Uppp Flashcards
(196 cards)
1
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676
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Chapter 6 • Upper Limb
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3
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Acromion
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4
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Coracoid
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process
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Glenoid
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cavity
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Facet for clavicle
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(A)
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Subscapular fossa
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Scapular
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mass
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Costal surface
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(C) Posterior view
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Supraspinous fossa
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Mass of
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free limb
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Humerus
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Posterior surface
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Clavicle (suspending strut)
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-Acromioclavicular joint
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Coracoclavicular ligament
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(suspending device and
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point of balance)
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Head of humerus
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Glenohumeral joint
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Suprascapular notch
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Coracoid process
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Crest of spine
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Acromion
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Head of scapula
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Neck of scapula
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The superior border is the thinnest and shortest of the three
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borders.
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Spine of scapula
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The scapula is capable of considerable movement on the
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thoracic wall at the physiological scapulothoracic joint
pro-
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viding the base from which the upper limb operates. These
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movements
enabling the arm to move freely
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later in this chapter with the muscles that move the scapula.
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Supraglenoid
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tubercle
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Deltoid tubercle of spine
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Infraspinous
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Acromion
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The humerus (arm bone)
the largest bone in the upper
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limb
articulates with the scapula at the glenohumeral joint
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and the radius and ulna at the elbow joint (Figs. 6.1
6.3
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6.5C). The proximal end of the humerus has a head
surgical
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and anatomical necks
and greater and lesser tubercles. The
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spherical head of the humerus articulates with the glenoid
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cavity of the scapula. The anatomical neck of the humerus
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is formed by the groove circumscribing the head and sepa-
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rating it from the greater and lesser tubercles. It indicates
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the line of attachment of the glenohumeral joint capsule. The
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surgical neck of the humerus
a common site of fracture
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is the narrow part distal to the head and tubercles (Fig. 6.3B).
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fossa
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Supraspinous
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fossa
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Spine
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Infraspinous
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fossa
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Lateral view
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Medial
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border
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Superior angle
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(B) Posterior surface
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Acromioclavicular (AC) joint
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-Clavicular joint
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Coracoclavicular
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ligament
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Coracoid
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process
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Infraglenoid
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tubercle
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-Scapula
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Lateral border
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of scapula
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Inferior angle
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Superior
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border
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Acromion
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Acromial
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angle
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Lateral
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angle
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Lateral
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FIGURE 6.5. Right scapula. A. The bony features of the costal and posterior surfaces of the scapula. B. The borders and angles of the scapula.
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C. The scapula is suspended from the clavicle by the coracoclavicular ligament
at which a balance is achieved among the weight of the scapula and
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its attached muscles plus the muscular activity medially and the weight of the free limb laterally.
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border
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Inferior
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angle
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The junction of the head and neck with the shaft of the
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humerus is indicated by the greater and lesser tubercles
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which provide attachment and leverage to some scapulo-
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humeral muscles (Fig
6.3A && B). The greater tubercle
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is at the lateral margin of the humerus
whereas the lesser
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tubercle projects anteriorly from the bone. The intertu-
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bercular sulcus (bicipital groove) separates the tubercles
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and provides protected passage for the slender tendon of the
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long head of the biceps muscle.
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The shaft of the humerus has two prominent features:
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the deltoid tuberosity laterally
for attachment of the del-
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toid muscle
and the oblique radial groove (groove for
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radial nerve
spiral groove) posteriorly
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nerve and profunda brachii artery lie as they pass anterior to
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the long head and between the medial and the lateral heads
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of the triceps brachii muscle. The inferior end of the humeral
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shaft widens as the sharp medial and lateral supra-epicon-
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dylar (supracondylar) ridges form
and then end distally in
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the especially prominent medial epicondyle and the lat-
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eral epicondyle
providing for muscle attachment.
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The distal end of the humerus--including the trochlea
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capitulum
olecranon
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What characterizes the upper limb?
The upper limb is characterized by its mobility and ability to grasp, strike, and conduct fine motor skills (manipulation).
## Footnote
These characteristics are especially marked in the hand when performing manual activities, such as buttoning a shirt.
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What is the role of joints in the upper limb?
Synchronized interplay occurs between the joints of the upper limb to coordinate the intervening segments for smooth, efficient motion.
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What are the four major segments of the upper limb?
1. Shoulder 2. Arm (L. brachium) 3. Forearm (L. antebrachium) 4. Hand (L. manus)
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What is the pectoral girdle?
The pectoral girdle is a bony ring formed by the scapulae and clavicles, completed anteriorly by the manubrium of the sternum.
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What is the function of the arm?
The arm is the first segment of the free upper limb, connecting the shoulder and the elbow, and is the longest segment of the limb.
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What does the forearm connect?
The forearm extends between and connects the elbow and wrist.
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What is included in the hand?
The hand is formed around the carpus, metacarpus, and phalanges, and includes the wrist, palm, dorsum of hand, and digits.
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How do the upper and lower limbs compare?
The upper and lower limbs share common features but are distinct in structure, enabling different functions and abilities.
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What is the primary role of the upper limb?
The upper limb is not usually involved in weight bearing or motility, sacrificing stability for mobility.
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What connects the upper limb to the axial skeleton?
The upper limb is connected to the axial skeleton via the bony pectoral girdle.
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What is the clavicle?
The clavicle (collar bone) connects the upper limb to the trunk and has a double curve in a horizontal plane.
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What are the key features of the clavicle?
The clavicle serves as a moveable strut, allows scapula movement, and transmits shocks from the upper limb to the axial skeleton.
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What is the scapula?
The scapula (shoulder blade) is a triangular flat bone that lies on the posterolateral aspect of the thorax.
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What are the main features of the scapula?
The scapula has a spine, acromion, glenoid cavity, and provides attachments for muscles.
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What is the function of the glenoid cavity?
The glenoid cavity receives and articulates with the head of the humerus at the glenohumeral joint.
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What are the bony features of the scapula?
The scapula has several features including the supraspinous fossa, suprascapular notch, coracoid process, acromion, crest of spine, head of scapula, neck of scapula, and deltoid tubercle of spine.
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What is the function of the coracoclavicular ligament?
The coracoclavicular ligament acts as a suspending device and point of balance for the scapula.
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What is the thinnest border of the scapula?
The superior border is the thinnest and shortest of the three borders.
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What joint does the humerus articulate with?
The humerus articulates with the scapula at the glenohumeral joint and with the radius and ulna at the elbow joint.
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What are the anatomical features of the proximal end of the humerus?
The proximal end of the humerus includes the head, surgical neck, anatomical neck, greater tubercle, and lesser tubercle.
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What is the intertubercular sulcus?
The intertubercular sulcus (bicipital groove) separates the greater and lesser tubercles and provides a protected passage for the tendon of the long head of the biceps muscle.
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What are the prominent features of the shaft of the humerus?
The shaft of the humerus features the deltoid tuberosity laterally and the oblique radial groove posteriorly.
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What forms the condyle of the humerus?
The condyle of the humerus consists of the capitulum and trochlea, along with the radial, coronoid, and olecranon fossae.
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What is the role of the ulna in the forearm?
The ulna is the stabilizing bone of the forearm and is the medial and longer of the two forearm bones.
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What are the two prominent projections of the ulna?
The two prominent projections of the ulna are the olecranon and the coronoid process.
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What is the function of the radial notch on the ulna?
The radial notch receives the broad periphery of the head of the radius.
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What is the radius?
The radius is the lateral and shorter of the two forearm bones, with a concave head for articulation with the capitulum of the humerus.
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What are the carpal bones?
The carpal bones consist of eight small bones arranged in proximal and distal rows, providing flexibility to the wrist.
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What are the carpal bones in the proximal row?
The proximal row includes the scaphoid, lunate, triquetrum, and pisiform.
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What are the carpal bones in the distal row?
The distal row includes the trapezium, trapezoid, capitate, and hamate.
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What is the structure of the metacarpus?
The metacarpus consists of five metacarpal bones, each with a base, shaft, and head.
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What articulates with the proximal surfaces of the distal row of carpal bones?
The proximal row of carpal bones articulates with the proximal surfaces of the distal row of carpal bones.
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What does the metacarpus form?
The metacarpus forms the skeleton of the palm of the hand between the carpus and the phalanges.
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How many metacarpal bones are there?
There are five metacarpal bones (metacarpals).
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What are the parts of each metacarpal?
Each metacarpal consists of a base, shaft, and head.
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What do the proximal bases of the metacarpals articulate with?
The proximal bases of the metacarpals articulate with the carpal bones.
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What do the distal heads of the metacarpals articulate with?
The distal heads of the metacarpals articulate with the proximal phalanges and form the knuckles of the hand.
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Which metacarpal is the thickest and shortest?
The 1st metacarpal (of the thumb) is the thickest and shortest of these bones.
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What distinguishes the 3rd metacarpal?
The 3rd metacarpal is distinguished by a styloid process on the lateral side of its base.
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How many phalanges does each digit have?
Each digit (finger) has three phalanges except for the first (the thumb), which has only two.
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What is the structure of each phalanx?
Each phalanx has a base proximally, a shaft (body), and a head distally.
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Which phalanges are the largest?
The proximal phalanges are the largest.
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What is the purpose of radiographs of the wrist and hand?
Radiographs of the wrist and hand are commonly used to assess skeletal age.
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When do ossification centers usually appear?
Ossification centers are usually obvious during the 1st year; however, they may appear before birth.
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What is notable about the clavicle's palpability?
The clavicle is subcutaneous and can be easily palpated throughout its length.
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What forms the palpable elevation at the acromioclavicular joint?
The acromial end of the clavicle often rises higher than the acromion, forming a palpable elevation at the acromioclavicular joint.
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What is the significance of the elasticity of the skin over the clavicle?
The elasticity of the skin over the clavicle is useful when ligating the third part of the subclavian artery.
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Where does the superior angle of the scapula lie when the upper limb is in anatomical position?
The superior angle of the scapula lies at the level of the T2 vertebra.
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What can be felt at the lateral side of the clavipectoral triangle?
The coracoid process of the scapula can be felt by palpating deeply at the lateral side of the clavipectoral triangle.
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How can the head of the humerus be palpated?
The head of the humerus can be palpated by pushing the fingers well up into the axillary fossa.
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What is the most lateral bony point of the shoulder?
The greater tubercle of the humerus is the most lateral bony point of the shoulder.
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What is the position of the lesser tubercle of the humerus during palpation?
The lesser tubercle of the humerus may be felt with difficulty by deep palpation through the deltoid.
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What is the significance of the olecranon of the ulna?
The olecranon of the ulna can be easily palpated and is important in the diagnosis of certain elbow injuries.
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Where can the head of the radius be palpated?
The head of the radius can be palpated on the posterolateral aspect of the extended elbow joint.
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What is the position of the radial styloid process?
The radial styloid process can be easily palpated in the anatomical snuff box on the lateral side of the wrist.
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What is the relationship between the radial and ulnar styloid processes?
The relationship of the radial and ulnar styloid processes is important in the diagnosis of certain wrist injuries.
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What is the common cause of clavicular fractures?
Clavicular fractures are often caused by an indirect force transmitted from an outstretched hand during a fall.
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What happens to the clavicle after a fracture?
After a fracture of the clavicle, the sternocleidomastoid muscle elevates the medial fragment of bone.
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What is a common type of clavicular fracture in younger children?
A fracture of the clavicle is often incomplete in younger children, known as a greenstick fracture.
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What may pull the clavicle medially?
The adductor muscles of the arm, such as the pectoralis major.
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What happens to the clavicle when bone fragments override?
It shortens the clavicle.
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How may neonates fracture their clavicles?
During delivery if they have broad shoulders.
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What type of fracture is common in younger children?
A greenstick fracture.
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What is the first long bone to ossify?
The clavicle.
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When does ossification of the clavicle begin?
During the 5th and 6th embryonic weeks.
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What forms at the ends of the clavicle during ossification?
Cartilaginous growth zones.
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When does the sternal end of the clavicle fuse with the shaft?
Between 18 and 25 years of age.
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What is a possible congenital defect of the clavicle?
A bony defect between the lateral and medial thirds.
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What usually causes a fracture of the scapula?
Severe trauma, such as pedestrian-vehicle accidents.
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What is the most common type of humeral fracture in elderly people?
Fractures of the surgical neck.
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What type of fracture often results from a fall on the hand?
An impacted fracture.
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What is an avulsion fracture of the greater tubercle?
A small part of the tubercle is torn away.
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What commonly causes a transverse fracture of the shaft of the humerus?
A direct blow to the arm.
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What results from a severe fall on the flexed elbow?
An intercondylar fracture of the humerus.
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Which nerve is associated with the surgical neck of the humerus?
The axillary nerve.
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What usually causes fractures of the radius and ulna?
Severe injury.
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What is the most common fracture of the forearm?
A Colles fracture.
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What causes a Colles fracture?
Forced extension of the hand during a fall.
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What is a common complication of a scaphoid fracture?
Avascular necrosis of the proximal fragment.
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What may occur due to a fracture of the hamate?
Non-union of the fractured bony parts.
