Upper Limb

Pectoral Girdle: Clavicle and Scapula (connects upper limb to thorax)

Clavicle, S Shape, Lateral end flatter

 Sternoclavicular Joint (ball-and socket synovial joint, fibrocartilage; to join limb to axial
skeleton)
 Acromioclavicular Joint (synovial, stabilized by two accessory ligaments)
 First Bones to Ossify (Intramembranous Ossification); but ends of clavicle by endochondral
ossification; convex anteriorly in medial two-thirds, cave for lateral

Clinical Relevance: Clavicle Fracture

 Weakest part is at junction of middle and lateral thirds; split into medial and lateral parts
 Medial part pulled upwards by Sternocleidomastoid, Lateral part is unable to be held upwards by trapezius due
to weight of arm, hence shoulder drops; but displaced medially due to pull of latissimus dorsi/pec. major

Scapula

3 Borders, Superior, Medial and Lateral; Acromion and Coracoid Process, Spine of Scapula,
Supraspinatus fossa, Infraspinatus fossa, Subscapular Fossa, Subscapularis Notch (Suprascapular
nerve), Infraglenoid tubercle, Supraglenoid tubercle; Glenohumeral Joint

Clinical Relevance: Winging of Scapula

 Serratus Anterior originates from Rib 1-8, attaching to the medial border of scapula, pulling against ribcage,
 Long Thoracic Nerve innervates Serratus Anterior, if damaged, scapula protrudes out back (winging)
 Arm cannot abduct above horizontal position as upward rotation of scapula is prevented
Upper Limb

Humerus

Head, Surgical Neck, Anatomical Neck, Greater Tubercle, Lesser Tubercle, Intertubercular Sulcus
(Bicipital Groove), Deltoid tuberosity (anterolateral), Radial Groove, Radial Fossa, Trochlea,
Olecranon Fossa, Coronoid Fossa, Medial Epicondyle, Lateral Epicondyle,

Ulna articulations: Olecranon, Trochlea, Coronoid Process,

Radius articulations: Radial Head,

 Upper Limb

Radial Fossa

Coronoid Fossa

Ulna (fatter one)

Upper Limb

Clinical Relevance: Humerus fractures: Nerve Injuries

 Surgical Neck, Axillary lies medial: not anatomical neck

 Radial Groove, Radial
o Mid-shaft Humerus fracture can lead to wrist drop
 Distal Humerus, Medial
 Medial Epicondyle, Ulna

Dislocation of Glenohumeral Joint

 Axillary nerve may be injured

 Upper Limb

Radius

Head, Radial Tuberosity, Shaft, Radial styloid Process, Ulna Notch

Clinical Relevance: Colles Fracture

 Distal fragment of radius displaced posteriorly, leading to ‘dinner fork’ deformity

Ulna

Distal and Proximal Radio-Ulna joint: Pivot Synovial Joint

Head, Ulna Tuberosity, Olecranon, Coronoid Process (both forms the trochlear notch), Radial Notch,
Ulna Styloid Process

Carpus

Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium

Clinical Relevance: Hand Fracture

 Avascular necrosis of proximal fragment of scaphoid may occur

 Hamate fracture may damage ulnar nerve
 Lunate Dislocation can affect median nerve

Fall On Outstretched Hands (FOOSH)

 Colles’ Fracture (distal end of radius) and Fracture of distal end of scaphoid are most common