Shoulder (neck->arm)=shoulder=scapula/clavicle

Arm (shoulder->elbow)=brachium=humerus

Forearm (arm->hand)=antibrachium=radius/ulna

Hand (forearm->distal)=manus

-wrist(carpus)=carpal bones

-hand proper(metacarpals)=metacarpal bones

-fingers(digits)=phalanges(plural) or phanlanx(singular)

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List the bones involved in the shoulder girdle

1. Clavicle

1. Scapula

3. Proximal end of the Humerus

Clavicle - suspends scpula and free limb, covers cervicoaxillary canal, transmits physical impacts from the upper limb to the axial skeleton

Scapula - muscle attachment, broad plate for strong anchoring of muscles of the upper extremety

Humerus - link elbow to shoulder blade, provide support to main muscles of the shoulder, the upper arm and the lower arm

1. sternoclavicular joint

2.acromioclavicular joint

3.scapulothoracic joint

4.glenohumeral joint

-synovial/multiaxial (rotate,elevate,depress...)

-prominent articular disk

-strong, stable, rarely damaged

-synnovial/gliding

-"AC joint"

-ligament: coracoclavicular

-scapula sits on the ribcage

-glids around posterior to the ribcage

-elevate/depress/aBduct/aDduct/rotate

-"true shoulder joint"

-glenoid fossa of the scapula->head of humerus

-synovial/multiaxial

-ball & socket joint

-made of losse ligaments(joint capsule)

-strength of shoulder provided by roatoer cuff muscles

-glenoid labrum/surrounds glenoid fossa, deepens socket, increases stability and allows for motion

Both: ball and socket, spherical head of one bone lodges in spherical cavity of another

Shoulder: shallow socket, loose joint, body's most mobile joint

Hip: head fits in deep socket, very strong ligament, less mobile, but more stable than ↑

What are the axiohumeral muscles?

pectoralis major

latissimus dorsi

(move scapula to move humerus)

Pectoalis minor

trapezius

levator scapulae

rhomboids

serratus anterior

(directly affect humeral movement)

deltoid

teres minor

infraspinatus

supraspinatus

subscapularis

Trapezius

Latissimus Dorsi

Levator Scapula

Rhomboid

-hold shoulder together and add strength to the glenohumeral joint

terres minor (lat rotation, ABduct shoulder)

infraspinatus (lat rotation, ADduction of shoulder)

supraspinatus (ABduction)

subscapularis (ADduct, medial rotate)

Ant: pectoralis major/minor

Med: ribs, serratus anterior

Post: subscapularis, latissimus dorsi, terres major

Contents: fat, lymph nodes, lymph vessels, axillar A and V, brachial plexus

-modified sweat glands

-packed in fat

-supported by fibrous ligaments borrowed from local fascia

-covered in delacate skin

Mammary glands: acessory organs of female reproductive system located w/in breast

Breast: contains mammary glands in a female

Glandular lobes (milk production)

Lactiferous ducts (lobes -> lactiferous sinuses)

Lactiferous sinuses (hold small amount of milk)

Suspensor ligaments (skin -> deep fascia / support)

Nipple (area where lactiferous ducts terminate)

Areola (area around the nipple)

Subascious glands (oil glands w/ openings in areola - helps prevent chafing)

mammography (low dosage xray)

CT scan

Ultrasound

Self exam

NONcancerous lumps in breast which can cause discomfort

related to hormonal influences from mensrual cycle

cysts move more freely than cancerous tumors

venous drainage

or

Lungs and opp breast: lymph system (parasternal nodes - on medial side of breast deep to sternum) Axilla: axilla nodes (most cancers are in superior lateral quadrant. drains to axilla lymph nodes)

*most of breast drains to axilla

Ventral rami of spinal nerves...

C5

C6

C7

C8

T1

supply motor, sensory an autonomic (sympathetic) to U.L.

Sensory cell bodies: Dorsal root ganglion

Motor cell bodies: ventral gray

trunks →divisions→cords→terminal branches

Trunk: in neck as plexus, emerges from scalenes

Divisions: head to ant or post limb

Cords: very thich, named in relationship to axillary artery

Lateral cord: musculocutaneous n, lateral pectoral n, lat root of median n

Posterior cord: upper subscapular n, thoracodorsal n, lower subscapular n, axillary n, radial n

Medial cord: medial pectoral n, ulnar n, medial root of median n

Axillary n - shoulder region

radial n - post arm and post forearm

musculocutaneous n - ant arm

ulnar n - hand

median n - and forearm

Parylysis: complete loss of motor movement

Paresis: weakness of motor movement

Anasthesia: sensation blocked or taken away

Parathesia: feeling of pins and needles/limb falling asleep (occurs when sustained pressure has been applied over a n, inhibiting/stimulating its function

Collateral Circulation is where a vein/artery has branches just around an articulation. These branches form anastomoses with each other to provide redundancy in the blood supply to that articulation and distally. These anastomoses can be vein-vein, artery-artery, or artery-vein

Aorta: brachiocephalic trunk -> Right subclavian a.

aorta -> left subclavian a.

*aortic arch--brachiocephalic trunc--r.subclavian a--r.common corotid a

*aortic arch--l.subclavian

*R.&L. subclavian--axillary a-(first rib)-brachial a-(teres major)-radial a--ulnar a

*Radial A--deep palmar arch

*Ulnar A--Superficial palmar arch

SUBCLAVIAN A.

-vertebral a (brain)

-thyrocervical trunk (cervical viscera and scapular mm)

-internal thoracic a (breast, anterior thoracic wall)

AXILLARY A.

Deep: named for aa for with which they run

Superficial: have own name, begin on dorsum(back) of hand

-cephalic v > axillary v > basilic v > brachail v > axillary v

-Cephalic (lat) empties into axillary

-basilic (med) joins brachial v

(where it joins brachial vein, it becomes the axillary v)

-connects basilic and cephalic veins

-great spot for phlebotomist to get blood as the v. stays in place typially and doesn't roll much

Humerus - ulna (trochlea)

Humerus - radius (capitulum

Can flex/or extend 

VERY STRONG!

limit AB/AD duction

Radial collateral

Ulnar collateral

-between radius and ulna

-synovial uniaxial joint (rotation)

-radius pivots on ulna

-nothing moves with rotation of radius but the radius and the hand

-A thick, ring-like band that surrounds the head of the radius and anchors it into the radial notch of the ulna. It attaches to the anterior margin of the radial notch of the ulna and extends around the radial head to attach to the posterior margin of the notch.

-Anchors and stabilizes the proximal radioulnar joint.

supination: palm up

pronation: palm down

Radius rotates on the ulna at the proximal and distal radioulnar joints to pronate/supinate

Anterior compartment (brachialis, biceps brachii, coracobrachialis)

Posterior compartment (triceps brachii)

Anterior compartment: INN - musculocutaneous n

Posterior compartment: INN - radial n

synnovial/uniaxial/pivot joint

ulnar notch of radius to head of ulna (head of ulna is distal)

A: External occipital protuberance

B: Acromion spine/clavicle

INN: CN XI, Spinal Accessor n

Act: ADduct scapula

A: vertebrae, crest of ilium, ribs

B: bicipital grove of humerus

INN: Thoracodorsal n

ACT: ADducts arm, medial rotation of arm, extends arm

A: TP of C1-C4

B: Superior medial border of scapula

INN: Dorsal scapular n

Act: Elevates scapula

A: Spinus processes

B: medial border of scapula

INN: Dorsal scapular n

Act: ADducts scapula

INN: Lateral and medial pectoral n (FOR BOTH!!)

Act:

Major(aDducts arm, medial rotatoin of arm, flexion of arm, extension of arm)

Minor (elevates rubs, depresses scapula, stabalizes scapula

Serratus anterior

deltoideus (acromial head, clavicular, spinal)

A: upper 8 ribs

B: ant/med border of scapula

INN: Long thoracic n

Act: hold scapula to chest, protract scapula, rotate glenoid fossa up

A: clavicle, acromion, scapular spine

B: Deltoid tuberosity of humerous

INN: Axillary n

Act: Lateral rotation, extension, medial rotation, flexion, aBduction all of arm

Teres Major

Teres Minor

Supraspinatus

Infraspinatus

Subscapularis

a: inferior angle/lat border of scapula

b: medial lip of bicipital groove of humerus

INN: lower subscapular n

Act: medial rotation, ADduction, extension of arm

A: Lateral border of the scapula

B: Greater tubercle of the humerus

INN: Axillary n

Act: Adducts/lateral rotation of arm

A: Supraspinous fossa

B: greater tubercle of humerus

INN: suprascapular n

Act: ABduct arm

A: infraspinous fossa

B: greater tubercle of humerus

INN: Suprascapular n

Act: Lateral rotation of humerus

A: Subscapular fossa

B: lesser tubercle of humerus

INN: UPper and Lower subscapular n

Act: medial rotatoin of arm, aDducts arm

Triceps Brachii

Biceps Brachii

Brachialis

Coracobrachialis

A: long/infraglenoid tubercle of scapula

lat/post and lat humerous

medial/distal 1/2 of posterior humerus

B: olecranon process of ulna

INN: radial n

Act: extends forearm

A: long/supraglenoid tubercle of scapula

Short/coracoid process of scapula

B: readial tuberosity/bicipital aponeurosis

INN: musculocutaneous n

Act: flexes shoulder and forearm, supinates hand

A: distal 2/3 of anterior humerus

B: Coranoid process of ulna/ulnar tuberosity

INN: musculocutaneous n

Act: PRIMARY forearm flexor

A: corocoid process of scapula

B: Middle 1/3 of medial humerus

INN: musculocutaneous n

Action: flexes shoulder, or arm, adducts arm

Muscles of the superficial flexor layer

*flexor means palm side

Pronator teres

Flexor carpi radialis

Palmaris longus

Flexor carpi ulnaris

A: medial epicondile of humerus

B: midlateral radius

INN: median n

Action: pronation, flexion of forearm

A: medial epicondyle of humerous

B: anterior 2nd and 3rd metacarpals

INN: median n

Action: flexes and ABducts wrist

A: medial epicondyle of humerous

B: pisiform bone

INN: ulnar n

Action: flexes and ADducts wrist

Flexor digitorum superficialis

Flexor pollicis longus

Flexor digitorum profundus

Pronator quadratus

A: medial epicondyle of humerous

B: middle phalanx, digits 2-5

INN: median n

Action: flexes proximal IP and MP joints

A: mid anterior radius

B: distal phalanx digit 1

INN: median n

Act: flexes IP, MP, CM joints of the thumb

A: proximal anterior ulna

B: distal phalanx of digits 2-5

Act: flexes all IP and MP joints

INN: 1/2 median n and 1/2 ulnar

A: distal ulna

B: distal anterior radius

INN: median n

Act: pronates forearm

Brachioradialis

Extensor carpi ulnaris

Extensor indicis

Supinator

Extensor carpi radialis longus

Extensor carpi radialis brevis

Extensor digitorum

Extensor digiti minimi

Brachioradialis

A: internal supracondylar ridge of humerus

B: styloid process of radius

INN: radial n

Action: flexes forearm/some supination

A: lat epicondyle of humerus

B: posterior 5th metacarpal

INN: radial n

Action: extends and adducts wrist

A: mid posterior ulna

B: joind ED tendon to digit 2

INN: radial n

Act: extends digit 2 IP and MP joints

A: lateral epicondyle of humerus and ulna

B: proximal lateral radius

INN: radial n

Action: supination

A: lat supracondylar ridge of humerus

B: post 2nd metacarpal

INN: radial nerve

Act: extends and ABducts wrist

A: Lat epicondyle of humerus

B: post 3rd metacarpal

INN: radial n

Act: extends and ABducts wrist

A: lat epicondyle of humerus

B: middle and distal phalanx of digits 2-5

INN: radial n

Act: extends MP and IP joints of digits 2-5

A: lat epicondyle of humerus

B: joins ED tendon to digit 5

INN: radial n

Act: extends IP nad MP joints of digit 5

Abductor pollicis longus

Extensor pollicis brevis

Extensor pollicis longus

A: proximal post radius/ulna

B: 1st metacarpal

INN: radial n

Act: aBducts and extends digit 1 at CM joint

A: mid post radius

B: prox phalanx of digit 1

INN: radial n

Act: extends digit 1 at MP and CM joints

A: mid post ulna

B: distal phalanx 1

INN: radial n

Act: extends digit 1 @ IP MP and CM joints

ABductor pollicis brevis

Flexor pollicis brevis

ADductor pollicis

Opponens pollicis

INN: median n

Act: ABducts thumb

INN: median n

Act: flexis thumb

INN: ulnar n

Act: ADducts thumb

INN: median n

Act: opposes thumb (flexion and medial rotation of digit 1)

ABductor digiti minimi

Flexor digiti minimi

Opponenes digiti minimi

INN: ulnar n

Act: ABducts 5th digit

INN: ulnar n

Act: flexes digit 5

INN: ulnar n

Act: opposes 5th finger to thumb

dorsal interossei

palmar interossei

INN: ulnar n

Act: ABducts digits

INN: ulnar n

Act: ADducts fingers/flex MP/extend IP

-between radius and carpal bones (mainly scaphoid)

-synnovial/biaxial (flex/ext, radial flex/ulnar flex)

-energy, tightens fibers in innerosteious membrane between radius and ulna, transfered from scaphoid to radius to ulna

-between all metacarpals, all encased in a single joint capsuel

-synnovial/plane or gliding/non axial

-enhance wrist movements

-include proximal and distal row of carpal bones

-synnovial/uniaxial/pivot

-ulnar notch of radius to head of ulna

(head of ulna is distal)

In the plane of the palm: flexion/extesion

Out of plane of palm: aBduction/aDduction

All movements together: opposition/reposition

DIGITS 2-5

-between carpal and metacarpal bones of digits 2-5

-synnovial/plane or gliding/non axial

DIGIT 1

-trapezium to 1st metacarpal

-synnovial/mulitaxial saddle jt

-allows for thumb opposition

DIGITS 2-5

-metcarpals->proximal phalanx of 2-5th dig

-flexion/extension, aB/aDduction

-synnovial, biaxial hinge joint 

DIGIT 1

-synnovial, uniaxial hinge joint

-2 IP joints on digits 2-5 (3 phalanx in phanlage)

-1 IP joint on digit 1 (2 phalanx in phalanges)

-uniaxial/ hinge joint

Flexor: proximal portion(superficial band) and a distal portion (deep band)

-deep flexor provides an attachment point to a # of hand intrinsics, ties carpal bones together and provides a tunnel where 8 of the long flexor tendons/median n run

-deep fascia

-fiborous sheath that enclosues several tendons on the metatarsophalangeal joints

-allows fingers to flex and extend at the same time

C5

C6

C7

C8

T1

lateral pectoral n

musculocutaneous n

lateral root of median n -> median n

upper subscapular n

thoracodorsal n

lower subscapular n

axillary n

radial n

medial pectoral n

ulnar n

medial root of median n

median n