and DI Abduction: Dorsal interossei [ DAB] Adduction: Palmar interossei [PAD]

24. Actions Inter- phalangeal joints: Flexion: Proximal: FDS Distal: FDP Extension: Lumbricals , Dorsal and Palmar interossei

25. Nerves: U lnar , Median and Radial

26. Nerves: Ulnar Elbow : lies behind medial epicondyle Enters forearm by passing b/w 2 heads of FCU In forearm runs b/w FDP and FDS Enters palm by passing superficial to flexor retinaculum b/w pisiform and ulnar vs Divides in to superficial and deep terminal branches

27. Ulnar nerve Contd … Superficial branch supply Palmaris brevis and skin of medial 1 &1/2 fingers. Deep branch passes backwards b/w flexor and abductor digiti minimi . Runs in the concavity of deep palmar arch. Ends by supplying adductor pollicis .

28. Ulnar Nerve

29. Ulnar nerve in Hand

30. Ulnar Nerve: branches/ supply FCU medial half of FDP Palmaris brevis 3 hypothenar muscles 3 rd and 4 th lumbricals All interossei Adductor pollicis Skin over hypothenar eminence. Skin of volar aspect of 1 & ½ fingers Skin of dorsum of hand and proximal parts of medial 2 & ½ fingers

31. Cutaneous innervation of Ulnar nerve

32. Median Nerve Main nerve of forearm In cubital fossa lies medial to brachial artery Enters forearm by passing between 2 heads of pronator teres Separated from ulnar artery by deep head of pronator teres Runs on the surface of FDP deep to FDS 5 cm above flexor retinaculum lies b/w FCR & FDS Overlapped by the tendon of Palmaris longus

33. Median nerve

34. Nerves: Median Enters the palm by passing deep to flexor retinaculum in carpal tunnel Breaks into medial and lateral branch Lateral branch gives off recurrent branch that curve around distal border of FR to supply thenar muscles & 3 digital branches Medial branch gives out 2 digital branches

35. Median Nerve : branches/supply Muscles: PT, FCR, PL, & FDS Via anterior interosseous nerve: FPL, PQ & radial half of FDP Palmar cutaneous branch: skin over thenar eminence & central part of palm In Hand: 5 muscles: 3 thenar muscles and 2 lumbricals skin of lateral 3 & ½ digits

36. Cutaneous innervation :Median nerve

37. Arteries of forearm and hand Nerves: Median Nerves: Median

38. Superficial and Deep Palmar Arches

39. Carpal Tunnel

40. Flexor Retinaculum

41. Palmar Aponeurosis and synovial sheaths of tendons

42. Ulnar nerve injury Which muscles are paralysed ? What do you understand by deformity?

43. Median nerve injury

44. Which of the following muscle of forearm helps in flexion at elbow? a. flexor digitorum profundus b. flexor pollicis longus C. pronator quadratus D. pronator teres

45. Which of the following nerve supplies skin over terminal phalanx of index finger? Median nerve Ulnar nerve Radial nerve Musculocutaneous nerve