In this post we have discussed all the important questions topics of the Upper Limb anatomy. This topics can help you to understand the theory and Viva exam questions.
Here In this post we are going to discuss about the Upper Limb topics of Gross Anatomy.
Meaning/ Definition :
Upper limb consists of Shoulder, Arm, Forearm and Hand.
What are the important topics :
1. Bones of the Upper Limb :
There are mainly 32 bones present in one upper limb. so total 64 bones are present in both right and left side. They are :
| Bones | Number(In one side) |
| 1. Scapula | 1 |
| 2. Clavicle | 1 |
| 3. Humerus | 1 |
| 4. Radius and Ulna | 2 |
| 5. Carpal Bones | 8 |
| 6. Metacarpals | 5 |
| 7. Phalanges | 14 |
2. Arteries :
The upper limb is mainly supplied by 4 arteries :
- Axillary artery : It supplies the shoulder region
- Brachial Artery : It Supplies the anterior and posterior compartments of the arm
- Radial Artery : Supplies the lateral part of the forearm
- Ulnar : Supplies the medial part of the forearm
3. Veins :
Venous Drainage – Axillary vein —> Subclavian vein–> Internal jugular vein —> Brachiocephalic vein
— Two Brachiocephalic veins joins each other to form Superior Vena Cava, which drains into the heart.
4. Lymphatics :
It starts from the hand, the superficial lymph vessels follow the superficial veins. The deep lymph vessels follow the deep arteries.
5. Fasciae :
There are mainly two Fasciae present in upper limb : A) Pectoral Fascia, B) Clavipectoral Fascia
A) Pectoral Fascia : Deep fascia which is covering the anterior aspect of the large Pectoralis major muscle.
B) Clavipectoral Fascia: This is present deep to the clavicular head of the Pectoralis major muscle.
6. Breast (Mammary Gland) :
The mammary gland is a modified sweat gland present in the superficial region of the pectoralis major muscle.
A) Arterial Supply : Internal thoracic artery, Axillary artery, Posterior intercostal arteries.
B) Venous Drainage : Axillary vein, Internal thoracic vein, and posterior intercostal veins.
C) Nerve Supply : Primarily Somatosensory and derived from 2nd to 6th intercostal nerves.
D) Lymphatic drainage (Very very important) : Axillary lymph nodes, Internal mammary nodes, Supraclavicular nodes, Posterior intercostal nodes, Cephalic nodes.
E) Breast cancer : Carcinoma of the breast.
7. Contents of the Axilla :
- Axillary artery and its branches
- Axillary veins and its tributaries
- Cords of brachial plexus
- Axillary lymph nodes
- Fatty tissues
- Axillary tail of breast
- Long thoracic and intercostobrachial nerves
Axillary Artery :
–> This artery acts as a main artery of the upper limb.
Parts : First part(Superior to the muscle), Second part(Deep to the muscle), Third part(Inferior to the muscle)
Axillary Vein :
–> This vein is formed by the Basilic vein and venae comitantes of the brachial artery.
Axillary Lymph Nodes :
–> They are divide into mainly 5 groups :
- Anterior or pectoral group
- Posterior or sub capsular group
- Lateral group
- Central group
- Apical or infraclavicular group
8. Brachial Plexus :
This is a plexus(Branching of intersecting nerves) formed by the anterior (ventral) rami of lower four cervical and he first thoracic (i.e., C5, C6, C7, C8 and T10 spinal nerves with little contribution from C4 to T2 spinal nerves.
Components : Roots, Trunks,Division, and Cords
9. Rotator Cuff :
When 4 tendons(Supraspinatus, Infraspinatus, Teres Minor, Subcapsularis ) are attached with the capsule of glenohumeral joint, then the Rotator Cuff is formed.
10. Triangular Space :
Two triangular spaces are present in the Subcapsular space.
- Upper Triangular Space : It consists of Circumflex scapular artery
- Lower Triangular Space : It consists of Radial nerve, Profunda brachia artery and vein
11. Quadrangular Space :
It consists of Axillary nerve, and Posterior circumflex humeral artery
12. Axillary Nerve :
It arises from the posterior cord of the brachial plexus near the lower border of the sbcapsularis.
Course : Brachial Plexus –> Posterior cord —> Lower border of subcapsularis –> Quadrangular space –> Surgical neck of humerus –> Inferior capsule of shoulder joint
13. Shoulder Joint :
This is a joint between the head of humerus and glenoid cavity of the scapula. It is a Ball-and-Socket type of synovial joint.
–> Articular Surfaces : The joint is formed by articulation of large round head of humerus with relatively shallow glenoid cavity of the scapula.
—> Ligaments : Capsular ligament, Glenohumeral ligaments, Coracohumeral ligaments, Transverse humeral ligaments.
—> Arterial Supply : Anterior and posterior circumflex humeral arteries, Supracapsular artery, Subscapsular artery.
—> Nerve Supply : Axillary Nerve, Supracapsular nerve, and Musculocutaneous nerve
14. Forearm :
—>Muscles : 8
—>Arteries : Radial and Ulnar
—>Nerves : Median, Ulnar and Radial
Superficial Muscles of front of forearm :
- Pronator teres
- Flexor carpi radialis
- Palmaris longus
- Flexor digitorium superficialis
- Flexor carpi ulnaris
Deep Muscles of the Front of the Forearm :
- Flexor pollicis longus (placed laterally)
- Flexor digitorum profundus(placed medially)
- Pronator quadratus(placed distally)
15. Arm :
16. Radio Ulnar Joint :
This joint includes mainly two articulations : 1. Humeri-ulnar articulation, 2. Humeri-radial articulation.
This is a Synovial Joint.
Ligaments : Capsular Ligament, Medial Ligament(Ulnar Collateral ligament) and Lateral Ligament(Radial Collateral Ligament).
Blood Supply : By arterial anastomosis around the elbow formed by the branches of Brachial, Radial, and Ulnar arteries.
Nerve Supply : Radial nerve, Musculocutaneous nerve, Ulnar nerve, Median nerve.
Carrying Angle :
The angle of deviation of the long axis of forearm from the long axis of arm is termed as carrying angle.
17. Hand :
Intrinsic Muscles of the Hand : Thenar muscles, Adductor of thumb, Hypothenar muscles, Lumbricals, Interossei
- Thenar Muscles : Abductor plaices brevis , Flexo pollicis brevis, Opponens pollicis
- Hypothenar Muscles : Abductor digiti minimi, Flexor digiti minimi, Opponens digiti minimi
- Lumbrical Muscles : Lumbricals 1 and 2, Lumbricals 3 and 4.
Arteries of the Hand : Superficial palmar arterial arch, Deep palmar arch
Nerves in the Palm of the Hand : Ulnar nerve and Median nerve
Anatomical Snuff-Box :
—> This is a triangular depression seen on lateral side of the dorm of hand when the thumb is hyperextended.
Clinical Importance :
- Radial artery pulsations can be felt
- IV fluids can be given in the cephalic vein at this site
- Scaphoid bone fracture can be assumed by seeing the tenderness in the box region
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