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Upper limb osteology •Identify the main features of the clavicle, scapula, and humerus •Identify•Identify the bones of the hands and ulna •Identify the major palpable features of the bones of the upper limb on yourself and on radiographic imagesClavicle • Horizontally orientated long bone • Attaches upper limb to trunk and protects underlying structures • Divided into sternal end, shaft, and acromial end • Articulates with manubrium at sternoclavicular joint (saddle type) • Articulates with acromion at acromioclavicular joint (plane type)Scapula • Triangular flat bone overlying the posterolateral aspect of ribs 2-7 • Articulates with humerus and clavicle • Spine expands to form acromion posteriorly. • Coracoid process anterior – attachment for pec minor, coracobrachialis, and short head of biceps brachiiGlenohumeral joint • Ball-and-socket joint • Glenoid cavity in scapula is shallow and articulates with head of the humerus • Glenoid labrum is a fibrocartilaginous ring that surrounds the cavity • Supraglenoid tubercle is attachment for long head of biceps brachii • Infraglenoid tubercle is attachment for long head of triceps brachiiHumerus •Head of humerus is part of glenohumeral joint •Anatomical neck of humerus where capsule of glenohumeral joint attaches •Surgical neck is narrowest part of humerus. Common site of fractures •Greater tubercle lateral and superior. Lesser tubercle anterior. •Bicipital groove/intertubercular sulcus between them • Hinge type joint Elbow joint • Medial and lateral epicondyles are palpable bony landmarks • Condyles are trochlea (pulley shaped) on the medial side and capitulum on the lateral side • Coronoid process on proximal end of ulna articulates with trochlea • Radial head articulates with capitulum. • Coronoid and radial fossa on humerus accommodate their respective processes during flexion Dislocations • Dislocation of radial head – Occurs in young children when they are lifted by the arm. The annular ligament is torn which separates the head of the radius from the ulna. • Dislocation of acromioclavicular joint – Common sports injury caused by a hard fall on shoulder or outstretched arm. Both ligaments torn. Known as a shoulderlar separation. Ulna and radius Ulna: • Olecranon on posterior side is the knobble of elbow. x • Olecranon fossa to accommodate this on posterior side of humerus • Trochlear notch where ulna articulates with humerus Radius: • Head is circular with a small depression • Neck between head and radial tuberosity (x) Styloid process on the ulna is more prominent than on the radiusWrist bones • Also known as carpal bones • Proximal row: scaphoid, lunate, triquetrum, pisiform • Distal row : trapezium, trapezoid, capitate, hamate • Some Lovers Try Positions That They Can't HandleHand bones •Five metacarpals •Phalanges divided into proximal, middle and distal in the four fingers •Thumb has just proximal and distal phalanges Fractures • Surgical neck of the humerus – Common in the elderly. Caused by falls. Risk of damage to axillary nerve and circumflex humeral arteries. • Scaphoid – Occurs after fall on outstretched hand (FOOSH). Typically diagnosed by tenderness in the anatomical snuffbox. May lead to avascular necrosis of the proximal scaphoid. • Clavicle – Can also be caused by falling on an outstretched hand. Shoulder drops. Unable to lift arm due to pain.SBA 1 Anna, a 5 year old girl, complains of pain in her elbow after asking her parents to swing her by the arms in the garden. Which ligament is displaced in the subluxation of the radial head? A: Radial ligament B: Medial collateral ligament C: Anterior cruciate ligament D: Annular ligament E: Sacrospinous ligamentSBA 2 Which part of the ulna articulates with the trochlea on the humerus? A: Radial notch B: Styloid process C: Capitulum D: Medial epicondyle E: Coronoid processSBA 3 John, an 83 year old man presents to A&E after falling on a slippery path. He is found to have a fracture of the surgical neck of the humerus. Which two important anatomical features could be damaged? A: Radial nerve and profunda brachii artery B: Axillary nerve and circumflex humeral arteries C: Axillary artery and biceps brachii tendon D: Head of the humerus and deltoid tuberosity E: Brachial artery and median nerve