UPPER LIMBS

Arm

G. O. Omotoso B.Sc., MB;BS, Ph.D.

Department of Anatomy
University of Ilorin
ARM
A Table Showing Attachments, Innervations and Actions of the muscles of anterior compartment of the arm

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Biceps brachii Coracobrachialis Brachialis
Muscles of the Arm
• Posterior (extensor)
compartment
• Anconeus

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Muscles of the Arm
• Posterior (extensor)
compartment

• Triceps brachii
• Main extensor of arm
• Stabilizes head of
humerus in glenohumeral
joint

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A Table Showing Attachments, Innervations and Actions of the muscles of posterior compartment of the arm

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Superficial veins of the upper limb
 Deep veins of upper limb

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Dermatome of the Upper Limbs

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CUBITAL FOSSA
 Cubital Fossa
• Cubital fossa is a superficial
triangular depression on the
anterior aspect of the elbow.

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 Contents of Cubital Fossa

Dissections of cubital fossa. A. Superficial dissection. B. In this deep dissection, part of the biceps is excised
and the cubital fossa is opened
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Dissections of cubital fossa. A. Superficial dissection. B. In this deep dissection, part of the biceps is excised
and the cubital fossa is opened
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 Illustrative diagrams of cubital fossa and some of its contents
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Dissections of cubital fossa. A. Superficial dissection. B. In this deep dissection, part of the biceps is excised
and the cubital fossa is opened
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Forearm
Flexor Muscles of the Forearm

• Superficial Layer
• pronator teres
• flexor carpi radialis
• palmaris longus
• flexor carpi ulnaris

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Flexor Muscles of the forearm

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Flexor Muscles of the
Forearm
Intermediate Layer

flexor digitorum superficialis

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Flexor Muscles of the forearm
Deep Layer

• flexor digitorum profundus

• flexor pollicis longus
• pronator quadratus

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Flexor Muscles of the Forearm
Attachments, Innervations and Actions of the deep flexor muscles of the forearm

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 Descriptive diagrams of flexor muscles of the forearm according to layers

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 Descriptive diagrams of extensor muscles of the forearm
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Extensor Muscles of the forearm
• A Table Showing Attachments, Innervations and Actions of the superficial & deep extensor muscles of the forearm

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 Illustrative diagram showing deep veins of the forearm and hand
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Nerves of the forearm (Median nerve)
• The median nerve and its branches.

FPL= Flexor Pollicis Longus

FDP= Flexor Digitorum Profundus

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Nerves of the forearm (Ulnar nerve)
• The Ulnar nerve and its branches.

FCU= Flexor Carpi Ulnaris

FDP= Flexor Digitorum Profundus

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Nerves of the forearm (Radial nerve)
• The Radial nerve and its branches.

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HAND and WRIST
Palmar Surface

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 Dorsal Surface
Anatomical Snuff Box

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 Cartilage

Articular Cartilage

Is smooth shiny material that covers the bones of the

hand and wrist. It absorbs forces of impact and
provides for low friction motion.

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 Articular Capsule
Synovial Membrane
• Is the inner membrane of a joint
made up of loose connective
tissue.
• Secretes synovial fluid which
serves to lubricate the joint and
reduce the friction between
bones in joints.
• Supplies nutrients to the joint
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Fibrous Layer
• Formed by dense irregular
connective tissue attached to
the periosteum surface of joints.
• Allows for movement.
• Provides stability
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 Joints in the Hand
• Metacarpo-phalangeal Joint

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 Joints in the Hand
Distal Interphalangeal Joint
Proximal Interphalangeal Joint

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 Types of Joints
Hinge Joints-
Convex surface of one bone fits into the concave surface
of the adjoining bone
Example: interphalangeal joints Condyloid Joints
Convex oval-shaped projection of one bone fits into the
oval-shaped depression of another bone
Example: MCPJ and radio-scapho-lunate (wrist) joint

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 Types of Joints

Planar Joints
• Flat or slightly
curved bones joined together that allow back and forth and side to
side movements.
Example: Intercarpal joints
Saddle Joints
• articular surface of one bone is the saddle-shaped, and the articular surface of
the other bone fits into the “saddle” as a sitting rider would sit.
Example: CMCJ between the trapezium and the thumb

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 Ligaments
Palmar Aponeurosis

Flexor Retinaculum

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 Ligaments

Common Flexor Sheath

• Surrounds the eight tendons of the
superficial and deep flexors of the digits of the
hand as they pass through the carpal canal.
Extensor Retinaculum
• Consists of a group of heavy connective fibers in the
tissues of the wrist.
•It connects the lateral margin of the radius with the
inside border of the ulna.

Common
flexor sheath
Extensor
retinaculum
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 Anterior Muscles of Wrist and Hand:
tendons of forearm muscles

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 Posterior Muscles of Wrist and Hand:
tendons of forearm muscles

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 Compartments of the Hand
• About 11 separate
osteofascial compartments
• 4 for dorsal interossei
muscles
• 4 for palmar interossei
muscles
• 1 each for thenar,
hypothenar and adductor
pollicis muscles

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 Muscles of the Hand
Lumbricals
Thenar
muscles

Hypothenar
muscles

Lumbricals

Dorsal
Interossei
4 3 1
2
Palmar
Interossei

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 Muscles of the Hand

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 Thenar Muscles
Abductor pollicis brevis
Opponens pollicis
Flexor
pollicis
brevis

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 Thenar
muscles

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 Thenar
muscles

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 Thenar
muscles

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 Hypothenar Muscles

Abductor digiti minimi

Flexor digiti minimi
Opponens digiti minimi

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 Hypothenar
muscles

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 Hypothenar
muscles

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 Hypothenar
muscles

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 Lumbrical Muscles
Flexor digitorum
profundus tendons

1st and 2nd 3rd and 4th

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 Interossei

Dorsal Interossei
Muscles

Palmar
Interossei
Muscles
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 • NOTES

• Most of the tendon in the hand originate in muscles arising from the
forearm
• Flexor on volar (anterior/ventral) aspect of forearm arise from
common flexor tendon (medial epicondyle)
• Extensors on dorsal aspect of the forearm arise from common
extensor tendon on lateral epicondyle

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 Arterial Supply of Hand

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Arterial Supply of Hand

• Arteries:
• 1. Deep palmar arch
• 2. Superficial palmar arch
• 3. Common palmar digital arteries

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Arterial Supply of Hand
• The Radial artery supplies blood to:
- 1. Flexor carpi radialis
- 2. Extensor carpi radialis longus
- 3. Extensor carpi radialis brevis
- 4. Flexor pollicis longus

The Ulnar artery supplies blood to:

- 1. Flexor carpi radialis
- 2. Flexor carpi ulnaris
- 3. Extensor carpi ulnaris
- 4. Flexor digitorum superficialis
- 5. Flexor digitorum profundus
- 6. Palmaris longus

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 Reccurent Interosseous Artery
• -supplies:
• -Extensor digitorum
• -Extensor digiti minimi

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 Posterior Interosseous Artery
• -supplies:
• - Abductor pollicis longus
• -Extensor pollicis brevis
• -Extensor pollicis longus

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Venous Drainage of Hand

- 1. Cephalic vein
- 2. Basillic vein
- 3. Superficial dorsal
venous arch (network)
- 4. Deep dorsal venous
arch (network)

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Venous Drainage of Hand

• Via : Dorsal digital vein,

dorsal venous arch,
Cephalic vein, Basillic
vein in front of
forearm

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 Innervation

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 Innervation: Median nerve
• - The Palmar
cutaneous branch:
• - splits off the median
nerve before crease of
the wrist

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 Innervation: Ulnar nerve

• The dorsal cutaneous branch:

• Known for famous debilitating wrist
lock

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 Clinical Correlates
Carpal tunnel Ganglion cyst

- The transverse carpal ligament in the wrist - Is a fluid filled cyst that develops
puts pressure on the medial nerve out of a joint.
- - possible cause: overuse, hormonal - - possible cause: joint trauma

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 De Quervain’s Tenosynovitis

• -irritation of the sheath around the tendon

• - affects the tendons on the thumb side of the wrist
• - possibly caused by repetitive actions, over use
• - http://www.youtube.com/watch?v=q87zSRYHa1o

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 Carpal Tunnel Syndrome

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