pediagenosis: UpperLimb
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Showing posts with label UpperLimb. Show all posts
Showing posts with label UpperLimb. Show all posts

Sunday, May 9, 2021

Deltoid Anatomy

Deltoid Anatomy


Deltoid Anatomy

Axillary nerve
Deltoid is a large multipennate muscle responsible for the rounded contour of the shoulder region (Fig. 3.10). The muscle overlies the shoulder joint and the attachments of the short scapular muscles to the upper end of the humerus (Fig. 3.11). Proximally, it has a continuous attachment to the lateral third of the clavicle and to the acromion and spine of the scapula. The distal attachment is to a roughened area, the deltoid tuberosity, midway down the lateral surface of the shaft of the humerus (Fig. 3.23). Deltoid acts only on the shoulder joint, where it is the main abductor. During this movement, produced by the acromial fibres, the joint is stabilized by the clavicular fibres and those from the scapular spine. Acting alone, the anterior fibres produce flexion, whereas the posterior fibres extend the shoulder joint. Deltoid is supplied by the axillary nerve, a terminal branch of the posterior cord of the brachial plexus.

Saturday, May 8, 2021

Axilla Anatomy

Axilla Anatomy


Axilla Anatomy
The axilla is the space between the root of the upper limb and the chest wall. It is traversed by the principal vessels and nerves that pass between the upper limb and the root of the neck. The shape and size of the axilla vary according to the position of the shoulder joint but when the limb is in the anatomical position the axilla is shaped as a truncated pyramid with a narrow apex (inlet) superiorly, a broad base and three walls (Fig. 3.12).

Structures that pass above pectoralis minor in the anterior wall of the axilla. Pectoralis major and fascia around pectoralis minor have been removed.

Fig. 3.14 Structures that pass above pectoralis minor in the anterior wall of the axilla. Pectoralis major and fascia around pectoralis minor have been removed.

Walls
The upper ribs and intercostal spaces, covered by serratus ante- rior, form the medial wall (Fig. 3.15), which is convex laterally. The anterior wall consists of pectoralis major overlying pectoralis minor and subclavius (Figs 3.14 & 3.16), while the posterior wall is formed by subscapularis, teres major and latissimus dorsi. The muscles of the anterior and posterior walls converge on the humerus (Fig. 3.15) so that the axilla is limited laterally by the narrow intertubercular sulcus of the humerus. The base of the axilla, convex upwards, is formed by fascia passing between the inferior margins of the anterior and posterior walls. The triangular apex of the axilla provides continuity between the root of the neck and the upper limb and is bounded by the clavicle, the superior border of the scapula and the first rib (Fig. 3.13).

Monday, April 19, 2021

Palm and Digits Anatomy

Palm and Digits Anatomy


Palm and Digits Anatomy
The hand comprises the wrist (carpus), the palm (metacarpus) and the digits (Figs 3.37 & 3.38). The palm of the hand (Fig. 3.39) contains the palmar aponeurosis, intrinsic muscles, tendons originating from muscles in the anterior compartment of the forearm, and palmar vessels and nerves. The intrinsic muscles comprise the thenar and hypothenar groups, the lumbricals and interossei, and adductor pollicis. The tendons enter the palm through the carpal tunnel (Fig. 3.98) deep to the flexor retinaculum. The skin of the anterior surface of the hand is thick, devoid of hair and contains many sweat glands. It is firmly bound to the underlying deep fascia, producing characteristic creases. Skin over the palmar surface of each distal phalanx is firmly tethered to the periosteum by fibrous septa, which enclose fat-filled spaces. Infection causing increased pressure in the pulp space may result in thrombosis of vessels supplying the distal phalanx causing bone necrosis.


Deep fascia of the palm
The deep fascia of the palm is thickened centrally to form the triangular palmar aponeurosis (Fig. 3.39) and is thinner at each side where it covers the thenar and hypothenar muscles. Proximally, the palmar aponeurosis attaches to the flexor retinaculum and is continuous with the tendon of palmaris longus. Distally, the aponeurosis gives rise to four pairs of digital slips, which cross the metacar- pophalangeal joints and attach to the proximal phalanges of the fingers via the fibrous flexor sheaths. The aponeurosis covers the superficial palmar arch, the median nerve and the tendons of the long flexors of the digits. Thickening and shortening of the aponeurosis in Dupuytren’s contracture produces fixed flexion of the metacarpophalangeal and proximal interphalangeal joints.
Short Scapular Muscles Anatomy

Short Scapular Muscles Anatomy


Short Scapular Muscles Anatomy
These short muscles, the four rotator cuff muscles and teres major, span the shoulder (glenohumeral) joint, attaching to the scapula and to the proximal part of the humerus (Figs 3.59 & 3.62).


Rotator cuff muscles
This important group of muscles, namely subscapularis, supraspinatus, infraspinatus and teres minor, is intimately related to the shoulder joint. By attaching not only to the tubercles of the humerus but also to the capsule of the joint, they hold the humeral head firmly in the glenoid fossa and help stabilize the joint.

Tuesday, May 5, 2020

Joints of the Hand Anatomy

Joints of the Hand Anatomy


Joints of the Hand Anatomy
The carpometacarpal, metacarpophalangeal and interphalangeal joints are synovial and allow the hand to perform its various functions, including the intricate movements involved in gripping objects. The intrinsic muscles perform delicate movements of the fingers; power is provided by contraction of the muscles in the compartments of the forearm.
Joints of Carpus Anatomy

Joints of Carpus Anatomy


Joints of Carpus Anatomy
The carpal bones are arranged in two rows: a proximal row, consisting of, from lateral to medial, scaphoid, lunate, triquetral and pisiform; and a distal row consisting of trapezium, trapezoid, capitate and hamate bones (Fig. 3.96).
Wrist Joint Anatomy

Wrist Joint Anatomy


Wrist Joint Anatomy
Mobility of the hand on the forearm is provided by a series of synovial joints. Most of the movement occurs at the radiocarpal (wrist) joint, supplemented by movement between the carpal bones themselves. However, minimal rotation occurs here but is achieved for the hand by pronation and supination.
Radioulnar Joints Anatomy

Radioulnar Joints Anatomy


Radioulnar Joints Anatomy
The radius and ulna articulate at the proximal and distal radioulnar joints, which are synovial. At the proximal joint, the head of the radius articulates with the radial notch of the ulna (Fig. 3.88). The head and neck are encircled by the anular ligament, which attaches to the anterior and posterior margins of the notch on the ulna (Fig. 3.92) and blends with the capsule and radial collateral ligament of the elbow. Thus the cavity of the proximal joint is continuous with that of the elbow.
Elbow Joint Anatomy

Elbow Joint Anatomy


Elbow Joint Anatomy
The elbow is a synovial hinge joint between the distal end of the humerus and the proximal ends of the radius and ulna (Fig. 3.88). Laterally, the capitulum of the humerus articulates with the slightly concave upper surface of the head of the radius.  Medially, the trochlea of the humerus articulates with the deep trochlear notch of the ulna. In the anatomical position (in which the elbow is extended and the forearm is supinated) the orientation of the joint surfaces produces a carrying angle, which displaces the hand somewhat laterally. This angle between the long axes of the arm and the forearm disappears when the forearm is pronated. The joint capsule (Figs 3.89 & 3.90) attaches proximally to the shaft of the humerus above the radial and coronoid fossae anteriorly and to the margins of the olecranon fossa posteriorly. Distally, it attaches to the anular ligament of the proximal radioulnar joint and to the margins of the trochlear notch of the ulna. Synovial membrane lines the capsule and clothes the underlying pads of fat that project into the radial, coronoid and olecranon fossae of the humerus. The cavity of the elbow joint is continuous with that of the proximal radioulnar joint.
Clavicular and Shoulder Joints Anatomy

Clavicular and Shoulder Joints Anatomy


Clavicular and Shoulder Joints Anatomy
Three joints contribute to the considerable mobility of the arm; movement occurs between the humerus and the scapula at the shoulder (glenohumeral) joint, and the scapula moves on the chest wall through the joints at each end of the clavicle. Although few muscles attach to the clavicle, the numerous muscles attached to the scapula and upper humerus all contribute to movement at the clavicular joints. Indeed, movement at the shoulder joint is almost always associated with movement at the sternoclavicular and acromioclavicular joints.

Monday, May 4, 2020

Dorsum of the Hand Anatomy

Dorsum of the Hand Anatomy


Dorsum of the Hand Anatomy
The dorsum of the hand is innervated by branches of the radial and ulnar nerves (Fig. 3.78). The superficial branch of the radial nerve usually supplies the skin of the lateral three and one-half digits (excluding the nail beds) and a corresponding part of the dorsum of the hand. Skin of the dorsal aspect of the first web space is usually supplied exclusively by the radial nerve and is tested when radial nerve injury is suspected. The skin over the remainder of the posterior aspect of the hand and the medial one and one-half fingers (excluding the nail beds) is supplied by dorsal branches of the ulnar nerve that arise in the anterior compartment and pass around the medial aspect of the wrist.
Posterior Compartment of the Forearm Anatomy

Posterior Compartment of the Forearm Anatomy


Posterior Compartment of the Forearm Anatomy
The posterior compartment of the forearm lies behind the radius and ulna and the intervening interosseous membrane. It contains the extensor muscles of the wrist and fingers, the extensors and long abductor of the thumb, and also brachioradialis, supinator and anconeus. The muscles are supplied by the posterior interosseous artery and nerve (deep branch of the radial nerve), assisted by the radial nerve itself. The compartment is enclosed by a layer of deep fascia, which attaches to the posterior (subcutaneous) border of the ulna. In the region of the wrist the fascia is thickened to form the extensor retinaculum (Fig. 3.69). The extensor tendons, invested by synovial sheaths, pass deep to the retinaculum and enter the hand.

Sunday, December 22, 2019

Muscles Attaching the Upper Limb to the Trunk Anatomy

Muscles Attaching the Upper Limb to the Trunk Anatomy


Muscles Attaching the Upper Limb to the Trunk Anatomy
Three muscles connect the root of the upper limb to the chest wall and are usually dissected with the thorax. For this reason, pectoralis major and minor and serratus anterior are described with the thoracic wall (p. 31). Only the posterior group of muscles attaching the limb and its girdle to the vertebral column are described here: trapezius, latissimus dorsi, levator scapulae and the rhomboids (Fig. 3.55).
Anterior Compartment of the Forearm Anatomy

Anterior Compartment of the Forearm Anatomy


Anterior Compartment of the Forearm Anatomy
The anterior compartment of the forearm (Fig. 3.4) contains a superficial and a deep group of muscles, which include flexors of the wrist, fingers and thumb and two muscles that act as pronators. The compartment is traversed by the median and ulnar nerves and by the radial and ulnar arteries with their venae comitantes. A layer of deep fascia continuous with a similar layer on the posterior aspect of the limb encloses the compartment and provides additional attachment for the superficial muscles. In front of the carpus, deep fascia forms the flexor retinaculum (Fig. 3.30), which lies anterior to tendons in the carpal tunnel (p. 124). Subcutaneous tissue overlying the compartment contains cutaneous nerves and tributaries of the cephalic and basilic veins. Branches of the medial and lateral cutaneous nerves of the forearm may continue distal to the wrist over the carpal region of the hand.
Cubital Fossa Anatomy

Cubital Fossa Anatomy


Cubital Fossa Anatomy
The cubital fossa is a triangular space in front of the elbow joint, bounded laterally by brachioradialis and medially by pronator teres (Fig. 3.28). By convention, the fossa is limited proximally by an imaginary line drawn between the two humeral epicondyles. The roof is formed by deep fascia, reinforced by the aponeurosis of biceps (Fig. 3.26).

Wednesday, November 20, 2019

Anterior Compartment of the Arm Anatomy

Anterior Compartment of the Arm Anatomy


Anterior Compartment of the Arm Anatomy
The anterior compartment of the arm contains three muscles (biceps brachii, coracobrachialis and brachialis), the brachial artery with its venae comitantes and three nerves (the median, ulnar and musculocutaneous nerves).

Tuesday, November 5, 2019

Cross Section of Hand: Axial View Anatomy

Cross Section of Hand: Axial View Anatomy


Cross Section of Hand: Axial View Anatomy
Flexor pollicis longus tendon 1st dorsal interosseous muscle, Interosseous muscle, Interosseous muscle, Interosseous muscle 1st lumbrical muscle, Adductor pollicis muscle 2nd lumbrical muscle, 4th lumbrical muscle, 3rd lumbrical muscle, Metacarpal 2, head, Metacarpal 3, Metacarpal 4, Metacarpal 5, head, Extensor digitorum tendon, Extensor digitorum tendon, Extensor digitorum tendon and extensor expansion, Extensor digitorum tendon, Extensor indicis tendon, Proximal phalanx 1, Flexor digitorum profundus tendons, Hypothenar muscles, Flexor digitorum profundus tendons Flexor digitorum superficialis tendons, Flexor digitorum superficialis tendons.

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