Anatomy

Upper Limb

These regions are

Introduction
1. Scapular region
 Upper limb anatomy is studying the structure of the upper limb. 2. Pectoral region
 We divide upper limb into five regions to make upper limb easy to study. 3. Arm
4. Forearm
5. Hand

Scapula Pectoral
region region

Arm

Hand
Forearm

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Throughout the upper limb anatomy lessons, we will be learning,

1. Skeleton of the upper limb

 Bones of the upper limb
 Clavicle and Scapula; Bones of Pectoral and Scapula region
 Humerus; Bone of the arm
 Radius and Ulnar; Bones of the forearm
 Carpal bones, Metacarpal bones, Phalanges; Bones of the hand
 Joints and ligaments of the upper limb
 Main joints; shoulder joint, Elbow joint, Wrist joint
 Other joints
2. Muscles of the Upper limb
 Muscles of Scapular region
 Muscles of Pectoral region
 Muscles of Arm
 Muscles of Forearm
 Muscles of Hand
3. Blood supply of the Upper limb
 Arterial supply of the upper limb
 Arteries arising from aorta
 Axillary artery; course, branches, termination
 Brachial artery; course, branches, termination
 Radial artery; course, branches, termination
 Ulnar artery; course, branches, termination
 Venous drainage of the upper limb
4. Innervation/ Nerve supply of the upper limb
 Brachial plexus
 Musculocutaneous nerve
 Axillary nerve
 Median nerve
 Ulnar nerve
 Radial nerve
 Cutaneous supply of the upper limb
5. Lymphatic system of the upper limb
6. Special areas in upper limb
 Axilla
 Cubital fossa
 Carpal tunnel
7. Breast anatomy
 Structure
 Blood supply
 Innervation
8. Lymphatic system

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First, we will go through the bones of the upper limb

Skeleton of the upper limb

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Terms used to describe bones

Anatomical position

Medial/Lateral/Anterior/Posterior/superior/Inferior

A is more medial than B

B is more lateral than A

B A
Midline of the body
 Medial= towards the midline
 Lateral= away from the midline
 Anterior/ Ventral= Infront
 Posterior/ Dorsal= behind
 Superior= above
 Inferior= below

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We’ll first discuss on Clavicle and Scapula bones Muscles of the Scapula Region

Clavicle
Clavicle is the bone of the pectoral region, which connects upper limb to the axial skeleton.

Clavicle is a long bone which is placed horizontally, so it has a medial end, lateral end and a connecting
shaft.

Medial end and Lateral end of the clavicle

Medial end is quadrangular in shape. But it doesn’t
has clear margins.

It has

 Anterior surface
 Posterior surface
 Superior surface
 Inferior surface
 Medial surface

Medial surface of the Medial end articulates with the Lateral end is flat above downwards.
clavicular notch of the manubrium of the sternum. So, it It has
is called sternal end.
 Superior surface
Sternal end articulates with the manubrium and forms  Inferior surface
the Sternoclavicular joint.
 Lateral surface
 Anterior border
 Posterior border

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Lateral border of the Lateral end articulates with the acromion process of the scapula and forms the
Acromioclavicular joint.

Connecting shaft

Medial 2/3 of the clavicle is convex anteriorly. Lateral 1/3 of the clavicle is concave anteriorly.

Lateral 1/3 Medial 2/3

Shaft has

 Anterior surface
 Posterior surface
 Superior surface
 Inferior surface

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To make it easy to learn, shaft is divided into three equal parts.

Medial 1/3
Lateral 1/3 Middle 1/3

Superior surface of the shaft

Inferior surface of the shaft

In the medial 1/3 – has an oval impression. Provide attachments for the costoclavicular ligament

In the middle 1/3 – has a subclavian groove. Provide insertion to the subclavius muscle

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In the lateral 1/3 – has two parts: conoid tubercle and trapezoid ridge. They give attachments to the
coracoclavicular ligament

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 Scapula
Scapula is the bone of the Scapula region. It is a triangular plate like bone. As it is a triangular bone, it
has three borders and three angles. It is placed posterolateral on the thoracic cage.

Posterior view Anterior view

Borders

1. Superior border/ upper border; this has a notch called suprascapular notch.
 More horizontally placed
2. Medial border; more vertically placed.
3. Lateral border; obliquely placed

Angles

1. Superior angle; between the upper and medial borders.

2. Inferior angle; between the medial and lateral borders.
3. Lateral angle: has formed a fossa called glenoid fossa. Articulates with the head of the humerus
and forms the shoulder joint. Above and below the glenoid fossa there are two tubercles for
attachment of muscle fibres. They are supraglenoid and infraglenoid tubercles.

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It has two surfaces

1. Anterior surface/ventral surface; has the subscapular fossa

2. Posterior surface/dorsal surface; has two fossae. Supraspinous fossa which is placed above the
spinous process. Infraspinous fossa which is placed below the spinous process.

There are three processes projecting from scapula

1. Spinous process/ spine of the scapula; this process projects from the posterior aspect of the
medial border of the scapula. A large part of it is attached to the dorsal surface of the scapula. it
is a triangular plate like structure. It has a superior surface, inferior surface, and a crest.
 There is an area left between the glenoid fossa and the spinous process in the dorsal
surface of the scapula. this is called spinoglenoid notch/ greater scapula notch. It creates a
passage to communicate with the supraspinous and infraspinous fossae.
2. Acromion process: it continues with the spine of the scapula. it is directed medially and forward.
Medial end of the acromion process articulates with the lateral end of the clavicle forming the
acromioclavicular joint.
3. Coracoid process: it is a thumb like bend which is situated in the upper border of the scapula
lateral to the suprascapular notch.

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 Muscles of the Upper Limb
 There are so many muscles attach to the bones of the upper limb.
 They are essential for the movements of the upper limb
 We classify these muscles according to the region they present to make it easy to learn

So, there are mainly following muscle groups

1. Muscles of the scapular region

 In the dorsal surface
 In the ventral surface
2. Muscles of the pectoral region
3. Muscles of the back
4. Muscles of the arm
 Anterior compartment
 Posterior compartment
5. Muscles of the forearm
 Flexor compartment
 Extensor compartment
6. Muscles of the hand
 1st layer
 2nd layer
 3rd layer
 4th layer

We will study the muscle groups one by one

When we are studying a muscle, we should know the origin, insertion, movements done by the muscle
and the blood supply and nerve supply of the muscle.

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 Muscles of the Scapula Region
Muscles attached to the dorsal surface of the scapula

1. Supraspinatus
 Supraspinatus is the muscle in the supraspinous fossa of the dorsal surface of the scapula.

Origin of supraspinatus

It origins from the medial 2/3 of the supraspinous fossa of the dorsal surface of the scapula.

Insertion

It inserts to the superior impression of the greater tubercle of the posterior surface of the humerus.

Actions of supraspinatus

 It is a rotator cuff muscle. So, it steadies the humerus during movements.

 Abduction of the shoulder joint up to 15 degrees.
 Important in initiation and continuation of the abduction.

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2. Infraspinatus

Infraspinatus is the muscle of the infraspinous fossa of the dorsal surface of the scapula.

Origin of infraspinatus

It origins from the medial 2/3 of the infraspinous fossa of the dorsal surface of the scapula.

Insertion of infraspinatus

It inserts to the middle impression of the posterior surface of the grater tubercle of the humerus.

Actions of infraspinatus

 It is a rotator cuff muscle. So, it steadies the humerus during movements of the humerus.
 Lateral rotation of the arm/ shoulder joint

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3. Teres minor

This is a muscle with origins from a border of the scapula.

Origin of Teres minor

It origins from the upper 2/3 of the lateral border of the dorsal surface of the scapula.

Insertion of Teres minor

It inserts to the lower impression of the posterior surface of the greater tubercle of the humerus.

Actions of teres minor

 It is a rotator cuff muscle. So it steadies the humerus during its movements

 Lateral rotation of the arm

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4. Teres major

Origin of Teres major

It origins from the lower 1/3 of thee lateral border of the dorsal surface of the scapula.

Insertion of Teres major

It inserts to the medial lip of the bicipital groove of the humerus.

Actions of teres major

 Medial rotation of the arm

 Abduction of the arm

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Muscles attached to the ventral surface of the scapula

There is only one muscle in the subscapular fossa

5. Subscapularis

Origin of subscapularis

It origins from medial 2/3 of the subscapular fossa

Insertion of subscapularis

It inserts to the lesser tubercle of the humerus

Actions of subscapularis

 Medial rotation of the arm

 Adduction of the arm

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