(Gen Ana) Arm and Cubital Fossa

8/3/2019 (Gen Ana) Arm and Cubital Fossa

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ARM

andCUBITAL FOSSA

By: Neil Dolendo

Marian Dale Escalona

Ma. Andrea Indadao

Monnel Loise Ordinario


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Arm

is the part of the upper limb between the shoulderand the elbow joints.

It is adapted for precise positioning of the hand and thus assist in the

hand's manipulative tasks.


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Brachial Fascia

o Deep fascia of the arm

o It is a sleeve of connective tissue that continuous at proximal end with the

pectoral fascia, the axillary fascia and the deep fascia that covers the

deltoid and latissimus dorsi muscles.

o It is connected to the medial and lateral sides of the humerus by the

intermuscular septa, creating an anterior compartment and a posterior

compartment for the muscles of the arm.


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Brachial Fascia

Brachial Fascia


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Anterior (flexor) Compartment of Arm

Muscles: Biceps Brachii, coracobrachialis, and brachialis.


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Blood Supply: Brachial artery



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Structures passing through the compartments: Musculocutaneous, medianand ulnar nerves; brachial artery and basilic vein.

Musculocutaneous Nerve

Median Nerve

Ulnar Nerve

Brachial Artery

Basilic

Vein


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Muscles of the Anterior Compartment

Biceps Brachii

a two-headed muscle located on the upper arm.

Both of its heads arise on the scapula and join to form a single

muscle belly which is attached to the upper forearm.

While the biceps crosses both the shoulderand elbow joints,

its main function is at the latter where it flexes the elbowand supinates the forearm.

Both these movements are used when opening a bottle with a

corkscrew: first biceps unscrews the cork (supination), then it

pulls the cork out (flexion).


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Biceps Brachii

Origin:long head: supraglenoid tubercle

short head: coracoid process (apex)

long head:

supraglenoidtubercle

short head:

coracoidprocess (apex)


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Insertion:

radial tuberosity


Biceps Brachii

Radial Tuberosity


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Biceps Brachii

Innervation:musculocutaneous nerve


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Lond head

Short head

Biceps Brachii


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Coracobrachialis

Origin:

coracoid process (apex)

Origin


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Coracobrachialis

Insertion:

mid-shaft of humerus (medial side)

Insertion

mid-shaft of

humerus

(medial side)


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Coracobrachialis



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Coracobrachialis

Function:helps flex and adduct arm

stabilize glenohumeral joint


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It makes up part of the floor of the region known as the cubital

fossa.


Brachialis

The brachialis (brachialis anticus) is a muscle in the upper arm that

flexes the elbow joint.

It lies deeper than the biceps brachii, and is a synergist that assists

the biceps brachii in flexing at the elbow.


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Brachialis

Origin:

distal half of humerus (anterior)

distal half of

humerus

(anterior)


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Insertion:tuberosity of ulna

Brachialis

tuberosity of ulna


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Brachialis


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Function:

pure flexor of forearm, in all directions

Brachialis


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Brachialis


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Structures Passing through the Anterior Compartment

Brachial Artery

o It begins at the lower border of the teres major muscle as a

continuation of the axillary artery.

o It provides the arterial supply of the arm.

o It terminates opposite neck of the radius by dividng into the radial

and ulnar arteries.


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Brachial Artery


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Brachial Artery


Branches:

Muscular branches to the anterior compartment of the upper arm.

Nutrient Artery to the humerus.

Profunda Artery arises near the beginning of the brachial artery and

follows the radial nerve into the spiral nerve of the humerus.

Superior Ulnar Collateral Artery arises near the middle of the middle arm

and follows the ulnar nerve.

Inferior Ulnar Collateral Artery arises near the termination of the arteryand takes part in the anastomosis around the elbow joint.


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or Profunda Artery


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Musculocutaneous

Nerve


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Branches:

Musculocutaneous Nerve

Muscular branches to the biceps, coracobrachialis, and brachialis.

Cutaneous branches the lateral cutaneous nerve of the forearmsupplies the skin of the front and lateral aspects of the forearm down

as far as the root of the thumb.

Articular branches to the elbow joint.


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Median Nerve

It runs downward on the lateral side of the brachial artery

Halfway down the upper arm, it brachial artery and continuous downward

on its medial side.

It has no branches in the upper arm, except for a small vasomotor nerve

to the brachial artery.

Nerve origin C5-T1, which is a branch of the lateral and medial cords of

the brachial plexus.


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Median Nerve


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Ulnar Nerve

It runs downward on the medial side of the brachial artery as far as

the middle of the arm.

At the insertion of the coracobrachialis, the nerve pierces the medial

fascial septum, accompanied by the superior ulnar collateral artery

and enters posterior compartment of the arm.

It has no branches in the anterior compartment of the upper arm.

Its origin C8-T1, is a continuation of the medial cord of the brachial

plexus.


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UlnarNerve


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Radial Nerve

The radial nerve is a nerve in the human body that supplies theupper limb.

It supplies the medial and lateral head triceps brachii muscle of

the arm, as well as all 12 muscles in the posterior osteofascial

compartment of the forearm, as well as the associated joints and

overlying skin.

It originates from the posterior cord of the brachial plexus with

roots from C5, C6, C7, C8 & T1.

It supplies the dorsal muscles, such as triceps brachii, the

extrinsic extensors of the wrist and hands, and the cutaneous nerve

supply to most of the back of the hand.


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Radial Nerve


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Posterior (Extensor) Compartment of Arm


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Posterior Compartment of Arm

Muscles: the three heads of the triceps muscle.

Lateral Head of Triceps

Long Head of Triceps

Median Head of Triceps


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Blood Supply: Profunda brachii and ulnar collateral arteries.

Profunda brachii artery

Anterior ulnar collateral artery

Posterior ulnar collateral artery


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Nerve Supply of the Muscles: Radial nerve


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Structures passing through the compartments: Radial nerve and ulnar

nerve.


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Origin:

long head: infraglenoid tubercle

lateral head: humerus (posterior,

superior to radial groove)

medial head: humerus (posterior)

Muscles of the Posterior Compartment

Triceps


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Insertion: Olecranon


Triceps


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Innervation:radial nerve


Triceps

Radial nerve


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Function:extensor of forearm

long head: extend and adduct arm,

shunt muscle


Triceps


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Triceps


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Structures Passing through the Posterior Compartment

Radial Nerve

Its origin is from the posterior cord of the brachial plexus in the axilla.

The nerve winds around the back of the arm, first between the long

and medial heads of the triceps, then the spiral groove on the back of

the humerus, between the lateral and medial heads of the triceps.

It pierces the lateral fascial septum above the elbow and continuous

downward into the cubital fossa in front of the elbow, between the

brachialis and brachioradialis muscles.

In the spiral groove, the nerve is accompanied by the profundavessels, and lies directly in the contact with the shaft of the humerus.


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Radial Nerve


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Radial Nerve

Branches:

In the axilla: Branches are given to the long and medial heads of the

triceps, and the posterior cutaneous nerve of the arm is given off.

In the spiral groove: Branches are given to the lateral and medial heads of

the triceps and to the anconeus. The lower lateral nerve of the arm supplies the skin over the

lateral and the anterior aspects of the lower parts of the arm.

The posterior cutaneous nerve of the forearm runs down the

middle of the back of the forearm as far as the wrist.

In the anterior compartment of the arm: After the nerve has piearced

the lateral fascial septum, it gives branches to the brachialis,

brachioradialis, and the extensor carpi radialis longus muscle. It also

gives articular branches.


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Ulnar Nerve

Having pierced the medial fascial septum halfway down the upper arm,the ulnar nerve descends behind the septum, covered posteriorly by the

medial head of the triceps.

The nerve is accompanied by the superior ulnar collateral vessels.

At the elbow, it lies behind the medial epicondyle of the humerus on

the medial ligamentof the elbow joint.

It continuous downward to enter the forearm between the two heads

of the origin of the flexor carpi ulnaris.

It has an articular branch to the elbow joint.


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UlnarNerve


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Profunda Brachii Artery

Arises from the brachial artery near its origin.

It accompanies the radial nerve through the spiral groove.

Supplies the triceps muscle.

Takes part in the anastomosis around the elbow joint.


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Profunda Brachii Artery


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Superior and Inferior Ulnar Collateral Arteries

Arise from the brachial artery.

Takes part in the anastomosis around the elbow joint


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Superior Collateral Artery

Inferior Collateral Artery


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Cubital FossaIs a depression in the anterior part of the elbow.

Clinically important because it contains superficial veins that are used

foe venipuncture.

Large nerves and vessels pass through this region to enter the forearm.


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Bounderies of the Cubital Fossa

Lateral boundary- brachioradialis


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Medial boundary- pronator tere muscle



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Superior boundary- an imaginary line connecting the medial and lateral

epicondyles of the humerus.

Lateral Epicodyle Medial Epicodyle


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Superficial boundary (roof of the cubital fossa) - antebrachial fascia

reinforced by the bicipital aponeurosis.



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Deep boundary (floor of the cubital fossa) brachialis and supinator

muscles.


Contents


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Contents

The cubital fossa contains four main vertical structures (from lateral to medial):

The radial nerve is in the vicinity of the cubital fossa, located

between brachioradialis and brachialis muscles. It is often but not

always considered part of the cubital fossa.

Radial nerve

Contents


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The biceps brachii tendon

Contents

Contents


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The brachial artery. The artery usually bifurcates near the apex

(inferior part) of the cubital fossa into the radial artery (superficial)

and ulnar artery (deeper).

Contents

Brachial artery

Contents


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The median nerve

Contents

Median nerve


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Skeleton of the Arm and Cubital Region

Humerus

It is the bone of the arm that joins with the scapula above inthe shoulder at the glenohumeral joint and with the ulna and radius

below at the elbow.

The elbow joint is the hinge joint between the distal end of the

humerus and the proximal ends of the radius and ulna.

It cannot be broken easily. Its strength allows it to handle loading up

to 300 pounds (140 kg.).



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Medial Epicondyle


Humerus

Medial

Epicondyle

- Is larger and more prominent than the

lateral epicondyle, is directed a little

backward.


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Lateral Epicondyle


Lateral Epicondyle

Humerus

is a small, tuberculated eminence, curved a

little forward, and giving attachment to the radial

collateral ligament of the elbow-joint, and to a

tendon common to the origin of the Supinator

and some of the Extensor muscles.



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Olecranon Fossa


Humerus

Olecranon Fossa

- Above the back part of the trochlea

of the humerus is a deep triangular

depression, the olecranon fossa, in

which the summit of the olecranon is

received in extension of the forearm.

Sk l t f th A d C bit l R i


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Radius

Headis the bone of the forearm that extendsfrom the lateral side of the elbow to the

thumb side of the wrist. The radius is

situated on the lateral side of the ulna,

which exceeds it in length and size. It is a

long bone, prism-shaped and slightly

curved longitudinally.



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Radius

Neck



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Radius

RadialTuberosity



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Ulna

Olecranon Olecranon

Olecranon

- the inner and longer of the two bones of

the human forearm which is fused to the

radius


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Documents

(Gen Ana) Arm and Cubital Fossa