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Block 2 review

Block 2 review

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Block 2 review

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  1. Block 2 review Upper limb and lower limb

  2. CUBITAL FOSSA The cubitalfossa is an important area of transition between the arm and the forearm. It is located anterior to the elbow joint and is a triangular depression formed between two forearm muscles: 1. Brachioradialis 2. Pronatorteres

  3. CONTENTS: From medial to lateral side 1-Median Nerve 2-Bifurcation of brachial artery into radial and ulnar artery 3-Tendon of biceps muscle 4-Radial nerve and its deep branch

  4. A N T RN [superficial br.]

  5. Cubital tunnel syndrome The symptoms are very similar to the pain from hitting your funny bone. 

  6. Compartments of forearm • Muscles in the anterior compartment of the forearm flex the wrist and digits and pronate the hand. • Muscles in the posterior compartment extend the wrist and digits and supinate the hand.

  7. Anterior Forearm

  8. Radial pulse • The radial pulse can be felt by gently palpating the radial artery against the underlying muscle and bone.

  9. POSTERIOR COMPARTMENT OF THE FOREARM

  10. Superficial layer • Seven muscles • 1.Brachioradialis • 2.Extensor carpiradialislongus • 3.Extensor carpiradialisbrevis • 4.Extensor digitorum • 5.Extensor digitiminimi • 6.Extensor carpiulnaris • 7.Anconeus

  11. Deep layer • Five muscles • 1-Supinator • 2-Abductor pollicislongus • 3-Extensor pollicisbrevis • 4-Extensor pollicislongus • 5-Extensor indicis

  12. ANATOMICAL SNUFFBOX • Boundries • Medially • -Extensor pollicislongus tendon • Laterally • Abductor pollicislongus tendon • Extensor pollicisbrevis tendon • Clinical importance • 1- Scaphoid bone • 2- Radial pulsation

  13. Carpal tunnel and structures at the wrist • The carpal tunnel is formed anteriorly at the wrist by a deep arch formed by the carpal bones and the flexor retinaculum.

  14. Structure and relations • Four tendons of the flexor digitorumprofundus • Four tendons of the flexor digitorumsuperficialis • One tendon of the flexor pollicislongus • Median nerve

  15. Carpal tunnel syndrome • Carpal tunnel syndrome is an entrapment syndrome caused by pressure on the median nerve within the carpal tunnel.

  16. Muscles of the HandThenar Muscles

  17. Muscles of the HandHypothenar Muscles

  18. Movements of thumb

  19. Movements of thumb • Extension: extensor pollicislongus, extensor pollicisbrevis • Flexion: flexor pollicislongus and flexor pollicisbrevis • Abduction: abductor pollicislongus and abductor pollicisbrevis. • Adduction: adductor pollicis • Opposition: opponenspollicis.

  20. Lumbrical muscles

  21. Dorsal interossei Action of Dorsal Interossei : DAB : Abduction

  22. Palmarinterossei Action of Palmarinterossei : PAD :Adduction

  23. Arteries of hand • Blood supply to the hand is by the radial and ulnar arteries, which form two interconnected vascular arches (superficial and deep) in the palm.

  24. Nerves • The hand is supplied by the ulnar, median, and radial nerves.

  25. Ulnar Canal Syndrome (Guyon Tunnel Syndrome) • Compression of the ulnar nerve may occur at the wrist where it passes between the pisiform and the hook of the hamate.

  26. Clawing of the hand

  27. Median nerve • The median nerve is the most important sensory nerve in the hand because it innervates skin on the thumb, index and middle fingers, and lateral side of the ring finger. • Branches: • 1. Recurrent branch: innervates the three thenar muscles • 2. Palmar digital nerves: In addition to skin, the digital nerves supply the lateral two lumbrical muscles

  28. Superficial branch of the radial nerve

  29. Brachial plexus lesions

  30. Glenohumeral Joint • SHOULDER JOINT • TYPE: • Synovial : ball and socket joint • Bony articulation • -Head of the Humerus • -Glenoid cavity of the Scapula • (deepened by Glenoid labrum)

  31. Bursa of Shoulder Joint Contain thin layer of synovial fluid Located where tendons rub against bone, ligaments, or tendons and when skin moves over bone directly beneath Subscapular bursa Subacromial (subdeltoid) bursa

  32. ANTERIOR DISLOCATION • shoulder joint is the most commonly dislocated large joints • Common type is anterior dislocation (post. Dislocation is very rare) • Young adult(athletes) • Excessive extension and lateral rotation of the humerus • Head of the humerus comes to lie inferior to the glenoidfossa • Head is pulled (by flexors and adductors of the shoulder joint) forward And upward into the subcoracoid position

  33. Movements of the Elbow Joint Flexion and extension occur at the elbow joint. Chief flexors of the elbow joint are the brachialis and biceps brachii. Chief extensor of the elbow joint is the triceps brachii.

  34. Proximal radioulnar joint Type: Pivot type of synovial joint Articulation: Head of the radius articulates with the radial notch of the ulna Ligaments: The strong anular ligament, attached to the ulna anterior and posterior to its radial notch.

  35. Movements Pronation and supination. Pronation: Pronatorquadratus (primarily) and pronatorteres Supination:Supinator and biceps brachii.

  36. Subluxation and Dislocation of Radial Head Pulled elbow or Nursemaid's elbow The sudden pulling of the upper limb tears the distal attachment of the anular ligament, where it is loosely attached to the neck of the radius.

  37. Muscles Moving the Wrist Joint

  38. Fractures • Clavicle • Humerus • Radius • Scaphoid

  39. Fall on Out stretched Hand Overall : Dorsal Displacement of Wrist and Hand Specifically: Dorsal and Proximal Displacement of Distal segment of fractured radius This is more common in older person

  40. Wrist Fractures Colles fracture: Distalfracture of the radius in the forearm with dorsal (posterior) displacement of the wrist and hand. Smiths fracture: The distal fracture fragment is displaced ventrally, as opposed to a Colles' fracture which the fragment is displaced dorsally.

  41. Lower limb

  42. Superficial Veins of the Lower Limb • Superficial Veins • The two major superficial veins in the lower limb are the great and small saphenous veins. • Are in subcutaneous tissue • Normally send blood to deep veins via perforating veins • Deep veins • Are deep to deep fascia and accompany all major arteries • Superficial and deep veins have valves, which are more numerous in deep veins.