06 Appendicular Skeleton Pectoral Girdle And Upper Limbs
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- 1. Theappendicularskeletonconsists of the pectoral girdle, upper extremities, pelvic girdle, and lower extremities.
2. In this lecture we will focus just on thepectoral girdle and upper limbs 3. Thepectoral girdleis not a complete girdle 4. Thepectoral girdleprovides for attachment of the arms and many of the arms associated muscles.It is a delicate structure. 5. The only bones that keep the scapulae and the shoulders laterally are the delicateclavicles . 6. Congenital absence of clavicles 7. Clavicle(collar bone) Inferior view Superior view 8. Epauletteswere originally designed as armor to help protect the delicate clavicle. 9. Currentlyepaulettesare minimal and just used for attachment of symbols of military rank. 10. Sternoclavicular joint Acromioclavicular joint (A-C joint). 11. Note theconoid tubercleon the inferior, lateral end of the clavicle that serves as an attachment site for several ligaments. Superior view Inferior view 12. Master Long is going to easilyfracture his opponents right clavicleso his opponent will be unable to use that arm. 13. ACCORDING TO THE CLINICAL VIEW IN YOUR TEXT, WHY IS APOSTERIOR FRACTUREOF THE CLAVICLE POTENTIALLY MORE SERIOUS THAN AN ANTERIOR FRACTURE? A MORE LIKELY TO BREAK THE SKIN B MORE LIKELY TO DAMAGE BLOOD VESSELS C MORE LIKELY TO ENTER HEART D MORE LIKELY TO INJURE ULNAR NERVE E MORE LIKELY TO TEAR DIAPHRAGM 14. Thescapulanormally lays over ribs #2-#7 on theposterioraspect of the rib cage. 15. Left scapula 16. Anterior Posterior 17. The head of the humerus articulates with theglenoid cavity . 18. Subscapular fossaonanteriorsurface of scapula. 19. Humerus clavicle Scapula 20. Thehumerusis the longest bone of the upper extremity. groove 21. Thedistal end of the humerusis modified to articulate with the two bones of the forearm. 22. 23. Theradial fossaaccommodates the head of the radius and thecoronoid fossaof the humerus receives the coronoid process of the ulna when the elbow is flexed. Anterior view 24. Theolecranon fossaof the humerus receives the olecranon of the ulna when the elbow is extended Posterior view 25. WHICH OF THE FOLLOWINGIS CORRECTABOUT THE DISTAL MEDIAL END OF THE HUMERUS? A NEAR THE ULNAR NERVE B SHAPED LIKE A PULLEY C ARTICULATES WITH THE ULNA D FORMS A FIRM HINGE JOINT WITH THEFOREARM E ALL OF THE ABOVE 26. The antebrachium contains theulnaon the medial side and theradiuson the lateral (thumb) side. 27. Note theheadof the radius and theradial notchin nearby ulna 28. Theradiusis lateral to the ulna. Note thehead ,neck , theradial tuberosity , theshaft , and thestyloid processon the lateral tip. Trochlear notch 29. Notestyloid processeson distal radius and ulnaandulnar notchon medial distal end of the radius 30. The proximal end of the ulna forms thetrochlear notch .Note the anteriorcoronoid processand the posteriorolecranon . Theradial notch , mentioned earlier, accommodates the nearby head of the radius 31. The distal end of theulnais called thehead .It has a medial projection called thestyloid process . The distal ulna also once again articulates with the nearby radius. Trochlear notch 32. Thestyloid processesof the distal ulna and radius create a U-shaped arrangement to help stabilize the bones of the wrist. 33. Theinterosseous membranehelps keep the radius and ulna a fixed distance from one another and also allows rotation of the forearm. 34. Crucifixion is NOT normally performed in the hand 35. Crucifixionis properly performed in the wristor between distal ends of radius and ulna 36. The Governor of California shownproperly crucifiedwith nails in wrist or between distal end of radius and ulna.Note the vulture perched on arm that is soon to be lunch. 37. It damagesmedian nerve 38. 39. Shroud of Turin black and white image. 40. Color image of blood 41. In the Shroud of Turin the tibia and fibula are NOTbroken. 42. There are 8carpal bonesin the wrist. 43. The bones of themanusat work on a keyboard 44. Kermit gets a surprise! 45. The palm of the manus is composed of5 metacarpalsnumbered 1-5 with #1 leading to the thumb. 46. The fingers (digits) containphalanges .All the digits have three phalanges, except for the thumb (finger #1) that only has two. 47. What specific phalanges have been nailed? 48. In this posterior x-ray of a childs right hand, what specific bone has been fractured? 49. What specific bone(s) of this persons left hand have been forked? 50. WHAT BONEIS ENCIRCLED BY A WEDDING RING? A METACARPAL #3 OF RIGHT HAND B PROXIMAL BONE OF POLLEX C DISTAL PHALANX OF FINGER #5 OF RIGHTHAND D BONE MEDIAL TO METACARPAL #4 ANDMIDDLE PHALANX #4 E MIDDLE PHALANX OF FINGER #3 OF LEFT HAND 51. One of many ways to fracture the delicateclavicle . 52. Crack the whip 53. Left clavicular fracture 54. Matt Crivellos fractured clavicle from football 55. Jagged ends of a fractured claviclecan easily damage underlying arteries and veinsunless the injured arm is quickly immobilized. 56. Matt Crivellos fractured clavicle from footballafter repair 57. Blows strong enough tofracture the scapulamay also result in fracture of the underlying ribs. 58. 59. Scapular fracture through the glenoid cavity 60. Blows or falls on the tip of the shoulder can lead to dislocation of the acromion process of the scapula from the clavicle (A/C separation). 61. When examining patient it is a good idea to palpate thenormalshoulder and compare tobadshoulder. Normal 62. Acromioclavicular separation(A/C separation) in the right shoulder 63. 64. 65. One way to reposition bones of a dislocated shoulder. 66. Fracture of the shaft of the humerusmay damage nearby nerves. 67. Open fracture of humeral shaft. 68. 69. Supracondylar fracture of the humerus. 70. Supracondylar fractureandmidline fracture of distal humerus. 71. Anterior view of repair of fracture shown in previous slide 72. Lateral view of repair of fracture shown in previous slide. 73. 74. Dislocation of the elbow. 75. The muscular tendons which attach to thelateral epicondyle of the humerusare put under tremendous stress during the backhand stroke. 76. 77. Note vibration-stopping rubber bands on racquet and support band on forearm 78. 79. A child who lived next door to me did this by falling off the trampoline 80. 81. Collesfracture. Fracture of the distal end of the radius causing a silver fork deformity. 82. Fracture of the distal end of the radius results in a characteristic silver fork deformity.This type of fracture is called aColles fracture . 83. IF YOU WERE LAYING IN THE PARK PROPPED UP BY ONEFULLY EXTENDED ARMAND A HEAVY CHILD RAN INTO THE POSTERIOR OF THIS SAME EXTENDED ARM,WHAT WOULD MOST LIKELY OCCUR ? A FRACTURE OF THE OLECRANON B A-C SEPARATION C COLLES FRACTURE D SCAPULAR FRACTURE E FRACTURE OF A SESAMOID BONE