WINDSOR UNIVERSITY SCHOOL OF MEDICINE MD 1 dr kola

 Also called Collar bone  Elongated S-shaped bone  Has no medullary cavity  First long bone to ossify via intramembranous ossification beginning during the 5 th and 6 th embryonic weeks at the shaft  2 nd Ossification ends between 25 and 31 years

 Has two ends and a shaft  Sternal end also called the medial end is wedge shaped or triangular, articulates with the manubrium of sternum (sternoclavicular joint)  Acromial end is flat and articulates with the acromium of the scapula at the acromioclaviular joint

 Shaft  Medial two thirds of the shaft is convex anteriorly  The lateral one third is flat and concave anteriorly  Surfaces  Superior surface is smooth and lies just deep to platysma muscle and skin.

 The inferior surface is rough due to attachment of ligaments.  Towards the acromial end, the conoid tubercle gives attachment to the conoid ligament which is a part of the medial side of coracoclavicalucular ligament.  The trapezoid line also at the acromial end gives attachment to the trapezoid ligament from the lateral side of the coracoclavicalucular.

 The subclavian groove- Groove for the subclavius muscle in the medial two thirds  Impression for the costoclavicular ligament- Rough depressed oval area that attaches to the 1 st rib and the cla vicle

 Fracture One of the most fractured bones An indirect blow transmitted from an outstretched hand or a fall directly on the shoulder Weakest part of the clavicle is the junction of the medial two thirds and the lateral one third.

 The medial fragment is elevated by the sternocleiodomas -toid muscle  The lateral fragment drops  Greenstick fracture in children

 Also called shoulder blade  On the posteriolateral aspect of the thorax  Overlies 2 nd to 7 th ribs  2 surfaces  3 angles  3 borders

 Surfaces  Posterior surface  Spine:divides it into supraspinous fossa and infraspionous  Spine has a deltoild tuberoisty  Ends distally in a flat acromion  Costal surface  attachment for the subscapularis muscle

 Borders  Medial border also called vertebral border  Lateral or axillary border: runs superiolaterally towards the apex of the axilla (thickest) and ends superiorly in the lateral angle  Superior borders: thinnest and marked with a suprascapular notch near the junction of the medial two thirds and lateral one third

 Arm bone  Largest bone in the upper limb  Articulates with the scapula and ulna  Long bones with two ends and a shaft

 Proximal end  Head, neck and tubercles  Head is rounded for articulataion with the glenoid cavity of the scapula at the glenohumeral joint

 Neck  Anatomical neck and surgical neck  Anatomical neck is the neck that circumscribes the head separating it from the tubercles  Line of attachment of the glenohumeral capsule  Surgical neck: distal to the head and tubercles. Easily fractured

 Tubercles  Greater tubercle which is lateral  Lesser tubercle which is anterior  Intertubercular sulcus or bicipital groove which separates the two, allowing for the passage of long head of biceps brachii

 Shaft has two prominent features  Deltoild tuberousity Lies laterally for attachment of deltoid muscle Radial groove: radial nerve and the deep artery of the arm

 Inferior end of the shaft widens as the sharp medial and lateral supracondylar ridges amd med distally in the medial and altera; epicondles  Distal ends  Condyle: trochlea, capitulum, olecranon,coronoid and radial fossae together with the distal end of the humerus make up the condyle

Condyle as two articular surfaces  Radial head and capitulum  Proximal end of ulna and trochlea Fossae  Anteriorly coronoid fossa recieves the coronoid process of the ulna on flexion full and radial fossa recieves the head of the radius  Posteriolry the olecranon fossa accomadates olecraon process on full extension

 Surgical neck: Axillary nerve and posterior circumflex humeral artery  Midshaft: radial nerve and deep artery of the arm  Supracondylar: Median nerve and brachial artery  Avulsion of medial epicondyle: Ulnar nerve

 Stabilizing bone of the forearm  Medial and longer  Proximal end for articulation  Olecranon and coronoid process  Inferior to the coronoid process is the ulnar tuberosity  Lateral side is the radial notch  Inferior to the radial notch on the shaft is the supinator crest and closer to it is the supinator fossa.

 Shaft is thick and cylindrical proximally but it tapers distally and ends in the ulnar styloid process  The ulna does not participate in the wrist joint

 Lateral and shorter bone of forearm  Proximally head of radius articulates with capitulum of the humerus  Head also articulates with radial notch of ulnar head is covered with articular catilage  The neck of the radius is a constriction distal to the head  Radial tuberosity: demarcates the head from shaft

 Shaft of radius enlarges distally  Distal end on the medial side has an ulnar notch  Lateral side terminates in a radial styloid process larger then ulnar styloid process and extends farther distally  Dorsal tubercle which allows for passage of tendons

 The two bones on the internal aspect have an interroseous border for attachment of the interrouseous membrane of the foream

 Usually a transverse fracture at the same level:  Colle’s fracture: most common fracture. The distal fragment is displaced dorsally  Mechanism: forced dorsiflexion of the outstrecthed hand trying to ease a fall

These small bones give flexibility to the wrist. ‘ SHE LOOKS TOO PRETTY TRY TO CHASE HER’ From lateral to medial, the four carpal bones in the proximal row are the: Scaphoid (G. skaphé, skiff, boat): a boat-shaped bone that articulates proximally with the radius, and has a prominent scaphoid tubercle; it is the largest bone in the proximal row of carpals.

Lunate (L. luna, moon): a moon-shaped bone between the scaphoid and the triquetral bones; it articulates proximally with the radius and is broader anteriorly than posteriorly. Triquetrum (L. triquetrus, three-cornered): a pyramidal bone on the medial side of the carpus; it articulates proximally with the articular disc of the distal radio-ulnar joint.

Pisiform (L. pisum, pea), a small, pea-shaped bone that lies on the palmar surface of the triquetrum. From lateral to medial, the four carpal bones in the distal row Trapezium (G. trapeze, table): a four-sided bone on the lateral side of the carpus; it articulates with the 1st and 2nd metacarpals, scaphoid, and trapezoid bones.

 Trapezoid: a wedge-shaped bone that resembles the trapezium; it articulates with the 2nd metacarpal, trapezium, capitate, and scaphoid bones. Capitate (L. caput, head): a head-shaped bone with a rounded extremity is the largest bone in the carpus; it articulates primarily with the 3rd metacarpal distally, and with the trapezoid, scaphoid, lunate, and hamate. Hamate (L. hamulus, a little hook): a wedge-shaped bone on the medial side of the hand; it articulates with the 4 th and 5th metacarpal, capitate, and triquetral bones; it has a distinctive hooked process, the hook of the hamate, that extends anteriorly.

 Fracture of Scaphoid Most frequently fractured carpal bone Pain experienced on the lateral side of the wrist mostly during dorsiflexion and abduction Avascular necrosis can occur due to loss of blood supply to the proximal part of the scaphoid

 Fracture of Hamate  This may cause injury to the ulnar nerve sometimes the ulnar artery also

It is composed of five metacarpal bones (metacarpals). Each metacarpal consists of a base, shaft, and head. The proximal bases of the meta carpals articulate with the carpal bones, and the distal heads of the metacarpals articulate with the proximal phalanges, and form the knuckles of the hand. The 1st metacarpal (of the thumb) is the thickest and shortest of these bones.

 Fracture of fifth metarcarpal  Common with unskilled boxers who punch with a closed fist

Each digit (finger) has three phalanges except for the first (the thumb), which has only two. Each phalanx has a base proximally, a shaft (body), and a head distally. The proximal phalanges are the largest, the middle ones are intermediate in size, and then distal ones are the smallest. The shafts of the phalanges taper distally. The terminal phalanges are flattened and expanded at their distal ends, which underlie the nail beds.