Upper Limb Bones

Appendicular Skeleton
• Girdles
• Upper Limbs
• Lower Limbs
Clavicle (2) (Beauty bone)
 The clavicle (collarbone) extends between the manubrium of the sternum and the
acromion of the scapula.
 Classified as a long bone.
 Only long bone placed horizontally.
Side Determination:
• Lateral end is flat while medial end is large and quadrangular in shape.
• Shaft is ‘S’ shaped as medial 2/3 is convex forward and lateral 1/3 is concave forward.
• Inferior surface is grooved at middle 1/3.

Features:
• Subcutaneous.
• First ossifying.
• Membranous.
• Two primary ossification centers.
• No medullary cavity.
• Transmits weight of upper limb to sternum.

Lateral End (Acromial): Flattened above downward. Bear facet for Acromian process of
scapula (forms Acromioclavicular Joint)
Medial End (Sternal): Quadrangular, Articulates with clavicular notch of manubrium sterni.
Shaft:
Lateral 1/3 and medial 2/3.
Lateral 1/3: Flattened above downward and have 2 border (Anterior-Posterior), 2 Surfaces
(Superior-Inferior).
On Inferior surface Conoid tubercle and Trapezoid ridge are present.
Medial 1/3- Rounded but have 4 surfaces. Anterior, Posterior, Superior and Inferior.
Anterior surface is Convex forward, Posterior surface is Smooth, Superior surface is medially
rough, Inferior surface bear rough oval impression medially and a groove (Subclavian)
laterally.
At the lateral end, the margin of the articular surface for the acromio-clavicular joint gives
attachment to the joint capsule.
At the medial end the margin of the articular surface for the sternum gives attachment to:
The fibrous capsule all round; the articular disc postero-superiorly; and the inter-clavicular
ligament superiorly.

Muscle attachments:
Lateral one-third of shaft:
The anterior border gives origin to the deltoid muscle,
The posterior border provides insertion to the trapezius,
Medial two-thirds of the shaft:
The anterior surface gives origin to the pectoralis major,
The rough superior surface gives origin to the clavicular head of the sternocleidomastoid.
The subclavian groove gives insertion to the subclavius muscle.
Ossification: The clavicle is the first bone in the body to ossify. It ossifies in membrane from
two primary centres and one secondary centre.
The two primary centres appear in the shaft between the fifth and sixth weeks of intrauterine
life, the secondary centre for the medial end appears during 15-17 years, and fuses with the
shaft during 21-22 years.
FUNCTIONS:
It supports the shoulder so that the arm can swing away from the trunk. The clavicle transmits
the weight in the limb to the sternum.

CLINICAL ANATOMY:
 Collarbone fracture: Commonly fractured by falling on the outstretched hand (indirect
violence) and the most common site of fracture is the junction between the two
curvatures of the bone, which is the weakest point.
 Acromioclavicular dislocation (“AC Separation”): The lateral fragment is displaced
downwards by the weight of the limb. Degeneration of the clavicle

Scapula
Introduction: Triangular flat bone present on Postero-lateral aspect of Thoracic cage.
Side Determination:
 Lateral/Glenoid angle is large and bears glenoid cavity.
 Dorsal surface is convex and divided by triangular spine in to supra-spinous and infra-
spinous fossa.
 Thickest border is lateral border.
Two Surface:
Costal or subscapular is concave. Dorsal bears spine which devide the surface in to supra-
spinous and infra-spinous fossa.
Three Borders:
Superior: Thin and shorter, bear supra scapular notch.
Lateral: Thick and bear infraglenoid tubercle.
Medial: from superior to inferior.
Three Angles:
Superior: covered by trapezius muscle.
Inferior: covered by Latissimus dorsi.
Lateral: bears glenoid cavity.
Processes:
Spinous process Crest of Spine- upper and lower lip.
Acromian Process has 2 border: Medial & Lateral Two Surface: Superior and Inferior and a
facet for clavicle.
Coracoid Process.

Muscular Attachments:
Subscapularis: Origin, 2/3 of Subscapular fossa
Serratus Anterior: Insrtion along the medial border of the costal surface; one digitations to
the superior angle, two digitations to the medial border, and five digitations to the inferior
angle.
Pectoralis Minor: Insert, Medial Border and Superior surface of coracoid process.
Subscapularis: It arises from the medial two-thirds of the subscapular fossa.
Biceps Brachii: The long head of the biceps brachii arises from the supraglenoid tubercle. The
short head from the lateral part of the tip of the coracoid process.
Coracobrachialis: arises from medial part of tip of the coracoid process.
Pectoralis Minor: is inserted into the medial border and superior surface of the coracoid
process.
Supraspinatus: It arises from the medial two-thirds of the supraspinous fossa (including the
upper surface of the spine).
Infraspinatus: arises from the medial two-thirds of the infraspinous fossa (including the lower
surface of the spine).
Deltoid: arises from the lower border of the crest of the spine and from the lateral border of the
acromion.
Trapezius: is inserted into the upper border of the crest of the spine and into the medial border
of the acromion.
Triceps: The long head of the triceps arises from the infraglenoid tubercle.
Teres Minor: arises from the upper two-thirds of the rough strip on the dorsal surface along
the lateral border.
Teres Major: It arises from the lower one-third of the rough strip on the lateral aspect of the
lateral border.
Levator Scapulae: is inserted along the dorsal aspect of the medial border, from the superior
angle up to the root of the spine.
Rhomboideus Minor: It is inserted into the medial border (dorsal aspect) opposite the root of
the spine of the scapula.
Rhomboideus Major: is inserted into the medial border (dorsal aspect) between the root of
the spine and the inferior angle.

(Extra Revision)
Tendons are tough bands of connective tissue made up mostly of a rigid protein called
collagen. Tendons firmly attach each end of a muscle to a bone. They are often located
within sheaths, which are lubricated to allow the tendons to move without friction.
Bursae are small fluid-filled sacs that can lie under a tendon, cushioning the tendon
and protecting it from injury. Bursae also provide extra cushioning to adjacent
structures that otherwise might rub against each other, causing wear and tear.
Ligaments are bundles of connective tissue that connect one bone to an adjacent bone.
The basic building blocks of a ligament are collagen fibres. These fibres are very
strong, flexible, and resistant to damage from pulling or compressing stresses.

Ligaments of the Scapula:

 Acromio-clavicular ligament
 Coraco-acromial ligament
 Coraco-humeral ligament
 Coraco-clavicular ligament
Ossification:
Scapula ossifies from one primary centre and seven secondary centres. The primary centre
develops near the glenoid cavity during the 8th week of development.
•coracoid process (two centers): 12-18 months
•inferior angle: 14-20 years (puberty)
•acromion (three centers): 14-20 years (puberty)
•medial border: 14-20 years (puberty)
Clinical Anatomy:
An abnormally projecting inferior angle of the scapula is identified as a winged scapula and
this is produced by paralysis of the serratus anterior muscle.