Muschi Mb Superior

7/24/2019 Muschi Mb Superior

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The upper limb


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Muscles That Move the

Pectoral Girdle Originate on the axial skeleton and insert on the clavicle andscapula.

Stabilize the scapula and move it to increase the arms angle of

movements.

Some of the superficial muscles of the thorax are groupedtogether according to the scapular movement they direct.

elevation, depression, protraction, or retraction


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The muscles of back

Superficial group Trapezius Latissimus dorsi Levator scapulae Rhomboideus

Deep group Erector spinae Splenius

Thoracolumbar fascia


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4


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The muscles of thoraxExtrinsic muscles

Pectoralis major ectoralis minor Serratus anterior

Intrinsic muscles Intercostales externi Intercostales interni !ntercostales intimi


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6


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The Muscles of Upper Limb

Muscles of shoulder

"eltoid

Supraspinatus

!nfraspinatus #eres minor

#eres ma$or

Subscapularis


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Major muscles of shoulder

Deltoid Origin% lateral third of

clavicle, acromion, and

spine of scapula

Insertion% deltoid tuberosity

of humerus

ction% abduction, flexion

and extension, medial and

lateral rotation of arm


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Major muscles of shoulderTeres major Origin% dorsal surface

of inferior angle of

scapula

Insertion!crest of

lesser tubercle of

humerus

ction!medially rotates

and adducts arm


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Arm and Forearm Muscles That Movethe Elbo !oint"Forearm

&nterior 'flexor( compartment

osterior 'extensor( compartment

&nterior compartment

primarily contains elbo) flexors

osterior compartmentcontains elbo) extensors

the principal flexors biceps brachii, brachialis, and brachioradialis

muscles that extendthe elbo) $oint

triceps brachii and anconeus


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Muscles of arm ntererior group

*iceps brachii

+oracobrachialis

*rachialis

Posterior group triceps brachii

anconeus


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Muscles of arm"iceps brachii

Origin% long head,supraglenoid tubercle shorthead, coracoid process

Insertion% radial tuberosity ction% supinator of forearm,

flexor of elbo) $oint, )eak

flexor of should $oint


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Muscles of armTriceps brachii Origin%

long head, infraglenoid tubercle

lateral head, above groove for

radial nerve

medical head, belo) groove forradial nerve

Insertion!olecranon of ulna

ction!extends elbo) $oint,

long head extends and adductsshoulder $oint


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Triceps brachii


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Forearm Muscles

Supinate and Pronate Supinator musclesupinates the forearm. *iceps brachiisupinates the forearm. ronator teresand pronator -uadratuspronate the forearm.

Mo#e the $rist %oint& 'and& and (ingers uscles in the forearm move the hand at the )rist and/or the fingers. 0xtrinsic muscles of the )rist and hand originate on the forearm, not

the )rist or hand.

#endons of forearm muscles typically are surrounded by tendon'synovial( sheaths and held ad$acent to the skeletal elements by strongfascial structures.

&t the )rist, the deep fascia of the forearm forms thickened, fibrousbands termed retinacula.


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Muscles of forearm

Superficial la)er ronator teres

1lexor carpi radialis

almaris longus 1lexor carpi ulnaris


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Muscles of forearm

Pronator teres Origin% medical epicondyle of

humerus and deep fascia offorearm

Insertion% middle of lateralsurface of radius ction% pronation of forearm

and flexion of elbo)


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Second la)er1lexor digitorum superficials


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Third la)er

1lexor digitorumprofundus

1lexor pollicis longus

(ourth la)er

ronator -uadratus

ction% flex radiocarpal

$oint and fingers,

pronate forearm


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Lateral #roup $%&

*rachioradialis

0xtensor carpi radialis

longus

0xtensor carpi radialisbrevis


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Posterior group (8)

Superficial la)er *+, 0xtensor digitorum

0xtensor digiti minimi

0xtensor carpi ulnaris

&ction% extension at

)rist $oint


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Deep la)er *-,

Supinator &bductor pollicis longus 0xtensor pollicis brevis 0xtensor pollicis longus 0xtensor indicis

&ction% extend at )rist$oint and fingers, andsupinate forearm

Posterior group (8)


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Muscles of hand Lateral group thenar *.,

&bductor pollicis brevis 1lexor pollicis brevis Opponens pollicis &dductor pollicis

&ction% flex, abduct, adduct

and oppose thumb Medial group h)pothenar *+,

&bductor digiti minimi 1lexor digiti minimi brevis Opponens digiti minimi

&ction% flex, abduct , and opposelittle finger


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Muscles of hand

Intermedial group

Lumbricales '2( flexfingers at $oints

extend fingers at !

$oints

Palmar interossei '3(adduct fingers to)ards

middle finger at

$oints

Dorsal interossei '3(abduct fingers a)ay

from middle finger at

$oints

A i f li b


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Arteries of upper limb

xillar) arter)

+ontinuation of subclavian artery atlateral border of first rib *ecomes brachial artery at lo)er

border of teres ma$or "ivided into three parts by overlying

pectoralis minor 1irst portion, above muscle givesrise to thoracoacromial a/

Second portion, behind musclegives rise to lateral thoracic a/

#hird portion, belo) muscle gives

rise to subscapular a/, anteriorandposterior humeral circumflex a/ theformer then divides into throcodorsala/ and circumflex scapular a/


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"rachial arter)

+ontinuation of axillaryartery "ivides into radial and

ulnar arteries at level ofneck of radius

*ranches "eep brachial a.

accompanies )ith radialnerve

Superior ulnar collaeral a.accompanies )ith ulnar

nerve !nferior ulnar collateral a.



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0adial arter) and branches

Radial recurrent a. Superfical palmar branch

rincipal artery of thumb

1lnar arter) and branches

4lnar recurrent a. +ommon interosseous artery

&nterior interossous a.

osterior interosseous a/

"eep palmar branch



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Superficial palmar arch 1ormed by ulnar artery

and superficial palmarbranch of radial artery

+urve of arch lies acrossthe palm, level )ith thedistal border of fully

extended thumb 5ives rise to three

common palmar digitalarteries each then dividesinto t)o proper palmar

digital arteries



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Deep palmar arch

1ormed by radial arteryand deep palmar branch

of ulnar artery

+urve of arch lies across

upper part of palmar at

level )ith proximal borderof extended thumb

5ives rise to three palmar

metacarpal arteries



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'eins of the upper limb

Deep #eins% accompany thearteries of the same region andbear similar names

Superficial #eins 2ephalic #ein

&rises from the lateral side ofthe dorsal venous rete of hand

&scends on radial side of theforearm to the elbo) and thenin the lateral side of bicepsbrachii furro), continues up the

arm in the deltopectoral grooveand then to the infraclavicularfossa, )here it piercesclavipectoral fascia to drain intoaxillary vein


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"asilic #ein &rises from the medial side of

the dorsal venous rete ofhand

&scends on the ulnar side of

forearm to the elbo) and then

in the medial bicepital brachii

furro) to middle of the arm

)here it pierces the deepfascia and $oins the brachial

vein or axillary vein

Median cubital #ein

links cephalic vein and basilic

vein in the cubital fossa. !t is a

fre-uent site for venipuncture

to remove a sample of blood

or add fluid to the blood


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The l(mphatic draina#e of

upper limbL)mphatic #essels Superficial follo) thesuperficial veins, drain intosupratrochlear and axillarylymph nodes

"eep

accompany mainvessels, end in axillary lymphnodes

l)mph nodes +ubital lymph node% lies above

medial epicondyle of humerus &xillary lymph node arranged

in five groups


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Axillar( l(mph nodesrranged in fi#e groups

Lateral l)mph nodes lie aroundthe distal end of axillary vein ,receiving drainage from the arm,forearm, and hand

Pectoral l)mph nodes lie along

lateral thoracic vessels, receiveafferents from anterior thoracic )allincluding central and lateral portion ofmamma

Subscapular l)mph node along

subscapular vessels, receive lymphfrom nape and scapular region 0fferents above three groups pass to

central lymph node


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2entral l)mph node lie in fat of axillary fossa,

receive drainage from all theabove nodes, efferents pass

to apical lymph node

pical l)mph node Lie in the apex of the axilla,

along the proximal end of

axillary vessels Receive drainage chiefly from

central lymph node , upper

portion of mamma

0fferents form subclavian

trunk, the right subclaviantrunk $oints the right

lymphatic duct left usually

drains directly into thoracic

duct


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)rachial plexus

(ormation! 1ive roots% formed by anterior rami

of +67+8 and #9 spinal nerves,roots +67+:give rise to longthoracic n/

#hree trunks #he upper trunk is formed by the

$oining of root +2,+6,+;. #he middle trunk is the

continuation of root +:. #he lo)er trunk is formed by the

$oining of root +8 and #9. Six divisions% above clavicle,

trunks form anterior and posterior

divisions #hree cords% belo) clavicle,

divisions form three cords thatsurround the second portion ofaxillary a.


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Position! passes through the scalene fissure to

posterosuperior of subclavian artery, thenenters the axilla to form lateral, medial andposterior cords

Main branches Lateral cord

Musculocutaneous n/ Lateral root to median n/

Medial cord Medial root to median n/

1lnar n/ Medial brachial cutaneous n/ Medial antebrachial cutaneous n/


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Posterior cord radial n/

axillar) n/

thoracodorsal n/


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Musculocutaneous

Distribution! *icepsbrachii, brachalis and

coracobrachialis


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Distribution! 1lexors offorearm exceptbrachioradialis, flexor carpi

ulnaris and ulnar half of flexordigitorum profundus,thenar except adductorpollicis, first t)o lumbricals

skin of thenar,central part of palm, palmaraspect of radial three and

one7half fingers, includingmiddle and distal fingers ondorsum.

Injur)% &pehand

produces sign ofbenediction, in )hich the

index and middle fingerscannot be flexed and thethumb cannot be opposed

Median nerve


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Distribution! 1lexor carpi

ulnaris, ulnar half of flexordigitorum profundus,

hypothenar muscles,

interossei, 3rd and 2th

lumbricals and adductor

pollicis skin of hypothenar,

palmar surface of ulnar one

and one7half fingers, ulnar half

of dorsum of hand, posterior

aspect of ulnar t)o and one7

half fingers

Injur)% cla)hand

Ulnar nerve

* di l


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Distribution! 0xtensor

muscles of arm andforearm,

brachioradialis skin on

back of arm, forearm,

and radial side of

dorsum of hand andradial t)o and one7half

fingers

Injur)% =ristdrop

*adial nerve


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xillar) Distribution! "eltoid

and teres minormuscle skin overdeltoid and upperposterior aspect of arm

Injur)% results in deltoidand teres minorparalysis 'loss ofshoulder abdution and)eel external rotation()ith loss of sensation

over the deltoid

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Muschi Mb Superior