Biochemistry Summary on Upper Limb. Upper limb buds appear by the end of week four and are regulated by Hox genes.
Bones are derived from somatopleuric layer of lateral plate mesoderm .
muscles para-axial mesoderm (somites).
Upper limbs rotate laterally by 90 degrees
Stuvia.com Biochemistry Summary on Upper Limb . Important points to remember Upper limb buds appear by the end of week four and are regulated by Hox genes . Bones are derived from somatopleuric layer of lateral plate mesoderm . muscles para-axial mesoderm (somites). Upper limbs rotate laterally by 90 degrees . The preaxial vein becomes the cephalic vein. The postaxial vein becomes the basilic vein . Subclavian artery represents the lateral branch of the seventh intersegmental artery . Osteology Clavicle The only long bone, positioned in a horizontal plane . the nutrient artery is derived from the suprascapular artery . Clavicle is the first bone to begin ossification (between the 5th and 6th week of intrauterine life ) last bone to complete ossification (at 25 years). It ossifies mostly in membrane except sternal and acromial zones (true cartilage) Fracture of clavicle usually occurs in the middle third (at the junction of medial 2/3rd and lateral 1/3rd). Coracoclavicular ligament is the major ligament to transmits weight of upper limb to axial skeleton Scapula Spine provides origin for the deltoid and insertion for the trapezius. Coracoid Process provides the origin of the coracobrachialis and short head of biceps brachii . Scapular Notch is bridged by the superior transverse scapular ligament and converted into a foramen that transmits the suprascapular nerve . Supraglenoid tubercle origin for the tendons of the long heads of the biceps brachii (intracapsular origin) . Infraglenoid tubercle provide origin for the tendon of long head of triceps brachii muscle. Lateral border of scapula gives origin to teres minor muscle (Teres minor > Long head of triceps ). Lateral border of scapula is NOT palpable because latissimus dorsi cover it so completely that it cannot be felt through the skin . Humerus Anatomic neck provides attachment for the fibrous joint capsule. Greater tubercle : provides attachments for the SIT (supraspinatus, infraspinatus, and teres minor) muscles . Greater and lesser tubercles on humerus are produced due to traction by muscles (traction epiphyses). Bicipital (intertubercular) groove/sulcus : Accommodates the tendon of the long head of the biceps brachii , ascending branch of anterior circumflex humeral artery and is bridged by the transverse humeral ligament . Stuvia.com Bicipital (intertubercular) groove/sulcus : Muscle attachments Pectoralis Major on the lateral lip teres major on the medial lip latissimus dorsi in the floor. (Mnemonic: Lady between two Majors). Surgical Neck : common site of fracture is in relation to axillary nerve and the posterior circumflex humeral artery. Deltoid Tuberosity : insertion of the deltoid muscle. Spiral (radial) groove : Radial nerve and profunda brachii vessels pass through it. Lateral epicondyle : origin of the supinator and extensor muscles of the forearm (common extensor origin)Radial collateral ligament attaches here . Medial epicondyle : provides attachment to the ulnar collateral ligament, the pronator teres, and the forearm flexor muscles (common flexor origin). medial epicondyle of humerus is termed ‘funny bone’ Nutrient artery is a branch of profunda brachii artery Medial and lateral epicondyles are NOT intracapsular . Coronoid bone ,Radial fossa , Olecranon fossa are intracapsular . Musculocutaneous nerve is not directly in contact with the bone humerus ( Mcq ) . Ulna Olecranon process : insertion of triceps. Coronoid process and ulnar tuberosity : insertion of brachialis. Radius Radius head : surrounded by the annular ligament. Radial tuberosity : insertion of biceps brachii tendon. Styloid Process : receives the insertion of the brachioradialis . Nutrient arteries to both ulna & radius are branches of anterior interosseus artery branch of ulnar artery. Colles fracture of the wrist is a distal radius fracture where distal fragment is displaced (tilted) posteriorly ( dinner fork deformity ). distal fragment is displaced anteriorly, it is called a reverse Colles fracture (Smith fracture). Major contributor to wrist joint . Distal end of radius has Lister’s tubercle on the dorsal side. The tendon of extensor carpi radialis longus (and Brevis) pass lateral to the tubercle. The tendon of extensor pollicis longus passes medial to the Lister’s tubercle. Joints of Upper Limb Sternoclavicular : Saddle ( It allows elevation and depression, protraction and retraction, and circumduction of the shoulder ) Acromioclavicular : Plane ( consists of the conoid and trapezoid ligaments ) Shoulder : Ball and socket Elbow : Hinge Superior and inferior radioulnar : Pivot (trochoid) Stuvia.com Middle radioulnar : Syndesmosis Wrist : Ellipsoid > Condylar 1st carpometacarpal : Saddle (sellar) Metacarpophalangeal : Ellipsoid > Condylar Intercarpal and midcarpal : Plane Interphalangeal : Hinge Shoulder (Glenohumeral) Joint Capsule is attached superiorly to the margin of the glenoid cavity and inferiorly to the anatomic neck of the humerus. Glenoid labrum ( fibrocartilage ) : deepens the glenoid cavity Three glenohumeral Ligaments (superior, middle and inferior ) Transverse humeral ligament : bridges intertubercular groove coracohumeral Ligament : extends from the coracoid process to the greater tubercle The weight of the upper limb is transmitted to the axial skeleton by: Coracoclavicular ligament transmission from upper limb to axial skeleton is not done by : Coracoacromial ligament coracoacromial Ligament : Extends from the coracoid process to the acromion. coracoclavicular Ligament : Extends from the coracoid process to the clavicle and consists of the trapezoid and conoid ligaments. Musculotendinous cuff stabilizes shoulder joint ( SITS ) Bursae : Bursae function to facilitate the gliding of muscles or tendons over bony or ligamentous surfaces. Subacromial bursa lies between the coracoacromial arch and the supraspinatus muscle, protects the supraspinatus tendon against friction with the acromion. subdeltoid bursa lies between the deltoid muscle and the shoulder joint capsule, usually communicates with the subacromial bursa, and facilitates the movement of the deltoid muscle over the joint capsule and the supraspinatus tendon. subscapular bursa lies between the subscapularis tendon and the neck of the scapula and communicates with the synovial cavity of the shoulder joint. Arterial supply : Suprascapular, anterior and posterior humeral circumflex, and circumflex scapular arteries. Nerve supply: Axillary, suprascapular, and lateral pectoral nerves. Dislocation: Anterior –inferior dislocation of the humerus is the most common type (may damage the axillary nerve ). Movement of glenohumeral joint : Flexion : Prime mover :Pectoralis major (clavicular head) , deltoid (clavicular and anterior acromial parts). Synergist : Coracobrachialis (assisted by biceps brachii) Extension : Prime mover : Deltoid (spinal part). Synergist : Teres major; latissimus dorsi; long head of triceps brachii
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