Laboratory Identifications and Relations -- Upper Limb (updated 1998)

The Structural Basis of Medical Practice - Human Gross Anatomy

The Pennsylvania State University College of Medicine

Shoulder Region - Posterior View: Scapular anastomosis, nerves, and related structures

  1. transverse cervical a. (superficial branch): lateral to levator scapula, anterior surface of trapezius
  2. spinal accessory n. - lateral to levator scapula, anterior surface of trapezius
  3. dorsal scapular n. - medial to levator scapula, anterior surface of rhomboids
  4. dorsal scapular a. - medial to levator scapula, anterior surface of rhomboids
  5. dorsal scapular a. and n. - along medial border of scapula
  6. suprascapular n. a.  - medial to transverse scapular notch
  7. suprascapular n. - lateral and just inferior to transverse scapular ligament (shown passing through foramen)
  8. suprascapular a. - superior to transverse scapular lagament (shown not passing through foramen)
  9. suprascapular n. a. - in infraspinous fossa
  10. lateral branch intercostal a. - entering serratus anterior near medial border of scapula
  11. circumflex scapular a. - posterior view in triangular space
  12. circumflex scapular a. - in infraspinous fossa within teres minor
  13. end to end anastomosis between suprascapular a. and circumflex scapular a.
  14. circumflex scapular a. tagged - tag reads "direction of blood flow when 2nd part axillary a. is ligated."
  15. dorsal scapular n. - tag reads "actions of innervated muscles?"
  16. serratus anterior indicated near vertebral border of scapular at insertion - tag reads "action of indicated structure"
  17. upper subscapular n. - window dissected through serratus anterior to show subscapularis (diabolical)
  18. axillary n. branch to teres minor - tag reads "fuctional deficit following damage to the indicated structure"
  19. axillary n. within quandrangular space
  20. posterior humeral circumflex a. within quandrangular space

Shoulder capsule, joint, and related structures

  1. corocoid process - tag reads "what muscle(s) inserts here?"
  2. corocoacromial lig. - from corocoid process to acromion, ligamentous part of coracoacromial arch
  3. subacromial bursa - separated from synovial cavity of joint by the supraspinatus tendon
  4. supraspinatus tendon - shown blending with joint capsule
  5. subscapularis tendon - shown blending with joint capsule
  6. infraspinatus tendon - shown blending with joint capsule
  7. teres minor tendon - shown blending with joint capsule
  8. corococlavicular ligs. (conoid and trapezoid) - tag reads "rupture of the indicated structures is called?"
  9. long head biceps tendon - within joint capsule of intact capsule (a window dissection through supraspinatus tendon)
  10. glenohumeral ligaments - three ligaments (superior, middle, and inferior) all related to the supraglenoid tubercle and the anterior joint capsule
  11. glenoid labrum - deepening the circumference of the glenoid fossa
  12. anterior humeral circumflex a. - show near lesser tubercle
  13. posterior humeral circumflex a. - shown near greater tubercle


  1. lateral cord - at level of clavical
  2. lateral pectoral n. - entering pectoralis minor or major
  3. lateral root median n. - shown as leg of "M"
  4. musculotaneous n. - entering coracobrachialis
  5. medial cord - at level of clavical
  6. medial brachial cutaneous n. - in axilla
  7. medial antebrachial cutaneious n. - in axilla
  8. medial root of median n. - shown as "leg" of "M"
  9. median N. - distal apex of "M"
  10. posterior cord - at level of clavical
  11. upper subscapular n. - medial in axilla entering subscapularis
  12. middle subscapular n. (thoracodorsal n.) - in axilla entering latissimus dorsi
  13. lower subscapular n. - posterior course sending lateral branch past subscapularis to teres major
  14. lower subscapular n. branch to teres major - shown from a posterior view
  15. axillary n. - entering the quadrangular space
  16. posterior humeral circumflex a. - show in quadrangular space with accompanying axillary n.
  17. radial n. - crossing anterior aspect of teres major as it leaves axilla
  18. supreme thoracic a. - at first and second intercostal region
  19. thoracoacromial trunk - deep to overlying pectoralis minor
  20. lateral thoracic a. - either from axillary or subscapular arteries, applied to lateral surface of serratus anterior
  21. anterior humeral circumflex a. - often a group of two or more aa.
  22. subscapular a. - perhaps the largest branch off axillary artery (brachial excepted)
  23. circumflex scapular a. - entering triangular space, terminal branch of subscapular artery
  24. thoracodorsal a. - coursing inferiorly along anterior border of lattissimus dorsi
  25. latertal thoracic a. - branching from thoracodorsal a. in some cases

Arm - Anterior Compartment

  1. transverse humeral ligament
  2. tendon long head biceps - through window in transverse humeral ligament
  3. brachial a. - at level of inferior free edge of teres major
  4. profunda brachaii - at origin
  5. ascending branch of profunda brachaii - at origin
  6. radial n. - entering triangular interval
  7. superior ulnar collateral a. - at origin
  8. inferior ulnar collateral a. - at origin
  9. musculocutaneous n. - emerging from the lateral side of coracobrachialis
  10. lateral antebrachial cutaneous n. - between biceps and brachialis
  11. lateral antebrachial cutaneous n. - piercing deep fascia lateral to insertion of biceps
  12. ulnar n. - piercing medial intermuscular septum
  13. ulnar n. - entering ulnar groove
  14. ulnar n. - between heads of flexor carpi ulnaris
  15. radial n. - piercing lateral intermuscular septum
  16. radial n. - between brachialis and brachioradialis
  17. median n. - crossing the brachial a.
  18. bicipital aponeurosis - blending with fascia of flexor carpi ulnaris
  19. median n. - in cubital fossa medial to brachial artery and medial to biceps tendon
  20. brachial a. - in cubital fossa lateral to median nerve  and medial to biceps tendon
  21. median n. - leaving cubital fossa between heads of pronator teres
  22. brachial a. - in cubital fossa
  23. biceps tendon - inserting on radial tuberosity
  24. brachialis insertion - at coronoid process

Arm - Posterior Compartment

  1. posterior humeral circumflex a. - on neck of humerus
  2. ascending branch profunda brachii - on surface of lateral head triceps
  3. profunda brachii - sprial groove
  4. middle collateral a. - terminal branch of profunda brachii
  5. radial collateral a. - terminal branch of profunda brachii
  6. radial collateral a. - lateral intermuscular septum
  7. radial n. - triangular interval
  8. radial n. - spiral groove
  9. radial n. - lateral intermuscular septum
  10. medial head triceps - origin inferior to spiral groove
  11. lateral head triceps - origin superior to spiral groove

Elbow Anastomosis

  1. radial collateral a. - between brachioradialis and brachialis
  2. radial recurrent a. - between biceps tendon and brachioradialis
  3. middle collateral a. - related to lateral head triceps
  4. interosseous recurrent a. - deep to anconeus on posterior surface of superior radioulnar ligament
  5. inferior ulnar collateral a. - between brachialis and humeral head of pronator teres
  6. anterior ulnar ulnar recurrent a. - between brachialis and humeral head of pronator teres
  7. superior ulnar collateral a. - coursing with ulnar nerve toward the ulnar groove.
  8. posterior ulnar recurrent a. - between humeral and ulnar head of flexor carpi ulnaris
  9. each of the previous 8 arteries at their origin.

Cubital Fossa

  1. median cubital vein - communicating branch between basilic and cephalic vein, superficial to bicipital aponeurosis
  2. bicipital aponeurosis - medial expansion of biceps tendon, roof of cubital fossa (anterior boundary)
  3. brachioradialis - lateral boundary of cubital fossa
  4. pronator teres (superficial head) - medial boundary of cubital fossa, crossing deep to brachioradialis and forming inferior boundary of cubital fossa
  5. median nerve - medial to brachial a., leaving cubital fossa between heads of pronator teres
  6. brachial artery - lateral to median n., dividing into radial and ulnar arteries
  7. ulnar artery - leaving cubital fossa deep to deep heard of pronator teres (not through heads of pronator teres)
  8. radial artery - leaving cubital fossa superficial to pronator teres and deep to brachioradialis
  9. radial nerve - branching into deep and superficial radial nerves, between brachioradialis and brachialis
  10. deep radial nerve - leaving floor of cubital fossa passing deep to superior edge of supinator
  11. superficial radial nerve - exiting cubital fossa with radial artery

Forearm - Anterior Compartment (flexor compartment)

  1. lateral antebrachial cutaneous nerve - terminal branch of musculocutaneous n., lateral aspect of forearm, intermingling with branches of cephalic v.
  2. radial artery - between brachioradialis and flexor carpi radialis, traveling with superficial radial n.
  3. median nerve - traveling distally between flexor digitorum superficialis and flexor digitorum profundus
  4. anterior interosseous nerve - branching from median n. in proximal forearm, traveling between flexor digitorum profundus and flexor pollicis longus
  5. anterior interosseous artery - on interosseous membrane, entering deep surface of pronator quadratus
  6. ulnar nerve - between flexor carpi ulnaris and flexor digitorum profundus, lateral branch to half of flexor digitorum profundus, medial branch to flexor carpi ulnaris
  7. ulnar artery - between flexor carpi ulnaris and flexor digitorum profundus, entering wrist lateral to pisiform bone
  8. medial antebrachial n. - related to basilic vein along medial aspect of forearm

Forearm - Posterior Compartment (extensor compartment)

  1. deep radial nerve - seen through window in supinator muscle, visible in posterior compartment immediately inferior to supinator
  2. posterior interosseous nerve - continuation of deep radial nerve extending along posterior surface of "outcropping" muscles (not on interosseous membrane)
  3. interosseous recurrent artery - radial side of ulnar deep to anconeus muscle
  4. posterior interosseous artery - entering posterior compartment superior to superior free edge of interosseous membrane and inferior to oblique cord
  5. anterior interosseous artery - piercing interosseous membrane in distal forearm to supply distal aspect of posterior forearm

Hand - Palmar Aspect

  1. radial a - lateral to flexor carpi radialis and medial to abductor pollicis longus
  2. median n. - medial to flexor carpi radialis
  3. median n. - entering carpal tunnel
  4. tendon of palmaris longus - at wrist
  5. flexor retinaculum - attaching to hook of hamate, pisiform bone, scaphoid tubercle, ?
  6. tendon of flexor carpi ulnaris - attaching to pisiform bone
  7. ulnar n. - lateral to pisiform bone
  8. ulnar n. - medial to hook of the hamate
  9. deep branch ulnar n. - crossing third palmar interosseous
  10. deep palmar arch - anastomosis between deep branch ulnar a. and radial a.
  11. palmar metacarpal a. - anterior surface of metacarpal bone
  12. ulnar a. - lateral to pisiform bone
  13. superficial branch ulnar n. - palmar surface of flexor digiti minimi
  14. recurrent median n. - entering thenar muscles
  15. superficial palmar branch of radial a. - contributing to superficial palmar arch
  16. median n. - branch to first dorsal interosseous
  17. vincula longa - tag reads "significance of the indicated structure"
  18. vincula breva - from flexor digitorum profundus tendon
  19. superficial transvers metacarpal ligament - distal aspect of palmar aponeurosis
  20. deep transverse metacarpal ligament - supporting heads of metacarpals
  21. collateral ligament - lateral support of interphalangeal joint capsule

Hand - Dorsum

  1. radial a. - in snuff box
  2. extensor pollicis brevis - anterior border of snuff box
  3. extensor pollicis longus - posterior border of snuff box
  4. first lumbrical tendon - inserting onto extensor hood
  5. first dorsal interosseous tendon - inserting onto extensor hood
  6. first palmar interosseous tendon - inserting onto extensor hood
  7. extensor indicis tendon - inserting onto extensor hood
  8. extensor digitorum tendon - inserting onto extensor hood of index finger
  9. oblique bands of extensor hood
  10. central band of extensor hood
  11. superficial radial n. - crossing superficial to extensor pollicis longus
  12. dorsal branch of ulnar n.
  13. dorsal venus arch - connecting cephalic v. (lateral) and basilic v. (medial)
  14. dorsal carpal branch of radial a. - contributing to dorsal carpal arch (rete)
  15. radial a. - between heads of first dorsal interosseous
  16. princeps pollicis - terminal branch of radial a.
  17. princeps pollicis - between adductor pollicis and first dorsal interosseous
  18. deep palmar arch - terminal branch of radial a.
  19. extensor carpi radialis longus tendon - base of second metacarpal
  20. extensor carpi radialis brevis tendon - base of third metacarpal
  21. extensor carpi ulnaris tendon - base of fifth metacarpal
The Structural Basis of Medical Practice
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