ANAT2000 6 Upper Limb 1 Fogg 2018 PDF

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Download ANAT2000 6 Upper Limb 1 Fogg 2018 PDF

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Upper Limb Bones & Joints Assoc. Prof. Quentin

A. F

BSc(Hons), PhD, FRCP

Y Al Harbi and QA Fogg (2014). Wrist mesh from CT data. University of Glasgow, UK.

Objectives

•

This class will address the: •

pectoral girdle

•

bones of the upper limb, including key features

•

joints of the upper limb

•

scaphoid fractures and joint disease

William Cheselden (1733) Osteographia, or The anatomy of the bones. London (William Bowyer).

ANTERIOR

Weight-bearing forelimbs of quadrupeds have limited additional functions due to: - reduced range of motion (ROM) - reduced precision within that ROM - increased interaction with the rest of the body

Kardong (1995) Wm. C. Brown Publishers

ANTERIOR Evolving away from the weight-bearing requirement allowed more several major advantages, but also some problems.

clavicle

And now modern humans have found ways to make some of those problems even greater!

bodybuilding.com

bodybuilding.com

scapula

humerus

au.sports.yahoo.com

sbs.com.au

aflphotos.com.au

so how is this attached to the body?

ANTERIOR

POSTERIOR

SUPERIOR

Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

acromioclavicular (AC) joint

sternoclavicular joint glenohumeral joint

SUPERIOR

acromial end

sternal end

LATERAL

MEDIAL

INFERIOR

conoid tubercle trapezoid line

ANTERIOR

interclavicular lig.

Sternum manubrium

suprasternal notch body

clavicle

Sternoclavicular Joint articular disc sternoclavicular lig.

2nd Rib

manubriosternal joint AKA sternal angle (of Louis)

ANTERIOR

POSTERIOR acromion process

suprascapular notch

suprascapular notch

coracoid process

acromion process

supraspinous fossa subscapular fossa infraspinous fossa glenoid fossa

Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

glenoid fossa

ANTERIOR head

greater tubercle

anatomical neck

intertubercular groove lesser tubercle

surgical neck

deltoid tuberosity

Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

SUPERIOR

ANTERIOR

POSTERIOR

proximal

coronoid fossa medial epicondyle

radial fossa lateral epicondyle

trochlea Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

capitulum

olecranon fossa

ANTERIOR

proximal

Medial Epicondyle

Lateral Epicondyle

site of the Common Flexor Origin

site of the Common Extensor Origin

long flexor mm., palmaris longus m. and pronator teres m. have their proximal attachments in this vicinity

long extensor mm. and supinator m.** have their proximal attachments in this vicinity

Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

** supinator m. is “wrapped” past this point, around the radius and then attached to the supinator crest of the ulna

ANTERIOR

POSTERIOR olecranon process coronoid process ulnar tuberosity

interosseous crest proximal head

styloid process Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

RADIAL trochlear notch radial notch supinator crest

ANTERIOR

POSTERIOR

ULNAR head neck

radial (bicipital) tuberosity

interosseous crest

proximal dorsal (Lister’s) tubercle styloid process ulnar notch Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

Fogg (2008)

olecranon process (of ulna)

radial head

radiohumeral joint

ulnohumeral joint proximal radioulnar joint

ANTERIOR (palmar/volar)

III II

IV

distal interphalangeal joints

V

proximal interphalangeal joints

I MEDIAL = ULNAR

LATERAL = RADIAL

phalanges

metacarpophalangeal joints

metacarpals

carpometacarpal joints intercarpal (midcarpal) joints

carpals

radiocarpal joint radius Sobotta – Atlas of Human Anatomy (2001) Lippincott Williams & Wilkins

ulna

trapezium -

forms base of thumb (1st CMC joint) most degenerative joint in the body

scaphoid -

most frequently fractured difficult to diagnose

Fogg (2004)

COLLE’S FRX •Posterior displacement (a Smith frx has anterior displacement) •“Shortening” of radius •Palpate styloid processes at same level

NORMAL

Fogg (2004)

SCAPHOID FRX the most fractured carpal bone

Fogg (2004)

Interphalangeal Joints •

• •

proximal (PIP) and distal (DIP) interphalangeal joints on each finger only one for the thumb strong ligament complex on either side

DON’T LEARN THESE LABELS!!

Schmidt and Lanz (2003) Thieme.

Learning Outcomes

Now you should be able to: •

describe the pectoral girdle

•

describe the bones of the upper limb, including their key features

•

describe joints of the upper limb

•

discuss scaphoid fractures and joint disease...