HARAMAYUNIVERSITY
COLLEGE OF HEALTH
AND MEDICAL SCIENCES
DEPARTMENT OF
HUMAN ANATOMY
Upper Limb
by TEFERA BELSTY (BSc.,
MSc.)
Email:teferabelsty18@[Link]
Office 2nd floor No.52
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LEARNING OBJECTIVES
[Link] each part of the UL and compartmental
relationship.
[Link] components and markings of UL bones
and identify to which side a bone belongs .
[Link] the venous and lymphatic drainage, and
coetaneous innervations of UL
[Link] the relationships of structures found in
of upper limb
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LEARNING OBJECTIVES
[Link] all of the components of the brachial
plexus.
[Link] the innervations and the
specific nerve deficits that occur in the
UL.
[Link] the vascular pattern and
the major anastomoses around each
joint.
[Link] the functions and bony
attachments of the UL muscles
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THE UPPER LIMB
It is associated with the lateral aspect of the
lower portion of the neck.
It is suspended from the trunk by muscles and
a small skeletal articulation b/n the clavicle and
the sternum-the sternoclavicular joint
Charchterstics
Multijointed lever
Movable on the trunk
Manipulation
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The upper limb is divided in to 4 segments:
Shouldergirdle
Arm (brachium)
Forearm (antebrachium)
Hand
The arm and forearm are joined at the elbow
(cubitus) and the forearm is joined to the hand at
the wrist (carpus).
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Bones of the Upper Limb
• The UL contains the
following bones
1. Shoulder girdle - Clavicle
and scapula
2. Arm -Humerus
3. Forearm - Radius and
ulna
4. Hand - Carpals
metacarpals and
phalanges
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Shoulder Girdle (Pectoral Girdle)
⚫Formed by two bones,
Clavicle(collar bone)
Scapula (Shoulder blade).
⚫It attaches the upper limb
to the axial skeleton.
⚫It forms no articulation
with the vertebral column.
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Functions of the Clavicle and Scapula
Join the upper limb to the trunk
Increase the range or extent of joint movement at the
shoulder.
Serve as origin and insertion for the muscles of the
shoulder girdle.
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CLAVICL
E
⚫ The clavicle is a long slender bone, it develops in
membrane with a double curvature.
⚫ It extends from the sternum laterally to the acromion
process of the scapula .
sternal
acromial
end
end
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Parts of the Clavicle
Sternal end
Is
rounded and articulates with the sternum.
Acromial end
Is a flattened part that articulates with the
acromion process of the scapula.
Nearer to the acromial end on the anterior border
of the clavicle there is a small thickening called
deltoid tubercle.
Shaft
Is the part b/n the two ends having a
double curvature in a horizontal plane.
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CLAVICL
E
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CLAVICL
Side identification
E
Place the rounded end medially, the concavity of the
adjacent curve posteriorly and the smooth surface
of the shaft superiorly.
Clavicle is the only long bone without a
medullary cavity.
Part of the clavicle b/n its medial 2/3 and its
lateral 1/3 is the weakest part and is a frequent
site of fracture.
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CLAVICL
⚫The inferior surface E
of its
lateral end contains two
prominences
Conoid tubercle
Trapezoid ridge or line, both
giving attachments to the
corresponding parts of
coracoclavicular ligament
Structures attached to the
clavicle
Clavicle provides an attachment
site for muscles and various
other structures.
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Muscles attached to the clavicle
Clavicular head of pectoralis major
Deltoid
Clavicularhead of sternocleidomastoid
Lateral part of sternohyoid
Trapezius
Subclavius
Other structures attached to the clavicle
Clavipectoral fascia,sternoclavicular lgts,
Interclavicular ligt, Costoclavicular ligt, parts
of coracoclavicular lgts, Articular capsule
of the sternoclavicular and acromioclavicular
joints.
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⚫ provides attachment for
muscles
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THE SCAPULA
⚫ Scapula is a large triangular
bone in the dorso-lateral aspect
of the thorax at the level of the
2nd - 7th ribs.
⚫ It articulates with the humerus
and the clavicle.
⚫ Separated from the ribs by
muscles gliding on the chest
wall in what has been termed
Scapulothoracic joint
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Anterior
Scapula
coracoi
d
process
subscapular
fossa
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Posterior Scapula
acromion process
supraspinous fossa
spine
infraspinous fossa
medial border
lateral border
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The scapula has:
Three borders
Superior , Medial , Lateral (axillary) border
Three angles
- Superior angle – b/n the superior and medial
borders
- Inferior angle – b/n the medial and lateral
borders
- Lateral angle – b/n the lateral and the superior borders
Two surfaces- Costal surface , Dorsal surface
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Three processes
⚫ Spine,Acromion,Coracoid process
Both the acromion and coracoid processes
project protecting over the glenoid cavity.
⚫The head of the scapula bears laterally a shallow
pear shaped articular cavity, the glenoid cavity.
⚫The cavity is enlarged by fibrocartilaginous rim
called glenoidal labrum to accommodate the large
head of the humerus
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⚫Above and below the glenoid cavity there
are supraglenoid and infraglenoid tubercles?
⚫The costal surface serves as the origin of
subscapularis muscle.
⚫The spine divides the dorsal surface into
infraspinous and supraspinous fossae giving origin
in their medial 2/3 to the infraspinatus and
supraspinatus muscles.
⚫The two fossae communicate laterally via
the spinoglenoidal notch
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⚫ On the superior border just medial to the coracoid process is
the suprascapular notch, which is bridged over by the
suprascapular (superior transverse scapular) ligament
forming a foramen .
⚫ It transmits the suprascapular nerve to the supraspinous
fossa, while the suprascapular vessels ride over the ligament.
⚫ The suprascapular ligament may ossify and is converted to
bone
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⚫ Stretching from the lateral border of the spine of
the scapula to the margin of the glenoid cavity is
the spinoglenoid ligament Under which arch
suprascapular nerve and vessels to enter the
infraspinous fossa
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HUMERUS
It
is tubular long bone
Has upper end, shaft and lower end.
Upper end
1. head
Directed medially backwards and upward
Articulate with the glenoid cavity to from
shoulder joint Covered by a hyaline cartilage
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Posterior view
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[Link] line separating the head from the rest of the upper end
is called the Anatomical neck.
[Link] tubercle is an elevation on the anterior aspect of
the upper end.
[Link] tubercle is an elevation that forms the lateral
part of the upper end; its posterior aspect is marked by three
impressions, upper, middle and lower
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[Link] sulcus ( Bicipital groove)
The sulcus has medial and lateral lips that
represent downward prolongation of lesser and
greater tubercles.
6. The line separating the upper end of the
humerus from the shaft is called the surgical neck.
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Anterior Humerus
lesser greater
tubercle tubercle
intertubercular
groove
deltoid
tuberosity
coronoid fossa
medial epicondyle
lateral epicondyle
trochlea capitulum
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Shaft
⚫Is rounded in the upper half and triangular in
the lower half.
⚫Has three borders and three surfaces.
SURFACES
Anteromedial surface: lies b/n the ant. and medial
borders.
[Link] surface: lies b/n the ant. and lat. borders .
Posterior surface b/n medial and lateral borders
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BORDERS
[Link] :extends from the lateral lip of the
intertubericular sulcus continues with the ant.
margin of deltoid tuberosity.
Lateral border extends b/n post. Surface of greater
tubercle and ends by forming the lateral supra
condylar ridge.
Medial border is traceable b/n the medial lip of
biceptal groove to the medial supracondylar ridge
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⚫ At about the middle on the lateral side there
is a V- shaped rough raised area called
deltoid tuberosity
to which the deltoid muscle is inserted.
⚫ Radial sulcus (radial groove, or spiral
groove)
• Through this sulcus runs the radial nerve
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Lower End
Forms the condyle which is expanded from side
to side and has articular and non articular parts.
Articular part.
[Link]
Is a rounded projection which
articulates between head of radius
2. Trochlea
Is a pulley shapes surface
It articulates with the trochlear notch of
the ulna
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Non articular part
1. Medial epicondyle-prominent bony projection
on the medial side of the lower end.
2. Lateral epicondyle-smaller than the medial one.
3. The sharp lateral margin just above the lower end
is
called the lateral supracondylar ridge.
4. Medial supracondylar ridge is a sharp ridge on
the medial side.
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5. Coronoid fossa
Is a depression just at the anterior aspect of
the trochlea.
It accommodates the coronoid process of the
ulna when the elbow is flexed.
6. Radial fossa
Is a depression present above the anterior aspect
of the capitulum
It accommodates the head of the radius when
the elbow is flexed.
7. Olecranon fossa
lies just above the posterior aspect of the
trochlea
is
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It accommodates
flexed the olecranon process when 3
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⚫ Side determination
[Link] end is rounded to form the head; lower end is
expanded from side to side and flattened form before
backwards.
2. Head is directed medially and backwards.
[Link] tubercle projects from the front of the upper end
and is limited laterally by intertubercular sulcus.
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[Link] nerves are directly related to the humerus
and are therefore liable to
injury. neck
Axillary nerve at the surgical
Radial nerve at the radial groove
Ulnar nerve behind the medial epicondyle
2. Common sites of fracture are
Surgical neck
Shaft & supracondylar region
3. The head of humerus commonly dislocates inferiorly
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BONES OF THE FOREARM
These are Radius and Ulna.
RADIUS
o Lateral bone of the forearm & is homologous with
tibia.
o Thinner proximally & progressively thickens
distally.
o Has three parts
- Proximal
- Shaft
- Distal
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Proximal end
Consists of the head, neck & radial tuberosity
1. Head
Is disc shaped & is covered with hyaline cartilage.
Concave superior surface articulates with
capitulum on humerus at elbow joint.
Has articular circumference that rotates in the radial
notch of the ulna, covered by hyaline cartilage &
surrounded by annular ligament.
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Radius
radial tuberosity
head styloid process
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2 Neck
Is enclosed the narrow lower margin of
the
by annular
ligament.
3 Radial
An tuberosity
oval found on the medial
aspect
eminence the neck, tendon of biceps is
of here
inserted
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Shaft
Has three borders and three surfaces.
Borders
Ant. border: exteds from the ant. margin of
radial tuberosity to the styloid process.
[Link]: mirror image of ant .border. The upper
oblique part is called [Link] line.
Medial or interosseous border; the sharpest border.
Surfaces: Ant., Post. and ,[Link]
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Distal end
Widest part of the bone
Has five surfaces
1. Anterior surface- forms a thick prominent
Radial artery is ridge. against
palpated this surface.
2. Posterior four grooves for the
surface-
⚫ The presents of radius (tubercle of Lister)
dorsal tubercle
extensor
lies lateral to tendons.
an oblique
groove.
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[Link] surface- is occupied by the notch of
ulnar the head of the ulna.
4. Lateral surface- is prolonged to form the
downwards
styloid process.
5. Inferior( carpal) surface
Bears triangular for the scaphoid bone, & a
area
quadrangular area for lunate
bone . in forming the wrist joint.
It takes part
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Clinical features
Radius commonly fractures ~2cm above its lower end
(Colle’s fracture) distal fragment is displaced upwards
& backwards (if upwards& forwards it is called Smith’s
fracture ) , caused by a fall on outstretched hand.
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ULNA
Is the medial and longer bone of the
forearm and is homologous to fibula
of lower limb.
Its thickness decreases in a distal
direction or vice versa.
Has 3 parts: proximal end, shaft and
distal end
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Proximal /Upper End.
⚫Proximal end has:
1. Trochlea or semilunar notch
2. Coronoid process- anteriorly
3. Olecranon process- posteriorly
4. Radial notch- laterally
trochlear notch
coronoid process
head
olecranon process radial notch styloid process
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Trochlear notch
articular surface that articulates to the trochlea of the
humerus to form the elbow joint.
Radial notch of ulna
articulates the head of the radius to form the superior
radioulnar joint
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Shaft:
Has interosseous border facing the interosseous border of
radius joined by interosseous membrane forming the middle
radioulnar joint
Has three borders and three surfaces.
1. Interosseons (lateral) border is the sharpest in the
middle 2/[Link] from the supinator crest to the lat. Side
of the head .
2. Anterior border: begins on the medial side of ulnar
tuberosity and terminates at the [Link] of styloid process.
3. Posterior border: begins at the apex of post. Surface and
terminates at the base of the styloid process.
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Surfaces.
[Link]
2. Medial
3. lateral
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Distal / Lower End.
⚫ Made up of head and styloid process.
1. Head-small knobs like enlargement of distal end.
[Link] process-located medially on the distal end and is
the most distally projecting part of the ulna.
[Link] articulates to ulnar notch of radius forming the
inferior or distal radioulnar joint
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⚫ Side Determination.
[Link] end is hook-like, with its concavity directed
forwards.
2. Lateral border of the shaft is sharp and crest line
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CARPAL
BONES
⚫The carpus is made up of 8
carpal bones- arranged in
two rows.
[Link] row contains (from
lateral to medial side)
⚫ Scaphoid---
lunate----
triquetral---pisiform .
[Link] row contains in the
same order
⚫Trapezium---
trapezoid--- capitate---
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IDENTIFICATION
1. Scaphoid , is boat shaped and has tubercle on lateral side.
2. Lunate , half moon-shaped or crescentic .
3. Triquetral – is pyramidal in shape.
[Link] , is pea shaped and has only one oval facet on
the proximal part of its dorsal surface.
[Link] is quadrangular in shape, and has a crest and
a groove anteriorly.
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6. Trapezoid- resembles shoe of a baby.
7. Capitate- largest carpal bone with a rounded head.
8. Hamate – is wedge shaped with a hook near its base
CLINICAL FEATURES
⚫ Commonest injuries which occur in the carpus are fracture
of the scaphoid and dislocation of the lunate
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METACARPAL BONES
These are 5 miniature long bones, which
are numbered from lateral to medial side(I-
V).
Each bone has a head (placed distally), a shaft and
a base (at the proximal end)
PHALANGES
There are 14 phalanges in each hand, 3 for
each finger and 2 for the thumb.
Each phalanx has a base , a shaft and a head.
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SESAMOID BONES OF THE UPPER LIMB.
⚫ Sesamoid bones are small rounded masses of bone located
in some tendons at points where they are subjected to
great pressure.
Pisiform is often regarded as sesamoid bone lying with
in flexor carpi ulnaris.
Two sesamoid bones are always found on the palmar
surface of the hand of 1st metacarpal bone.
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