UPPER EXTREMITYBONES , MUSCLES

DR.VINIT.K.ASHOK

ADJUNCT FACULTY

BONES

• FORM PART OF THE APPENDICULAR SKELETON

• ARE ATTCHED TO THE TRUNK VIA THE PECTORAL GIRDLE( CLAVICLE , SCAPULA). SHOULDER JOINT ( UNSTABLE, GREATER RANGE OF MOVEMENT)

BONES

A) UPPER ARM- HUMERUS

B) FOREARM – RADIUS/ULNA

C) WRIST – CARPAL BONES

D) PALM –METACARPALS

E) FINGERS- PHALANGES

* STUDY IN DETAIL FROM THE BOOK AND IN THE LAB

MUSCLES• ANY MUSCLE THAT CROSSES A JOINT ACTS ON THAT JOINT• ORIGIN IS THE MORE FIXED ATTACHMENT• INSERTION IS MOVED TOWRDS THE ORIGINMUSCLES CROSSING THE SHOULDER JOINT( ACT ON THE JOINT AND

ALSO MOVE THE UPPER ARM ( HUMERUS)1. PRIME MOVERS ( LARGEST)- PECTORALIS MAJOR,LATISSIMUS

DORSI,DELTOID2. ROTATOR CUFF MUSCLES- SUPRASPINATUS, INFRASPINATUS

SUBSCAPULARIS AND TERES MINOR3. TERES MAJOR AND CORACOBRACHIALIS• TABLE 11.9MUSCLES ANTERIOR-FLEXION ARMMUSCLES POSTERIOR- EXTENSION OF ARMABDUCTORS- MIDDLE FIBRES OF DELTOIDADDUCTORS P.MAJOR,LATISSIMUS DORSI * STUDY THE NERVE SUPPLY

ANTERIOR SHOULDER MUSCLES

POSTERIOR SHOULDER

MUSCLES CROSSING THE ELBOW JOINT

• ANTERIOR ---FLEXORS) FOREARM

• POSTERIOR-EXTENSORS

• 1. ANTERIOR- BICEPS, BRACHIALIS, BRACHIORADIALIS

• 2. POSTERIOR-TRICEPS

• * biceps brachii also supinates the forearm

• * BICEPS AND BRACIALIS ------MUSCULOCUTANEOUS NERVE

• TRICEPS AND BRACHIORADIALIS------ RADIAL NERVE

MUSCLES CROSSING SHOULDER AND ELBOW JOINT

MUSCLES OF FOREARM

• CAUSE MOVEMENT OF THE WRIST , HAND AND FINGERS, SUPINATION AND PRONATION OF THE FOREARM

• ANTERIOR – FLEXORS

• POSTERIOR-EXTENSORS

• PRONATORS( ANT COMPARTMENT) PRONATOR TERES, PRONATOR QUADARTUS

• SUPINATORS-( POSTERIOR COMPARTMENT) SUPINATOR MUSCLE

• MOST FLEXORS ARISE FROM THE MEDIAL EPICONDYLE

• MOST OF THE EXTENSORS ARISE FROM THE LATERAL EPICONDYLE

• AT THE WRIST THE FOREARM MUSCLES PRODUCE FLEXION, EXTENSION,ADDUCTION AND ABDUCTION OF THE HAND

• AT THE FINGERS THEY CAUSE ONLY FLEXION AND EXTENSION

MUSCLES OF THE FOREARM

• SUPERFICIAL AND DEEP• SUPERFICIAL-

A) PRONATOR TERES

B) FLEXOR CARPI RADIALIS

C) PALMARIS LONGUS

D) FLEXOR CARPI ULNARIS

E) FLEXOR DIGITORUM SUPERFICIALIS

* ALL ARE SUPPLIED BY THE MEDIAN NERVE EXCEPT THE FLEXOR CARPI ULNARIS ----SUPPLIED BY THE ULNAR NERVE

SUPERFICIAL MUSCLESFOREARM

DEEP MUSCLES FOREARM

• FLEXOR POLLICIS LONGUS- MEDIAN NERVE• FLEXOR DIDGITORUM PROFUNDUS- MEDIAN/ULNAR NERVE• PRONATOR QUADRATUS- MEDIAN NERVE

DEEP MUSCLES OF FOREARM

POSTERIOR MUSCLES OF FOREARM

• Extensors• SUPERFICIAL AND DEEP GROUPS• SUPERFICIAL

A) BRACHIORADIALIS

B) EXTENSOR CARPI RADIALIS LONGUS

C) EXTENSOR CARPI RADIALIS BREVIS

D) EXTENSOR DIGITORUM

E) EXTENSOR CARPI ULNARIS• ORIGIN –LATERAL EPICONDYLE EXCEPT THE

BRACHIORADIALIS/EXT CARPI RADDIALIS LONGUS• NERVE SUPPLY- RADIAL NERVE

SUPERFICIAL MUSCLE BACK OF FOREARM

DEEP MUSCLES

• SUPINATOR• ABDUCTOR POLLICIS LONGUS• ENTENSOR POLLICIS BREVIS / LONGUS• EXTENSOR INDICIS• ALL ARE SUPPLIED BY THE DEEP BRANCH OF THE RADIAL

NERVE( POSTERIOR INTEROSSEOUS NERVE)

DEEP MUSCLES

INTRINSIC MUSCLES OF THE HAND

• MOVE FINGERS• ALL ARE ON THE PALMAR SIDE• ABDUCTORS, ADDUCTORS, OPPOSITION• 3 GROUPS

A) THENAR MUSCLES

B) HYPOTHENAR MUSCLES

C) MIDPALMAR MUSCLES( LUMBRICALS AND INTEROSSEI)

THENAR MUSCLES

• ABDUCTOR POLLICIS BREVIS• FLEXOR POLLICIS BREVIS• OPPONENNS POLLICIS• ADDUCTOR POLLICIS

* ALL ARE SUPPLIED BY THE MEDIAN NERVE EXCEPT THE ADDUCTOR POLLICIS( ULNAR NERVE)

HYPOTHENAR MUSCLES

• ABDUCTOR DIGITI MINIMI• FLEXOR DIGITI MINIMI BREVIS• OPPONENES DIGITI MINIMI

* ALL SUPPLIED BY THE ULNAR NERVE

THENAR AND HYPOTHENAR MUSCLES

MIDPALMAR MUSCLES

A)LUMBRICALS- 4 IN NUMBER( NONE TO THUMB)- WORM SHAPED- ARISE FROM THE TENDON OF FDP- NERVE SUPPLY ( LAT 2-MEDAIN NERVE, MEDIAL-2 ( ULANR)

B) INTEROSSEI

-PALMAR ( 4- LIE VENTRAL TO THE DORSAL)- UNIPENNATE

-DORSAL ( 4-)- BIPENNATE- SUPPLIED BY ULNAR NERVE- PAD, DAB

*

LUMBRICALS

PALMAR INTEROSSEI

DORSAL INTEROSSEI