Introduction

● Limbs were evolved basically for bearing

the weight of the body & for locomotion.
● Each limb is made up of basal segment or
girdle, & Free part divided into proximal,
middle, & distal segments.
● Girdle attaches the limb to axial skeleton,
distal segment carries five digits.
● With the Evolution of the erect posture in
man, function of weight bearing was taken
over by lower limb
● Upper limbs, especially hands , became
free & gradually evolved into organs having
great manipulative skills.
● This has become possible because of wide
range of mobility at the shoulder.
Parts of Upper Limb
● Upper limb is made up of 4 parts
● 1. Shoulder Region
● 2. Arm / Brachium
● 3. Forearm / Antebrachium
● 4. Hand / Manus.
 ● Parts of the Upper Limb
Sr. Parts Subdivision Bones Joints
No

1. Shoulder Region a. Pectoral region on Bones of the 1. Sternoclavicular

the Front of the Chest Shoulder girdle joint
a. Clavicle 2. Acromioclavicula
b. Scapula r joint

2. Upper Arm ( Arm / - Humerus Shoulder Joint

Brachium) From (Scapulohumeral
Shoulder to the Elbow joint)

3. Forearm - a. Radius 1. Elbow

( Antebrachium) b. Ulna 2. Radioulnar joints
From Elbow to the
wrist
 ● Continue – Parts of Upper limb
Sr. Parts Subdivision Bones Joints
nos

4. Hand a. Wrist g. Carpus , made up of 8 Carpal j. Wrist Joint

b. bones ( Radiocarpal joint)
k. Intercarpal joints
c. h. l.
b. Hand proper i. a. Carpometacarpal joints
d. a. Metacarpus , made up of 5
e. metacarpal bones
f.

c. Five digits , m. Intermetacarpal

numbered from lateral a. 14 Phalanges – two for the thumb, joints
to medial side & 3 for each of four fingers n.
st
1 = Thumb / Pollex o. Metaphalangeal joints
nd
2 = Index / Forefinger p.
rd
3 = Middle Finger q.
th
4 = Ring Finger r. Proximal & Distal
th
5 = Little finger interphalangeal joints
Distribution of bones in upper limb

■ Total 64 bones
● 32 on each side
● 10 Shoulder and arm,
● 16 wrist and
● 38 hand bones.
Clavicle (Akshakasthi /Jatrukasthi)
● Long bone
● Arm can swing clearly away from trunk
● Transmits weight of limb to Sternum
● Cylindrical
● Parts – 1. Shaft
● 2. Two ends - Lateral & Medial
 ● Shaft – Divisible into Lateral 1/3 rd & Medial
2/3 rd.
rd
● A. Lateral 1/3 of Shaft – Flattened from above
downwards
-Has 2 borders & 2surfaces
Borders-
1. Anterior – Concave forwards
2. Posterior – Convex backwards
Surfaces-
1. Superior – Subcutaneous
2. Inferior- Present an elevation called conoid
tubercle & ridge called trapezoid ridge
 rd
● Medial 2/3 of shaft – Rounded & have
four surfaces
1.Anterior- Convex forwards
2. Posterior – Smooth
3. Superior- Rough in its medial
4.Inferior – Lateral half has longitudinal
subclavian groove. Nutrient foramen lies
lateral end of groove
Two ends
● Lateral End / Acromial end – flattened.
Bears facet ( smooth, flat surface) that
articulates with the acromion process of
scapula to form acromioclavicular joint.
● Medial / Sternal end – Quadrangular &
articulates with clavicular notch of
manubrium sterni to form the
sternoclavicular joint.
Side Determination
● 1. Lateral end is Flat & medial end is
large & quadrilateral.
● 2. The Shaft is Slightly curved , so that
rd
it is convex forwards in medial 2/3 rd
, &
concave forward in its lateral 1/3 .
● Inferior Surface is grooved rd
longitudinally in middle 1/3
Peculiarities of Clavicle

● 1. Only long bone that lies horizontally

● 2. subcutaneous throughout
● 3. First bone to start ossifying
● 4.Only Long bone which has two
Primary centres of Ossification.
Attachments

Two ends
● Lateral end margin of articular surface
for acromioclavicular joint gives
attachment to joint capsule
● Medial end margin of articular surface
for sternum – Fibrous capsule ,
Articular disc, Interclavicular ligament
Shaft attachment
● Lateral 1/3 rd -
1.Anterior Border – Origin to deltoid muscle
2.Posterior Border – Insertion to Trapezius
3.Conoid Tubercle & trapezoid ridge –
Coracoclavicular ligament
● Medial 2/3 rd –
1.Anterior Surface – Origin to Pectoralis major
2.Rough Superior Surface – Origin to Clavicular
head of Sternocleidomastoid
3. Inferior Surface – Attachment to
costoclavicular ligament
4. Subclavian Groove – Insertion to subclavius
muscle
5. Nutrient foramen transmit a branch of
Suprascapular artery
Ossification:
● Ossification is the gradual transition from a
fibrous or cartilaginous template to bone.
This process takes place at different rates
and is completed at different ages depending
on the site of ossification.
● First bone in the body to ossify
● Ossifies from two primary & one secondary
centre
Clinical Anatomy
● Commonly fractured by falling on the
outstretched hand, common site is junction
between two curvatures of bone.
● Congenitally absent or imperfectly
developed in disease called cleidocranial
dysostosis. In this shoulders droop
anteriorly in front of chest
Scapula (Ansaphalak )
● Thin bone placed on Posterolateral
aspect of thoracic cage
● Has – 2 Surface, 3 borders, 3 angles,
3 Processes
Surfaces
● 1. Costal Surface / Subscapular fossa-
● concave & marked by 3 ridged. Thick
ridge adjoins lateral border. Rod-like.
● Acts as lever for action serratus
anterior in overhead
Abduction of arm.
● 2. Dorsal Surface –
- attachment to spine of Scapula divide
surface into smaller supraspinous &
Infraspinous fossa.
- 2 fossa are connected by spinoglenoid notch,
situated lateral to root of spine
Borders
● 1.Superior Border – Thin , shorter. Near
root of coracoid process it present
suprascapular notch.
● 2. Lateral border – Thick, at the upper
end it presents the infraglenoid
tubercle.
● 3. Medial Border – Thin, extends from
Superior angle to inferior angle.
Angles

● 1. Superior angle
● 2. Inferior angle
● 3. Lateral or Glenoid angle – Bears
glenoid cavity
Processes

● 1. Spine
/ Spinous Process –
● 2. Acromion
● 3. Coracoid
●1.Spine or Spinous process – Triangular
plate of bone with 3 borders & 2 surfaces. It
divide dorsal surface of scapula into
Supraspinous & Infrapinous fossae.
●Posterior border called Crest of spine – Has
Upper & lower lips
●2. Acromion – has facet for clavicle
●3.Coracoid Process directed forwards &
slightly laterally.
Side Determination
● 1.
Lateral or glenoid angle is large &
bears glenoid cavity
● 2. Dorsal surface is convex is divided
by triangular spine into Supraspinous
& Infraspinous fossae.
● Lateral thickest border runs from
glenoid cavity above to inferior angle
below.
Muscle Attachment
● Origin -
rd
● 1. Subscapularis from medial 2/3 Subscapular
fossa
rd
● 2. Supraspinatus – Medial 2/3 of Supraspinatous
fossa
rd
● 3. Infraspinatus – Medial 2/3 of Infraspinatous
fossa
● 4.Deltoid – from lower border of crest of spine
● 5. long head of bicep brachii from supraglenoid
tubercle.
● 6. Short head bicep from lateral part of coracoid
Process.
● 7. Coracobrachialis – from medial part of tip of
coracoid process.
● 8. Long head of tricep from infraglenoid tubercle
rd
● 9.Teres minor from upper 2/3 of rough strip on
dorsal surface along lateral border
rd
● 10. Teres major arises lower 1/3 of rough strip of
dorsal aspect of lateral border.
● 11. Inferior belly Omohyoid from upper border of
Suprascapular notch.
● 12. lattismus dorsi –covered inferior angle
● Insertion –
● 1. Trapezius – Inserted into upper border of crest
of spine
● 2. Serratus anterior – along medial border of costal
surface.
● 3.Pectoralis minor – medaily superior surface of
coracoid process.
● 4. Levator scapulae – Dorsal aspect of medial
border , from superior angle to root of spine.
● 5. Rhomboideus minor –Dorsal aspect medial
border opposite root of spine
● 6. Rhomboideus major – dorsal aspect medial
border between root of spine & inferior angle.
Ligaments

●Margin of Glenoid cavity gives attachment to

capsule of Shoulder joint & to glenoidal
labrum.
●Coracoacromial ligament
●Coracohumeral ligament
●Coracoclavicular ligament
●Suprascapular Ligament
●Spinoglenoid ligament
Ossification
●Ossifies from 1 Primary & 7 secondary
centers.
Clinical Anatomy
● 1.
Paralysis of Serratus Anterior causes
‘Winging’ of the Scapula. The Medial border
of the bone becomes unduly prominent. & the
arm cannot be abducted beyond 90 degrees.
●2. Developmental Anomaly called Scaphoid
Scapula, the medial border is concave.
Humerus (Pragandaasthi)
● Bone of Arm
● Longest bone of the Upper limb
● Has – Upper end
● Lower end
● Shaft
Upper end
● Head is directed medially, backwards &
upwards. Articulates with glenoid cavity of
Scapula to form Shoulder joint.
●Line Separating the head from rest of the
upper end called Anatomical neck
●Lesser tubercle is an elevation on anterior
aspect of upper end
●Greater tubercle is an elevation that forms
the lateral part of upper end. Having 3
impressions – Upper , middle & Lower
●Intertubercular sulcus / Bicipital Groove –
Separates lesser tubercle medially from
anterior part of the greater tubercle.
Shaft
●Rounded in upper half & triangular in lower
half
●3 borders & 3 surfaces
●Borders –
rd
●Anterior border – upper 1/3 forms lateral lip
of intertubercular sulcus, middle part, it
forms anterior margin of deltoid tuberosity.
● Lateral border – Prominent only at
lower end where it forms lateral
supracondylar ridge, in middle part, it
is interrupted by radial or spiral groove.
● Medial border – In upper part it forms
medial lip of intertubercular sulcus ;
continous below with medial
supracondylar ridge
●3 Surfaces –
●1. Anterolateral – Between Anterior & lateral
borders.upper half covered by deltoid. Little
above middle it is marked by V- Shaped
deltoid tuberosity.
●Anteromedial – Between Anterior & Medial
border.
●Posterior – between medial & lateral borders.
Lower End
●Lower end of Humerus forms condyle which
is expanded from side to side, has articular &
non- Articular Parts.
●Articular Parts –
●1. Capitulum – Rounded projection which
articulates with head of radius.
●2. Trochlea – Pulley- shaped surface;
articulate with trochlear notch of ulna.
Non – articular Part
●1.Medial Epicondyle – Prominent bony
projection on medial side at lower end.
Subcutaneous.
●2.Lateral Epicondyle – Smaller
●3. Lateral Supracondylar ridge – Sharp lateral
margin just above lower end
●4. Medial Supracondylar ridge – similar ridge
on medial side
● 5.Coronoid fossa – Depression just above
anterior aspect of Trochlea. It accomodates
coronoid process of ulna when elbow is flexed
● 6. Radial fossa – Depression present just above
anterior aspect of Capitulum. It accommodates
head of radius when elbow is flexed.
● 7. Olecranon Fossa – just above the Posterior
aspect of Trochlea. It accommodates the
olecranon process of ulna the elbow is extended
Side Determination
●1. Upper End rounded to form head. The
lower end is expanded from side to side &
flattened from before backwards.
●2.Head is directly medially & backward
●3. Lesser tubercle projects from the front of
the upper end & limited laterally by
intertubercular sulcus /Bicipital groove
Attachments on the Humerus
●Insertion -
●1. Subscapularis – inserted into lesser
tubercle
●2. Supraspinatus – upper impression on
greater tubercle
●3. Infraspinatus – Middle impression on
greater tubercle
●4. Teres minor – Lower impression on
Greater tubercle
●5. Pectoralis Major – Inserted on lateral lip of
Intertubercular sulcus
●6. Lattssimus dorsi – into the floor of
Intertubercular sulcus
●7. Teres major – into the medial lip of
intertubercular sulcus
●8.Deltoid – inserted into deltoid tuberosity
●9. Coracobrachialis – into rough area on
middle of medial border.
Contents of Intertubercular sulcus
● 1. Tendon of Long head of Biceps, Its
Synovial sheath
● 2. Ascending branch of anterior
circumflex humeral artery.

A tendon is a tough band of fibrous connective tissue that

usually connects muscle to bone and is capable of
withstanding tension.
Origin -
●Brachialis – From lower halves of
anteromedial & anterolateral surfaces of
Shaft.
rd
●Brachioradialis – upper 2/3 of Lateral
Supracondylar ridge
●Extensor Carpi radialis longus – From lower
rd
1/3 lateral supracondylar ridge
●Pronator teres ( humeral head) – From lower
rd
1/3 Medial supracondylar ridge.
●Superficial flexor muscles of forearm arise by
common origin from anterior aspect of Medial
epicondyle. ( Common flexor Origin)
●Superficial extensor muscles – Common origin
from lateral epicondyle.
●Anconeus – from Posterior surface of lateral
epicondyle
●Lateral head of tricep brachii from posterior
surface above radial groove, while medial head
from posterior surface below radial groove
●Ligament – 1. Capsular ligament of shoulder
joint
●2.Capsular ligament of elbow joint

●Ossification
●Ossifies from 1 Primary & 7 secondary
centres
Clinical Anatomy
● 1 Three nerves are directly related to humerus &
are , therefore, liable to injury, the axillary at
surgical neck, radial at radial groove, ulnar
behind medial epicondyle
● 2.The common sites of Fracture are surgical
neck, the shaft, Supracondylar region.
● 3. The humerus has poor blood supply at
junction of its upper & middle thirds. Fractures at
this site delayed union or non – union
● Head of Humerus commonly dislocates inferiorly
.
Compartments of Arm
● Arm divided into anterior & posterior compartment
by extension of deep fascia which called medial /
lateral intermuscular septa
● 1. Anterior Compartment –
● Contents -
● Coracobrachialis
● Bicep brachii
● Brachialis
●2. Back / Posterior Compartment of upper
arm
●Contents -
●Triceps muscle
●Radial nerve, profundal brachii artery
Radius ( Bahirprakosthasthi)

●Lateral bone of Forearm & homologous with

tibia of lower limb
● Has – Upper end
● Lower end
● Shaft
● Upper end
●1.head – Disc Shaped . Has Superior concave
surface which articulates with capitulum of
humerus at elbow joint. Circumference of
head is also articular. Its fits into socket
formed by radial notch of ulna & annular
ligament, thus forming superior radioulnar
joint
●Neck – enclosed by narrow lower margin of
annular ligament. head & neck are free from
capsular attachment & can rotate freely
within the socket
●Tuberosity lies just below medial part of the
neck.
●Shaft – Has 3 Borders & 3 Surfaces

●Borders –
●1.Anterior – extends from anterior margin of
radial tuberosity to styloid process.
●2.Posterior – mirror image of anterior border,
but clearly defined only in its middle one third.
●3. Medial or interosseous – Sharpest,
extends from radial tuberosity above to
posterior margin of above ulnar notch below.
●Surfaces –
●1. Anterior – between anterior & interosseous
border
●Posterior – between Posterior &
interosseous border.
●Lateral – Between anterior & Posterior
borders.
Lower End
● Is the widest part of the bone. Has 5 surfaces
● 1. Anterior – form thick Prominent ridge. Radial
artery is palpated against this surface.
● Posterior – Presents 4 grooves for extensor
tendons. Dorsal tubercle is present( of Lister) lies
lateral to oblique groove.
● Medial – occupied by ulnar notch for head of ulna.
● Lateral – prolonged downwards to form Styloid
process
● Inferior –bears triangular area for scaphoid bone,
medial quadrangular area for lunate bone, this
surface takes part in forming wrist joint.
Side Determination
●1. Smaller circular & upper end is concave
followed by constricted neck
●2. Just below the medial aspect of neck is
radial tuberosity.
●3.wider lower end is thick with pointed styloid
process on its lateral aspect & prominent
dorsal tubercle on posterior surface.
●4. Medial Interosseous border is thin & sharp.
Front of the forearm
●Components –
●1.Eight muscles, Five superficial, three deep
●2. Two arteries – Radial & ulnar
●3. Three Nerves – Median, ulnar, radial
front of forearm
● Common flexor origin – All superficial flexors have
common origin from front of medial epicondyle of
humerus.
● 5 Muscles –
● 1. Pronator teres
● 2. Flexor carpi radialis
● 3. Palmaris longus
● 4. Flexor carpi ulnaris
● 5. Flexor Digitorum Superficialis.
Deep muscles of Front of forearm
●3 in no.
●1. Flexor digitorum Profundus
●2. Flexor pollicis longus
●3. Pronator quadratus.
Back of Forearm
● Seven Superficial Muscles & 5 deep muscles of
Back of forearm
●Seven Superficial muscles – Most of them
take origin from tip of lateral epicondyle of
humerus ( Common Extensor Origin)
●1. Anconeus
●2. Brachioradialis
●3. Extensor Carpi radialis longus
●4. Extensor carpi radialis brevis
●5. Extensor digitorum
●6. Extensor digiti minimi
●7. Extensor carpi ulnaris
●Deep Muscles of the back of Forearm –
●1. Supinator
●2. Abductor pollicis longus
●3. Extensor pollicis brevis
●4. Extensor pollicis longus
●5. Extensor indicis
Attachments of Radius
Insertion
1.Bicep Brachii –inserted into rough posterior part
of radial tuberosity.
2. Supinator – Inserted into upper part of lateral
surface.
3. Pronator teres – inserted into middle of lateral
surface.
4. Brachioradialis - inserted into lowest part of
lateral surface just above styloid process.
5. Pronator Quadratus –Inserted into lower part of
anterior surface & into triangular area on medial
side of lower
end.
Origin
● 1. Radial head of Flexor digitrorum superficialis
origin from upper part of anterior border
rd
● 2. Flexor pollicis longus from upper 2/3 of anterior
surface.
● 3. Abductor pollicis longus & extensor pollicis
brevis from posterior surface.
●1. Articular capsule for wrist joint
●2. Articular disc of inferior radioulnar joint.
●3. Extensor retinaculum is attached to lower
part of anterior border.
●4. Interosseous membrane is attached to
th
lower 3/4 of interosseous border.
Clinical Anatomy
●1. Colles’s Fracture- Fractured about 2 cm
above lower end. Caused by fall on
outstretched hand.
●2. Smith’s Fracture
●3. Congenital absence of Radius
●4. Radioulnar synstosis
●5. A sudden powerful jerk on hand of child
may dislodge head of radius from grip of
annular ligament. Known as Subluxation of
head of radius
Ulna ( Antaprakosthasthi)
●Ulna is medial bone of the forearm, its
homologous with fibula of lower limb.
●Has
●Upper end
●Lower end
●Shaft
Upper End
●Presents olecranon & coronoid Processes,
●Trochlear notch
●Radial notch
● 1.
Olecranon Process – Projects upwards
from Shaft. Has Superior , Anterior, Posterior,
Medial, Lateral surfaces.
●Anterior Surface – articular, it forms the
upper part of trochlear notch.
●Posterior Surface forms triangular
subcutaneous area.
●2.Coronoid Process. Projects forwards from
shaft just below olecranon & has four
surfaces- Superior, Anterior, Medial, lateral.
●Superior – Forms lower part of trochlear
notch.
●Anterior – triangular, lower corner forms ulnar
tuberosity.
●Upper part Lateral Surface – Marked by radial
notch for head of radius
●Lower part of lateral surface – forms
depressed area to accommodate radial
tuberosity. It is limited behind by ridge called
Supinator Crest.
●Trochlear Notch forms an articular surface that
articulates with trochlea of humerus to form
elbow joint.
●Radial notch articulates with head of radius to
form superior radioulnar joint.
● Shaft -
● Has Three Borders & Three surfaces.
● Borders –
● 1. Interosseous Border / Lateral border – Sharpest
in middle, Superiorly , it is continuous with supinator
crest., Inferiorly ,it can be traced to lateral side of
head.
● Anterior – Thick , rounded, begins above medial
side of ulnar tuberosity, terminates at medial side
of styloid process.
● Posterior – Subcutaneous. Begins above at apex of
triangular Subcutaneous area at back of olecranon,
terminates at base of Styloid process.
●Surfaces –
●1. Anterior –Lies between anterior &
interosseous borders.
●2. Medial surface – lie between anterior &
posterior borders
●3. Posterior Surface – lie between Posterior &
interosseous Borders. Subdivided by two
lines. A oblique line divides into upper & lower
parts. Lower part further divided by vertical
line into medial & lateral area.
Lower End

●Made up of Head & Styloid Process.

●Head articulates with Ulnar notch of radius to
form the inferior radioulnar joint, It is
separated from wrist joint by articular disc.
Ulnar artery & nerve lie on the anterior aspect
of head of ulna.
●Styloid process projects downwards from
posteromedial side of lower end of ulna.
Side determination

●1. Upper end is hook like , with its concavity

directed forwards
●2. Lateral border of shaft is sharp & crest like.
●3. Pointed Styloid process lies medial to the
rounded head of ulna
Attachments of Ulna
●Insertion
●1. Triceps – Inserted into Posterior part of
Superior Surface of olecranon.
●2. Brachialis – into Anterior surface of
coronoid process including tuberosity of ulna
●3.Anconeus – into lateral aspect of olecranon
th
process & upper 1/4 of posterior surface
●Origin
●1. Supinator – From supinator Crest
●2. Ulnar head of Flexor digitrorum superficialis – from
tubercle at upper end of medial margin of coronoid process.
●3.Pronator teres ( Ulnar head) – from medial margin of
coronoid process
●4.Flexor digitorum profundus –
●5.Flexor carpi ulnaris
●6.Extensor carpi Ulnaris Common
- aponeurosis
●7.Pronator Quadratus – From oblique ridge
on lower part of anterior surface.
●8.Abductor pollicis longus
●9. Extensor pollicis longus
From Lateral part of
●10.Extensor indicis Posterior surface.
●Other Attachments
●1. Interosseous membrane is attached to
interosseous border
●Capsular ligament of elbow joint , attached to
margins of trochlear notch.
●Annular ligament of Superior radioulnar joint is
attached to two margins of radial notch of
ulna.
●Ulnar collateral ligament of wrist is attached to
styloid process.
Clinical Anatomy
● 1. Ulna is Stabilising bone of forearm, with its
Trochlear notch gripping the lower end of
humerus.
● 2. Shaft of Ulna may Fracture either alone or
along with that of radius. Cross union between
radius & ulna must be prevented to preserve
pronation & supination of hand.
● Dislocation of the elbow
● Fracture of olecranon is common
● Madelung’s deformity – dorsal subluxation
(displacement) of lower end of ulna.
Carpal Bones
●Carpus made up of 8 carpal bones, arranged
in two rows
●1. Proximal row – (Lateral to Medial Side)
● i) Scaphoid ii) Lunate iii) Triquetral
iv) Pisiform

●2. Distal row –

i) Trapezium ii) Trapezoid iii) Capitate
iv) Hamate
●Identification
●1. Scaphoid is boat shaped, tubercle on its
lateral surface.
●Lunate half moon shaped
●Triquetral pyramidal in shape
●Pisiform is pea- shaped
●Trapezium is Quadrangular in shape
●Trapezoid is resembles the shoe of baby.
●Capitate largest carpal bone.
●Hamate is wedge shaped with hook near its
base
Articulation
● 1. Scaphoid Articulate with Radius , Lunate,
Capitate, trapezium, trapezoid.
● 2. Lunate articulates with Radius, Scaphoid,
capitate, Hamate, triquetral
● 3. Triquetral articulates with Pisiform, lunate,
hamate, Articular disc of inferior radioulnar joint.
● 4. Pisiform articulates with Triquetral
● 5. Trapezium articulates with following bones
Scaphoid, first & second metacarpal & capitate
● 6.Trapezoid – with scaphoid, trapezium, second
metacarpal & capitate
nd rd
● 7. Capitate – with Scaphoid, lunate, hamate, 2 & 3
th
& 4 metacarpals & trapezoid.
Clinical Anatomy
●Fracture of Scaphoid is quite common
●Dislocation of Lunate may be produced by
fall on acutely dorsiflexed hand with forearm
flexed. This displaces the lunate anteriorly,
causing carpal tunnel syndrome.
● The carpal tunnel or carpal canal is the passageway on the palmar side of
the wrist that connects the forearm to the hand.
● The tunnel is bounded by the bones of the wrist and flexor retinaculum
from connective tissue. Normally several tendons from the flexor group of
forearm muscles and the median nerve pass through it. There are
described cases of variable median artery occurrence.
● The canal is narrow, and when any of the nine long flexor tendons passing
through it swell or degenerate, the narrowing of the canal may result in the
median nerve becoming entrapped or compressed, a common medical
condition known as carpal tunnel syndrome.
● A total of nine flexor tendons (not the muscles themselves)
pass through the carpal tunnel:
● flexor digitorum profundus (four tendons)
● flexor digitorum superficialis (four tendons)
● flexor pollicis longus (one tendon)
● flexor carpi radialis (one tendon), considered by some as
part of the carpal tunnel although it is more precise to state
that it travels in the flexor retinaculum which covers the
carpal tunnel, rather than running in the tunnel itself.
● A single nerve passes through the tunnel: the median nerve
between tendons of flexor digitorum profundus and flexor
digitorum superficialis
Metacarpal Bones
●Metacarpal bones are 5 miniature long
bones, which are numbered from lateral to
medial side
●Each bone has a head placed distally , Shaft
& base at proximal End.
●The heads of Metacarpal bones form the
knuckles
●Shaft is concave on Palmar surface.
●Base is Irregularly expanded.
 st
●Characteristic of 1 Metacarpal Bones
●1. Shortest & stoutest of all metacarpal
bones.
●2. The First metacarpal bone is rotated
medially through 90 degree relative to other
metacarpals. As a result of this rotation the
movements of thumb take place at right
angles to those of other digits
●3. It does not Articulate with any other
metacarpal bone
Clinical anatomy
● 1.Fracture of base of first metacarpal is called Bennett’s
Fracture.
● 2.Other metacarpals may be Fractured by Direct Or indirect
violence.
● 3. Tubercular or Syphilitic disease of metacarpals or
Phalanges is located in middle of diaphysis rather than in
metaphysis because of nutrient artery.
● 4.When thumb possesses three phalanges , first
metacarpal has two epiphyses one at each end.
Occasionally , first metacarpal bifurcates distally. Then
medial branch has no distal epiphysis & has only two
phalanges. Lateral has distal epiphysis & three phalanges
●
 Bennett’s Fracture

Polydactyly
Tubercular / Syphilitic
Phalanges
● There Are 14 Phalanges in each hand,
● 3 for each Finger, 2 for Thumb, Phalanx has a base,
shaft, & head.
● Means thumb has Proximal & Distal Phalanx not
have middle phalanx