The Department of Human anatomy

Blood supply and innervation of

upper limb

Lecture

Plan Blood supply of the upper limb Major

arterial anastomoses of the upper extremity

The veins of the upper limb Innervation of the upper limb

Schematic representation of the innervation of the skin of the upper limb

Lymphatic vessels of the upper extremity

The aortic arch gives off the brachiocephlic trunk (right subclavian) and the left subclavian arteries course into the arm and change their names to the axillary arteries (axillar region) which then continue into the arm as the brachial arteries The brachial artery gives off a deep brachial artery high in the arm which courses in the posterior compartment The brachial artery divides into the ulnar and radial arteries of the forearm and hand

Blood Supply

Spatium interscalenum bullContent

1048766The roots of the brachial plexus(C5-T1)1048766Subclavian artery(which becomes the axillary artery as it crosses the lateral boarder of rib1)

Figure 1923b

Vertebral artery

Costocervical trunkThoracoacromial arteryAxillary artery

Subscapular artery

Radial arteryUlnar artery

Brachial artery

Suprascapular arteryThyrocervical trunk

Posterior circumflexhumeral arteryAnterior circumflexhumeral artery

Deep artery of armCommoninterosseousartery

Deep palmar archSuperficial palmar archDigital arteries

Common carotidarteries

Right subclavian arteryLeft subclavian artery

Brachiocephalic trunkPosterior intercostalarteriesAnterior intercostalarteryInternal thoracic artery

Lateral thoracic arteryDescending aorta

Arteries of the Upper Limb Subclavian passes

between clavicle amp 1st rib

Vessel changes names as passes to different regions subclavian to

axillary to brachial to radial amp ulnar

brachial used and radial artery for pulse

Frolich Human AnatomyUpprLimb

Vascular supply Subclavianaxillary

radial Collateral circulation

Posterioranterior circumflex humeral

Deep brachial a Radial a (with median

n) deep palmar arch

Ulnar a (with ulnar n) superficial palmar arch

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Plan Blood supply of the upper limb Major

arterial anastomoses of the upper extremity

The veins of the upper limb Innervation of the upper limb

Schematic representation of the innervation of the skin of the upper limb

Lymphatic vessels of the upper extremity

The aortic arch gives off the brachiocephlic trunk (right subclavian) and the left subclavian arteries course into the arm and change their names to the axillary arteries (axillar region) which then continue into the arm as the brachial arteries The brachial artery gives off a deep brachial artery high in the arm which courses in the posterior compartment The brachial artery divides into the ulnar and radial arteries of the forearm and hand

Blood Supply

Spatium interscalenum bullContent

1048766The roots of the brachial plexus(C5-T1)1048766Subclavian artery(which becomes the axillary artery as it crosses the lateral boarder of rib1)

Figure 1923b

Vertebral artery

Costocervical trunkThoracoacromial arteryAxillary artery

Subscapular artery

Radial arteryUlnar artery

Brachial artery

Suprascapular arteryThyrocervical trunk

Posterior circumflexhumeral arteryAnterior circumflexhumeral artery

Deep artery of armCommoninterosseousartery

Deep palmar archSuperficial palmar archDigital arteries

Common carotidarteries

Right subclavian arteryLeft subclavian artery

Brachiocephalic trunkPosterior intercostalarteriesAnterior intercostalarteryInternal thoracic artery

Lateral thoracic arteryDescending aorta

Arteries of the Upper Limb Subclavian passes

between clavicle amp 1st rib

Vessel changes names as passes to different regions subclavian to

axillary to brachial to radial amp ulnar

brachial used and radial artery for pulse

Frolich Human AnatomyUpprLimb

Vascular supply Subclavianaxillary

radial Collateral circulation

Posterioranterior circumflex humeral

Deep brachial a Radial a (with median

n) deep palmar arch

Ulnar a (with ulnar n) superficial palmar arch

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

The aortic arch gives off the brachiocephlic trunk (right subclavian) and the left subclavian arteries course into the arm and change their names to the axillary arteries (axillar region) which then continue into the arm as the brachial arteries The brachial artery gives off a deep brachial artery high in the arm which courses in the posterior compartment The brachial artery divides into the ulnar and radial arteries of the forearm and hand

Blood Supply

Spatium interscalenum bullContent

1048766The roots of the brachial plexus(C5-T1)1048766Subclavian artery(which becomes the axillary artery as it crosses the lateral boarder of rib1)

Figure 1923b

Vertebral artery

Costocervical trunkThoracoacromial arteryAxillary artery

Subscapular artery

Radial arteryUlnar artery

Brachial artery

Suprascapular arteryThyrocervical trunk

Posterior circumflexhumeral arteryAnterior circumflexhumeral artery

Deep artery of armCommoninterosseousartery

Deep palmar archSuperficial palmar archDigital arteries

Common carotidarteries

Right subclavian arteryLeft subclavian artery

Brachiocephalic trunkPosterior intercostalarteriesAnterior intercostalarteryInternal thoracic artery

Lateral thoracic arteryDescending aorta

Arteries of the Upper Limb Subclavian passes

between clavicle amp 1st rib

Vessel changes names as passes to different regions subclavian to

axillary to brachial to radial amp ulnar

brachial used and radial artery for pulse

Frolich Human AnatomyUpprLimb

Vascular supply Subclavianaxillary

radial Collateral circulation

Posterioranterior circumflex humeral

Deep brachial a Radial a (with median

n) deep palmar arch

Ulnar a (with ulnar n) superficial palmar arch

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Spatium interscalenum bullContent

1048766The roots of the brachial plexus(C5-T1)1048766Subclavian artery(which becomes the axillary artery as it crosses the lateral boarder of rib1)

Figure 1923b

Vertebral artery

Costocervical trunkThoracoacromial arteryAxillary artery

Subscapular artery

Radial arteryUlnar artery

Brachial artery

Suprascapular arteryThyrocervical trunk

Posterior circumflexhumeral arteryAnterior circumflexhumeral artery

Deep artery of armCommoninterosseousartery

Deep palmar archSuperficial palmar archDigital arteries

Common carotidarteries

Right subclavian arteryLeft subclavian artery

Brachiocephalic trunkPosterior intercostalarteriesAnterior intercostalarteryInternal thoracic artery

Lateral thoracic arteryDescending aorta

Arteries of the Upper Limb Subclavian passes

between clavicle amp 1st rib

Vessel changes names as passes to different regions subclavian to

axillary to brachial to radial amp ulnar

brachial used and radial artery for pulse

Frolich Human AnatomyUpprLimb

Vascular supply Subclavianaxillary

radial Collateral circulation

Posterioranterior circumflex humeral

Deep brachial a Radial a (with median

n) deep palmar arch

Ulnar a (with ulnar n) superficial palmar arch

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Figure 1923b

Vertebral artery

Costocervical trunkThoracoacromial arteryAxillary artery

Subscapular artery

Radial arteryUlnar artery

Brachial artery

Suprascapular arteryThyrocervical trunk

Posterior circumflexhumeral arteryAnterior circumflexhumeral artery

Deep artery of armCommoninterosseousartery

Deep palmar archSuperficial palmar archDigital arteries

Common carotidarteries

Right subclavian arteryLeft subclavian artery

Brachiocephalic trunkPosterior intercostalarteriesAnterior intercostalarteryInternal thoracic artery

Lateral thoracic arteryDescending aorta

Arteries of the Upper Limb Subclavian passes

between clavicle amp 1st rib

Vessel changes names as passes to different regions subclavian to

axillary to brachial to radial amp ulnar

brachial used and radial artery for pulse

Frolich Human AnatomyUpprLimb

Vascular supply Subclavianaxillary

radial Collateral circulation

Posterioranterior circumflex humeral

Deep brachial a Radial a (with median

n) deep palmar arch

Ulnar a (with ulnar n) superficial palmar arch

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Arteries of the Upper Limb Subclavian passes

between clavicle amp 1st rib

Vessel changes names as passes to different regions subclavian to

axillary to brachial to radial amp ulnar

brachial used and radial artery for pulse

Frolich Human AnatomyUpprLimb

Vascular supply Subclavianaxillary

radial Collateral circulation

Posterioranterior circumflex humeral

Deep brachial a Radial a (with median

n) deep palmar arch

Ulnar a (with ulnar n) superficial palmar arch

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Frolich Human AnatomyUpprLimb

Vascular supply Subclavianaxillary

radial Collateral circulation

Posterioranterior circumflex humeral

Deep brachial a Radial a (with median

n) deep palmar arch

Ulnar a (with ulnar n) superficial palmar arch

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

1 a circumflexa scapulae ( a subscapularis ) and a suprascapular (from tr thyrocervicalis )2 a circumflexa scapulae (a subscapularis ) and a transversa colli (a subclavia ) 3 a thoracica superior a thoracica lateralis a thoracodorsalis (a axillaris ) and a intercostalis suprema rr intercostales anteriores (a subclavia )

Important anastomosis axillary and subclavian arteries are

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

CUBITAL FOSSA

The brachial artery divides into the ulnar and radial arteries of the forearm and hand

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

1 Brachial artery (a brachialis)2 Deep shoulder artery (a profunda brachii)3 The upper collateral ulnar artery (a collateralis ulnaris superior)4 Lower collateral ulnar artery (a collateralis ulnaris inferior)5 Anterior branch of the ulnar swivel artery (r anterior a recurrens ulnaris)6 Posterior branch of the ulnar swivel artery (r posterior a recurrens ulnaris)7 Ulnar swivel artery (a recurrens ulnaris)8 Ulnar artery (a ulnaris)9 Common interosseous artery (a interossea communis)10 Anterior interosseous artery (a interossea anterior)11 Posterior interosseous artery (a interossea posterior)12 Swivel interosseous artery (a interossea recurrens)13 Radial artery (a radialis)14 Radial swivel artery (a recurrens radialis)15 The middle collateral artery (a collateralis media)16 Radial collateral artery (a collateralis radialis)

Schematic representation of the arterial network of elbow joint

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Rete carpi dorsale

rcarpeus dorsales (from a radialis) r carpeus dorsales (from a ulnaris ) aa interosseae anterior et posterior (from a ulnaris)

Aarcus palmaris superficialis

a ulnaris and r palmaris superficialis (from a radialis )

Arcus palmaris profundus

а radialis and r palmaris profundus (from a ulnaris )

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Frolich Human AnatomyUpprLimb

Anatomical Snuffbox Lateral = Epollicis brevis Medial = E pollicis longus Floor = scaphoid styloid of radius Contains Radial Artery (pulse)

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Determining the arterial pulse on the upper limbs

The Axillary pulse palpated in the lower part of the lateral wall of the armpit (axillary artery)The Brachial pulse it is determined by brachial artery within the upper extremity near the elbow The Radial pulse palpated on the lateral side of the wrist(radial artery)The Ulnar pulse defined on the medial part of the wrist (ulnar artery)

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Clinical note- Any structure (such as a cervical rib) which reduces the size of the spacium interscalenum can compromise blood flow and innervation to the upper limb reduced radial pulse paresthesia andor motor weakness (venous return is not impaired)

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Veins of the upper limbVeins of the upper limb are divided into superficial and deep drainage Deep drainage follows the arteries previously mentioned and are named similarly (ie brachial arterymdashbrachial vein) The superficial drainage is the cephalic and basilic veins which drain subcutaneous tissue and eventually drain

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Veins of the upper limb

SUPERFICIAL VEINS

-DORSAL VENOUS NETWORK-CEPHALIC VEIN-BASILIC VEIN-MEDIAN CUBITAL VEIN-MEDIAN VEIN OF FOREARM

-RADIAL VEIN (2)-ULNAR VEIN (2)-BRACHIAL VEIN (2)-AXILLARY VEIN (1)

-DEEP VEINS

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Figure 1928b

Right subclavian veinBrachiocephalic veins

Axillary veinBrachial veinCephalic veinBasilic vein

Median cubital vein

Median antebrachialvein

Basilic vein

Internal jugular veinExternal jugular veinLeft subclavian veinSuperior vena cavaAzygos vein

Inferior vena cavaAscending lumbar vein

Accessory hemiazygosveinHemiazygos veinPosterior intercostals

Ulnar veinDeep palmar venous archSuperficial palmar venous archDigital veins

Cephalic veinRadial vein

Anterior view

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Upper Limb

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Spinal Nerves 31 pairs ndash contain thousands of

nerve fibers

Connect to the spinal cord 8 pairs of cervical nerves (C1-

C8) 12 pairs of thoracic nerves

(T1-T12) 5 pairs of lumbar nerves (L1-

L5) 5 pairs of sacral nerves (S1-S5) 1 pair of coccygeal nerves

(Co1)

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

The plexusesForms by ventral rami

Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus

Thoracic ventral rami do not form nerve plexuses

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial Plexus The brachial plexus

is a network of nerve fibers running from the spine formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8 T1)

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial plexus componentsbullsupraclavicular part

Trunks (3)bullsupraclavicular partbullUpper (superior) trunkformed by the union of roots C5 amp C6

bullMiddle trunkthe lateral extension of the C7 root

bullLower (inferior) trunk formed by the union of roots C8 amp T1

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial plexus components

Cords (3)

bullLateral cord formed by the union of anterior divisions of the superior amp middle trunks (C5 C6 amp C7)

bullMedial cordformed by the anterior division of the inferior trunk (C8 amp T1)

bullPosterior cord formed by the union of the three posterior divisions (C5 to T1)

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

bull Posterior compartmentmdashposterior cordbull Anterior compartmentmdashmedial lateral cordsbull Name of cord is relative to axillary artery

Brachial Plexus

1 UPPER TRUNK2 MIDDLE TRUNK3 LOWER TRUNK

Supraclavicular part

Infraclavicular part

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial Plexus

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial Plexus

Fasciculus

lateralis

n musculocutaneus

rlateralis nmedianus

Fasciculus

medialis

ncutaneus brachii

medialis

ncutaneus antebrachii

medialis

n ulnaris

r medialis

nmedianus

Fasciculus

posterior

n axillaris

n radialis

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

INPORTANT NERVES AND THEIR AREA OF SUPPLY

MUSCULOCUTANEOUS NERVEA) SUPPLIES THE BICEPS CORACOBRACHIALIS AND

BRACHIALIS AXILLARY NERVE- SUPPLIES THE DELTOID AND TERES MINOR MUSCLE- SUPPLIES THE SHOULDER JOINTRADIAL NERVE- SUPPLIES THE TRICEPS - SUPPLIES THE BRACHIORADIALIS- SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial plexus Main nervesMusculocutaneous ndash

to arm flexorsMedian ndash anterior

forearm muscles and lateral palm

Ulnar ndash anteromedial muscles of forearm and medial hand

Axillary ndash to deltoid and teres minor

Radial ndash to posterior part of limb

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial plexus Major branches a Axillary Nerve (shoulder regionmdash2 muscles) b Musculocutaneous Nerve (anterior compartment of arm) c Radial Nerve (posterior compartment of arm and forearm) d Median Nerve (anterior compartment of forearmmdash1frac12 exceptions) e Ulnar Nerve (intrinsic hand musclesmdashexcept thenar eminence)

Innervation

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Brachial plexus

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

IMPORTANT NERVES AND AREA OF SUPPLY

1 MEDIAN NERVE( formed from both medial and lateral cord)- a) supplies all the flexors of the forearm b) intrinsic muscles in the lateral palm including thenar eminence) 2 ULNAR NERVE a) supplies the flexor carpi ulnaris b) supplies most of the intrinsic muscles of the hand including the

hypothenar eminence and skin on the medial side of the hand

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

CLINICAL APPLICATION

- injury to median nerve-rdquo APE HANDrdquo

- injury to ulnar nerve-rdquo CLAW HANDrdquo

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

3THE RADIAL NERVE

INJURY TO RADIAL NERVE- rdquoWRIST DROPrdquo

Motor FunctionsAs mentioned above the triceps brachii muscle is innervated by the radial nerve this muscle extends the arm at the elbow In the forearm it gives rise to the deep branch of the radial nerve which innervates the muscles in the posterior compartment of the forearmSensory FunctionsThe radial nerve gives rise to cutaneous branches that supply sensory innervation to the skin for most of the back of the arm and hand

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

CUTANEOUS INNERVATION

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Sensory innervation of the hand

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

UMRU

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Lymphatic System of the upper extremity

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

The lymph glands of the upper extremity The lymph glands of the upper

extremity are divided into two sets-superficial and deep

The superficial lymph glands (supratrochlear and deltoideopectoral glands)

The deep lymph glands The Axillary Glands are of large size vary from twenty to thirty in number and may be arranged in the following groups

lateral anterior or pectoral posterior or subscapular central or intermediate medial or subclavicular

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43

Thank you for attention

• The Department of Human anatomy
• Plan
• PowerPoint Presentation
• Spatium interscalenum
• Slide 5
• Arteries of the Upper Limb
• Vascular supply
• Slide 8
• Slide 9
• Slide 10
• Slide 11
• Slide 13
• Slide 14
• Determining the arterial pulse on the upper limbs
• Clinical note
• Veins of the upper limb
• Slide 18
• Slide 19
• Upper Limb
• Spinal Nerves
• The plexuses
• Brachial Plexus
• Brachial plexus components
• Slide 25
• Slide 26
• Slide 27
• Slide 28
• Slide 29
• INPORTANT NERVES AND THEIR AREA OF SUPPLY
• Brachial plexus
• Slide 32
• Slide 33
• Slide 34
• IMPORTANT NERVES AND AREA OF SUPPLY
• CLINICAL APPLICATION
• 3THE RADIAL NERVE
• CUTANEOUS INNERVATION
• Sensory innervation of the hand
• UMRU
• Slide 41
• The lymph glands of the upper extremity
• Slide 43