The Elbow and Radioulnar Joints
Total Page：16
File Type：pdf, Size：1020Kb
Load more
Recommended publications
-
List: Bones & Bone Markings of Appendicular Skeleton and Knee
List: Bones & Bone markings of Appendicular skeleton and Knee joint Lab: Handout 4 Superior Appendicular Skeleton I. Clavicle (Left or Right?) A. Acromial End B. Conoid Tubercle C. Shaft D. Sternal End II. Scapula (Left or Right?) A. Superior border (superior margin) B. Medial border (vertebral margin) C. Lateral border (axillary margin) D. Scapular notch (suprascapular notch) E. Acromion Process F. Coracoid Process G. Glenoid Fossa (cavity) H. Infraglenoid tubercle I. Subscapular fossa J. Superior & Inferior Angle K. Scapular Spine L. Supraspinous Fossa M. Infraspinous Fossa III. Humerus (Left or Right?) A. Head of Humerus B. Anatomical Neck C. Surgical Neck D. Greater Tubercle E. Lesser Tubercle F. Intertubercular fossa (bicipital groove) G. Deltoid Tuberosity H. Radial Groove (groove for radial nerve) I. Lateral Epicondyle J. Medial Epicondyle K. Radial Fossa L. Coronoid Fossa M. Capitulum N. Trochlea O. Olecranon Fossa IV. Radius (Left or Right?) A. Head of Radius B. Neck C. Radial Tuberosity D. Styloid Process of radius E. Ulnar Notch of radius V. Ulna (Left or Right?) A. Olecranon Process B. Coronoid Process of ulna C. Trochlear Notch of ulna Human Anatomy List: Bones & Bone markings of Appendicular skeleton and Knee joint Lab: Handout 4 D. Radial Notch of ulna E. Head of Ulna F. Styloid Process VI. Carpals (8) A. Proximal row (4): Scaphoid, Lunate, Triquetrum, Pisiform B. Distal row (4): Trapezium, Trapezoid, Capitate, Hamate VII. Metacarpals: Numbered 1-5 A. Base B. Shaft C. Head VIII. Phalanges A. Proximal Phalanx B. Middle Phalanx C. Distal Phalanx ============================================================================= Inferior Appendicular Skeleton IX. Os Coxae (Innominate bone) (Left or Right?) A. -
Chapter 5 Upper Limb Anatomy Bones and Joints
Chapter 5 Upper limb anatomy Bones and joints Scapula Costal Surface The costal (anterior) surface of the scapula faces the ribcage. It contains a large concave depression over most of its surface, known as the subscapular fossa. The subscapularis (rotator cuff muscle) originates from this fossa. Originating from the superolateral surface of the costal scapula is the coracoid process. It is a hook-like projection, which lies just underneath the clavicle. Three muscles attach to the coracoid process: the pectoralis minor, coracobrachialis, the short head of biceps brachii. Acromion Coracoid process Glenoid fossa Subscapular fossa © teachmeanatomy Lateral surface • Glenoid fossa - a shallow cavity, located superiorly on the lateral border. It articulates with the head of the humerus to form the glenohumeral (shoulder) joint. • Supraglenoid tubercle - a roughening immediately superior to the glenoid fossa. The place of attachment of the long head of the biceps brachii. • Infraglenoid tubercle - a roughening immediately inferior to the glenoid fossa. The place of attachment of the long head of the triceps brachii. Supraglenoid tubercle Glenoid fossa Infraglenoid tubercle gn teachmeanatomy Posterior surface • Spine - the most prominent feature of the posterior scapula. It runs transversely across the scapula, dividing the surface into two. • Acromion - projection of the spine that arches over the glenohumeral joint and articulates with the clavicle at the acromioclavicular joint. • Infraspinous fossa - the area below the spine of the scapula, it displays a convex shape. The infraspinatus muscle originates from this area. • Supraspinous fossa - the area above the spine of the scapula, it is much smaller than the infraspinous fossa, and is more convex in shape.The supraspinatus muscle originates from this area. -
The Critical Shoulder Angle As a Diagnostic Measure for Osteoarthritis and Rotator Cuff Pathology
Open Access Original Article DOI: 10.7759/cureus.11447 The Critical Shoulder Angle as a Diagnostic Measure for Osteoarthritis and Rotator Cuff Pathology Zak Rose-Reneau 1 , Amanda K. Moorefield 1 , Derek Schirmer 1 , Eugene Ismailov 1 , Rob Downing 2 , Barth W. Wright 1 1. Anatomy, Kansas City University of Medicine and Biosciences, Kansas City, USA 2. Graduate Medical Education, University of Missouri-Kansas City (UMKC), Kansas City, USA Corresponding author: Amanda K. Moorefield, [email protected] Abstract The purpose of this study was to correlate critical shoulder angle (CSA), a measurement that takes into account both glenoid tilt and the acromial index (AI), with shoulder pathologies as presented in an earlier study by Moor et al. (2013). Based on Moor et al.’s predicted normal CSA range of 30-35°, we hypothesized that a greater-than-normal CSA would be correlated to or associated with rotator cuff pathology, while a smaller-than-normal CSA would be associated with osteoarthritis (OA). Following Moore et al., we utilized Grashey radiographic imaging because it provides the clearest view of the entire glenoid fossa and acromion. We analyzed 323 anterior-posterior (AP) radiographs to identify and measure the CSA, classifying each patient into one of five groups [none reported (n=94), mild OA (n=156), moderate OA (n=36), severe OA (n=37), and rotator cuff pathology (n=40)]. Our results were statistically significant, supporting the association of smaller CSAs with OA and larger CSAs with rotator cuff pathology. CSA measurements could provide a new means for identifying shoulder pathology and thereby reduce the need for costly and timely imaging techniques. -
Level Diagnosis of Cervical Compressive Myelopathy: Signs, Symptoms, and Lesions Levels
Elmer Press Original Article J Neurol Res • 2013;3(5):135-141 Level Diagnosis of Cervical Compressive Myelopathy: Signs, Symptoms, and Lesions Levels Naoki Kasahata ficult to accurately localize the lesion before radiographic Abstract diagnosis. However, neurological level diagnosis of spinal cord is important for accurate lesion-specific level diagnosis, Background: To elucidate signs and symptoms corresponding to patients’ treatment, avoiding diagnostic error, differential di- each vertebral level for level-specific diagnoses. agnosis, and especially for accurate level diagnosis of other nonsurgical myelopathies. Moreover, level diagnosis should Methods: We studied 106 patients with cervical compressive my- be considered from multiple viewpoints. Therefore, we in- elopathy. Patients who showed a single compressive site on mag- tend to make level diagnosis of myelopathy more accurate. netic resonance imaging (MRI) were selected, and signs, symp- Previously, lesion-specific level diagnoses by determin- toms, and the levels of the MRI lesions were studied. ing a sensory disturbance area or location of numbness in Results: Five of 12 patients (41.7%) with C4-5 intervertebral level the hands had the highest accuracy [1, 2]. Previous stud- lesions showed decreased or absent biceps and brachioradialis re- ies reported that C3-4 intervertebral level lesions showed flexes, while 4 of these patients (33.3%) showed generalized hyper- increased or decreased biceps reflexes, deltoid weakness, reflexia. In comparison, 5 of 24 patients (20.8%) with C5-6 inter- and sensory disturbance of arms or forearms [1, 3, 4], while vertebral level lesions showed decreased or absent triceps reflexes; C4-5 intervertebral level lesions showed decreased biceps however, 9 of these patients (37.5%) showed decreased or absent reflexes, biceps weakness, and sensory disturbance of hands biceps and brachioradialis reflexes. -
Morphology of Extensor Indicis Proprius Muscle in the North Indian Region: an Anatomy Section Anatomic Study with Ontogenic and Phylogenetic Perspective
DOI: 10.7860/IJARS/2019/41047:2477 Original Article Morphology of Extensor Indicis Proprius Muscle in the North Indian Region: An Anatomy Section Anatomic Study with Ontogenic and Phylogenetic Perspective MEENAKSHI KHULLAR1, SHERRY SHARMA2 ABSTRACT to the index finger were noted and appropriate photographs Introduction: Variants on muscles and tendons of the forearm were taken. or hand occur frequently in human beings. They are often Results: In two limbs, the EIP muscle was altogether absent. discovered during routine educational cadaveric dissections In all the remaining 58 limbs, the origin of EIP was from the and surgical procedures. posterior surface of the distal third of the ulnar shaft. Out of Aim: To observe any variation of Extensor Indicis Proprius (EIP) these 58 limbs, this muscle had a single tendon of insertion in 52 muscle and to document any accessory muscles or tendons limbs, whereas in the remaining six limbs it had two tendinous related to the index finger. slips with different insertions. Materials and Methods: The EIP muscle was dissected in 60 Conclusion: Knowledge of the various normal as well as upper limb specimens. After reflection of the skin and superficial anomalous tendons on the dorsal aspect of the hand is fascia from the back of the forearm and hand, the extensor necessary for evaluating an injured or diseased hand and also at retinaculum was divided longitudinally and the dorsum of the the time of tendon repair or transfer. Awareness of such variants hand was diligently dissected. The extensor tendons were becomes significant in surgeries in order to avoid damage to the delineated and followed to their insertions. -
The Branching and Innervation Pattern of the Radial Nerve in the Forearm: Clarifying the Literature and Understanding Variations and Their Clinical Implications
diagnostics Article The Branching and Innervation Pattern of the Radial Nerve in the Forearm: Clarifying the Literature and Understanding Variations and Their Clinical Implications F. Kip Sawyer 1,2,* , Joshua J. Stefanik 3 and Rebecca S. Lufler 1 1 Department of Medical Education, Tufts University School of Medicine, Boston, MA 02111, USA; rebecca.lufl[email protected] 2 Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA 94305, USA 3 Department of Physical Therapy, Movement and Rehabilitation Science, Bouve College of Health Sciences, Northeastern University, Boston, MA 02115, USA; [email protected] * Correspondence: [email protected] Received: 20 May 2020; Accepted: 29 May 2020; Published: 2 June 2020 Abstract: Background: This study attempted to clarify the innervation pattern of the muscles of the distal arm and posterior forearm through cadaveric dissection. Methods: Thirty-five cadavers were dissected to expose the radial nerve in the forearm. Each muscular branch of the nerve was identified and their length and distance along the nerve were recorded. These values were used to determine the typical branching and motor entry orders. Results: The typical branching order was brachialis, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, supinator, extensor digitorum, extensor carpi ulnaris, abductor pollicis longus, extensor digiti minimi, extensor pollicis brevis, extensor pollicis longus and extensor indicis. Notably, the radial nerve often innervated brachialis (60%), and its superficial branch often innervated extensor carpi radialis brevis (25.7%). Conclusions: The radial nerve exhibits significant variability in the posterior forearm. However, there is enough consistency to identify an archetypal pattern and order of innervation. These findings may also need to be considered when planning surgical approaches to the distal arm, elbow and proximal forearm to prevent an undue loss of motor function. -
Articulationes Membri Thoracici • 1. Articulatio
ARTICULATIONES MEMBRI THORACICI • 1. ARTICULATIO HUMERI-art. simplex, art. spheroidea (but functions as a hinge joint) movement: eq, Ru only flexion, extension is possible, in ca: rotation, abduction, adduction also between scapula (cavitas glenoidalis) and humerus (caput) Capsula articularis Recessus: cranial and caudal recesses Labrum glenoidale Ligg. glenohumeralia (eq, ca)- tickened part of the capsule (capsular ligament) in the med. and lat. walls in ca, and cranially in eq Lig. coracohumerale (eq, Ru)- capsular ligament between scapula (tub. supraglenoidale) and humerus (tub. majus, minus) No collateral ligaments! Instead of them: laterally m. infraspinatus (1), medially m. subscapularis (5) ca: part of the joint capsule surrounds the tendon of m. biceps brachii (9) and forms vagina synovialis intertubercularis eq, bo: bursa intertubercularis (=bursa bicipitalis) under the tendor of the m. biceps brachii (may communicate with the joint cavity of the shoulder joint in horse) • 2.ARTICULATIO CUBITI-art. composita, ginglymus (hinge joint) movement: extension and flexion between humerus (condyle), radius (caput), ulna (insisura trochlearis) Articulatio humeroulnaris Articulatio humeroradialis Capsula articularis Recessus: recessus cranialis, large recessus caudalis Lig. collaterale cubiti mediale- from epicondylus med. to radius (in ca also to ulna) Lig. collaterale cubiti laterale- from epicondylus lat. to radius (in ca, Ru also to ulna) Lig. olecrani (ca)- capsular ligament from fossa olecrani of humerus to olecranon •3. ARTICULATIO RADIOULNARIS PROXIMALIS- art. simplex, art. trochoidea movement: ca: rotational movements are possible (pronatio, supinatio) eq, Ru: no movement! between radius (circumferentia articularis radii) and ulna (incisura radialis ulnae) Lig. anulare radii (ca)- encircles the head of the radius, running under the collateral ligaments Membrana interossea antebrachii (ca) (in eq, Ru it is ossified) • 4. -
Anatomical, Clinical, and Electrodiagnostic Features of Radial Neuropathies
Anatomical, Clinical, and Electrodiagnostic Features of Radial Neuropathies a, b Leo H. Wang, MD, PhD *, Michael D. Weiss, MD KEYWORDS Radial Posterior interosseous Neuropathy Electrodiagnostic study KEY POINTS The radial nerve subserves the extensor compartment of the arm. Radial nerve lesions are common because of the length and winding course of the nerve. The radial nerve is in direct contact with bone at the midpoint and distal third of the humerus, and therefore most vulnerable to compression or contusion from fractures. Electrodiagnostic studies are useful to localize and characterize the injury as axonal or demyelinating. Radial neuropathies at the midhumeral shaft tend to have good prognosis. INTRODUCTION The radial nerve is the principal nerve in the upper extremity that subserves the extensor compartments of the arm. It has a long and winding course rendering it vulnerable to injury. Radial neuropathies are commonly a consequence of acute trau- matic injury and only rarely caused by entrapment in the absence of such an injury. This article reviews the anatomy of the radial nerve, common sites of injury and their presentation, and the electrodiagnostic approach to localizing the lesion. ANATOMY OF THE RADIAL NERVE Course of the Radial Nerve The radial nerve subserves the extensors of the arms and fingers and the sensory nerves of the extensor surface of the arm.1–3 Because it serves the sensory and motor Disclosures: Dr Wang has no relevant disclosures. Dr Weiss is a consultant for CSL-Behring and a speaker for Grifols Inc. and Walgreens. He has research support from the Northeast ALS Consortium and ALS Therapy Alliance. -
Unusual Cubital Fossa Anatomy – Case Report
Anatomy Journal of Africa 2 (1): 80-83 (2013) Case Report UNUSUAL CUBITAL FOSSA ANATOMY – CASE REPORT Surekha D Shetty, Satheesha Nayak B, Naveen Kumar, Anitha Guru. Correspondence: Dr. Satheesha Nayak B, Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Madhav Nagar, Manipal, Karnataka State, India. 576104 Email: [email protected] SUMMARY The median nerve is known to show variations in its origin, course, relations and distribution. But in almost all cases it passes through the cubital fossa. We saw a cubital fossa without a median nerve. The median nerve had a normal course in the upper part of front of the arm but in the distal third of the arm it passed in front of the medial epicondyle of humerus, surrounded by fleshy fibres of pronator teres muscle. Its course and distribution in the forearm was normal. In the same limb, the fleshy fibres of the brachialis muscle directly continued into the forearm as brachioradialis, there being no fibrous septum separating the two muscles from each other. The close relationship of the nerve to the epicondyle might make it vulnerable in the fractures of the epicondyle. The muscle fibres surrounding the nerve might pull up on the nerve and result in altered sensory-motor functions of the hand. Since the brachialis and brachioradialis are two muscles supplied by two different nerves, this continuity of the muscles might result in compression/entrapment of the radial nerve in it. Key words: Median nerve, cubital fossa, brachialis, brachioradialis, entrapment INTRODUCTION The median nerve is the main content of and broad tendon which is inserted into the cubital fossa along with brachial artery and ulnar tuberosity and to a rough surface on the biceps brachii tendon. -
Bone Limb Upper
Shoulder Pectoral girdle (shoulder girdle) Scapula Acromioclavicular joint proximal end of Humerus Clavicle Sternoclavicular joint Bone: Upper limb - 1 Scapula Coracoid proc. 3 angles Superior Inferior Lateral 3 borders Lateral angle Medial Lateral Superior 2 surfaces 3 processes Posterior view: Acromion Right Scapula Spine Coracoid Bone: Upper limb - 2 Scapula 2 surfaces: Costal (Anterior), Posterior Posterior view: Costal (Anterior) view: Right Scapula Right Scapula Bone: Upper limb - 3 Scapula Glenoid cavity: Glenohumeral joint Lateral view: Infraglenoid tubercle Right Scapula Supraglenoid tubercle posterior anterior Bone: Upper limb - 4 Scapula Supraglenoid tubercle: long head of biceps Anterior view: brachii Right Scapula Bone: Upper limb - 5 Scapula Infraglenoid tubercle: long head of triceps brachii Anterior view: Right Scapula (with biceps brachii removed) Bone: Upper limb - 6 Posterior surface of Scapula, Right Acromion; Spine; Spinoglenoid notch Suprspinatous fossa, Infraspinatous fossa Bone: Upper limb - 7 Costal (Anterior) surface of Scapula, Right Subscapular fossa: Shallow concave surface for subscapularis Bone: Upper limb - 8 Superior border Coracoid process Suprascapular notch Suprascapular nerve Posterior view: Right Scapula Bone: Upper limb - 9 Acromial Clavicle end Sternal end S-shaped Acromial end: smaller, oval facet Sternal end: larger,quadrangular facet, with manubrium, 1st rib Conoid tubercle Trapezoid line Right Clavicle Bone: Upper limb - 10 Clavicle Conoid tubercle: inferior -
Trapezius Origin: Occipital Bone, Ligamentum Nuchae & Spinous Processes of Thoracic Vertebrae Insertion: Clavicle and Scapul
Origin: occipital bone, ligamentum nuchae & spinous processes of thoracic vertebrae Insertion: clavicle and scapula (acromion Trapezius and scapular spine) Action: elevate, retract, depress, or rotate scapula upward and/or elevate clavicle; extend neck Origin: spinous process of vertebrae C7-T1 Rhomboideus Insertion: vertebral border of scapula Minor Action: adducts & performs downward rotation of scapula Origin: spinous process of superior thoracic vertebrae Rhomboideus Insertion: vertebral border of scapula from Major spine to inferior angle Action: adducts and downward rotation of scapula Origin: transverse precesses of C1-C4 vertebrae Levator Scapulae Insertion: vertebral border of scapula near superior angle Action: elevates scapula Origin: anterior and superior margins of ribs 1-8 or 1-9 Insertion: anterior surface of vertebral Serratus Anterior border of scapula Action: protracts shoulder: rotates scapula so glenoid cavity moves upward rotation Origin: anterior surfaces and superior margins of ribs 3-5 Insertion: coracoid process of scapula Pectoralis Minor Action: depresses & protracts shoulder, rotates scapula (glenoid cavity rotates downward), elevates ribs Origin: supraspinous fossa of scapula Supraspinatus Insertion: greater tuberacle of humerus Action: abduction at the shoulder Origin: infraspinous fossa of scapula Infraspinatus Insertion: greater tubercle of humerus Action: lateral rotation at shoulder Origin: clavicle and scapula (acromion and adjacent scapular spine) Insertion: deltoid tuberosity of humerus Deltoid Action: -
Analysis on the Acromial Curvature and Its Relationships with The
r e v b r a s o r t o p . 2 0 1 4;4 9(6):636–641 www.rbo.org.br Original article Analysis on the acromial curvature and its relationships with the subacromial space and ଝ,ଝଝ types of acromion a,b,∗ c José Aderval Aragão , Leonardo Passos Silva , b a Francisco Prado Reis , Camilla Sá dos Santos Menezes a Department of Morphology, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil b Medical School, Universidade Tiradentes (UNIT), Aracaju, SE, Brazil c Orthopedics and Traumatology Service, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil a r t i c l e i n f o a b s t r a c t Article history: Objective: To correlate the acromial curvature, using the angles proposed, with the subacro- Received 13 September 2013 mial space and types of acromion. Accepted 24 October 2013 Methods: Ninety scapulas were studied. The acromia were classified as types I, II or III. The Available online 31 October 2014 acromial curvature was analyzed by means of the alpha, beta and theta angles. We also measured the distance between the anteroinferior extremity of the acromion and the supra- Keywords: glenoid tubercle (DA). The scapulas were grouped in relation to sex and age. The angles proposed were analyzed in relation to each type of acromion and also in relation to the Acromion/anatomy & histology Shoulder collision syndrome measurements of the distance DA. Rotator cuff Results: Out of the total number of acromia, 39 (43.3%) were type I, 43 (47.7%) type II and eight (9%) type III.