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UPPER LIMB. What is a limb? Skeleton Joints Shoulder/Scapula muscles Brachial plexus—getting spinal nerves out onto limb Muscles—anterior and posterior compartments Sensory innervation Surface anatomy. From Royal Collection da Vinci drawings. What is a limb?.

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upper limb
UPPER LIMB
  • What is a limb?
  • Skeleton
  • Joints
  • Shoulder/Scapula muscles
  • Brachial plexus—getting spinal nerves out onto limb
  • Muscles—anterior and posterior compartments
  • Sensory innervation
  • Surface anatomy

From Royal Collection da Vinci drawings

Frolich, Human Anatomy,UpprLimb

what is a limb
What is a limb?
  • Ventral somatic outgrowth of outer tube
    • Bones (made of bony tissue, cartilage, and other tissues)
    • Joints
    • Muscles
    • Nerves (with motor neurons to muscles, sensory neurons to skin, proprioceptors)
  • No viscera--all innervation is somatic (motor or sensory) from ventral ramus of spinal nerve (except autonomics to blood vessels)

Frolich, Human Anatomy,UpprLimb

upper limb skeleton
Upper Limb Skeleton
  • Scapula
  • Humerus
  • Radius, ulna
  • Carpals--proximal, distal
  • Digits
    • Metacarpals
    • Phalanges

Frolich, Human Anatomy,UpprLimb

joints
Joints

Frolich, Human Anatomy,UpprLimb

muscle origins and insertions
Muscle origins and insertions
  • Muscle crosses joint
  • Origin is usually proximal and insertion is usually distal
  • Origin is considered fixed in analyzing muscle action
  • Muscle action (concentric) is given by movement of insertion relative to origin across joint
  • Remember:
    • Sometimes insertion might be fixed
    • Muscle may be active isometrically and concentrically giving different real function during real activity

Frolich, Human Anatomy,UpprLimb

slide7

Muscles of Scapula

  • If INSERTION on scapula, muscle moves scapula
    • Trapezius
    • Rhomboids
    • Pectoralis Minor
    • Serratus Ventralis
    • Levator Scapulae
  • If ORIGIN on scapula, muscle moves arm
    • Teres Major
    • Latissimus Dorsi (partially on scapula)

Frolich, Human Anatomy,UpprLimb

rotator cuff
Rotator Cuff
  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis
  • Muscles originate on fossae of scapula
  • Help support “open socket” of shoulder joint
  • Insert around ball of femur
  • Medial and lateral rotation of upper limb
  • Typical baseball pitcher injury

Frolich, Human Anatomy,UpprLimb

axilla armpit
Axilla = Armpit
  • Region between arm and chest
  • Boundaries
    • Ventral - pectoral muscles
    • Dorsal = latissimus dorsi, teres major subscapularis
    • Medial = serratus ventralis
    • Lateral = bicipital groove of humerus
  • Contents
    • Axillary nerves and blood vessels
    • Axillary lymph nodes
    • And….the……Brachial plexus

Frolich, Human Anatomy,UpprLimb

brachial plexus
Brachial Plexus
  • Posterior Compartment—posterior cord
  • Anterior compartment—medial, lateral cords
  • Name of cord is relative to axillary artery

Frolich, Human Anatomy,UpprLimb

brachial plexus organizes nerves out to muscles of upper limb
Brachial plexus organizes nerves out to muscles of upper limb
  • One posterior nerve
    • Radial n.
  • Three anterior nerves
    • Musculocutaneous n.
    • Median n.
    • Ulnar n.

Frolich, Human Anatomy,UpprLimb

muscles and nerves by compartment
Muscles and nerves by compartment

Frolich, Human Anatomy,UpprLimb

posterior and anterior compartments
POSTERIOR AND ANTERIOR COMPARTMENTS

Frolich, Human Anatomy,UpprLimb

slide15
Biceps—anterior compartment, flexion (M-C n.)
  • Triceps—posterior compartment, extension (radial n.)

Frolich, Human Anatomy,UpprLimb

slide16

Anterior Compartment Forearm--flexors

Medial Epicondyle

Brachioradialis

Pronator Teres

Flexor Carpi Radialis

Flexor Carpi Ulnaris

Flexor Retinaculum

Flexor Digitorum Superficialis is deep to other flexors

Anterior View

Frolich, Human Anatomy,UpprLimb

slide17

Posterior Compartment of Forearm--extensors

Lateral Epicondyle

Brachioradialis

Extensor digitorum

Ext Carpi Radialis Longus

Extensor carpi ulnaris

Posterior View

Frolich, Human Anatomy,UpprLimb

slide18
ANTERIOR MUSCLES
  • M-C nerve
    • Biceps
    • brachialis
  • Median nerve
    • Forearm flexors
    • Thumb intrinsics (1M$ nerve)
  • Ulnar nerve
    • Flexor carpi ulnaris
    • Hand intrinsics

POSTERIOR MUSCLES

  • Muscles (radial nerve)
    • Triceps
    • Anconeus
    • Brachioradialis
    • Carpal, digit extensors

Frolich, Human Anatomy,UpprLimb

sensory from limb dermatomes sensory skin segments from spine
Sensory from limb (dermatomes/sensory skin segments from spine)
  • Dermatomes extend over limbs
  • Twisted orientation reflects twisting of limb during development
  • Named nerves generally innervate skin over muscles that they innervate

Frolich, Human Anatomy,UpprLimb

sensory territory of nerves
Sensory territory of nerves

REMEMBER: Brachial plexus re-directs spinal routes into named nerves covering certain territory

Cutaneous branches of medial cord/ulnar nerve

Frolich, Human Anatomy,UpprLimb

routes of nerves in human
Routes of nerves (in human)
  • M-C: between biceps brachii and brachialis
  • Median: medial/posterior to biceps, branches into forearm flexors at elbow then to hand through carpal tunnel
    • Recurrent median (1M$) superficial at wrist to thumb over thenar emminence) deficit - ape’s hand
  • Ulnar: medial in arm, posterior to medial epicondle of humerus (funny bone) down medial forearm medial to carpal tunnel into palm
  • Radial: deep posterior arm around lateral epicondyle of humerus to forearm (deep and superficial branches)

Frolich, Human Anatomy,UpprLimb

slide22

Median Nerve

Ulnar Nerve

Brachial Artery

Musculocutaneous Nerve

UlnarArtery

Where’s Radial Nerve?

Radial Artery

Median Nerve

Ulnar Nerve

Frolich, Human Anatomy,UpprLimb

surface anatomy of upper limb
Surface Anatomy of Upper Limb
  • Biceps + Triceps brachii
  • Olecranon Process
  • Medial Epicondyle
  • Cubital Fossa
    • Anterior surface elbow
    • Contents
      • Brachial Artery
      • Median Nerve
    • Boundaries
      • Medial = Pronator teres
      • Lateral = Brachioradialis
      • Superior = Line between epicondyles

Frolich, Human Anatomy,UpprLimb

surface anatomy of upper limb24
Surface Anatomy of Upper Limb
  • Carpal Tunnel
    • Carpals concave anteriorly
    • Carpal ligament covers it
    • Contains: long tendons, Median nerve
    • Inflammation of tendons = compression of Median nerve
  • Anatomical Snuffbox
    • Lateral = E.pollicis brevis
    • Medial = E. pollicis longus
    • Floor = scaphoid, styloid of radius
    • Contains Radial Artery (pulse)

Frolich, Human Anatomy,UpprLimb

slide25
Suggestion: a muscle table organized by Joint crossed? Nerve innervating? Action? Compartments? All of the above?

Frolich, Human Anatomy,UpprLimb

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