Axilla: (armpit)

Location : upper part of the arm and the side of the chest. Shape : Triangular space / Pyramid-like space. - Base: (Axillary Fascia) Skin stretching et!een anterior and posterior !all. "o#ered y hair. Bounded $$ -orms and important passage for ner#es 1 lood and lymph #essels1 as they tra#el from the root of the neck to the upper lim . Anterior : anterior axillary fold Posterior : posterior axillary fold Medially: chest !all. - Apex: directed into the root of the neck. %each midcla#icular point. Bounded$$ Anterior : cla#icle Posterior : upper order of scapula Medially: the outer order of the first ri . Walls: &) Anterior wall :Skin ' Pectoralis Major ' Pectoralis (inor ' Su cal#ius. )) Posterior wall: Su scapularis ' Latissimus dorsi ' Teres (a*or. +) Medial wall: ,pper four or -i#e ri s ' .ntercostal spaces co#ered y Serratus anterior. /) Lateral wall: 0iceps ' coraco ranchialis . .n the icipti al space of humerus.

Lateral ' Medial (ein ) artery ) plexus# *own the axilla : #ein remain medially 1 artery and plexus !ill mingle. Artery !ill e central 1 surrounded y + cords. 2ateral ' medial ' posterior.

ontents:

- 0rachial Plexus - Axillary artery and axillary #eins - 2ymph #essels and 2ymph nodes.

3l o!:
Articulation : Trochlea 4 capitulum of humerus A56 trochlear notch of the ulna and the head of the radius. o!ered with: 7yaline cartilage. "ype: Syno#ial 7inge 8oint. apsule : Anterior and Posterior# o!ered $y Syno#ial (em rane.

Li%aments: 2ateral (triangular)and (edial (triangular 1 consist of + strong ands). &er!e Supply : 0ranches from the median 1 ulnar 1 musculocutaneous and radial ner#es.

M+(,M,&" : Flexion : By : rachialis 1 iceps rachii 1 racioradialis and pronator teres# ,xtension : By: Triceps and anconeus muscles.

"u ital -ossa :

anterior re%ion o- the el$ow# (trian%ular

depression) Boundaries: laterally : 0rachioradialis muscle (edially: Pronator teres muscle. Location: "an e determined y a slight flexion of el o! *oint 1 and palpating the tendon of iceps. Structues: *eep structures: (medial $$ lateral) &)(edian ner#e- rachial artery- iceps tendon- %adial ner#e. )) Suprtrochlear lymph nodes: lies in the superficial fascia o#er the upper part of the fossa 1 a o#e the trochlea. 99,lnar ner#e : located posterior to the medial epicondyle1 so cant e seen in cu ital fossa. Super-icial structures: - "ephalic :ein : radial side. - 0asilic #ein: ulnar side. - (edian cu ital #ein: connection et!een the t!o superficial #eins. ( An important ner#e and it;s usually the one !hich is used to dra! lood) &eedle .njection: <e in*ect the needle in the median cu$ital !ein. 0elo! it there;s a *eep Fascia. 7as a specific strength. = %esistance result from it is a sign that !e shouldn;t in*ect deeper. = .f the needle is in*ected deeper it can reach either the artery 1 and the lood !ill flo! under #ery high pressure (&)> mm7g) 1 or the (edian 5er#e the patient !ill loose the feeling of his/her arm.

Proximal %adioulnar 8oint:

Articulation : "ircumference of the head of the radius A56 the anular ligament and radial notch of ulna. "ype: Syno#ial pi#ot *oint.

apsule : 3nclosed the *oint and continuous !ith that of the el o! *oint. Li%aments: Anular ligament. "ontinuous !ith the capsule of el o! *oint 1 not attached to the radius. Syno!ial mem$rane continuous !ith the mem rane of el o! *oint. &er!e Supply : 0ranches from the median 1 ulnar 1 musculocutaneous and radial ner#es. M+(,M,&" : pronation and supination o- the -orearm#

6istal %adioulnar 8oint:

Articulation : rounded head of elnua A56 ulnar notch on the radius. "ype: Syno#ial pi#ot *oint. apsule : 3nclosed the *oint 1 ut deficient superiorly. Li%aments: <eak anterior and posterior. Syno!ial mem$rane:. &er!e Supply : Anterior interosseous ner#e and the deep ranch of the radial ner#e. M+(,M,&" : rotary mo!ement accompany pronation and supination o- the -orearm#

The <rist:
Anterior Aspect: .mportant region 1 ecause it;s #ery prone to in*ury. -lexors of the hand are found there. arpal "unnel: A tunnel formed of the carpal 0ones. 0ridged y -lexor retinaculum. All Flexors pass throu%h it / and median ner!e# "+ *,",0M.&, S"01 "10,S2 L+ A".+&S : 0ring the thum and little finger close to each other and flex the !rist slightly. "wo tendons will appear: &) Tendon of -lexor carpi radialis (in all people) )) Tendon of Palmaris longus. ( 6oesn?t appear in some people).
Flexor carpi ulnaris 1lnar ner!e Palmaris lon%us Median ner!e Flexor carpi radialis 0adial Artery

0adial Artery;s Pulse can e felt. Median &er!e is only superficial in the region of the !rist. .t egins in the axilla / %un !ith artery hidden in the iceps/ hidden under deep fascia in cu ital fossa / 7idden under superficial flexors in the forearm et!een deep and superficial flexors / Superficial in the !rist / hidden in the carpal tunnel. Traumas of the !rist in the anterior aspect are most pro a ly associated !ith the in*ury of the median ner#e.