ConncoBRAcHtALrs Tip of coracoid Deltoid process (with short tuberosity of the head of biceps) humerus Flexion of the arm Musculocutaneous Nerve SunctcAL IMPoRTANcE: o lt is a landmark for musculocutaneous N. . At the level of its insertion. the followinq occurs: - Ulnar nerve goes to the posterior compartment. - Radial nerve enters the anterior compartment. - Median nerve crosses the brachial artery.

 

scapula (90"-180')

UPPER LIMB I

SuescAPULARrs

sub-scapurar rossa :iirflLll:[:,,, y#r1]'fi:i' *o-

*"r*il?,Ti:?f

Suncrcnl lupoRTANcE:

o During reduction of shoutder dislocatioh --+ we overcome the spasm of

subscapularis muscle by external rotation of the arm (Kocher's method).

. ln recurrent dislocation of the shoulder, the subscapularis tendon should

be fixed by double breast operation to limit abduction & external rotation

(putti-plate) operation.

o lt forms the posterior wall of axilla.

LITISSIMUS DORSI

Lower 6 thoracic Floor of the

spines, lumbar

fascia, iliac crest,

lower 8 ribs &

inferior angle of

scapula

bicipital groove of

the humerus

Nerve to latissimus

dorsi (Thoracodorsal nerve)

Adduction of the

arm.

Used in climbing &

swimming.

SunCICAL IMPORTANCE:

During mastectomy, we preserve the nerve to Latissimus dorsi to use the muscle

in mammoplasty

UPPER

Tnepezrus iF

- external occipital

protuberance

- Superior Nuchal line

- ligamentum nuchae

- 7th cervical spine

- spines of all thoracic

vertebrae

lat. Ts of

clavicle

-Med. Border of

acromion

-Upper lip of

spine of

scapula

Spinal root of

accessory nerve

Nerve to

rhomboids

Retraction,

elevation of the

shoulder & rotation

of scapula (90"-

190')

rustgkrllhr

SUnCICAL IMPORTANCEI lts paratysis ) shoutder drop.

It is the only muscle in upper limb which is not supplied by brachial plexus.

LevnToR ScAPULAE

Transverse

processes of the

upper 4 cervical

vertebrae.

Medial border of

the scapula from

superior angle to

the root of the

spine

Elevation of the

medial end os

scapula

fhprrx,sthns0el

Spho o, sdeX/ills

UPPER LIMB I

RnomBorDUS MrNoR

7th cervical spine & Medial border of the

1't thoracic spine scapula opposite to

the root of the spine

RNOuBOIDUS MAJOR

, 3t,4tn & Medial border of the

scapula from root of

spine till inferior

angle

thoracic spines

Nprve to

rhomboids

Nerve to

rhomboids

Retraction of the

scapula

Retraction of tG

scapula

SupnasPtNATUS

Supra-spinous Upper impression of Supra-scapular

fossa in sbapula the greater Nerve

tuberosity of

humerus

SuncIcAL IMPoRTANcE:

. Supraspinatustendenitis.

. Rupture of supinatus tendon.

lnitiation of

abduction (0"-30')

Stabilization of

shoulder joint.

ITTnasPINATUS

lnfra-spinous fossa Middle impression Supra-scapular Lateral rotation &

of scapula of the greater Nerve adduction tuberosity Stabilization of

shoulder joint.

N.B: Supra-scapular nerve passes through the supra-scapular notch 1[

UPPER LIMB I

Tenes MrNoR

Upper 2A ol lateral

border of the

scapula (dorsal)

Lower impression of

the greater

tuberosity of

humerus

Axillary Nerve

(circumflex

Nerve)

Lateral rotation &

adduction of

shoulder.

ftto&aof doltoB

Lower Ts of lateral

border of the

scapula (dorsal)

SunelceL IMPORTANCE:

At the lower border of teres major = lower limit of axilla.

. AxillaU artery becomes brachial artery.

. Basilica vein becomes axillary vein.

C*rt4lBo{

Trirulilrspxs

Medial lip of the Lower subbicipital groove scapular Nerve

Adduction,

extension & medial

rotation

TeneS MAJOR

Supr#ailr riotfi mramBrrl

Deuroro

Ant. Border of Lateral

% of clavicle

Lateral border of

acromion

Crest of the spine of

the scapula

Deltoid tuberosity

of the humerus

Axillary Nerve

(circumflex N)

Extension & lateral

rotation of the arm.

PostedE

perl ot

delloid

MUdl6

-

part ol

dBltoid

Acrdnion

Spins 6l

scsprda

Scap{la

DBhoE

lub6rosily

d hullH{g

lStrrllvtu

m. Deltoid is multi-pinnate.

' lnjury of axillary nerve )

(flat shoulder deformity +

from 15 -90) & loss of

lateralTz.

fuin*of

fstpr/l*

paralysis of deltoid

failure of abduction

sensation over its

tfrororiry

UPPER LIMB I

ConncoBRAcHtALrs

Tip of coracoid Deltoid

process (with short tuberosity of the

head of biceps) humerus

Flexion of the arm Musculocutaneous Nerve

SunctcAL IMPoRTANcE:

o lt is a landmark for musculocutaneous N.

. At the level of its insertion. the followinq occurs:

- Ulnar nerve goes to the posterior compartment.

- Radial nerve enters the anterior compartment.

- Median nerve crosses the brachial artery.

BTcEPS

Lonq head:

supra-glenoid

tubercle of

scapula (intraarticular

tendon)

Short head: tip

of coracoid

process of

scapula.

Radialtuberosity &

bicipital aponeurosis

th&falftE SryaCerpU

ol sorflron

9roca6E

Trargwrts

li.rmgral

I0aflr6fi

lnbr.

t barculir

gfoovs

Musculo- Supination &

cutaneous nerye flexion of elbow

& shoulder

Bhh6fie]

sporl€{rrsits

SuneIcAL IMPORTANCE:

. Rupture of biceps tendon --- pop eye deformity:

- Diagnosed on flexion of the elbow against resistance, where the

affected muscle bunches distally leaving a gape proximally.

. Bicipital aponeurosis separates the brachialA. from median cubitalV.

o Biceps tendon reflex.

I UPPER LIMB

BnecntALts

Front of the lower

Tz of the humerus.