Anatomage Table Instructors Guide- Upper Limb

Transcription

1 The Upper Limb

2 Anatomage Table Instructors Guide- Upper Limb Table of Contents Upper Limb 1- The Skeletal System...3 1: Clavicle...3 2: Scapula...5 3: Shoulder (Glenohumeral) and Proximal Humerus...7 4: Distal Humerus and Elbow...9 5: Wrist : Hand...14 Suggested Clinical Correlates (CC):...16 Upper Limb 2- The Muscular System : Anterior Axioappendicular (Pectoral) Muscles : Posterior Axioappendicular Muscles : Scapulohumeral Muscles : Arm Muscles : Anterior Forearm : Posterior Forearm : Hand...29 Suggested Clinical Correlates (CC):...31 Upper Limb 3- The Cardiovascular System : Arterial Supply to the Axilla and Arm : Arterial Supply to the Forearm and Hand : Venous Return of the Upper Limb...36 Suggested Clinical Correlates (CC):...38 Appendix...39

3 Upper Limb 1- The Skeletal System 1: Clavicle Name the bones comprising the shoulder girdle and discuss the difference between a separated and dislocated shoulder 1st and 2nd Rib Clavicle Humerus Manubrium Scapula Sternum (body) 1. a. Shoulder Girdle Acromial end of clavicle Acromioclavicular (AC) joint Acromion Clavicle Deltoid tubercle Manubrium Sternal end of clavicle Sternoclavicular (SC) joint 1. b. Vertebral Arch (Superior)

4 1st and 2nd Rib Acromial end of clavicle Acromioclavicular (AC) joint Acromion process Clavicle Humerus Manubrium Scapula Sternal end of clavicle Sternoclavicular (SC) joint 1. c. Intervertebral Joint Acromial end of clavicle Acromioclavicular (AC) joint Acromion angle Clavicle Coracoid process Deltoid tubercle Humerus Scapula 1. d. Zygopophyseal Joint (Low Visibility)

5 2: Scapula Describe the features of the scapula and list the various processes and fossa Acromion process Coracoid process Glenoid cavity Inferior angle Lateral (axillary) border Medial (vertebral) border Subscapular fossa Superior angle Suprascapular notch 2. a. Subscapular Fossa Acromion angle Acromion process Coracoid process Head of scapula Medial (vertebral) border Neck of scapula Spine of scapula Superior angle Suprascapular notch Supraspinous fossa 2. b. Supraspinous Fossa

6 Acromion process Head of scapula Inferior angle Infraspinous fossa Lateral (axillary) border Medial (vertebral) border Neck of scapula Spine of scapula 2. c. Infraspinous Fossa Acromion process Coracoid process Glenoid fossa (cavity) Head of scapula Inferior angle Infraglenoid tubercle Lateral (axillary) border Neck of scapula Subscapular fossa Supraglenoid tubercle Suprascapular notch 2. d. Glenoid Fossa Acromion process Coracoid process Glenoid cavity Inferior angle Lateral (axillary) border Medial (vertebral) border Spine of scapula Subscpular fossa Superior angle Suprascapular notch 2. e. Subscapular Fossa

7 3: Shoulder (Glenohumeral) and Proximal Humerus Identify the component parts and features that stabilize the shoulder joint Describe the proximal humerus and explain the difference between the surgical and anatomical necks of the humerus Anatomical neck of humerus Glenoid fossa( cavity) Head of humerus Infraglenoid tubercle Supraglenoid tubercle Surgical neck of humerus 3. a. Glenohumeral Joint Compact (cortical) bone Epiphyseal line Glenoid fossa (cavity) Head of humerus Marrow (medullary) cavity Spongy (Cancellous) bone 3. b. Spongy and Compact Bone (Coronal Cut)

8 Anatomical neck of humerus Greater tubercle Head of humerus Intertubercular groove Lesser tubercle Surgical neck of humerus 3. c. Intertubercular Groove (Anterior) Acromion process Anatomical neck of humerus Deltoid tuberosity Glenoid fossa (cavity) Greater tubercle Head of humerus Surgical neck of humerus 3. d. Proximal Humerus (Posterior) Acromial end of clavicle Acromion process Anatomical neck of humerus Clavicle Coracoid process Glenoid fossa (cavity) Greater tubercle Head of humerus Humerus Lateral (axillary) border Scapula 3. e. Shoulder X-ray (Anterior)

9 4: Distal Humerus and Elbow Classify the elbow joint and identify the sites of articulation between the various bones Deltoid tuberosity Greater tubercle Head of humerus Intertubercular groove Lateral epicondyle Lesser tubercle Medial epicondyle Radial groove Shaft of the humerus 4. a. Humerus (Anterior) Capitulum Coronoid fossa Lateral epicondyle Lateral supracondylar ridge Medial epicondyle Medial supracondylar ridge Radial fossa Radius Shaft of humerus Ulna 4. b. Coronoid Fossa (Anterior)

10 Capitulum Head of radius Lateral epicondyle Lateral supraepicondylar ridge Medial epicondyle Medial supraepicondylar ridge Olecranon fossa Olecranon process Shaft of humerus Trochlea 4. c. Olecranon Fossa (Posterior) Coranoid fossa Coranoid process Olecranon fossa Olecranon process Shaft of humerus Trochlea Trochlear notch Ulna Ulnar tuberosity 4. d. Humeroulnar Joint (Medial) Capitulum Head of radius Lateral epicondyle Lateral supraepicondylar ridge Neck of radius Radial fossa Radial tuberosity 4. e. Humeroradial Joint (Anterior)

11 Coranoid fossa Coranoid process Head of radius Neck of radius Olecranon fossa Olecranon process Shaft of humerus Trochlea Trochlear notch 4. f. Elbow X-ray (Medial) 5: Wrist Describe the articulation of the bones at the wrist and review the bones involved both directly and indirectly with this joint Coronoid process Head of radius Neck of radius Radial notch Radial tuberosity Radius Ulna Ulnar tuberosity 5. a. Proximal Radioulnar Joint (Anterior)

12 Anterior compartment of forearm Interosseous border of radius Interosseous border of ulna Location of interosseous membrane Posterior compartment of forearm Shaft of radius Shaft of ulna Skin Superifical v. 5. b. Interosseous Borders (Axial Slice) Distal radioulnar joint Head of ulna Shaft of radius Shaft of ulna Styloid process of radius Styloid process of ulna Ulnar notch of radius 5. c. Distal Radioulnar Joint (Anterior) Lunate Pisiform Radiocarpal joint Scaphoid Styloid process of radius Styloid process of ulna Triquetrum Tubercle of scaphoid Ulnar notch of radius 5. d. Wrist (Radioulnar) Joint (Anterior)

13 Capitate Hamate Hook of hamate Lunate Pisiform Scaphoid Styloid process of radius Trapezium Trapezoid Triquetrum Tubercle of scaphoid Tubercle of trapezium 5. e. Carpal Bones (Anterior) Lunate Pisiform Radiocarpal joint Scaphoid Styloid process of radius Styloid process of ulna Triquetrum Ulnar notch of radius 5. f. Carpal Bones (Posterior) Capitate Distal radioulnar joint Hamate Head of ulna Lunate Pisiform Radiocarpal joint Scaphoid Styloid process of radius Styloid process of ulna Trapezium Trapezoid Triquetrum 5. g. Wrist X-ray (Posterior)

14 6: Hand Name the bones and joints in the hand 1st-5th Metacarpals Capitate Carpometacarpal joint Hamate Midcarpal joint Trapezium Trapezoid 6. a. Carpometacarpal Joint (Posterior) 1st-5th Metacarpals Intermetacarpal joints Sesamoid bones 6. b. Metacarpals (Anterior) 1st-5th Metacarpals 1st-5th Proximal phalanx Metacarpophalangeal (MP) joint

15 6. c. Metacarpophalangeal (MP) Joint (Posterior) 1st distal phalanx 1st Metacarpal 1st Proximal phalanx Carpometacarpal (CMC) joint Interphalangeal (IP) joint Metacarpophalangeal (MP) joint Sesamoid bones Trapezium 6. d. Thumb 2nd-5th Distal phalanx 2nd-5th Middle phalanx 2nd-5th Proximal phalanx Base, shaft, head of middle phalanx Base, shaft, head of proximal phalanx Base, shaft, tubersotiy, and head of distal phalanx 6. e. Phalanges 5th Distal phalanx 5th Metacarpal 5th Middle phalanx 5th Proximal phalanx Distal interphalangeal (DIP) joint Metacarpophalangeal (MP) joint Proximal interphalangeal (PIP) joint 6. f. Interphalangeal Joints X-ray (Posterior)

16 Suggested Clinical Correlates (CC): Anteroinferior Dislocation with Hill-Sachs Impaction Fracture of Greater Tuberosity Luxation Erecta Positioning of Arm Case 0106 Shoulder Dislocation Distal Radial Ulnar Joint with TFCC Perforation or Tear Scapholunate and/or a Lunotriquetral Perforation or Tear Case 0092 Scapholunate Tear Comminuted Frx of 3rd and 4th Metacarpal Metaphysis, Comminuted Frx of Base and Proximal Shaft of 5th Metacarpal Comminuted Mildly Displaced Hamate Frx Mildly Displaced Frx of Base of 2nd Metacarpal Case 0321 Metacarpal Fractures

17 Upper Limb 2- The Muscular System 1: Anterior Axioappendicular (Pectoral) Muscles Name the attachments for the muscles of the anterior chest wall Describe the dominant actions for pectoralis major and serratus anterior Explain the clinical significance of winging of the scapula and identify the primary muscle involved Body of sternum Clavicle Clavicular head of pectoralis major Lateral lip of intertubecular groove Manubrium Sternocostal head of pectoralis major 1. a. Pectoralis Major (Anterior) Cephalic v. Clavicle Clavicular head of pectoralis major Deltoid Deltopectoral groove Deltopectoral triangle 1. b. Deltopectoral Triangle (Superior)

18 3rd -4th Rib Medial border of scapula Pectoralis major Pectoralis minor Serratus anterior 1. c. Serratus Anterior (Inferior) 2nd -3rd Rib Axillary a. Axillary v. Coracoid process Pectoralis major Pectoralis minor Spine of scapula 1. d. Pectoralis Minor (Sagittal Cut Lateral)

19 2: Posterior Axioappendicular Muscles Identify and describe the sites of attachment for the extrinsic muscles of the back Review the associated actions of these muscles on the scapula and upper limb Acromial end of clavicle C7, T1-T4 spinous process Exteranl occipital protuberance Inferior fibers of trapezius Medial border of scapula Middle fibers of trapezius Spine of scapula Superior fibers of trapezius 2. a. Trapezius (Posterior) Acromial end of clavicle Inferior fibers of trapezius Intertubucular groove of humerus Latissimus dorsi Medial border of scapula Middle fibers of trapezius Spine of scapula 2. b. Latissimus Dorsi (Posterolateral)

20 Levator scapulae SCM Superior border of scapula Superior fibers of trapezius 2. c. Levator Scapulae (Low Visibility) Medial border of scapula Rhomboid major Rhomboid minor Spine of scapula Trapezius 2. d. Rhomboids (Sagittal Cut Low Visibility)

21 3: Scapulohumeral Muscles Identify and describe the muscles that comprise the rotator cuff Discuss the clinical consequence of damaging the various muscles of the rotator cuff Acromial end of clavicle Acromion process Anterior fibers of deltoid Deltoid tuberosity Middle fibers of deltoid Posterior fibers of deltoid Spine of scapula 3. a. Deltoid (Posterior) Anterior axillary fold Latissimus dorsi Lymph nodes Pectoralis major Pectoralis minor Posterior axillary fold Teres major 3. b. Axillary Fossa (Anterior)

22 1st and 2nd Rib Axillary a. Axillary v. Body of scapula Deltoid Glenoid cavity Head of the humerus Pectoralis major Pectoralis minor Serratus anterior Subscapularis 3. c. Axillary Borders (Inferior) Acromion process Body of scapula Deltoid Glenoid cavity Head of humerus Infraspinatus Spine of scapula Subscapularis Supraspinatus 3. d. Rotator Cuff (Sagittal Cut Lateral)

23 4: Arm Muscles Identify the compartments of the arm and list the muscles located within each compartment Describe the attachments and function of each muscle within the anterior and posterior compartments of the arm Anterior compartment of arm Brachial a. Cephalic v. Deep artery of arm Huermus Posterior compartment of arm 4. a. Arm Compartments (Axial Cut) Brachialis Coracobrachialis Long head of biceps brachii Short head of biceps brachii Tendon of biceps brachii 4. b. Anterior Compartment of Arm

24 Brachioradialis Brachialis Long head of biceps brachii Short head of biceps brachii 4. c. Elbow Flexors (Lateral) Brachioradialis Lateral head of triceps brachii Long head of triceps brachii 4. d. Posterior Compartment of Arm (Lateral) Lateral head of triceps brachii Long heado f triceps brachii Medial head of triceps Olecranon process of ulna 4. e. Triceps (Medial)

25 5: Anterior Forearm Describe the boundaries and contents of the cubital fossa Name the muscles that comprise the three layers of the forearm and describe their attachments and functions Explain the consequence of injury to the common flexor and extensor attachments Biceps brachii tendon Brachialis Brahioradialis Medial epicondylesbrachial a. Median cubital v. Pronator teres 5. a. Cubital Fossa (Anterior) Flexor carpi radialis Flexor carpi radialis tendon Flexor carpi ulnaris tendon Medial epicondylesflexor carpi ulnaris Pronator teres 5. b. Superficial Forearm Flexors (Anterior)

26 Flexor digitorum superficialis Flexor digitorum superficialis tendon Flexor digitorum superficialis tendon Radius Ulna 5. c. Intermediate Forearm Flexors Flexor digitorum profundus Flexor pollicis longus Pronator quadratus Radius Ulna 5. d. Deep Forearm Flexors (Axial-cut Low-visibility) 5. e. Carpal Tunnel Contents (Axial-cut Low-visibility) Capitate Flexor digitorum profundus tendons Flexor digitorum superficialis tendons Flexor pollicis longus tendon Hook of hamate Lunate Pisiform Radial a. Superficial palmar branch of ulnar a. Trapezium Trapezoid Triquetrum

27 6: Posterior Forearm Review the muscles in the extensor group and describe their attachments and action Describe the anatomical snuffbox, including its boundaries and contents Extensor carpi radialis brevis Extensor carpi radialis brevis tendon Extensor carpi radialis longus Extensor carpi radialis longus tendon Extensor carpi ulnaris Extensor carpi ulnaris tendon Extensor digiti minimi tendon Extensor digitorum Extensor digitorum tendons 6. a. Superficial Layer Posterior Forearm Abductor pollicis longus tendon Extensor indicis tendon Extensor pollicis brevis Extensor pollicis brevis tendon Extensor pollicis longus tendon 6. b. Deep Layer Posterior Forearm

28 Crest of ulna Neck of radius Supinator 6. c. Supinator (Axial-cut- Low-visibility) Abductor pollicis longus tendon Extensor carpi radialis brevis tendon Extensor carpi radialis longus tendon Extensor pollicis brevis tendon Extensor pollicis longus tendon Radial a. Scaphoid 6. d. Anatomical Snuff Box (Posterolateral)

29 7: Hand Review the intrinsic muscles of the hand and discuss the actions of these muscles Describe the structural and functional relationship between the long tendons from the forearm and the intrinsic muscles of the hand Abductor pollicis brevis Flexor pollicis brevis Opponens pollicis 7. a. Thenar eminence Abductor digiti minimi Flexor digiti minimi brevis 7. b. Hypothenar eminence

30 1st-4th Dorsal interossei 2nd-5th Metacarpal 7. c. Dorsal Interossei (Low-visibility) 1st-3rd Palmar interossei 2nd-5th Metacarpal 7. d. Palmar Interossei (Anterior Low-visibility) 1st -4th Lumbricals Adductor pollicis FDP tendon 7. e. Lumbricals (Anterior Low-visibility)

31 Adductor pollicis Hypothenar eminence Thenar eminence 7. f. Adductor Pollicis (Low-visibility) Suggested Clinical Correlates (CC): Ill-defined Hypoattenuation in Triceps, Deltoid, Teres Major Case 0240 Axilla Tumor Post Mastectomy Partial Tearing of Subscapularis Tendon Partial Thickness and Pinhole Thickness Tearing of Supraspinatus and Infraspinatus Tendons Case 0239 Shoulder Arthritis

32 Upper Limb 3- The Cardiovascular System 1: Arterial Supply to the Axilla and Arm Describe the arteries and their branching patterns within the axilla and arm Identify the boundaries of the major vessels in the axilla and arm and review the points of name change Arch of the Aorta Axillary a. Brachiocephalic trunk Clavicle Lateral border of 1st Rib Subclavian a. 1. a. Axillary Artery (Anterior) Axillary a. Circumflex scapular a. Internal thoracic a. Lateral thoracic a. Pectoral a. Subscapular a. Subscapular a. Thoracoacromial trunk Thoracodorsal a. 1. b. Branches of Axillary Artery

33 Axillary a. Brachial a. Circumflex scapular a. Deep artery of the arm Dorsal scapular a. Posterior circumflex humeral a. Subscapular a. 1. c. Proximal Arm Vasculature (Anterior) Axillary a. Brachial a. Circumflex scapular a. Deep artery of the arm Posterior circumflex humeral a. Radial a. Subscapular a. Thoracodorsal a. Ulnar a. 1. d. Arteries in the Arm

34 2: Arterial Supply to the Forearm and Hand Describe the arteries and their branching patterns within the forearm and hand Review the collateral circulation of the elbow Brachial a. Radial a. Ulnar a. 2. a. Cubital Fossa (Medial) Anterior ulnar recurrent a. Brachial a. Inferior ulnar collateral a. Posterior ulnar recurrent a. Radial a. Superior ulnar collateral a. Ulnar a. 2. b. Elbow Collateral Circulation (Medial)

35 Anterior interosseous a. Posterior interosseous a. Radial a. Ulnar a. 2. c. Arteries in the Forearm (Anteromedial) Deep palmar arterial arch Radial a. Superficial palmar arterial arch Superficial palmar branch of radial a. Ulnar a. 2. d. Superficial Palmar Arterial Arch (Anterior) Common palmar digital a. Proper palmar digital a. Superficial palmar arterial arch 2. e. Digital Arteries (Anterior)

36 Deep palmar arterial arch Radial a. 2. f. Radial a. and Deep Arch (Lateral) 3: Venous Return of the Upper Limb Describe the branching patterns and path of venous return for the veins of the upper limb Basilic v. Cephalic v. Dorsal venous network 3. a. Dorsal Venous Network (Posterior)

37 Basilic v. Cephalic v. Ulnar a. Venae commitantes 3. b. Venae Commitantes (Anterior) Basilic v. Cephalic v. Median cubital v. 3. c. Median Cubital Vein (Anterior) Axillary a. Axillary v. Basilic v. Brachial a. Cephalic v. Deep v. 3. d. Axillary Vein

38 Suggested Clinical Correlates (CC): Extensive Convoluted Vessels in Palmar Surface of Right Hand Over First Through Third Metacarpals Hypertrophy of Radial, Ulnar, and Interossei Arteries Hypertrophy of Superficial and Deep Palmar Arch Prominant Earlyfilling Veins Case 0155 Complex AV Formation Metacarpals To 1st/2nd-2nd/3rd Intermetacarpal and 5th Metacarpal Artery Moderately Attenuated Case 0015 Thoracic Outlet Syndrome

39 Appendix Upper Limb 1-The Skeletal System Library Case: 0082 (Topics 1-3), 0186 (Topics 4-6) Goal(s): Identify, describe structures, and discuss clinical correlates of (1) the osteology of the shoulder, humerus, and hand, and (2) explain the basis for the classification of surrounding joints Annotated Anatomy: 1: Clavicle 1st and 2nd Rib, Acromial end of clavicle, Acromioclavicular (AC) joint, Acromion, Acromion angle, Acromion process, Clavicle, Coracoid process, Deltoid tubercle, Humerus, Manubrium, Scapula, Sternal end of clavicle, Sternoclavicular (SC) joint, Sternum (body) 2: Scapula Acromion angle, Acromion process, Coracoid process, Glenoid cavity, Glenoid fossa (cavity), Head of scapula, Inferior angle, Infraglenoid tubercle, Infraspinous fossa, Lateral (axillary) border, Medial (vertebral) border, Neck of scapula, Spine of scapula, Subscapular fossa, Superior angle, Supraglenoid tubercle, Suprascapular notch, Supraspinous fossa 3: Shoulder (Glenohumeral) and Proximal Humerus Acromial end of clavicle, Acromion process, Anatomical neck of humerus, Clavicle, Compact (cortical) bone, Coracoid process, Deltoid tuberosity, Epiphyseal line, Glenoid fossa (cavity), Greater tubercle, Head of humerus, Humerus, Infraglenoid tubercle, Intertubercular groove, Lateral (axillary) border, Lesser tubercle, Marrow (medullary) cavity, Scapula, Spongy (Cancellous) bone, Supraglenoid tubercle, Surgical neck of humerus 4: Distal Humerus and Elbow Capitulum, Coranoid fossa, Coranoid process, Coronoid fossa, Deltoid tuberosity, Greater tubercle, Head of humerus, Head of radius, Intertubercular groove, Lateral epicondyle, Lateral supracondylar ridge, Lateral supraepicondylar ridge, Lesser tubercle, Medial epicondyle, Medial supracondylar ridge, Medial supraepicondylar ridge, Neck of radius, Olecranon fossa, Olecranon

40 process, Radial fossa, Radial groove, Radial tuberosity, Radius, Shaft of humerus, Trochlea, Trochlear notch, Ulna, Ulnar tuberosity 5: Wrist Anterior compartment of forearm, Capitate, Coronoid process, Distal radioulnar joint, Hamate, Head of radius, Head of ulna, Hook of hamate, Interosseous border of radius, Interosseous border of ulna, Location of interosseous membrane, Lunate, Neck of radius, Pisiform, Posterior compartment of forearm, Radial notch, Radial tuberosity, Radiocarpal joint, Radius, Scaphoid, Shaft of radius, Shaft of ulna, Skin, Styloid process of radius, Styloid process of ulna, Superifical v., Trapezium, Trapezoid, Triquetrum, Tubercle of scaphoid, Tubercle of trapezium, Ulna, Ulnar notch of radius, Ulnar tuberosity 6: Hand 1st-5th Metacarpals, 1st-5th Proximal phalanx, 1st-5th Distal phalanx, 2nd-5th Middle phalanx, Base, shaft, head of middle phalanx, Base, shaft, head of proximal phalanx, Base, shaft, tubersotiy, and head of distal phalanx, Capitate, Carpometacarpal (CMC) joint, Distal interphalangeal (DIP) joint, Hamate, Intermetacarpal joints, Interphalangeal (IP) joint, Metacarpophalangeal (MP) joint, Midcarpal joint, Proximal interphalangeal (PIP) joint, Sesamoid bones, Trapezium, Trapezoid

41 Upper Limb 2-The Muscular System Library Case: 0155 (Topics 1-4), 0238 (Topics 5-7) Goal(s): Identify, describe structures, attachments, functions and discuss clinical correlates of (1) the shoulder, axilla, rotator cuff, (2) forearm, and hands. Annotated Anatomy: 1: Anterior Axioappendicular (Pectoral) Muscles 2nd-4th Rib, Axillary a., Axillary v., Body of sternum Cephalic v., Clavicle, Clavicular head of pectoralis major, Coracoid process, Deltoid, Deltopectoral groove, Deltopectoral triangle, Lateral lip of intertubecular groove, Manubrium, Medial border of scapula, Pectoralis major, Pectoralis minor, Serratus anterior, Spine of scapula, Sternocostal head of pectoralis major 2: Posterior Axioappendicular Muscles Acromial end of clavicle, C7, T1-T4 spinous process, Exteranl occipital protuberance, Inferior fibers of trapezius, Intertubucular groove of humerus, Latissimus dorsi, Levator scapulae, Medial border of scapula, Middle fibers of trapezius, Rhomboid major, Rhomboid minor, SCM, Spine of scapula, Superior border of scapula, Superior fibers of trapezius, Trapezius 3: Scapulohumeral Muscles Clavicle, Ribs (1-2), Head of humerus, Deltoid tuberosity, Superior border of scapula, Spine of scapula, Acromion process, Body of scapula, Glenoid cavity, Anterior and Posterior axillary fold, Axillary a. and v., Lymph nodes, Anterior, Middle and Posterior fibers of Deltoid, Pectoralis major, Pectoralis minor, Serratus anterior, Teres major, Latissimus dorsi, Deltoid, Subscapularis, Supraspinatus, Infraspinatus 4: Arm Muscles 1st and 2nd Rib, Acromial end of clavicle, Acromion process, Anterior axillary fold, Anterior fibers of deltoid, Axillary a., Axillary v., Body of scapula, Deltoid, Deltoid tuberosity, Glenoid cavity, Head of humerus, Infraspinatus, Latissimus dorsi, Lymph nodes, Middle fibers of deltoid, Pectoralis major, Pectoralis minor, Posterior axillary fold, Posterior fibers of deltoid, Serratus anterior, Spine of scapula, Supraspinatus, Teres major

42 5: Anterior Forearm Biceps brachii tendon, Brachial a., Brachialis, Brahioradialis, Capitate, Flexor carpi radialis, Flexor carpi radialis tendon, Flexor carpi ulnaris, Flexor carpi ulnaris tendon, Flexor digitorum profundus, Flexor digitorum profundus tendons, Flexor digitorum superficialis, Flexor digitorum superficialis tendon, Flexor pollicis longus, Flexor pollicis longus tendon, Hook of hamate, Lunate, Medial epicondyle, Median cubital v., Pisiform, Pronator quadratus, Pronator teres, Radial a., Radius, Superficial palmar branch of ulnar a., Trapezium, Trapezoid, Triquetrum, Ulna 6: Posterior Forearm Abductor pollicis longus tendon, Crest of ulna, Extensor carpi radialis brevis, Extensor carpi radialis brevis tendon, Extensor carpi radialis longus, Extensor carpi radialis longus tendon, Extensor carpi ulnaris, Extensor carpi ulnaris tendon, Extensor digiti minimi tendon, Extensor digitorum, Extensor digitorum tendon, Extensor indicis tendon, Extensor pollicis brevis, Extensor pollicis brevis tendon, Extensor pollicis longus tendon, Neck of radius, Radial a., Scaphoid, Supinator 7: Hand 1st -4th Lumbricals, 1st-3rd Palmar interossei, 1st-4th Dorsal interossei, 2nd-5th Metacarpal, Abductor digiti minimi, Abductor pollicis brevis, Adductor pollicis, FDP tendon, Flexor digiti minimi brevis, Flexor pollicis brevis, Hypothenar eminence, Opponens pollicis, Thenar eminence

43 Upper Limb 3- The Cardiovascular System Library Case: 0155 (Topic 1), 0015 (Topic 2-3) Goal(s): Identify, describe structures, and discuss clinical correlates of the artereis and veins of the arm Annotated Anatomy: 1: Arterial Supply to the Axilla and Arm Arch of the Aorta, Axillary a., Brachial a., Brachiocephalic trunk, Circumflex scapular a., Clavicle, Deep artery of the arm, Dorsal scapular a., Internal thoracic a., Lateral border of 1st Rib, Lateral thoracic a., Pectoral a., Posterior circumflex humeral a., Radial a., Subclavian a., Subscapular a., Thoracoacromial trunk, Thoracodorsal a., Ulnar a. 2: Arterial Supply to the Forearm and Hand Anterior interosseous a., Anterior ulnar recurrent a., Brachial a., Common palmar digital a., Deep palmar arterial arch, Inferior ulnar collateral a., Posterior interosseous a., Posterior ulnar recurrent a., Proper palmar digital a., Radial a., Superficial palmar arterial arch, Superficial palmar branch of radial a., Superior ulnar collateral a., Ulnar a. 3: Venous Return of the Upper Limb Axillary a., Axillary v., Basilic v., Brachial a., Cephalic v., Deep v., Dorsal venous network, Median cubital v., Ulnar a., Venae commitantes