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Describe the clavicle

  • Medial 1/3 convex
  • Middle 1/3 begins to curve backwards
    • Trunks of the brachial plexus lie in the supraclavicular notch posterior to this part.
  • Lateral 1/3 is flattened with a concave anterior border


What is below the anterior border of the lateral 1/3 of the clavicle?

The infraclavicular fossa and coracoid process of the scapula


Where in terms of surface anatomy is the coracoid process of the scapula?

3cm below the juction of the middle and lateral thirds of the clavicle


What ends the clavicle at the lateral part?

Acromioclavicular joint


What happens to the clavicle when raising the upper limb?

  • The lateral end of the clavicle elevates
  • As the upper limb is fully raised the whole clavicle rotates backwards so that the normal anterior surface of the clavicle faces more superiorly.


Where is the medial border of the scapule?

Approximately 5cm lateral to the spines of T2-T8 vertebrae

(It is hard to palpate the actual border due to attachment of rhomboids etc.)


Where is the inferior angle of the scapula?

Normally overlies the posterolateral parts of the 7th/8th ribs - can be easily palpated.


Why can't the superior angle of the scapula not be easily palpated?

Because of the muscle mass of the superficial muscle layer of the back


Why can't the lateral border of the scapula not be easily palpated?

Because it is usually hidden under muscles, for example, teres major


What happens to the inferior angle of the scapula with raising of the upper limb? Why?

  • It elevates
  • Without this movement, the head of the humerus comes into contact with the acromion process of the scapula as the limb raises, making it impossible to bring the limb above shoulder height.


When reaching the upper limb out in front, what happens to the medial border of the scapula?

The medial border moves forwards - this is protraction.



Why is the greater tubercle of the humerus difficult to palpate?

Because it is usually covered by deltoid


Which muscle group originates from the lateral epicondyle of the humerus?

The extensor muscles


Which muscle inserts onto the olecranon process?

Triceps brachii


Which structure lies in the intertubercular groove of the humerus?

The tendon of the long head of the biceps


Where is the medial epicondyle of the humerus?

Lies approximately 2cm above the elbow joint and 1cm below the level of the lateral epicondyle


Which muscle group originates from the medial epicondyle of the humerus?

The Forearm flexor mucles


There is a deep, bony groove on the posterior surface of the medial epicondyle of the humerus, carrying a cord-like structure. Which structure is this?

Ulnar nerve


Where is the coronoid process of the ulna?

Anteromedial to the medial epicondyle 


How do you palpate the hook of the hammate?

  • Place your fingers on either side of the pissiform bone 
  • Then move your fingers 1cm distal and slightly lateral to the pissiform and apply some moderate pressure.
  • 2 small branches of the ulnar nerve pass close to this bony landmark.


Where is the radial styloid process located?

What else is located here?

Within the anatomical snuff box

Scaphoid and trapezium 

The first metacarpal may also be palpated in the floor of the anatomical snuff box


Where can the proximal end of the thenar eminence be palpated?

1cm medial to the tip of the radial styloid process


What can be palpated 1cm distal to the tubercle of the scaphoid bone?

The trapezium


What type of joint is the first carpo-metacarpal joint?

Synovial saddle joint


Where does the dorsal tubercle of the radius lie?

Just above the level of the styloid process


Where does the trapezoid lie?

At the base of the 2nd metacarpal 


Where does the capitate lie?

At the base of the 3rd metacarpal


Where does the hammate lie?

At the base of the 4th and 5th metacarpals


Where, if you have the palmaris longus muscle, would its tendon appear upon clenching of fist and flexion of wrist?

Just medial to the tendon of flexor carpi radialis


Which structures form the boundaries of the anatomical snuff box?

Tendons of abductor pollicis longus, extensor pollicis brevis (lateral) and extensor pollicis longus (medial).