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Flashcards in Bones Of Upper Limb Deck (51):
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Four segments of upper limb

Shoulder
Arm
Forearm
Hand

1

Shoulder region

Deltoid, pectoral, scapular and lateral part of lateral cervical region

2

Pectoral girdle

Bony ring, incomplete posteriorly, formed by scapulae and clavicles and completed anteriorly by manubrium of the sternum

3

Arm region

Between the shoulder and the elbow
Centered around humerus
Consists of anterior and posterior regions of the arm

4

Forearm region

Between elbow and wrist and contains ulna and radius
Consists of anterior and posterior regions of the forearm

5

Hand region

Distal to the forearm and contains the carpus, metacarpus and phalanges
Composed of the wrist, palm, dorsum of hand, and digits
Richly supplied with sensory endings for touch, pain and temperature

6

Superior appendicular skeleton

Pectoral girdle and bones of free part of upper limb
Articulates with axial skeleton only at sternoclavicular joint

7

Pectoral girdle is supported, stabilized and propelled by

Axio appendicular muscles
Which attach to the ribs, sternum and vertebrae of axial skeleton

8

Clavicle aka

Collar bone

9

Clavicle articulations

Sternal end with manubrium of sternum at sternoclavicular joint
A criminal end articulates with acromion of scapula at acromioclavicular joint

10

Structure of clavicle

Medial two thirds of shaft of clavicle are convex anteriorly
Lateral third is flattened and concave anteriorly

11

Functions or clavicle

Pivoting strut from whch scapula and free limb are suspended, keeping the free limb lateral to the thorax so that the arm has maximum freedom of motion
Fixing the strut in position, especially after it's elevation enables elevation of the ribs for deep inspiration
Forms one of boundaries of cervical axillary canal, affording protection to neurovascular bundle supplying upper limb
Transmits shocks from the upper limb to the axial skeleton

12

Bony structure of clavicle

Designated as a long bone
Has no medullary cavity
Spongy bone with a shell of compact bone

13

Scapula general info

Shoulder blade
Triangular flat bone that lies on posterolateral aspect of the thorax, overlying the 2nd through 7th ribs

14

Detailed structure of scapula

Convex posterior surface, divided by spine of scapula into small supra spinous fossa and larger infra spinous fossa
Concave costal surface has large sub scapular fossa
Medial, lateral, and superior borders
Superior and inferior angles
Lateral border is thickest part
Head of the scapula: where glenoid cavity is, in superior lateral border
Neck of scapula: just medial to the head
Supra scapular notch: superior border of scapula is marked near the junction of its medial two thirds and lateral third by notch
Acromion: subcutaneous point of the shoulder
Glenoid cavity: superolaterally, lateral surface of head of scapula articulates with head of humerus. Shallow, concave, oval fossa, directed anterolaterally and slightly superiorly
Coracoid process: superior to glenoid cavity and projects anterolaterally

15

Humerus in general

Largest bone in upper limb
Articulates with scapula and ulna and radius

16

Proximal end of humerus

Head of humerus articulates with glenoid cavity of the scapula
Inter tubercular sulcus (bicipital groove) separates lesser tubercle from greater tubercle
Anatomical neck of humerus separates the head from tubercles
Distal to tubercles is narrow surgical neck of humerus

17

Shaft of humerus

Deltoid tuberosity: laterally
Radial groove: groove for radial nerve, spiral groove: posterior for radial nerve and profunda brachii artery
Inferior end of humoral shaft widens as sharp medial and lateral supra epicondylar ridges form and then end distally in the prominent medial epicondyle and lateral epicondyle

18

Distal end of the humerus

Trochlea, olecranon, capitulum, coronoid and radial fossae makes up condylar of humerus

19

Capitulum

Lateral articulation with the head of the radius

20

Trochlea

Medial for articulation with trochlear notch of the ulna

21

Coronoid fossa

Superior to the trochlea anteriorly
Receives coronoid process of ulna during full flexion of elbow

22

olecranon fossa

Posteriorly accomodates olecranon of the ulna during extension of elbow

23

Radial fossa

Superior to capitulum anteriorly
Accomodates edge of the head of the radius when the elbow is fully flexed

24

ulna general

stabilizing bone of the forearm
medial and longer of two forearm bones

25

proximal end of ulna

olecranon: posteriorly
coronoid process:anteriorly
together: form walls of trochlear notch which articulates with trochlea of humerus
inferior to coronoid process is tuberosity of the ulna
on lateral side of coronoid process is radial notch, which articulates with the head of the radius
distal to radial notche is supinator crest, and between it and the distal part of coronoidprocess is supinator fossa

26

shaft of ulna

thick proximally, but it tapers, diminishing in diameter distally

27

distal end of ulna

narrow
rounded head of ulna with small conical, ulnar styloid process
does not articulate directly with carpal bones
separated from carpals by a fibrocartilaginous articular disc

28

radius general

lateral, and shorter of two forearm bones

29

radius proximal end

cylindrical head, short neck and radial tuberosity (projection from medial surface)
head is concave for articulation with the capitulum of humerus. also articulates medially with the radial notch of the ulna
the neck of the radius is the narrw part betweenthe head and radial tuberosity
the radial tuberosity demarcates the proximal end from the shaft

30

the shaft of the radius

has a lateral convexity and gradually enlarges as it passes distally

31

distal radius

medial aspect of distal end of the radius forms ulnar notch, which accomodates head of ulna
lateral aspect terminates distally as the radial styloid process. larger than the ulnar styloid process and extends farther distally
dorsal tubercle of the radiuslies between two of the shallow grooves for passage of the tendons of the forearm musclesand serves as a trochlea for the tendon of the long extensor of the thumb

32

bones of wrist

lateral to medial, proximal then distal
scaphoid, lunate, triquetram, pisiform
trapezium, trapezoid, capitate, hamate

33

scaphoid

boat shaped bone that has a prominent scaphoid tubercle

34

lunate

moon shaped bone that is broader anteriorly than posteriorly

35

triquetram

a pyramidal bone on the medial aspect of the carpus

36

pisiform

a small, pea shaped bone that lies on the palmar surface of the triquetram

37

trapezium

a four sided bone on the lateral side of the carpus

38

trapezoid

a wedge shaped bone

39

capitate

the head shaped bone thsat is the largest bone in the carpus

40

hamate

a wedge shaped bone which has a hooked process (the hook of hamate) that extends anteriorly

41

metacarpus

forms the skeleton of the palm of the hand between the carpus and the phalanges
composed of five metacarpals
each consists of a base, shaft and head
proximal bases articulate with carpal bones and distal heads articulate with the proximal phalanges and form knuckles
1st metacarpal is thumb

42

phalanges`

each digit has three phalanges (proximal, middle, distal) except for the first (thumb has no middle)
each phalanxhas a base, shaft (body) and a head (distal)
distal phalanges are flattened and expanded at their distal ends

43

fracture of clavicle

weakest part at junction of middle and lateral thirds
SCM elevates medial fragment of bone
trapezius is unable to hold up lateral fragment b/c of weight of limb, shoulder drops
lateral fragment pulled medially by muscles that adduct arm like pectoralis major

44

ossification of clavicle

first long bone to ossify via intramembranous ossification, during fifth and sixth embryonic weeksfrom medial and lateral primary centers. ends of clavicle later pass through cartilaginous phase, form growth zones similar to those of other long bones
secondary ossification center appears at sternal end and forms scale like epiphysis that begins to fuse with diaphysis between 18 and 25 years of age, completly fused between 25 and 31 years of age
sometimes, fusion of two ossification centers fails to occur: defect: usually bilateral

45

fracture of scapula

usually result of severe trauma, usually accompanied by fractured ribs
require little treatment because scap is covered by muscle
most fractures involve acromion

46

fractures of humerus

fractures of surgical neck of humerus especially common in osteoporosis: fall on hand
transverse fractures on shaft of humerus: direct blow to the arm
supra-epicondylar fracture: distal partof humerus
nerves may be injured
surgical neck: axillary nerve
radial groove: radial nerve
distal humerus: median nerve
medial epicondyle: ulnar nerve

47

fractures of ulna and radius

direct injury usually produces transverse fractures at same level, often middle third of both bones
b/c of interosseus membrane, fracture of one bone is likely dislocation of nearest joint
fracture of distal radius is most common fracture in people> 50 years of age
Colles fracture: complete fracture of distal 2 cm of radius: forced dorsiflexion of hand:comminuted and displaced dorsally; ulnar styloid avulsed

48

fractures scaphoid

results from a fall on palm with hand abducted
across narrow part (waist) of scaphoid
pain primarily on lateral side of wrist, especially during dorsiflexion and abduction of hand
radiographs immediately may not show, but 10 to 14 days later will
avascular necrosis of proximal fragment of scaphoid may lead to DJD of wrist

49

fracture of hamate

non union of fractured bony parts because of traction produced by attached muscles
because ulnar nerve is close to hook of hamate, may be injured, causing decreased grip strength of hand
ulnar artery may also be damaged

50

severe crushing injuries of hand

multiple metacarpal fractures, resulting in instability of the hand
fracture of distal phalanx: usually comminuted with hematoma
fractures of proximal and middle phalanges: usually crushing or hyperextension injuries