Pierces the interosseous membrane at its distal end (at the upper border of pronator quadratus) to reach the dorsal carpal anastomosis
2. superficial/deep ulnar nerve
Lies in a groove posterior to the medial epicondyle, where it can be felt against the "funny bone"
Enters the forearm between the to heads of flexor carpi ulnaris, then shortly joins the ulnar artery, then becomes superficial
lies between the flexor digitorum superficialis laterally and the flexor carpi ulnaris medially
Nerve and artery enter the hand by passing anterior to the flexor retinaculum, lateral to the pisiform, and between bone and hook of the hamate
Source is the medial cord of the brachial plexus (C8, T1)
Motor to: flexor carpi ulnaris muscle, flexor digitorum profundus muscle (ulnar half), abductor digiti minimi muscle, flexor digiti minimi brevis muscle., opponens digiti minimi muscle., ulnar 2 lumbrical muscle, and palmar and dorsal interosseous muscles.
Sensory to: skin of the medial side of the wrist and hand; skin of the medial 1.5 digits
3. posterior cord of brachial plexus
An arrangement of nerve fibers (a plexus. . .duh) running from the spine of vertebrae C5-T1 through the neck and axilla and into the arm; all nerves of the arm stem from the brachial plexus (exception: the intercostobrachialis nerve which supplies an area of skin near the axilla)
The posterior cord is formed from the three posterior divisions of the trunks
lower subscapular nerve (C5, C6) supplies lower part of subscapularis and teres major
axillary nerve (C5, C6) anterior branch supplies deltoid and small area overlying skin, posterior branch supplies teres minor and deltoid muscles and then becomes upper lateral cutaneous nerve of the arm
radial nerve (largest in plexus, C5, C6, C7, C8, T1) supplies triceps brachii, skin of posterior arm as posterior cutaneous nerve of arm, anconeus, and extensor muscles of the forearm
4. median nerve
Source is the lateral and medial cords of the brachial plexus, then courses with brachial artery on medial side of arm between biceps brachii and brachialis.
At first, is lateral to the artery, then crosses it anteriorly to run medial to the artery in the distal arm and into the cubital fossa
Enters the hand throug the carpal tunnel, deep to the flexor retinaculum
Branches include: anterior interosseous nerve, palmar branch, recurrent (motor) branch, common palmar digital nerves (for digits 1-3)
Sensory supply to: skin of the radial half of the palm and the palmar side of the lateral 3 1/2 digits (and the nail bed for these digits)
Is motor to the flexor muscles of the forearm, except flexor carpi ulnaris and the medial 1/2 of the flexor digitorum profundus, and the muscles of the thenar compartment and the lateral 2 lumbricals
5. suprascapular nerve
Source is the superior trunk of the brachial plexus (C5-C6)
Motor supply to: supraspinatus muscle and infraspinatus muscle
No cutaneous branches
Runs laterally beneath the trapezius and omohyoideus
Passes through the suprascapular notch inferior to the superior transverse scapular ligament
Then passes beneath the supraspinatus muscle and curves around the lateral border of the spine of the scapula to the infraspinatus muscle
6. coracoclavicular ligament
Serves to connect the clavicle with the coracoid process of the scapula
Reinforces the acromioclavicular joint
Consists of to parts: trapezoid and conoid ligaments
Trapezoid: Quadrangular in shape; attached to the coracoid process for about 1 inch, and runs upward and laterally to attach to trapezoid line on inferior surface of clavicle
Conoid: Cone-shaped; lies partly behind the trapezoid ligament; apex is attached to the knuckle of coracoid process and the base to the conoid tubercle on undersurface of clavicle
7. coracoacromial ligament
Strong triangular band extending between the coracoid process and the acromion
Attached by its apex to the summit of the acromion in front of articular surface of clavicle and by its base to the whole length of lateral border of coracoid process
This ligament, together with coracoid process and acromion, forms protection for the head of the humerus
8. 1st dorsal interosseous muscle
Originates on the radial side of the second metacarpal and proximal half of the ulnar side of the first metacarpal
Inserts on the radial side of the of the base of the second proximal phalanx and the extensor expansion
Larger than the other dorsal interosseous muscles
Between its to heads the radial artery passes from the back of the hand to the palm
Arterial supply to muscles and tissues of the posterior compartment of the arm
Arises just below lower border of teres major muscle
Follows the radial nerve, running at first posteriorly between medial and lateral heads of triceps brachii muscles, then along the groove for the radial nerve
Pierces lateral intermuscular septum and descends between brachioradialis muscle and brachialis muscle anterior to lateral epicondyle of humerus
Ends by anastomosing with radial recurrant artery
Spirals around the shaft of the humerus in the radial groove where it is susceptible to injury in mid-shaft fractures
10. deep palmar arch
Formed mainly from terminal branch of radial artery, with ulnar artery contributing via deep palmar branch
Lies upon bases of metacarpal bones and interossei
Deep to oblique head of adductor pollicis muscles, flexor tendons, and lumbricals
Alongside is the deep branch of ulnar nerve (running in opposite direction toward radius)
Branches include palmar metacarpal arteries
11. glenoid labrum
A ring of fibrocartilage that runs around the cavity of the scapula in which the head of the humerus fits
Deepens the cavity (glenoid cavity) and increases surface of shoulder joint
12. Recurrant branch of median nerve
Also referred to as the muscular branch of the median nerve
Goes to the thenar eminence, where it provides motor innervation to (3) thenar muscles: abductor pollicis brevis, flexor pollicis brevis, and oponens pollicis
Control movement of the thumb
13. radial artery
Arises from bifurcation of brachial artery in the cubital fossa
Runs distally down anterior portion of forearm
Runs laterally around the wrist, passing through the anatomical snuff box and between heads of 1st dorsal interosseous muscle
Passes anteriorly between heads of adductor pollicis and becomes the deep palmar arch (which joins with deep branch of ulnar artery)
14. anterior interosseous nerve
Branch of median nerve
Motor supply to: flexor pollicis longus muscle, radial half of flexor digitorum profundus muscle, and pronator quadratus muscle
No sensory innervation
Courses along the anterior surface of the interosseous membrane
15. circumflex scapular artery
Branch of subscapular artery
Arterial supply to: teres major muscle, teres minor muscle, and infraspinatus muscle
Curves around axillary border of the scapula, traveling through the anatomical "triangular Space" made up of the subscapularis superiorally, the teres major inferiorally, and the long head of the triceps laterally
Enters the infraspinatus fossa under the teres minor muscle
Anastomoses with the suprascapular artery and the dorsal scapular artery to form the scapular anastomosis
16. spinal accessory nerve
Eleventh of twelve cranial nerves
Leaves cranium through jugular foramen along with glossopharyngeal nerve (C-9) and the vagus nerve (C-10)
Innervates: sternocleidomastoid muscle and trapezius muscle on the ipsilateral side
17. radial nerve
Branch of the posterior cord of the brachial plexus (C5, 6, 7, 8, & T1)
Branches include: posterior brachial cutaneous nerve, inferior lateral brachial cutaneous nerve, posterior antebrachial cutaneous nerve, superficial and deep branches
Sensory supply to: skin of the posterior arm, forearm and hand
Motor supply to:
muscles of the posterior arm: triceps brachii muscle, anconeus muscle
Arterial supply to the lateral side of the elbow and adjacent extensor muscles
Anastomoses with the radial collateral artery
It courses in the groove between the brachioradialis muscle and the brachialis muscle
21. annular ligament of radius
Strong band of fibers that encircles the head of the radius and keeps it in contact with the radial notch of the ulna
Forms about four-fifths of the osseo-fibrous ring, and is attached to the anterior and posterior margins of the radial notch
A few of its lower fibers are continued around below the cavity and form at this level a complete fibrous ring
22. dorsal scapular nerve
Arises from the brachial plexus, usually from anterior ramus of C5
Provides motor innervation to rhomboideus major and minor muscles, and levator scapulae muscle
No sensory
Passes through the scalenus medius muscle
23. princeps pollicis artery
Branch of the radial artery
Descends between first dorsal interosseous muscle and oblique head of adductor pollicis, along medial side (ulnar side) of first metacarpal bone to the base of proximal phalanx
Lies beneath tendon of flexor pollicis longus muscle, where it divides into to branches, which run along the sides of the thumb
24. axillary nerve
Comes off posterior cord of brachial plexus at the level of the axilla, and carries fibers from C5 and C6
Travels through the quadrangular space with the posterior circumflex humeral artery and vein
Motor supply: deltoid muscle and teres minor muscle
Sensory: skin of upper lateral arm (interior region of deltoid muscle) by superior lateral cutaneous nerve
25. brachial artery
Branch of axillary artery; brachial artery is the continuation of the axillary artery distal to the teres major muscle
Branches/continuations from this artery include: deep brachial artery, superior ulnar collateral arter, nutrient artery, inferior ulnar collateral artery; terminal branches are the radial artery and the ulnar artery
Continues down the arm until it reaches the cubital fossa and elbow; ends by dividing into radial artery and ulnar artery which run down forearm
26. supraspinatus muscle
Origin: supraspinatus fossa superior to spine of scapula
Insertion: greater tubercle of humerus (highest facet)
Abducts the arm; initiates abduction
Innervation: suprascapular nerve (C5,6) from the superior trunk of the brachial plexus
Arterial supply: suprascapular artery
27. subscapularis muscle
Origin: medial 2/3s of costal surface of scapula (subscapular fossa)
Insertion: lesser tubercle of humerus
Medially rotates the arm, assists in extension of arm
Innervation: upper and lower subscapular nerves (C5,6)
Arterial supply: subscapular artery
The rotator cuff muscles are subscapularis muscle, supraspinatus muscle, infraspinatus muscle, and teres minor muscle.
28. viniculum
Given off by tendons of both digital flexors (flexor digitorum superficialis and profundus and flexor pollicis longus) before they reach sites of insertion
Attach directly to the phalanx
There is a short viniculum and a long viniculum for each tendon
They provide routes for blood vessels to reach the tendons from the periosteum
29. Upper trunk C5-C6
Formed by merging of ventral/anterior rami of C5 and C6 spinal nerves
One of three trunks of the brachial plexus
30. Common interosseous artery
Branch of ulnar artery
About 1 inch in length, arises below tuberosity of radius
Branches into anterior and posterior interosseous arteries
Arterial supply to deep structure of forearm
31. winging at scapula
See long thoracic nerve
32. thoracodorsal artery
Branch of subscapular artery
Travels inferiorly with thoracodorsal nerve
Arterial supply to latissimus dorsi
33. Long thoracic nerve
Source is the brachial plexus (ventral primary rami of spinal nerves C5-C7)
Motor to serratus anterior muscle
No cutaneous branches
Located on the superficial surface of the serratus anterior muscle
Lesion of this nerve causes scapular winging, hence the saying "C5, 6, & 7 keep the wings from heaven"
34. Extensor hood
Triangular aponeurosis through which extensor digitorum, the interossei, and the lumbricals act on the metacarpophalangeal and interphalangeal (MP and IP) joints
Located over the MP joints and proximal and middle phalanges
Formed by the aponeurotic expansions of extensor digitorum tendons, tendons of interossei, lumbricals, and some intrinsic bands
35. Articular disk
Located on distal end of radius (part of wrist-joint)
The articular disk and the radius together form a transversely elliptical concave surface, or the receiving cavity
The superior articular surfaces of the navicular, lunate, and triangular form a smooth convex surface (the condyle) which is received into the concavity created by the articular disk/radius
36. Anterior humeral circumflex artery
Branch of axillary artery (3rd part)
Arterial supply to: deltoid muscle, arm muscles near neck of humerus
Runs horizontally from lateral side of axillary artery, beneath the coracobrachialis and short head of the biceps brachii, in front of the neck of the humerus
Upon reaching the intertubercular sulcus, it gives off a branch to supply head of humerus and shoulder joint
Continues onward beneath long head of biceps brachii muscle and deltoideus muscle, and anastomoses with the posterior humeral circumflex artery
37. Posterior interosseous artery
Branch of common interosseous artery
Gives off the interosseous recurrant artery
Arterial supply to the muscles of the posterior (extensor) forearm compartment: supinator muscle, abductor pollicis longus muscle, extensor pollicis longus muscle, extensor pollicis brevis muscle, and extensor indicis muscle.
Passes proximal to the interosseous membrane (over upper border) to reach the extensor compartment of the forearm
Appears between the borders of the supinator muscle and the abductor pollicis longus, and runs down the posterior forearm between superificial and deep layers of muscles
Anastomoses with the termination of the volar interosseous artery
38. Tendon flexor digitorum superficialis
Four long tendons come off the flexor digitorum superficialis muscle, an extrinsic flexor muscle of the fingers
Tendons travel through the carpal tunnel
They attach to the base of the proximal phalanges of the four fingers
These tendons each have a hole, or split, at the end through which the tendons of flexor digitorum profundus will travel
39. Brachialis muscle
Originates on the anterior surface of the lower 1/2 of the humerus, and associated intermuscular septa
Inserts on the coronoid process of the ulna
Powerful flexor of the forearm
Innervated by the musculocutaneous nerve (C5,C6)
Arterial supply from brachial artery and radial recurrant artery
40. Superior ulnar collateral artery
Branch of brachial artery; sometimes branches from upper part of profunda brachial artery
Arterial supply to the medial arm muscles
Travels with the ulnar nerve
It pierces the medial intermuscular septum, and descends on the surface of the medial head of the Triceps brachii to the space between the medial epicondyle and olecranon.
Ends under the flexor carpii ulnaris by anastomosing with the posterior ulnar recurrant and inferior ulnar collateral
41. Pronator teres
Muscle mainly of the forearm
Serves to pronate the forearm
Two heads: humeral and ulnar
Humeral: larger and more superficial, arises above medial epicondyle of humerus and common flexor tendon
Ulnar: thin, arises from medial side of coronoid process of ulna and joins the humeral head at an acute angle
Passes obliquely accross the forearm and ends in a flat tendon, which inserts into a rough impression at the middle of the lateral surface of the body of the radius, just below insertion of supinator muscle
Median nerve enters forearm between the two heads; innervates this muscle
Arterial supply from ulnar artery and anterior ulnar recurrant arter
42. Superficial palmar arch
Formed predominately by the ulnar artery, with a contribution from the superficial palmar branch of the radial artery
Passes across the palm; more distal than the deep palmar arch
With the thumb fully extended, the arch would be at the level of a line drawn from the distal border of the thumb across the palm
43. Capitate bone
Largest of the carpal bones
Occupies the center of the wrist
Superior surface is rounded, smooth, and articulates with the lunate bone
Inferior surface is divided by two ridges into three facets for articulation with the second, third, and fourth metacarpal bones; the third is the largest
Medial surface articulates with the hamate bone
Lateral surface articulates with the lesser multangular bone
Dorsal surface is broad and rough
Palmar surface is rounded, narrow, and rough for attachment of ligaments and part of adductor pollicis muscle
44. Deep radial nerve
Originates from posterior cord of brachial plexus (C5-C8 and T1)
Radial nerve divides into a deep branch and then continues as the superficial branch which goes on to innervate the dorsum of the hand
Pierces the supinator muscle, after which it is known as the posterior interosseous nerve
A narrow fibrous band that runs across the palmar surface of the heads of the second, third, fourth, and fifth metacarpal bones, connecting them together
It is blended with the palmar metacarpophalangeal ligaments
46. Extensor digiti minimi
Origin: Common extensor tendon, lateral epicondyle of the humerus
Insertion: Joins the extensor digitorum tendon to the 5th digit and inserts in the extensor expansion
Action: Extends the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of the 5th digit
Innnervated by deep radial nerve
Arterial supply by interosseous recurrent artery
It appears to be the ulnar-most portion of the extensor digitorum muscle
47. Musculocutaneous nerve
Arises from lateral cord of brachial plexus (C5, C6, C7)
Pierces the coracobrachialis muscle and passes obliquely between the biceps brachii muscle and the brachialis muscle, to the lateral side of the arm
Slightly above the elbow, pierces the deep fascia lateral to the tendon of the biceps brachii muscle and continues into the forearm as the lateral antibrachial cutaneous nerve
Motor supply to: coracobrachialis muscle, biceps brachii muscle, and the greater part of brachialis muscle
Sensory supply to: skin of lateral side of forearm
48. Posterior ulnar recurrent artery
Branch of ulnar artery
Often arises from a common trunk with the anterior ulnar recurrent artery
Provides arterial supply to medial side of the elbow and flexor muscles of the forearm
Lies beneath flexor carpi ulnaris as it passes/ascends from the surface of flexor digitorum profundus
Ascends between the heads of flexor carpi ulnaris; it supplies the neighboring muscles and elbow joint, and anastomoses with the superior and inferior ulnar collateral arteries and interosseous recurrent arteries
49. Scaphoid bone
Bone of the wrist (carpal) found on the radial side
AKA navicular bone
Largest bone of the proximal row
Superior surface is convex, smooth, and articulates with the trapezium bone (greater multangular) laterally and trapezoid bone (lesser multangular) medially
Medial surface articulates with lunate and capitate bones
Lateral surface gives attachment to the radial collateral ligament of the wrist
Anterior boundary (floor) of the anatomical snuff box? lae
Posterior surface crossed by radial artery? lae
50. Tendon flexor digitorum profundus
Of the flexor digitorum profundus muscle, which originates from anterior side of the ulna
The tendons insert at the base of the distal phlanx of digits 2-5
Along with flexor digitorum superficialis, has long tendons that run down the forearm and through the carpal tunnel and attach to the palmar side of the phalanges
Flexes the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints
Innervations from medial nerve (radial 1/2) and ulnar nerve (ulnar 1/2)
Arterial supply from ulnar artery and anterior interosseous artery
51. Transverse humeral ligament
Broad band passing from the lesser to the greater tubercle of the humerus
Converts the intertubercular groove into a canal; spans the intertubercular groove
Holds the biceps tendon (long head) in place
52. Upper subscapular nerve
Branch of posterior cord of brachial plexus (C5, C6)
Motor supply to subscapularis muscle
No cutaneous branches
Subscapularis muscle is a medial rotator of the humerus
53. Abductor pollicis brevis
Origin: flexor retinaculum, scaphoid bone, trapezius bone
Inserts by a thin, flat tendon into the base of the proximal phalanx of 1st digit
Action: Abducts the thumb
Innervated by recurrent branch of median nerve
Arterial supply from superficial palmar branch of radial artery
Abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis are located in the thenar compartment of the hand
54. Cephalic vein
Forms the lateral side of the dorsal veinous arch of the hand, and is the main superficial vein of the lateral forearm
Drains into the axillary vein
Communicates with the basilic vein via the median cubital vein at the elbow
Is also found in the superficial fascia along the anterolateral surface of the biceps brachii muscle
55. Common palmar digital artery
Branch of superficial palmar arterial arch
Gives off two proper palmar digital arteries
Arterial supply to the palmar aspect of two adjacent digits
Common palmar digital arteries anastomose with palmar metacarpal arteries
56. Coracoacromial ligament/arch
A strong triangular band that extends from the coracoid process to the acromion
Attached, by its apex, to the summit of the acromion just in front of the articular surface for the clavicle; and by its broad base to the whole length of the lateral border of the coracoid process
57. Dorsalis indicis artery
Suggestions???
58. Extend fingers at extend wrist MP and IP joints
??
Extensor carpi radialis brevis muscle
Extensor indicis muscle
59. Extensor carpi radialis brevis
Origin: Common extensor tendon, lateral epicondyle of humerus
Inserts on the dorsum of the 3rd metacarpal bone at the base
Action: Extends the wrist, abducts the hand
Innervated by deep radial nerve
Arterial supply from radial artery
Works with the extensor carpi radialis longus and flexor carpi radialis in abduction of the hand
60. Extensor indicis
A deep forearm extensor muscle
Origin: Interosseous membrane and posterolateral surface of distal ulna
Insertion: Its tendon joins the tendon of the extensor digitorum to the 2nd digit and both tendons insert into the extensor expansion
Action: Extends the 2nd digit at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints
Innervated by deep radial nerve
Arterial supply from posterior interosseous artery
61. Extensor pollicis longus tendon
Origin: Interosseous membrane and middle part of posterolateral surface of the ulna
Inserts into the base of the distal phalanx of the thumb
Action: Extends the thumb at the interphalangeal joint
Innervated by deep radial nerve
Arterial supply from posterior interosseous artery
Hooks around dorsal radial tubercle and forms part of the medial border of the anatomical snuffbox
62. Flexor retinaculum
Strong, fibrous band that arches over the carpus
Converts the deep groove on the anterior surface of the carpal bones into a tunnel (the famous carpal tunnel)
Flexor tendons of the digits, tendon of flexor pollicis longus, and median nerve pass through the carpal tunnel
Attached medially (ulnar side) to the pisiform bone and hook of the hamate bone
Attached laterally (radial side) to the tuberosity of the scaphoid bone and trapezium bone
Superiorly, blends with the deep layer of antebrachial fascia
Inferiorly, blends with the fascia that invests the thenar and hypothenar muscles, both of which takes origin at the retinaculum
63. Interosseous membrane
A fibrous sheath that stretches between the radius and the ulna
Provides additional area for muscle attachment
Point of reference for several nerves and vessels of the forearm: anterior/posterior interosseous arteries, anterior/posterior interosseous nerves, common interosseous artery (from ulnar artery), recurrent interosseous arter
64. Interosseous recurrent artery
Branch of posterior interosseous artery
Arterial supply to the anconeus muscle and elbow joint
Anastomoses with the middle collateral artery (a branch of profunda brachii)
65. Lower subscapular artery??? (I'm going to assume they meant lower subscapular nerve)
Branch of posterior cord of the brachial plexus (C5, C6)
Motor supply to subscapularis muscle and teres major muscle
No cutaneous branches
66. Tendon of flexor pollicis longus
Of the flexor pollicis longus muscle
Origin: anterior surface of the radius and interosseous membrane
Inserts into the base of the distal phalanx of the thumb
Flexes the MP and IP joints of the thumb
Innervated by median nerve
Arterial supply from anterior interosseous artery
67. Thoracodorsal nerve
Branch of posterior cord of brachial plexus (C7, C8)
Motor supply to latissimus dorsi muscle
No cutaneous branches
AKA middle subscapular nerve
68. Trochlear notch of the ulna
Cresent shaped notch on the anterior surface of the proximal end of the ulna
It is located between the olecranon and coronoid process of the ulna
Articulates with the trochlea of the humerus
69. Ulnar collateral ligament
A triangular fibrous band that spans the space between the medial epicondyle of the humerus, the subcutaneous edge of the olecranon, and the coronoid process
Can be divided into an anterior and a posterior portion:
Anterior: Attached by its apex to the medial epicondyle of the humerus, and below by its base to the medial margin of the coronoid process
Posterior: Attached by its apex to the posterior portion of the medial epicondyle, and by its base more posteriorly to the medial margin of the olecranon
70. Abductor digiti minimi muscle
Origin: pisiform bone
Tendon inserts into the base of the proximal phalanx of the 5th digit on its ulnar side
Action: Abducts the 5th digit
Innervated by the deep branch of the ulnar nerve
Arterial supply from the ulnar artery
Abductor digiti minimi, flexor digiti minimi brevis, and opponens digiti minimi are located in the hypothenar compartment of the hand
Hello all- Now that we've recieved the updated lists from Hessam I will be working from those now and will add the terms from the back region that my list did not include. -- AndreaConway - 28 Sep 2006 - 10:09
Shweta: I took the liberty to start a second page (UpperLimbBackIdendificationsRegion) for the tags by region work. Perhaps these two topic can be merged as they mature. There is a link to the region page from the "Collaborative Study" page. lae -- LorenEvey - 28 Sep 2006 - 05:09
I have begun annotating the HITs list for the upper limb. I have completed the first 40 terms from the identifications list from 1997-2004, so there will definitely be some changes and additions when I get the updated list (1997-2005). I am planning on annotating the majority of the list, and hopefully arranging it in some logical manner (time permitting, of course). I hope this is a help to someone other than myself! Evey- I wasn't sure how to present it as nicely as you did for the last list, so I just made it an attachment like before. Feel free to work your magic on this one. Thanks! -- AndreaConway - 25 Sep 2006 - 05:04
This is an annotation of the first 40 terms on the upper limb practical identifications list (1997-2004). I will be compeleting more of the list, and will hopefully recieve the updated list soon.