Appendicular Skeleton - UL - Transcript

Appendicular Skeleton – Upper Limb
The appendicular skeleton.
In this video, we will go through the anatomy of the appendicular skeleton, concentrating
on some major bony features as well as some application to surface anatomy and imaging.
Limb bones and their girdles are appended, or attached, to the axial skeleton. They are
called the appendicular skeleton. Let’s look at the upper limb skeleton for a moment. The
upper limb is composed of three segments: the arm, the forearm which has the radius and
ulna, and the hand. The shoulder region is based on pectoral or shoulder girdle, which
includes the clavicle and the scapula.
The shoulder girdle consists of a clavicle anteriorly and scapula posteriorly. The paired
shoulder girdles and their associated muscles form the shoulders. Gird means to bind. In
anatomy, the girdle is a bone or bones through which the free limbs (in this case the upper
limb) is attached to the axial skeleton. Note that the medial end of the clavicle articulates
with the manubrium. This is the actual point of the articulation between the appendicular
and the axial skeleton. The lateral end of the clavicle articulates with the scapula. The
scapula, in turn, articulates with the head of the humerus. Therefore, the shoulder girdle
bones form a chain with few segments and articulations prior to the shoulder joint. This
significantly increases the mobility of the upper limb. Since only the clavicle articulates with
the axial skeleton, the scapula can move quite freely across the thorax allowing the arm to
move with it. Many muscles attach to the bones of the shoulder girdle and allow for high
mobility of this region.
The scapula is a thin flat bone aligned with the posterior aspect of the thoracic cage and
held in place by many muscles attached to it. The scapula has three borders: superior,
medial, and lateral. Like a triangle, the scapula has three angles: superior, inferior, and
lateral. The large lateral angle features the glenoid cavity or glenoid fossa. This is a shallow
depression for articulating with the humeral head of the shoulder joint. The glenoid is
translated from Greek as a socket of a joint. On the anterior surface, the scapula has a large
subscapular fossa where the muscle called subscapularis originates from. Projecting
anteriorly from the lateral part of the superior scapular surface, is the coracoid process.
Coracoid is translated, from Greek, "like a crow's beak“. This process is an attachment point
for the short head of the biceps brachii muscle and a couple other muscles.
In this image we are looking at the posterior aspect of the scapula. The prominent spine can
be easily identified in this view. The spine extends laterally as an acromion. The acromion
means the apex of the shoulder and is a point that can be palpated as the shoulder tip. The
acromion articulates with the distal end of the clavicle at the acromioclavicular joint, which
is important for repositioning of the glenoid fossa and increasing the range of movement.
The spine separates the posterior aspect of the scapula into two fossae: the supraspinous
fossa superiorly and the infraspinous fossa inferiorly. The fossae are shallow depressions.
The supraspinatus and infraspinatus muscles arise from each of these fossae. These
muscles belong to a group of muscles that we call rotator cuff muscles.
The next bone in the upper limb is the humerus. The humerus is a long bone of the arm with
a round head on the proximal end. Just inferior to the head is the anatomical neck. The
proximal end of the humerus features the greater and lesser tubercles and is separated
from the shaft by a surgical neck. On the lateral aspect of the proximal shaft is the deltoid
tuberosity and the spiral (radial) groove immediate below it. At the distal end, two
epicondyles (the lateral and medial) can be identified with corresponding supracondylar
ridges running upwards (these serve as muscle attachment points). The two articular
features participating in the elbow joint are the capitulum which articulates with head of
radius and the trochlea which articulates with the trochlear notch of the ulna.
The next segment of the upper limb is the forearm, in which there are two bones: the radius
and the ulna. The radius is the lateral bone of the forearm. It features the head with the
shallow depression on the proximal end. Pointing anteriorly at the proximal radius is the
radial tuberosity. This serves for the attachment of the tendon of biceps brachii muscle.
Radial shaft gradually widens towards the distal end, which forms the articulation at the
wrist joint. The medial aspect of the distal radius has the ulnar notch for articulating with
the ulnar head. The ulna is the medial bone of the forearm. Unlike the radius or the
humerus, the head of the ulna is located on the distal end. The proximal, posterior aspect
features the olecranon process, which from the Greek word means “the head of the
elbow”. When the elbow is fully flexed, the olecranon forms the most prominent point on
the posterior aspect of the elbow. The anterior surface of the proximal ulna has the
trochlear notch for articulating with the trochlea of the humerus.
The head of the radius is rounded with a shallow depression. This articulates with the
rounded capitulum to allow greater movement. The olecranon and the coronoid process
form the trochlear notch – a somewhat U-shaped structure. This articulates with the
trochlea of the humerus.
Below the trochlear notch the ulnar tuberosity can be identified – for the attachment of the
brachialis muscle. The distal end of the ulna forms the ulnar head that articulates with the
ulnar notch on the radius.
The bones of the head include the 8 carpal bones that are arranged in two rows – the
proximal and distal rows. The proximal row of the carpals articulates at the radiocarpal
(wrist) joint while the distal row articulates with the metacarpals. The five metacarpals
form the palm and dorsum of the hand. The digits are numbered 1 to 5 starting with the
thumb. Each digit is formed by three phalanges: proximal, middle, and distal. Except for the
thumb, which only has two phalanges: the distal and proximal.
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Appendicular Skeleton – Upper Limb

The appendicular skeleton.

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