Frolich, Human Anatomy,UpprLimb UPPER LIMB What is a limb? Skeleton Joints Shoulder/Scapula muscles...

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Transcript of Frolich, Human Anatomy,UpprLimb UPPER LIMB What is a limb? Skeleton Joints Shoulder/Scapula muscles...

  • Slide 1
  • Frolich, Human Anatomy,UpprLimb UPPER LIMB What is a limb? Skeleton Joints Shoulder/Scapula muscles Brachial plexus getting spinal nerves out onto limb Musclesanterior and posterior compartments Sensory innervation Surface anatomy From Royal Collection da Vinci drawings
  • Slide 2
  • Frolich, Human Anatomy,UpprLimb What is a limb? Ventral somatic outgrowth of outer tube Bones (made of bony tissue, cartilage, and other tissues) Joints Muscles Nerves (with motor neurons to muscles, sensory neurons to skin, proprioceptors) No viscera--all innervation is somatic (motor or sensory) from ventral ramus of spinal nerve (except autonomics to blood vessels)
  • Slide 3
  • Frolich, Human Anatomy,UpprLimb Upper Limb Skeleton Scapula Humerus Radius, ulna Carpals-- proximal, distal Digits Metacarpals Phalanges
  • Slide 4
  • Frolich, Human Anatomy,UpprLimb Joints
  • Slide 5
  • Frolich, Human Anatomy,UpprLimb
  • Slide 6
  • Muscle origins and insertions Muscle crosses joint Origin is usually proximal and insertion is usually distal Origin is considered fixed in analyzing muscle action Muscle action (concentric) is given by movement of insertion relative to origin across joint Remember: Sometimes insertion might be fixed Muscle may be active isometrically and concentrically giving different real function during real activity
  • Slide 7
  • Frolich, Human Anatomy,UpprLimb Muscles of Scapula If INSERTION on scapula, muscle moves scapula Trapezius Rhomboids Pectoralis Minor Serratus Ventralis Levator Scapulae If ORIGIN on scapula, muscle moves arm Teres Major Latissimus Dorsi (partially on scapula)
  • Slide 8
  • Frolich, Human Anatomy,UpprLimb Rotator Cuff Muscles originate on fossae of scapula Help support open socket of shoulder joint Insert around ball of femur Medial and lateral rotation of upper limb Typical baseball pitcher injury Supraspinatus Infraspinatus Teres minor Subscapularis
  • Slide 9
  • Frolich, Human Anatomy,UpprLimb Axilla = Armpit Region between arm and chest Boundaries Ventral - pectoral muscles Dorsal = latissimus dorsi, teres major subscapularis Medial = serratus ventralis Lateral = bicipital groove of humerus Contents Axillary nerves and blood vessels Axillary lymph nodes And.theBrachial plexus
  • Slide 10
  • Frolich, Human Anatomy,UpprLimb
  • Slide 11
  • Posterior Compartmentposterior cord Anterior compartmentmedial, lateral cords Name of cord is relative to axillary artery Brachial Plexus
  • Slide 12
  • Frolich, Human Anatomy,UpprLimb Brachial plexus organizes nerves out to muscles of upper limb One posterior nerve Radial n. Three anterior nerves Musculocutaneous n. Median n. Ulnar n.
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  • Frolich, Human Anatomy,UpprLimb Muscles and nerves by compartment
  • Slide 14
  • Frolich, Human Anatomy,UpprLimb POSTERIOR AND ANTERIOR COMPARTMENTS
  • Slide 15
  • Frolich, Human Anatomy,UpprLimb Bicepsanterior compartment, flexion (M-C n.) Tricepsposterior compartment, extension (radial n.)
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  • Frolich, Human Anatomy,UpprLimb Anterior Compartment Forearm--flexors Flexor Carpi Radialis Flexor Retinaculum Medial Epicondyle Flexor Digitorum Superficialis is deep to other flexors Flexor Carpi Ulnaris Brachioradialis Pronator Teres Anterior View
  • Slide 17
  • Frolich, Human Anatomy,UpprLimb Posterior Compartment of Forearm--extensors Extensor digitorum Extensor carpi ulnaris Ext Carpi Radialis Longus Brachioradialis Lateral Epicondyle Posterior View
  • Slide 18
  • Frolich, Human Anatomy,UpprLimb ANTERIOR MUSCLES M-C nerve Biceps brachialis Median nerve Forearm flexors Thumb intrinsics (1M$ nerve) Ulnar nerve Flexor carpi ulnaris Hand intrinsics POSTERIOR MUSCLES Muscles (radial nerve) Triceps Anconeus Brachioradialis Carpal, digit extensors
  • Slide 19
  • Frolich, Human Anatomy,UpprLimb Sensory from limb (dermatomes/sensory skin segments from spine) Dermatomes extend over limbs Twisted orientation reflects twisting of limb during development Named nerves generally innervate skin over muscles that they innervate
  • Slide 20
  • Frolich, Human Anatomy,UpprLimb Sensory territory of nerves REMEMBER: Brachial plexus re-directs spinal routes into named nerves covering certain territory Cutaneous branches of medial cord/ulnar nerve
  • Slide 21
  • Frolich, Human Anatomy,UpprLimb Routes of nerves (in human) M-C: between biceps brachii and brachialis Median: medial/posterior to biceps, branches into forearm flexors at elbow then to hand through carpal tunnel Recurrent median (1M$) superficial at wrist to thumb over thenar emminence) deficit - apes hand Ulnar: medial in arm, posterior to medial epicondle of humerus (funny bone) down medial forearm medial to carpal tunnel into palm Radial: deep posterior arm around lateral epicondyle of humerus to forearm (deep and superficial branches)
  • Slide 22
  • Frolich, Human Anatomy,UpprLimb Ulnar Nerve Brachial Artery Median Nerve Ulnar Nerve Median Nerve Radial Artery Musculocutaneous NerveUlnarArtery Wheres Radial Nerve?
  • Slide 23
  • Frolich, Human Anatomy,UpprLimb Surface Anatomy of Upper Limb Biceps + Triceps brachii Olecranon Process Medial Epicondyle Cubital Fossa Anterior surface elbow Contents Brachial Artery Median Nerve Boundaries Medial = Pronator teres Lateral = Brachioradialis Superior = Line between epicondyles
  • Slide 24
  • Frolich, Human Anatomy,UpprLimb Surface Anatomy of Upper Limb Carpal Tunnel Carpals concave anteriorly Carpal ligament covers it Contains: long tendons, Median nerve Inflammation of tendons = compression of Median nerve Anatomical Snuffbox Lateral = E.pollicis brevis Medial = E. pollicis longus Floor = scaphoid, styloid of radius Contains Radial Artery (pulse)
  • Slide 25
  • Frolich, Human Anatomy,UpprLimb Suggestion: a muscle table organized by Joint crossed? Nerve innervating? Action? Compartments? All of the above?
  • Slide 26
  • Frolich, Human Anatomy,UpprLimb