BONES of Upper Limb

1. What are the parts that make up the parts of the upper limb?
It has been seen that the upper limb is made up of 4 parts. They are namely
Shoulder region
Arms or brachium
Forearm or antebrachium
Hand or manus

Shoulder region includes

Scapular region on the back comprising parts around the scapula

Pectoral/breast
region on the front
of the chest
Axilla or armpit

Scapular region on the back

comprising parts around the
scapula.

Clavicle
Learning outcome
1.1 Side determination
1.2 Features of clavicles ( shaft, lateral and medial ends )
1.3 Attachments
1.4 Clinical anatomy
1.5 Peculiarities of clavicles

What is this ?
Its a LONG bone.

What does it function ?

Function 1 : Supports the shoulder so that the arm can swing clearly away from the trunk.
Function 2 : Transmits the weight of the limb to the sternum

What is the side determination ?

Medial end is large and quadrilateral

Lateral end is flat

Shaft is slightly curved so that its convex forwards in its medial 2/3 + concave
forwards in lateral 1/3rd

Inferior surface is grooved longitudinally in its middle 1/3rd

Features
1.2.1 Shaft
1.2.2: Lateral and medial ends

1.2.1 Shaft
How many parts its divided ?
Its divisible into the lateral 1/3rd and medial 2/3rd

What is the characteristics of Lateral 1/3rd ?

Lateral 1/3rd is flattened from above to downwards

It has 2 borders anterior and posterior
It has 2 surface superior and inferior
Superior surface subcutaneous
Inferior surface elevation of conoid tubercle

Concave forwards

Convex backwards

What is the characteristics of medial 2/3rd ?

It is rounded and have 4 surfaces

The surfaces are anterior, posterior, superior and inferior.

Anterior

Convex backwards

Posterior

Smooth

Superior surface rough in its medial part

Inferior surface has a rough oval impression at the medial end.

The lateral half of this surface has a longitudinal subclavian groove.

1.2.2 Lateral and medial ends

A. Lateral end

Lateral end is flattened from above downwards

It bears a facet that articulates with acromion process of the scapula to form the
acromioclavicular joint

B. Medial end
o Medial end is quadrilateral and articulates with the clavicular notch of the manubrium
sterni to form sternoclavicular joint
The articular surface extends to the inferior aspect for articulation with the first costal cartilage

1.3 Attachments
1.3.1 Lateral end and medial ends
1.3.2 Shaft

Lateral and medial ends

A. Lateral end
o At the lateral end the margin of the articular surface for its acromioclavicular joint, gives
attachment of the joint capsule
B. Medial end
o At the medial end, the margin of the articular surface for the sternum gives attachment to
o Fibrous capsule of sternoclavicular joint all around
o Articular disc posterosuperiorly
o Interclavicular ligament superiorly

Shaft
A. Lateral 1/3rd of the shaft
o The anterior border gives origin of deltoid
o Posterior border provides insertion to trapezius

o Conoid tubercle and trapezoid ridge give attachment to the conoid and trapezoid parts of
the coracoclavicular ligament

B. Medial 2/3rd of the shaft

o Most of the anterior surface gives origin to the pectoralis major

o Half of the rough superior surface gives origin to the clavicular head of the
sternocleidomastoid

o The oval impression on the inferior surface of the medial end gives attachment to the
costoclavicluar ligament

o The subclavian groove gives insertion to the subcalvius muscle. The margins of the
groove give attachment to the clavipectoral fascia

o The posterior surface close to the medial end gives origin to sternohyoid muscle

o Subclavian vessels and cords of brachial plexus pass towards the axilla lying between the
inferior surface of the clavicle and upper surface of the first rib

o Subcalvius muscle act as cushion

o The nutrient foramen transmits a branch of the suprascapular artery

1.4 Clinical importance

o Clavicle is commonly fractured by falling on the outstretched hand ( indirect violence)
o The most common sit of fracture is the junction between the two curvatures of the bone
which is the weakest point of the bone

1.6 Peculiarities of the clavicle

o
o
o
o
o
o
o
o

Its the only long bone that lies horizontally

Subcutaneous throughout
The first bone to start ossifying
The only long bone which ossifies in membrane
The only bone which have two primary centers of ossification
No medullary cavity
It is occasionally pierced by middle supraclavicular nerve
It receive weight of upper limb via lateral one third thorough coracoclavicular
ligament and transmits weight o upper limb to the axial skeletal via media 2/3rd part

Scapula
Learning outcome
1.1 Side determination
1.2 Features
1.3 Attachments
1.4 Clinical importance

What is this?
Its a thin bone placed in the posterolateral aspect of the thoracic cage

What is the side determination of the scapula?

o The lateral / glenoid angle is large and bears the glenoid cavity
(Glenoid shallow foremen)

o The dorsal surface (upper surface) is convex and is divided by the triangular spine into
the supraspinous and infraspinous fossae.

o The thickest lateral border runs from the glenoid cavity about to the inferior angle below

1.2 Features
o The scapula has two surfaces, three borders, three angles and three
processes.
1.2.1 Surface
1.2.2 Border
1.2.3 Angles
1.2.4 Processes

1.2.1 Surface
A.
o
o
o
o

Costal surface / subscapular fossa ( inside)

It is concave and is directed medially and forwards
Its marked by three longitudinal ridges
Another thick ridge adjoins the lateral border
This part of the bone is almost rod like

3 longitudinal
ridges
Lateral
border

What the function of this part of the bone?

o Act as a lever for the action of the serratus anterior in overhead abduction of the arm

z
B. Dorsal surface ( outside)

o This surface give the attachment to the spine of the scapula which divides the surface
into
- a smaller supraspinous fossa
- a larger infraspinous fossa
The two fossae are connected by the spinoglenoid notch situated lateral to the root of the spine

ROOT OF
SPINE

1.2.2 Borders
A. Superior
o Superior border is thin and shorter
o Near the root of the coracoid process it present the suprascapular notch

Suprascapu
lar notch

B. Lateral border
o Its thick
o At the upper end it presents the infraglenoid tubercle

C. Medial border is thin

o It extends from the superior angle to the inferior angle

1.2.3 Angles
A. Superior angle

o Its covered by trapezius muscle

B. Inferior angle

o Its covered by latissimus dorsi.

o It moves forwards round the chest when the arm is abducted

C. Glenoid angle
o Broad
o Bears the glenoid cavity or fossa which is directed forward, laterally and slightly
upwards

1.2.4 Processes
A. Spinous process
o Its a triangular plate of bone with three borders and two surface

o Its divided the dorsal surface of the scapula into the supraspinous and infraspinous
fossae
o The posterior border is called the crest of the spine
o The crest has upper and lower lips