01 Introduction Upper Limb

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Introduction To The Study of Upper Limb.

UWI, MONA.

Dr.SujAnatomy,U.W.I. Mona.


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• The upper limb is specialised in man for:

- Prehension- precision.

• Anatomical position of upper limb,

- Upper limb is by the side of the trunk,- Elbow, wrist and digits are in extension,- Palm facing forward,(in erect posture)- Forearm is supinated.

• Midline of upper limb: passes through 3 rd digit.

• Axial lines: differ in their extent.


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Axial lines of the upper limbAnterior axial line and Posterior axial line.


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The study of upper limb is considered in regions ,

Pectoral region,Scapular regionAxillaShoulder regionArmCubital fossaForearmWristHand.


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Pectoral region Scapular region ,


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Axilla .


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Shoulder region , The arm.


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Cubital fossa,


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Forearm.


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The Wrist and The Hand


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Anatomical aspects to focus in various regions ,• Surface land marks and surface anatomy

• Axial lines• Skeleton• Compartments and disposition of the structures,• Muscles

• Joints,• Nerves, myotomes & dermatomes• Arteries and veins,• Lymphatics and lymph nodes,•Tissue planes and fascial spaces• Development,• Functional and clinical aspects,


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Surface land marks and surface anatomy.Eg; in the pectoral region


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Skeleton of the upper limb.


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Disposition of the structures in any region,Eg. In the cubital fossa;


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Focus on the following aspects of muscles.

Name

Type (histological and gross )

Attachments

Nerve supply and blood supply

Action.Test and functional integrity


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Joints of the upper limb

•Sternoclavicular.J•Acromioclavicular.J•Glenohumeral.J•Elbow.J

•Radioulnar.Js- Superior- Inferior

•Radiocarpal.J•Intercarpal.Js•Carpometacalpal.Js•Metacarpophalangial.Js•Interphalangial.Js


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• Type of joint• Aurticular components• Capsule and synovial membrane

• Ligaments• Topographycal relations• Movements and the muscles involved• Nerve supply and myotomes• Blood supply• Clinical aspect.

What you need to know about any joint?


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Nerves for the upper limb are providedmainly by the brachial plexus.

+ Intercostobrachial nerve.

Motor innervationSensory innervation

Cutaneous

ProprioceptiveAutonomic innervation

To the upper limb.


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Study of nerves of the upper limb.

• Name and root value• What is it a branch of • Course and relations• Its branches and their distribution• Testing of the nerve function• Clinical manifestations of the functional deficit.


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•Myotomes

and•Dermatomes

•Axial lines


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The arteries of the upper limb. .

Stem artery of upper limb- Subclavian artery

-Lt side, it is a branch of the arch of aorta,-Rt side, it is a branch of brachiocephalic trunk .


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Subclavian artery

Axillary artery

Brachial artery

Radial and ulnar arteries

Palmar arches- Superficial- deep

Digital arteries.

Beginning,course & relations, branches &distribution of :


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Venous return from upper limb,through,

Superficial and deep veins drain into:

Axillary vein,

Subclavian vein,

Brachiocephalic vein,(on both sides)

Superior vena cava,

Right atrium of the heart.


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Arterial anastamosis.• Actual anastamosis• Potential anastamosis


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,Lymph from the upper limb goes to- --Epitrochlear and axillary lymph nodes


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Upper limb develops througha series of epithelial*-mesenchymal interactions

in the lateral body wall - lower cervical area.

*AER


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Upper limb buds .

Hand plates

Digital rays

Notches

During 8th

wk ,digits : short and webbed.end of week 8 , distinctfingers.

Elbow and wrists regions

End of 4 th week


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Upper limbs rotate externally through 90 degreeson their long axis and maintain anatomical

position.

Rotation of upper limbs


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Congenital defects

• Supernumerary digits• Syndactily• Amelia,

• Meromelia• Amniotic band,• Lobster hand,• Absence of radius,• Acledia,• Manus varum,• Manus valgus,

• Aberrant radial artery,

And more.

• Cubitus valgus,

• Cubitus varum,

Clinical aspects


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• Amelia complete absence of a limb.

• Meromelia the partial absence of a limb.• Hemimelia the absence of half a limb.• Phocomelia a flipper-like appendage attached to

the trunk.• Acheiria a missing hand or foot.• Adactyly the absence of metacarpal or metatarsal• Aphalangia an absent digit, finger or toe


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Syndactyly


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Syndactyly


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Amniotic band ,


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Amelia, Meromelia

Acheiria

a missinghand or foot.


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Clinical aspects, contd.

Acquired conditions

• Injuries,• Infections,

• Lymph node enlargement • Lymphatic obstruction,• Arterial insufficiency

• Venous obstruction,Etc.


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Praise the Lord.

End of topic

Amen.

01 Introduction Upper Limb

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