Upper limb

Muscles
• ATTACHMENTS OF UPPER LIMB TO THE AXIAL
SKELETON
• BONY CONNECTION - CLAVICLE
• MUSCULAR ATTACHMENTS - Trapezius,
Latissmus Dorsi, Levator Scapulae,
Rhomboideus Major, Rhomboideus Minor
 MUSCLES OF PECTORAL REGION
• PECTORALIS MAJOR
• PECTORALIS MINOR
• SUBCLAVIUS
 SERRATUS ANTERIOR
• The serratus anterior, also known as Boxer's muscle,

• originates on the surface of the 1st to 8th ribs at the

side of the chest and inserts along the
entire anterior length of the medial border of the
scapula.

• The serratus anterior acts to pull the scapula forward

around the thorax.
WINGING OF SCAPULA
 MUSCLES OF SHOULDER GIRDLE
• Deltoid

• Rotator cuff muscles- Supra Spinatus Infra

Spinatus, Subscapularis, Teres Minor.

• Teres major
 MUSCLES OF ARM
FLEXOR COMPARTMENT:
• BICEPS BRACHII
• CORACO BRACHIALIS
• BRACHIALIS

EXTENSOR COMPARTMENT
• TRICEPS
 MUSCLES OF FOREARM
Anterior Compartment: common flx.origin SUPERFICIAL
1.Pronator Teres
2.Flx Carpi Ulnaris
3.Palmaris Longus
4.Flx.Carpi Radialis
5.Flx.Digitorum Superficialis (sublimus)

DEEP:
1.Flx.Digitorum Profundus
2.Flx.Pollicis Longus
3.Pronator Quadratus
 POSTERIOR COMPARTMENT
SUPERFICIAL:
1. Anconeus
2. 2.Brachioradialis
3. 3.Ext.Carpi Radialis Longus
4. 4.Ext.Carpi Radialis Brevis
5. 5.Ext.Digitorum
6. 6.Ext.Digiti Minimi
7. 7.Ext.Carpi Ulnaris

DEEP
1.Abductor Pollicis Longus
2.Ext.Pollicis Brevis
4.Ext.Indicis
5.Supinator
 INTRINSIC MUSCLES OF THE HAND

Thenar muscles

• abductor pollicis brevis

• flx.pollicis brevis
• opponens pollicis
• Adductor pollicis

Hypothenar muscles-
•
palmaris brevis
• abductor digiti minimi
• flx.digiti minimi
• opponens digiti minimi

• Lumbricals -4
• Palmar interossei-4
• Dorsal interosei-4
 nerves
• Radial
• Ulnar
• Median
 Root value for upper limb nerves
• Label your fingers from C5 (thumb) to T1
(little finger). .

• Mnemonic: "3 Musketeers Assassinated 5

Rats, 5 Mice, and 2 Unicorns." .
 Name of nerves
• Musician’s nerve – ulnar
• Labourer’s nerve – median
• Nerve of bell- long thoracic nerve
• Surgeons nerve- axillary
 Hand applied
• Wrist drop
• Claw hand
• Ape hand

(DR CUMA)
• BENEDICTION HAND
JOINTS OF UPPER LIMB
Definition
Fracture of scaphoid bone of wrist

Features
Most common carpal bone fracture
Investigation may be delayed as patient may suspect sprain rather
than fracture
Most fractures are complete (80%)

Causes
Fall on to outstretched hand (FOOSH)
Repeated stress: gymnastics, shot put...
More likely to cause Scaphoid Impaction Syndrome

Associated S/S
Wrist pain
Anatomical snuff box
Tenderness with axial compression of thumb towards snuff box
Tenderness with supination against resistance
Pain with forced dorsiflexion
Pain on radial side of wrist with rdial and ulnar deviation
 Dupuytren’s Contracture

Dupuytren’s contracture, also known as Dupuytren’s disease, is a condition in the

hand that causes the fascia, or layer of tissue beneath the skin, to tighten and
draw the fingers in the palm. Dupuytren’s disease develops over time and is most
common in the ring and small fingers; however, it may be found in any digit of the
hand.
De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb
side of your wrist. If you have de Quervain's tenosynovitis, it will probably hurt when
you turn your wrist, grasp anything or make a fist.
BLOOD VESSELS