Clavice

Scapula

Whole hand: Manus

-Wrist: Carpus

-hand proper: metacarpis

-fingers: digits

Coracoclavicular ligament

-ligament that is towrn in a shoulder separation (achromioclavicular dislocation)

-"true shoulder joint"

-made of loose ligaments (joint capsule)

-strength of shoulder provided by rotator cuff muscles

-glenoid labrum

deepens socket of shoulder

circular cartilage

increases stability

allows for a greater range of motion

Drainage of breast

Lateral -->  parasternal nodes (very close to lungs)

OR

Lateral-->superior (axillary lymphnodes)

-most drainage, and most cancer found in upper lateral breast

motor supply

sensory supply

autonomic/sympathetic supply

Segmental back injury

INjury to the back/spinal cord!!!

Example: C5 and C6 are injured

Periferal nerve is comprimised

Example: wrist is cut, superficial radial nerve is compromised

-vertibral a

-thyrocervical trunk

-internal thoracic a

• thoracoacromial a (pectoral m, shoulder joint, scapular mm)
• subscapular a (lateral thoracic wall, posterior shoulder)

Lateral/posterior forearm (supplys all of extensors of wrist and digits)

-deep palmar arch->metacarpal branches->digital branches

-medial/anterior forearm

-supplys flexors of wrist and digits

-wrist->superficial ulnar arch->digital branches

***Radial and Ulnar aa both provide dorsal hand blood supply

-functional/ 1 way valves

-Deep set: naimed pairs

-Superficial set: accessible from skin, own names, valves

1. cephalic

2. axillary

3. basilic

4. brachial

5.median cubital v

There are 3!!

1. ulna to humerous-"true" elbow joint

2. radius to humerous- ""

3. radius to ulna-proximal radioulnar joint

**All encased in a single joint capsuel = composite joint**

-trochlea of humerous and trochlear notch of ulna

and capitulum of humerous and head of radius

-synovial/uniaxial/hinge

-STRONG collateral liaments (limit AB/ADduction)

-"Carrying"angle

-lateral epicondylitis

-inflammation of extensors on the lateral epicondyle

-ligament associated with the prosimal radioulnar articulation

-allows the head of the radius to spin while holding it in place

-synnovial biaxial

-radius and scaphoid bone

-synnovial joints/plane or gliding type/nonaxial jt

-enhance wrist movements

-all encased in a singel joint cavity

-synnovial joint

-plane or gliding type

-nonaxial

-trapezium to 1st metacarpal

-synnovial/multiaxial joint

-allows for thumb opposition

-metacarpals to proximal phalanx (knuckles)

-synnovial

-biaxial

synnovial

uniaxial

hinge joint

-proximal, middle, distal phaland

-1 on thumb

-2 on each digit

-anterior/middle side of forearm

-attach on medial epicondyle of the humerous

-INN: medain n

-posterior/lateral forearm

-attach on lateral epicondyle of the forearm

-INN: radial n

-brachioradialis

-pronator teres

-pronator quadratus

-supinator

Muscles that act on the wrist

(radiocarpal joint)

-flexor carpi radialis

-flexor carpi ulnaris

-palmaris longus

-extensor carpi radialis longus

-extensor carpi radialis brevis

-extensor carpi ulnaris

-flexor digitorum profundus

-flexor digitorum superficialis

-extensor digitorum

-extensor indicis

-extensor digiti minimi

-flexor pollicis longus

-aBductor pollicis longus

-extensor pollicis brevis

-extensor pollicis longus

-Adductor pollicis *oddball

-opponens pollicis

-flexor pollicis brevis

-aBductor pollicis brevis

Odd ball/Ulnar innervations

(excluding the digiti minimi muscles)

FCU - flexor carpi ulnaris

FDP - flexor digitorum profundus

ADP - aDductor pollicis

I - interoseii mm

-opponens digiti minini

-flexor digiti minimi

-aBductor digiti minimi

Lumbricles: tendon of FDP to extensor expansion

-radial side of flexor digitorum profundus

-ABdut the digits 2 and 3

-ADduct the digits 4 and 5

-INN = 1/2 median, 1/2 ulnar

*w/ interossei, involved in flexion of MP joints and extension of IP joints

-Palmar or dorsal

-Palmar = aDduction (on each but middle finger, can't aDduct the midline)

-Dorsal = aBduction (indec finger has 2, you can aBduct both ways)

-INN: ulnar n

**w/ lumbricles, involved in flexion of MP joints and extension of IP joints**

The hand

lumbricles and interossei things to note

*no balance between FDP an dED at the MP and IP joints

-interossei and lumbricles hold the balance forces between FDP and ED joints

*cut ulnar nerve = claw hand (extended MP and flexed IP joints)

*w/out ulnar nerve we have lost 1/2 of lumbricles and all interossei (other half of lumbricles supplied by ulnar n)

-muscles that run from the axial skeleton to the scapula

-primarily involved in movements of the scapula

-DO NOT directly affect moveement at the true glenohumeral joint

-pec minor, trapezius, rhomboids, levator scapulae, and the serratus anterior

-origins on the axial skeleton and insertions on the humerous

-involved with the movements of the humerous and the glenohumeral joint

-pectoralis major, latissimus dorsi

Scapulohumeral definitions

-AKA "intrinsic muscles"

-originate and insert within the confines of the shoulder

-direct effect on shoulder joint

-teres major, teres minor, deltoids, supraspinatus, ingraspinatus, subscapularis

Spinal n,

C5

C6 &

C7

C5+C6 ventral rami = upper trunk

C7 ventral rami = middle trunk

C8+T1 ventral rami = lower trunk

Posterior/anterior divisions

**each trunk has an anterior division as well as a posterior division

-all 3 posterior divisions join to create posterior cord

-lateral cord created by two anterior divisions (from mid and upper trunk)

-lower cord created by anterior division (from lower trunk)

Innervation of the

LONG THORACIC NERVE

Inn of the

DORSAL SCAPULAR N

rhomboids

levator scapulae

INN of the

SUPRASCAPULAR N

supraspinatus

infraspinatus

(upper trunk)

INN of the

UPPER SUBSCAPULAR N

INN of the

THORACODORSAL N

INNs of the

LOWER SUBSCAPULAR N

subscapularis m

teres major m

INNs of the

AXILLARY N

deltoid

teres minor

INNs of the

MEDIAL AND LATERAL PECTORAL NN

pectoralis major

pectoralis minor