Anatomy 1.4 Upper Limbs - Muscle and Fascia
Anatomy 1.4 Upper Limbs - Muscle and Fascia
Subject:
(1.4) Upper Limbs Muscle and Fascia
Title:
Lecturer:
Dr. Adelia Quijano, MD
Transcribers: Bascara, Battad, Bautista, Bautista, Baybay, Bayona
Trans Subject Head: Jacinto, C. (09157536686/[email protected])
I.
A.
B.
C.
D.
E.
F.
3.
4.
5.
6.
III.
Sem/ A.Y.:
1st/A.Y. 2014-2015
Thoracic cage = 25
Hyoid = 1
2. Appendicular Skeleton
Bones of extremities
Superior appendicular skeleton -comprised of the
pectoral girdle and bones of the free part of the upper
limb
Inferior appendicular skeleton comprised of the
pelvic girdle and bones of the free part of the lower limb
Composition:
o
Pectoral girdle = 4
o
Pelvic girdle = 2
o
Upper limbs = 60
o
Lower limbs = 60
OUTLINE
OBJECTIVES
Review the bones and joints of the upper limbs and be able to
classify them.
Describe the deep fascia of the UL and its subsequent
functional compartmentalization of the muscle groups.
Describe the fascial spaces: axilla, cubital fossa, and those in
the hand, and enumerate their contents.
Describe the muscles of the pectoral girdle conceived as
anatomical group/functional group and stating their functions.
Identify the main muscles of the UL conceived as functional
groups in each region with respect to the principal joint
movements rather than as individual muscles.
Identify the principal attachments of the muscle groups and the
joints upon which they act.
2.
1.
Date:
a.
1.
1.
-
Axial Skeleton
Bones along the axis of the body
Composed of the
Skull = 22+6
Vertebral column = 26
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Shoulder
JOINTS:
Arm (Brachium)
Humerus
longest and largest of UL bones
JOINTS:
Forearm (Antebrachium)
Radius (lateral)
Ulna (medial)
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4.
Wrist (Carpus)
5.
Hand (Manus)
Metacarpals (5)
***NOTE:
DIGITS NOT EQUAL TO FINGERS: 5 digits: 4 fingers and a thumb
(thumb has no middle phalanges)
JOINTS:
Figure 1. Bones of the Wrist and Hand (posterior view of the right
hand)
B. FASCIA OF THE UPPER LIMB
Fascia wrapping, packing & insulating materials of deep structures
1.
2.
Deep Fascia
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PECTORALIS MAJOR
convergent group of muscles, fan-shaped
a. Proximal attachment
Clavicular head: anterior surface of medial half of
clavicle
Sternocostal head: anterior surface of sternum,
superior six costal cartilages, aponeurosis of
external oblique muscle
b. Distal attachment
Lateral hip of intertubercular sulcus of humerus
c. Main action
Adducts and medially rotates humerus; draws
scapula anteriorally and inferiorly
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2.
b.
2.
TRAPEZIUS
a. Proximal attachment
Medial third of superior nuchal line; external
occipital protuberance; nuchal ligament; spinous
processes of C7 to T12 vertebrae
b. Distal attachment
Lateral third of clavicle; acromion and spine of
scapula
c. Muscle action
Descending part (lower fibers) elevates scapula
Ascending part (upper fibers) depresses scapula
Middle part (or all parts together) retracts
scapula
Both descending and ascending parts together
act together to rotate to glenoid cavity superiorly
LATISSIMUS DORSI
a. Proximal attachment
Spinous processes of inferior 6 thoracic
vertebrae, thoracic columbar fascia, iliac crest,
and inferior 3 or 4 ribs
b. Distal attachment
Floor of intertubercular sulcus of humerus,
bicipital groove
c. Muscle action
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c.
SCAPULOHUMERAL MUSCLES
(INTRINSIC SHOULDER MUSCLES)
-
a.
DELTOID
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3.
4.
5.
6.
d.
2.
Pectoral fascia
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3.
e.
Axillary fascia
AXILLA
-
Base of axilla
3.
4.
5.
6.
Subfascial Spaces
A. Quadrangular Space
teres minor (above), teres minor (below), triceps brachii, long
head (medial), humerus (lateral)
Contents: axillary nerve, post humeral circumflex artery
B. Triangular Space
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*Triangle of Auscultation
formed by superomedial border of latissimus dorsi,
inferolateral border of trapezius, lower part of scapula
area where you apply your stethoscope to hear the sounds
of the posterior segments of lungs, lesser intervening
structures
b.
c.
D. ARM
-
a.
2.
BICEPS BRACHII
2 heads: long head and short head
o
Origin: scapula (both heads)
o
Fuse distally into a single biceps tendon that attaches
to radius
o
Short head appears longer (grossly)
Action and effectiveness are affected by the position of the
3.
CORACOBRACHIALIS
Elongated muscle in the supero- medial part of the arm
biceps brachii
Workhorse of the elbow flexors (most powerful flexor of
the forearm)
Main flexor of the forearm: flexes the forearm in all
Origin: humerus
Origin: humerus
ANCONEUS
Small triangular muscle on the posterolateral aspect of the
elbow
Assist triceps in extending forearm
Superficial Layer
Crosses elbow joint
Wrist joint action (except for pronator teres acts on radioulnar
joint)
Muscles involved:
1. PRONATOR TERES pronates and flexes
2. FLEXOR CARPI RADIALIS (FCR) flexes
Most medial
arm
Main extensor of the forearm
Origin: scapula
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Lateral to FDP
3.
Deepest muscle
Profundus/profound deep
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Deep layer
1. SUPINATOR prime mover for slow unopposed supination
esp when extended forearms
2. ABDUCTOR POLLICIS LONGUS Abducts thumb
Compartments
1. THENAR COMPARTMENT
space between the attachment of the palmar aponeurosis to
the 3rd metacarpal bone
contains thenar muscle
lateral to lateral fibrous septum
Figure 10 Posterior muscles of the forearm
2.
F. HAND
a.
3.
Retinacula
1. FLEXOR RETINACULUM
- forms the carpal tunnel (palmar side of the wrist that
connects the forearm to the middle compartment of the
deep plane of the palm) where the ff. pass through:
HYPOTHENAR COMPARTMENT
space between the attachment of the palmar aponeurosis to
the 5th metacarpal bone
medial to medial fibrous septum
-
4.
CENTRAL COMPARTMENT
between the thenar and hypothenar compartments
space occupied by:
flexor tendons
lumbricals
digital vessels
nerves
ADDUCTOR COMPARTMENT
Deepest muscular plane of the palm
INTEROSSEUS COMPARTMENT
Found between metacarpals
5.
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c.
Thenar Compartment
1. ABDUCTOR POLLICIS BREVIS
abducts the thumB
assists the opponenspollicis during early stages of
opposition through rotating its proximal phalynx
2. FLEXOR POLLICIS BREVIS
short flexor of the thumb
has two heads (bellies): the larger superficial head is
innervated by the median nerve while the smaller deep
head is innervated by the ulnar nerve
3. OPPONENS POLLICIS
quadrangular muscle, opposes the thumb
flexes and rotates the first metacarpal medially at the
carpometacarpal joint during opposition
4. ADDUCTOR POLLICIS
With two heads of origin (oblique and transverse) which
are separated by the radial artery as it enters the palm
to form the deep palmar arch
Adducts the thumb
Hypothenar Compartment (act on little finger)
1.
2.
3.
4.
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MUSCLES IN INTEROSSEI
**(Mnemonic: DABPAD)
IV.
1.
2.
A girl picks up and puts down her morning cup of tea. Which arm
muscle is primarily used?
a. triceps brachii
b. brachialis
c. biceps brachii
d. anconeus
3.
4.
GUIDE QUESTIONS
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anatomical snuffbox
Answers: ABCABA
V. REFERENCES
1. Moore, K. et al. (2010). Clinically oriented anatomy. 8th ed.
Lippincott Williams & Wilkins: Baltimore, MD
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