G24: Shoulder and Axilla

Transcription

1 G24: Shoulder and Axilla Syllabus - Pg. 2 ANAT Medical Gross Anatomy David A. Morton, Ph.D.

2 Objectives Upper limb Systemically: Bones (joints) Muscles Nerves Vessels (arteries/veins) Fascial compartments

3 Objectives Upper limb Regionally: Skin of upper limb Shoulder Axilla Arm (brachium) Forearm (antebrachium) Hand

4 1) Upper Limb Skin Cutaneous nerves Cutaneous veins

5 What is the difference between these images? Pg. 2

6 1a) Dermatomes/cutaneous fields Lateral cutaneous n. of forearm Superficial radial n. Pg. 2

7 1a) Dermatomes/cutaneous fields Dermatome of C6 ~ Area of skin supplied by a ~ single spinal cord level

8 1a) Dermatomes/cutaneous fields Dermatome of C6 ~ Area of skin supplied by a ~ single spinal cord level To multiple spinal nerves

9 1a) Dermatomes/cutaneous fields Cutaneous fields of: Lateral cutaneous n. of forearm Superficial radial n.

10 1a) Dermatomes/cutaneous fields Musculocutaneous n. Lateral cutaneous n. of forearm Radial n. Superficial radial n.

11 1) Upper Limb Skin Cutaneous nerves Cutaneous veins

12 b) Major vessels i) Veins Cephalic v. Basilic v. Median cubital v. Dorsal hand vv. Pg. 3

13 b) Major vessels Pg. 3 ii) Arteries Subclavian a. Axillary a. Brachial a. Radial a. Ulnar a. Sprf. palmar arch Deep palmar arch

14 2) Actions of the Upper Limb Axial skeleton Pg. 3

15 2) Actions of the Upper Limb Pectoral girdle Clavicle Scapula

16 2) Actions of the Upper Limb Pectoral girdle Clavicle Scapula

17 2) Actions of the Upper Limb Pectoral girdle Clavicle Scapula Scapular Movements Protraction and Retraction Elevation and Depression Rotation

18 2) Actions of the Upper Limb Glenohumeral joint Scapula (glenoid cavity) Humerus (head)

19 2) Actions of the Upper Limb Glenohumeral joint Scapula (glenoid cavity) Humerus (head) Glenohumeral Joint Movements Flexion and Extension Abduction and Adduction Medial and Lateral Rotation

20 3) Fascia of the Upper Limb A little today Tomorrow Pg. 4

21 4) Skeletal muscle basics - Skeletal muscles in the limbs: - Attach to at least two separate bones - Origin and insertion - Act on the joint(s) that the muscle crosses between the attachments I O Pg. 4

22 4) Skeletal muscle basics - Skeletal muscles in the limbs: - Attach to at least two separate bones - Origin and insertion - Act on the joint(s) that the muscle crosses between the attachments I O Pg. 4

23 4) Skeletal muscle basics - Skeletal muscles do not push they contract: - Concentric : muscle shortens - Isometric : no change in length - Eccentric : muscle lengthens Pg. 5

24 4) Skeletal muscle basics - Skeletal muscles contraction: - Concentric : muscle shortens - Isometric : no change in length - Eccentric : muscle lengthens Pg. 5

25 4) Skeletal muscle basics - Skeletal muscles contraction: - Concentric : muscle shortens - Isometric : no change in length - Eccentric : muscle lengthens Pg. 5

26 4) Skeletal muscle basics - Skeletal muscles contraction: - Concentric : muscle shortens - Isometric : no change in length - Eccentric : muscle lengthens Muscles of hand gripping an object Pg. 5

27 4) Skeletal muscle basics - Skeletal muscles contraction: - Concentric : muscle shortens - Isometric : no change in length - Eccentric : muscle lengthens Setting an object down (a) Pg. 5

28 4) Skeletal muscle basics - Skeletal muscles contraction: - Concentric : muscle shortens - Isometric : no change in length - Eccentric : muscle lengthens Setting an object down (b) Pg. 5

29 5) Muscles of the Shoulder Girdle Scapular muscles Trapezius Levator scapulae Rhomboids Serratus anterior Pectoralis minor Pg. 5

30 5) Muscles of the Shoulder Girdle Intertubercular groove muscles Pectoralis major Teres major Latissimus dorsi

31 5) Muscles of the Shoulder Girdle Deltoid m. Anterior belly Middle belly Posterior belly Pg. 5

32 5) Muscles of the Shoulder Girdle Rotator cuff mm. (SITS) Supraspinatus Infraspinatus Teres minor Subscapularis Pg. 5

33 6) Brachial Plexus Pg. 6

34 Brachial Plexus Roots

35 Brachial Plexus Trunks

36 Innervation Divisions

37 Innervation Cords

38 Innervation Branches

39 6) Innervation Brachial Plexus Randy Travis Drinks Cold Beer Pg. 6

40 6) Innervation Brachial Plexus Randy Travis Drinks Cold Beverages Pg. 6

41 6) Innervation Brachial Plexus Randy Travis Drinks Cold Beer Pg. 6

42 Brachial Plexus Roots

43 GAFS Fig Brachial Plexus Roots

44 Brachial Plexus Trunks

45 Brachial Plexus Trunks GAFS Fig. 7.36

46 GAFS Fig Brachial Plexus Trunks

47 Innervation Divisions

48 Innervation Divisions

49 Innervation Divisions

50 Innervation Divisions

51 Innervation Divisions

52 Innervation Divisions Derived from: Ventral musculature Innervated by Anterior Division of Anterior Rami Derived from: Dorsal musculature Innervated by Posterior Division of Anterior Rami

53 Innervation Cords

54 GAFS Fig. 7.54

55 GAFS Fig. 7.55

56 Innervation Branches Pick-up with picture on pg. 7 tomorrow

57 THANK-YOU