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Upper Limb Study Guide 6

Biceps brachii tendon: palpable in cubital fossa, lateral to


6.1 TOPOGRAPHIC ANATOMY midline with arm flexed
Flexor tendons: wrist and finger flexors visible distally on
ventral aspect of forearm
Study Aims Extensor tendons: wrist and finger flexors visible on the
dorsum of hand
At the end of your study, you should be able to: Thenar eminence: muscles at base of thumb (see Section
Identify the bony landmarks: acromion, coracoid process 6.5, Wrist and Hand)
of scapula, olecranon and head of ulna, medial and lateral Hypothenar eminence: muscles at base of little finger (see
epicondyles, radial styloid process Section 6.5, Wrist and Hand)
Identify the muscle masses of the deltoid, biceps, triceps,
brachioradialis, and thenar and hypothenar eminences ARTERIES AND VEINS
Identify the deltopectoral triangle and cubital fossa Brachial artery
Identify the course of the cephalic, basilic and median
Pulsations can be palpated deep to medial border of
cubital veins
biceps muscle
Used to determine heart rate in children
Radial artery: pulse can be felt by compressing artery
against distal end of radius
GUIDE Median cubital vein (see Section 6.4, Elbow and Forearm)
Traverses cubital fossa connecting cephalic to basilic
BONES veins
Clavicle: subcutaneous; palpable throughout its length Often used for venipuncture
Acromion: easily palpable, traced medially to acromiocla- Cephalic vein ascends along lateral forearm and arm (see
vicular joint (see Section 6.2, Shoulder and Axilla) Section 6.6, Neurovasculature)
Coracoid process of scapula: palpable deep and lateral to Basilic vein ascends along medial forearm and distal arm
deltopectoral triangle (see Section 6.6, Neurovasculature)
Head of humerus: palpable deep to deltoid inferior to Dorsal venous network seen on dorsum of hand
lateral edge of acromion when arm is rotated
Elbow: palpable medial and lateral epicondyles of NERVES
humerus and visible olecranon process of ulna (see Section Ulnar nerve can be felt under medial epicondyle
6.4, Elbow and Forearm)
Head of radius: palpable as it rotates during pronation ANATOMICAL POINTS
and supination on posterolateral aspect of extended
elbow, just distal to lateral epicondyle FUNCTIONAL OVERVIEW
Ulnar head: visible on medial side of dorsal aspect of wrist The upper limb is highly mobile and characterized by its
(see Section 6.5, Wrist and Hand) ability to perform a wide range of controlled movements to
Radial styloid: palpable in anatomical snuff box on lateral manipulate the surrounding environment. It is suspended
side of wrist from the trunk at the shoulder, and its stability has been
Ulnar styloid: just distal to ulnar head with hand sacrificed to gain mobility. Clinically the limb is divided into
supinated four regions: pectoral girdle, arm, forearm and hand.
Pisiform: hard, round structure on anteromedial aspect
of wrist UPPER LIMB DEVELOPMENT
Tubercles of scaphoid and trapezium: palpable at proxi- The upper limb buds from the embryonic trunk and rotates
mal end of thenar eminence 90 degrees laterally, so in the anatomical position, the
ventral structures face anteriorly and the dorsal structures
MUSCLES AND TENDONS posteriorly. This contrasts with the medial rotation of the
Deltoid muscle: Overlies shoulder, giving it rounded lower limb. Thus, the upper and lower limbs are 180 degrees
appearance out of phase. Flexors of all joints in the upper limb are
Biceps: Bulge on anterior aspect of arm anterior and extensors are posterior.

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