Upper limb revision , upper limb shorts noted

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1. The National University
Department of Anatomy
Upper limb revision
Abubakr Elawad

3. The muscles of back
Superficial group
Trapezius
Latissimus dorsi
Levator scapulae
Rhomboideus
Deep group
Erector spinae
Splenius
Thoracolumbar fascia

4. 4

5. Pectoral region
Extrinsic muscles
Pectoralis major
Pectoralis minor
Serratus anterior

6. The Muscles of Upper Limb
Muscles of shoulder

Supraspinatus

Infraspinatus
Teres minor
Subscapularis
Deltoid
Teres major

7. Major muscles of shoulder
Deltoid
Origin: lateral third of
clavicle, acromion, and
spine of scapula
Insertion: deltoid tuberosity
of humerus
Action: abduction, flexion
and extension, medial and
lateral rotation of arm

8. Major muscles of shoulder
Teres major
Origin: dorsal surface
of inferior angle of
scapula

Insertion: crest of
lesser tubercle of
humerus
Action: medially rotates
and adducts arm

10. Muscles of arm
Antererior group

Biceps brachii

Coracobrachialis

Brachialis
Posterior group

triceps brachii

anconeus

11. Muscles of arm
Biceps brachii

Origin: long head,
supraglenoid tubercle; short
head, coracoid process

Insertion: radial tuberosity

Action: supinator of forearm,
flexor of elbow joint, weak
flexor of should joint

12. Muscles of arm
Triceps brachii

Origin:

long head, infraglenoid tubercle

lateral head, above groove for
radial nerve

medical head, below groove for
radial nerve
Insertion: olecranon of ulna
Action: extends elbow joint,
long head extends and adducts
shoulder joint

13. Triceps brachii

14. Forearm Muscles
Supinator muscles

Supinator muscle

Biceps brachii
Pronator muscles

Pronator teres

pronator quadratus

16. Muscles of forearm
Superficial layer

Pronator teres

Flexor carpi radialis

Palmaris longus

Flexor carpi ulnaris

Flexor digitorum superficials

17. Muscles of forearm
Pronator teres

Origin: medical epicondyle of
humerus and deep fascia of
forearm

Insertion: middle of lateral
surface of radius

Action: pronation of forearm
and flexion of elbow

18. Deep layer

Flexor digitorum
profundus

Flexor pollicis longus

Pronator quadratus

19. Lateral group (3)

Brachioradialis

Extensor carpi radialis longus

Extensor carpi radialis brevis

20. Posterior group (8)
Superficial layer (3)

Extensor digitorum

Extensor digiti minimi

Extensor carpi ulnaris

Action: extension at wrist joint

21. Deep layer (5)
Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis
Action: extend at wrist joint
and fingers, and supinate
forearm
Posterior group (8)

22. Medial: EPL
Lateral: EPB and APL

Anatomical snuff box

23. Muscles of hand
Lateral group thenar (4)
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Adductor pollicis
Action: flex, abduct, adduct and
oppose thumb

24. Muscles of hand
Medial group hypothenar (3)
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Action: flex, abduct , and oppose
little finger

25. Muscles of hand
Lumbricales (4) flex
fingers at MP joints; extend
fingers at IP joints
Palmar interossei (3)
adduct fingers towards
middle finger at MP joints
Dorsal interossei (3)
abduct fingers away from
middle finger at MP joints

26. Arteries of upper limb
Axillary artery
Continuation of subclavian artery at lateral
border of first rib
Becomes brachial artery at lower border of
teres major
Divided into three parts by overlying
pectoralis minor
First part, above muscle－gives rise to
thoracoacromial artery.
Second part, behind muscle－gives rise to
lateral thoracic artery.
Third part, below muscle－gives rise to
subscapular artery., anterior and posterior
humeral circumflex arteries.; the former then
divides into throcodorsal a. and circumflex
scapular a.

28. Brachial artery
Continuation of axillary artery
Divides into radial and ulnar arteries at
level of neck of radius
Branches
Deep brachial a. accompanies with
radial nerve
Superior ulnar collaeral a.
accompanies with ulnar nerve
Inferior ulnar collateral a.
Arteries of upper limb

29. Radial artery and branches
Radial recurrent a.
Superfical palmar branch
Principal artery of thumb
Ulnar artery and branches
Ulnar recurrent a.
Common interosseous artery

Anterior interossous a.

Posterior interosseous a.
Deep palmar branch
Arteries of upper limb

30. Superficial palmar arch
Formed by ulnar artery
and superficial palmar
branch of radial artery
Curve of arch lies across
the palm, level with the
distal border of fully
extended thumb
Gives rise to three
common palmar digital
arteries each then divides
into two proper palmar
digital arteries
Arteries of upper limb

31. Deep palmar arch
Formed by radial artery
and deep palmar branch
of ulnar artery
Curve of arch lies across
upper part of palmar at
level with proximal border
of extended thumb
Gives rise to three palmar
metacarpal arteries
Arteries of upper limb

32. Veins of the upper limb
Deep veins: accompany the
arteries of the same region and
bear similar names
Superficial veins
Cephalic vein
Arises from the lateral side of
the dorsal venous rete of hand
Ascends on radial side of the
forearm to the elbow and then
in the lateral side of biceps
brachii furrow, continues up the
arm in the deltopectoral groove
and then to the infraclavicular
fossa, where it pierces
clavipectoral fascia to drain into
axillary vein

33. Basilic vein

Arises from the medial side of
the dorsal venous rete of
hand

Ascends on the ulnar side of
forearm to the elbow and then
in the medial bicepital brachii
furrow to middle of the arm
where it pierces the deep
fascia and joins the brachial
vein or axillary vein
Median cubital vein
links cephalic vein and basilic
vein in the cubital fossa. It is a
frequent site for venipuncture
to remove a sample of blood
or add fluid to the blood

34. The lymphatic drainage of upper limb
Lymphatic vessels
Superficial－follow the
superficial veins, drain into
supratrochlear and axillary
lymph nodes
Deep－accompany main
vessels, end in axillary lymph
nodes
lymph nodes
Cubital lymph node: lies above
medial epicondyle of humerus
Axillary lymph node－arranged
in five groups

35. Axillary lymph nodes
Arranged in five groups
Lateral lymph nodes lie around
the distal end of axillary vein ,
receiving drainage from the arm,
forearm, and hand
Pectoral lymph nodes lie along
lateral thoracic vessels, receive
afferents from anterior thoracic wall
including central and lateral portion of
mamma
Subscapular lymph node along
subscapular vessels, receive lymph
from nape and scapular region
Efferents above three groups pass to
central lymph node

36. Central lymph node

lie in fat of axillary fossa,
receive drainage from all the
above nodes, efferents pass
to apical lymph node
Apical lymph node

Lie in the apex of the axilla,
along the proximal end of
axillary vessels

Receive drainage chiefly
from central lymph node ,
upper portion of mamma

Efferents form subclavian
trunk, the right subclavian
trunk joints the right
lymphatic duct; left usually
drains directly into thoracic
duct

37. Brachial plexus
Formation:

Five roots: formed by anterior rami of C5-C8 and T1
spinal nerves, roots C5-C7give rise to long thoracic n.

Three trunks

The upper trunk is formed by the joining of root C5,C6.

The middle trunk is the continuation of root C7.

The lower trunk is formed by the joining of root C8 and
T1.

Six divisions: above clavicle, trunks form anterior and
posterior divisions

Three cords: below clavicle, divisions form three cords
that surround the second portion of axillary a.

38. Position:
passes through the scalene fissure to
posterosuperior of subclavian artery, then
enters the axilla to form lateral, medial and
posterior cords
Main branches
Lateral cord
Musculocutaneous n.
Lateral root to median n.
Medial cord
Medial root to median n.
Ulnar n.
Medial cutaneous nerve of the arm.
Medial cutaneous nerve of the forearm

39. Posterior cord

Upper subscapular nerve

Lower subscapular nerve

radial nerve.

axillary nerve.

thoracodorsal nerve.

40. Musculocutaneous
Distribution: Biceps
brachii, brachalis and
coracobrachialis ‘BBC
nerve’; skin on
anterior aspect of
forearm

41. Distribution: Flexors of
forearm except
brachioradialis, flexor carpi
ulnaris and ulnar half of flexor
digitorum profundus,
thenar except adductor
pollicis, first two lumbricals;
skin of thenar, central
part of palm, palmar aspect of
radial three and one-half
fingers, including middle and
distal fingers on dorsum.
Injury: Apehand
produces sign of benediction,
in which the index and middle
fingers cannot be flexed and
the thumb cannot be opposed
Median nerve

42. 
Distribution: Flexor carpi
ulnaris, ulnar half of flexor
digitorum profundus,
hypothenar muscles,
interossei, 3rd and 4th
lumbricals and adductor
pollicis; skin of hypothenar,
palmar surface of ulnar one
and one-half fingers, ulnar half
of dorsum of hand, posterior
aspect of ulnar two and one-
half fingers
Injury: clawhand
Ulnar nerve

43. 
Distribution: Extensor
muscles of arm and
forearm,
brachioradialis; skin on
back of arm, forearm,
and radial side of
dorsum of hand and
radial two and one-half
fingers

Injury: Wristdrop
Radial nerve

44. Axillary
Distribution: Deltoid
and teres minor
muscle; skin over
deltoid and upper
posterior aspect of arm
Injury: results in deltoid
and teres minor
paralysis (loss of
shoulder abdution and
weel external rotation)
with loss of sensation
over the deltoid