3.bones of upperlimb
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BONES OF UPPERLIMB
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Bones pectoral (shoulder) girdle
clavicle scapula
Humerus Radius Ulna carpals metacarpals Phalanges
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SHAFTDivided into Lateral 1/3rd
Medial 2/3rd
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Lateral 1/3rd
Anterior border concave forwards
Posterior border is convex backwards
Superior surface is subcutaneous
Inferior surface containsElevationconoid tubercle
Ridge Trapezoid ridge
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LATERAL END OR Acromial end
Articulates with aromion process of scapula toform Acromioclavicular joint
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MEDIAL END Or Sternal end
Articulates with clavicular notch of ofmanibrium sterni to form Sternoclavicular
joint.
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Side DeterminationThe lateral end is flat
The medial end is large and quadrilateral
The medial 2/3
rd
is convex forwardThe lateral 1/3rd is concave forward
The inferior surface is grooved longitudinally
in its middle 1/3rd
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Peculiarities of the ClavicleOnly long bone that lies horizontally
First bone to start ossifying
No medullary cavity (not always true)
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Sex DeterminationFemales: Shorter, lighter, thinner ,smoother
and less curved
The lateral End of the clavicle is little below
the medial end
Males: The lateral end is at the same level or
slightly higher than the medial end.
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Joints of the clavicle:
They are two in number:
Medially sternoclvicular joint
Laterally acromioclavicular joint
Ligaments:
medially two ligaments:
Sternocalvicular ligament Costoclavicular ligament
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Laterally:
Acromioclavicular ligament
Coracoclavicular ligament
Muscles attached to the clavicle:Medially: sternomastoid and pectoralis major
Laterally: deltoid and trapezius
Inferiorly: the subclavius is attached
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CLINICAL CONSIDERATIONS Fracture of the Clavicle
commonly fractured, often by indirect force
resulting from violent impacts to the
outstretched hand during a fall transmitted
through the bones of the forearm and
shoulder or by falls directly onto the
shoulder itself
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weakest part of clavicle junction of middle
and lateral thirds
medial fragment is elevated by
sternocleidomastoid; lateral fragment is
depressed by weight of shoulder and pulled
medially by adductor muscles overriding offragments
often incomplete in childrengreenstick
fracture
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What is a green stick fracture?
If a bone is fractured on one side and is not
fractured on the other side, then it is called a
green stick fracture
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Clavicle is congenitally absent or imperfectly
developed in some disorders like cleidocranial
dysostosis
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Hypoplasia of clavicle
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SCAPULA it is a flat bone, roughly triangular in shape,
placed on a posterolateral aspect of the
thoracic cage.
the bone that connects the humerus (arm
bone) with the clavicle (collar bone).
http://en.wikipedia.org/wiki/Trianglehttp://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Humerushttp://en.wikipedia.org/wiki/Claviclehttp://en.wikipedia.org/wiki/Claviclehttp://en.wikipedia.org/wiki/Humerushttp://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Triangle -
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Surfaces
Costal (Front, Ventral, Anterior)
presents a broad concavity, the subscapular
fossa.
The medial two-thirds of this fossa are markedby several oblique ridges, which run
lateralward and upward
The ridges give attachment to the tendinous
insertions, and the surfaces between them to
the shelby, of the Subscapularis.
http://en.wikipedia.org/wiki/Subscapularishttp://en.wikipedia.org/wiki/Subscapularis -
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The lateral third of the fossa is smooth and
covered by the fibers of subscapularis muscle.
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Dorsal (Back, Posterior)
The dorsal surface is arched from above
downward, and is subdivided into two
unequal parts by the spine; the portion above
the spine is called the supraspinous fossa, and
that below it the infraspinous fossa.
http://en.wikipedia.org/wiki/Supraspinous_fossahttp://en.wikipedia.org/wiki/Infraspinous_fossahttp://en.wikipedia.org/wiki/Infraspinous_fossahttp://en.wikipedia.org/wiki/Supraspinous_fossa -
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The supraspinous fossa, the smaller of the
two, is concave, smooth
its medial two-thirds give origin to the
Supraspinatus.
http://en.wikipedia.org/wiki/Supraspinatushttp://en.wikipedia.org/wiki/Supraspinatus -
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The infraspinous fossa is much larger
toward its vertebral margin a shallow
concavity is seen at its upper part
its center presents a prominent convexity
the axillary border is a deep groove whichruns from the upper toward the lower part.
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The medial two-thirds of the fossa give origin
to the Infraspinatus; the lateral third is
covered by this muscle.
http://en.wikipedia.org/wiki/Infraspinatushttp://en.wikipedia.org/wiki/Infraspinatus -
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Borders
There are three borders of the scapula:
The superior border is the shortest and
thinnest; it is concave, and extends from the
medial angle to the base of the coracoid
process.
http://en.wikipedia.org/wiki/Superior_border_of_scapulahttp://en.wikipedia.org/wiki/Medial_anglehttp://en.wikipedia.org/wiki/Coracoid_processhttp://en.wikipedia.org/wiki/Coracoid_processhttp://en.wikipedia.org/wiki/Coracoid_processhttp://en.wikipedia.org/wiki/Coracoid_processhttp://en.wikipedia.org/wiki/Medial_anglehttp://en.wikipedia.org/wiki/Superior_border_of_scapula -
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The axillary border (or "lateral border") is the
thickest of the three. It begins above at the
lower margin of the glenoid cavity, and
inclines obliquely downward and backward tothe inferior angle
http://en.wikipedia.org/wiki/Axillary_borderhttp://en.wikipedia.org/wiki/Glenoid_cavityhttp://en.wikipedia.org/wiki/Glenoid_cavityhttp://en.wikipedia.org/wiki/Axillary_border -
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The vertebral border (or "medial border") is
the longest of the three, and extends from the
medial to the inferior angle.
http://en.wikipedia.org/wiki/Vertebral_borderhttp://en.wikipedia.org/wiki/Vertebral_border -
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The acromion
The acromion forms the summit of the
shoulder, and is a large, somewhat triangular
or oblong process, flattened from behind
forward, projecting to overhang the glenoid
cavity
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clinical
scapular fractures are uncommon; when they
do occur, they are an indication that severe
chest trauma has occurred.
http://en.wikipedia.org/wiki/Chest_traumahttp://en.wikipedia.org/wiki/Chest_trauma -
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winged scapula
Is a condition in which the medial border (the
side nearest the spine) of a person's scapula is
abnormally positioned outward and
backward. The resulting appearance of theupper back is said to be wing-like because the
inferior angle of the shoulder blade protrudes
backward rather than lying mostly flat like inpeople without the condition.
http://en.wikipedia.org/wiki/Winged_scapulahttp://en.wikipedia.org/wiki/Winged_scapula -
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Winged Scapula
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HUMERUSLongest bone
Three parts: Upper End
Lower End
Shaft
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Upper EndHead dierected medially,backwards and
upwards
Articulates with gleniod cavity of scapula to
form shoulder joint
Line separating head and upperend is
anatomical neck
Greater tubercle forms lateral part
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Intertubercular sulucs or bicipital groove
Separates lesser tubercle medially from
anterior part of greater tubercle
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The shaftRounded in upper half
Triangular in lower half
Three borders
Three surfaces
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BordersAnterior border:
upper 1/3rd forms lateral lip of intertubercular
sulcus
Middle part forms anterior margin of detoid
tuberosity
Lower half smooth and rounded
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Lateral Border:
Lower end forms the lateral supracondylar
ridge
Upper part , barely traceable
Middle part interrupted by radial or spiral
groove
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Medial Border:
Upper part forms medial lip of intertubercular
sulcus
Middle presents rough strip and continuous
below with medial supracondylar ridge
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Lower EndForms condyle from side to side
Articular and non articular part
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Articular part:
Capitulum: rounded projection, articulates
with head of radius
Trochlea :pulley-shaped,articulates with
trochlear notch of ulna.
Medial edge projects 6mmdownwards than
lateral edge
Results formation of carrying angle
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Non articulate Part:
Medial condoyle : prominent bony projection
on medial side ,subcutaneous, felt on medial
side of elbow.
Lateral condoyle: smaller, anterolateral part
has muscular impression
Sharp lateral margin above lower end called
lateral supracondylar ridge
Medial supracondylar ridge on medial side
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Clinical
Fracture of the Shaft of the Humerus
results from a direct blow to the arm
may injure the radial nerve in the radial
groove as it winds around the humeral body
paralysis of the elbow, wrist, and digit
extensorswrist drop
L t l E i d liti
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Lateral Epicondylitis
also known as elbow tendinitis, golfers
elbow, tennis elbow repeated forceful flexion and extension of the
wrist strain attachment of common tendon
inflammation of periosteum of lateralepicondyle
pain felt over lateral epicondyle and radiates
down posterior aspect of forearm pain often felt when opening a door or lifting
a glass
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Neck: enclosed by narrow lower margin of
annular ligament
Head and neck rotate freely within socket
Tuberosity :lies below medial part of neck,
rough posterior part and smooth anterior part
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Posterior border: mirror image of anterior
border
Clear defined middle 1/3rd
Upper oblique part know as posterior oblique
line
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Lateral surface: prolong downwards to form
styloid process
Inferior surface: bears triangular area for
scaphoid bone, medial quadrangular area for
lunate bone, takes part in forming wrist bone
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Side determinationSmaller ,circular upper end followed by
constricted neck just medial to neck is radial
tuberosity
Wider lower end : thick with pointed styliodprocesses on lateral aspect and prominent
dorsal tubercle on posterior surface
Medial border is thin and sharp
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SMITHS #
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Coronoid Process: projects forward from shaft
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Coronoid Process: projects forward from shaft
just below olecranon ,has four surfaces
superior, anterior,medial and lateral Superior surface forms lower part of trochelar
notch
Anterior surface, triangular, rough,lowercorner forms ulnar tuberosity
Lateral surface upper part marked by radial
notch for head of radius ,lower part formsdepressed area to accommodate radial
tuberosity
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Shaft
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3 borders and 3 surfaces
Borders
Interosseous or lateral border: sharpest in
middle 2/4th
,inferiorly traced to lateral side ofhead,superiorly continous with supinator crest
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SurfacesAnterior surface:between anterior and
interossoeus border,nutrient formen on upper
part ,upward directed.
Medial surface : between anterior and
posterior borders
Posterior surface:between posterior and
interosseous border,subdivide by two lines
into three areas.
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Styloidprocess projects downwards fromposteromedial side of lower end of ulnar
Posteriorly between head and styloid process
groove for tendon of extensor carpi ulnaris
present
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Facture of olecranon is common by a FALL ONTHE POINT OF ELBOW.
Fracture of coronoid is uncommon
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MADELUNG DEFORMITY
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MADELUNG DEFORMITY
The carpal bones
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Crapus made up of 8 bones,arranged in 2 rows
Proximal row (lateral to medail): the scaphoid,
the lunate, the triquetral, the psisform bones
Distal row(same order): the trapezius,the
trapezoid,the capitate,the hamate
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The trapezium:quadrangular,has crestandgroove anteriorlyand concavoconvex articular
surface distally
The trapezoid: resembles shoe of baby
The capitate: largest carpal bone,rounded end
The hamate:wedge shape ,hook near base
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Side determination
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Proximal row convex proximally and
Concave distally
Distal row convex proximally and flat distally
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METACARPALS located between the phalanges (bones of the
fingers) distally and the carpus which forms
the connection to the forearm
Its equivalent in the foot is the metatarsals
http://en.wikipedia.org/wiki/Phalangeshttp://en.wikipedia.org/wiki/Distalhttp://en.wikipedia.org/wiki/Carpushttp://en.wikipedia.org/wiki/Forearmhttp://en.wikipedia.org/wiki/Forearmhttp://en.wikipedia.org/wiki/Carpushttp://en.wikipedia.org/wiki/Distalhttp://en.wikipedia.org/wiki/Phalanges -
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Shaft
Base
Head
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The body(corpus; shaft)
convex behind,
concave in front.
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The medialand lateral surfacesare concave,for the attachment of the interosseus muscles,
and separated from one another by a
prominent anterior ridge.
http://en.wikipedia.org/wiki/Interosseus_musclehttp://en.wikipedia.org/wiki/Interosseus_muscle -
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The dorsal surfacepresents in its distal two-thirds a smooth, triangular, flattened area
which is covered in by the tendons of the
Extensor muscles
This surface is bounded by two lines, which
commence in small tubercles situated oneither side of the digital extremity
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Base The base or carpal extremity(basis) is of a
cuboidal form, and broader behind than in
front: it articulates with the carpus, and with
the adjoining metacarpal bones
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Head The heador digital extremity(capitulum)
presents an oblong surface markedly convex
from before backward, less so transversely,
and flattened from side to side; it articulateswith the proximal phalanx.
Articulations
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the first with the trapezium;
the second with the trapezium, trapezoid,
capitate and third metacarpal;
the third with the capitate and second andfourth metacarpals;
the fourth with the capitate, hamate, and
third and fifth metacarpals;
and the fifth with the hamate and fourth
metacarpal.
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Bennett's fracture is a fracture of the base ofthe first metacarpal bone which extends into
the carpometacarpal (CMC) joint
Thumb is forced into semiflex and can not be
opposed
Fist cannot be clenched
http://en.wikipedia.org/wiki/Fracturehttp://en.wikipedia.org/wiki/First_metacarpal_bonehttp://en.wikipedia.org/wiki/Carpometacarpal_jointhttp://en.wikipedia.org/wiki/Carpometacarpal_jointhttp://en.wikipedia.org/wiki/First_metacarpal_bonehttp://en.wikipedia.org/wiki/Fracture -
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PHALANGES
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14 phalanges in each hand
Base
Shaft
head
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Distal phalanges: are at the tips of the fingersand toes.
Proximal phalanges: are closest to the hand
(or foot) and articulate with the metacarpalsof the hand, or metatarsals of the foot.
Middle or intermediate phalanges: are
between the distal and proximal. The thumband big toe do not have middle phalanges.
http://en.wikipedia.org/wiki/Distal_phalangeshttp://en.wikipedia.org/wiki/Proximal_phalangeshttp://en.wikipedia.org/wiki/Handhttp://en.wikipedia.org/wiki/Foothttp://en.wikipedia.org/wiki/Metacarpalhttp://en.wikipedia.org/wiki/Metatarsalhttp://en.wikipedia.org/wiki/Intermediate_phalangeshttp://en.wikipedia.org/wiki/Intermediate_phalangeshttp://en.wikipedia.org/wiki/Metatarsalhttp://en.wikipedia.org/wiki/Metacarpalhttp://en.wikipedia.org/wiki/Foothttp://en.wikipedia.org/wiki/Handhttp://en.wikipedia.org/wiki/Proximal_phalangeshttp://en.wikipedia.org/wiki/Distal_phalanges -
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