1. DR VINIT K ASHOK ADJUNCT FACULTY
UPPER EXTREMITY-2
DR VINIT K ASHOK
ADJUNCT FACULTY

2. BLOOD SUPPLY ARTERIAL SUPPLY -SUBCLAVIAN ARTERY(NECK)
- AXILLARY ARTERY( UPPER ARM;UPTO LOWER BORDER OF TERES MAJOR)
BRACHIAL ARTERY(LOWER PART OF ARM)
RADIAL ARTERY( LATERAL)
ULNAR ARTERY( MEDIAL),COMMON INTEROSSEOUS
PALMAR ARCHES
DIGITAL

3. VEINS OF UPPER LIMB SUPERFICIAL VEINS DORSAL VENOUS NETWORK
CEPHALIC VEIN
BASILIC VEIN
AXILLARY VEIN( BASILIC+ BRACHIAL VEIN)
MEDIAN CUBITAL VEIN
MEDIAN VEIN OF FOREARM
DEEP VEINS
NAMED ACCORDING TO COMPANIAN ARTERIES
RADIAL VEIN
ULNAR VEIN
BRACHIAL VEIN
AXILLARY VEIN

4. SURFACE ANATOMY ACROMION CLAVICLE DELTOID ( IM INJECTIONS) HUMERUS
BICEPS MUSCLE
BICIPTAL GROOVE
BRACHILA PULSE( BLOOD PRESSURE)
TRICEPS
OLECRNON PROCESS( PT OF THE ELBOW)
MEDIAL /LATERAL EPICONDYLES
TRIANGLE
CUBITAL FOSSA
MEDIAN CUBITAL VEIN- IV
CEPHALIC VEIN
ULNA
RADIUS
STYLOID PROCESS
RADIAL ARTERY( PULSE)
ULNAR ARTERY
ANATOMICAL SNUFF BOX
THENAR EMINENC
HYPOTHENAR EMINENCE
CARPAL TUNNEL

9. CUBITAL FOSSA

10. CUBITAL FOSSA

11. STYLOID PROCESS

12. ANATOMICAL SNUFF BOX

13. AXILLA( ARMPIT) CONTENTS -AXILLARY LYMPH NODES -AXILLARY ARTERY /VEIN
PYRAMIDAL SPACE BETWEEN THE UPPER LATERAL CHEST AND THE INNERSIDE OF THE ARM
BOUNDARIES
-APEX –( BETWEEN THE CLAVICLE,SCAPULA AND 1ST RIB)
-BASE-(AXILLARY FASCIA)
-ANTERIOR ( PECTORALIS MAJOR AND MINOR MUSCLES)
-POSTERIOR( SUBSCAPULARIS,LATISSIMUS DORSI AND TERES MAJOR)
MEDIAL- ( FIRST 4 RIBS AND SERRATUS ANTERIOR MUSCLE)
LATERAL-( BICEPETAL GROOVE OF THE HUMERUS)
CONTENTS
-AXILLARY LYMPH NODES
-AXILLARY ARTERY /VEIN
-BRACHIAL PLEXUS

14. BRACHIAL PLEXUS PLEXUS- IS A NETWORK OF NERVES BRACHIAL PLEXUS-
FOUND IN THE NECK AND AXILLA
FORMED BY VENTRAL RAMI OF C5- C8 AND T1 ( THERE MAY BE CONTRIBUTIONS FROM C4, T2)
GIVES RISE TO NERVES THAT SUPPLY THE UPPER LIMB
FORMATION
ROOTS- C5-C8 AND TI( VENTRAL RAMI)
TRUNKS-UPPER , MIDDLE, LOWER
DIVISONS-ANTERIOR/POSTERIOR
CORDS-MEDIAL/LATERAL/POSTERIOR
ROOTS FORMATION OF TRUNKS C5 C6 C7 C8 T1
UPPER
MIDDLE
LOWER
FORMED IN THE NECK

15. DIVISIONS AND CORDS OF BRACHIAL PLEXUS
TRUNKS DIVISIONS CORDS
UPPER TRUNK
MIDDLE TRUNK
LOWER TRUNK
PINK-ANTERIOR DIVISION
BLUE -POSTERIOR DIVISION
LATERAL CORD-ANTERIOR DIVISIONS OF UPPER AND MIDDLE TRUNK
POSTERIOR CORD-POSTERIOR DIVISIONS OF ALL TRUNKS
MEDIAL CORD-ANTERIOR DIVISION OF LOWER TRUNK
CORDS ARE NAMED ACCORDING TO THEIR RELATIVE POSITIONS TO THE AXILLARY ARTERY

16. BRACHIAL PLEXUS

18. NERVES ARISING FROM THE CORDS
MEDIAL CORD
MEDIAL CUTANEOUS NERVE OF ARM- CUTANEOUS SUPPLY TO SKIN
MEDIAL CUTANEOUS NERVE OF FOREARM-CUTANEOUS SUPPLY TO THE SKIN
MEDIAL ROOT OF MEDIAL NERVE- JOINS WITH LATERAL ROOT TO FORM MEDIAN NERVE
ULNAR NERVE
MEDIAL PECTORAL NERVE
LATERAL CORD
LATERAL ROOT OF MEDIAN NERVE
MUSCULOCUTANEOUS NERVE
LATERAL PECTORAL NERVE

19. NERVES FROM THE POSTERIOR CORD
1. UPPER SUBSCAPULAR NERVE
2.LOWER SUBSCAPULAR NERVE
3.THORACODORSAL NERVE
4. RADIAL NERVE
5. AXILLARY NERVE

20. IMPORTANT NERVES AND AREA OF SUPPLY
1. MEDIAN NERVE( FORMED FROM BOTH MEDIAL AND LATERAL CORD)-
A) SUPPLIES ALL THE FLEXORS OF THE FOREARM( EXCEPT FLEXOR CARPI ULNARIS AND MEDIAL HALF OF FDP)
B) INTRINSIC MUSCLES IN THE LATERAL PALM INCLUDING THENAR EMINENCE)
2. ULNAR NERVE
A) SUPPLIES THE MEDIAL HALF OF FDP AND THE FLEXOR CARPI ULNARIS
B) SUPPLIES MOST OF THE INTRINSIC MUSCLES OF THE HAND INCLUDING THE HYPOTHENAR EMINENCE, AND SKIN ON THE MEDIAL SIDE OF THE HAND
CLINICAL APPLICATION
*INJURY TO MEDIAN NERVE-” APE HAND”
INJURY TO ULNAR NERVE-” CLAW HAND”

21. INPORTANT NERVES AND THEIR AREA OF SUPPLY
MUSCULOCUTANEOUS NERVE
SUPPLIES THE BICEPS, CORACOBRACHIALIS AND BRACHIALIS
AXILLARY NERVE
SUPPLIES THE DELTOID AND TERES MINOR MUSCLE
SUPPLIES THE SHOULDER JOINT
RADIAL NERVE
SUPPLIES THE TRICEPS
SUPPLIES THE BRACHIORADIALIS
SUPPLIES MOST OF THE EXTENSORS OF THE FOREARM
* INJURY RESULTS IN “ WRIST DROP”

22. CARPAL TUNNEL
TUNNEL FORMED BETWEEN THE CONCAVITY OF THE CARPAL BONES AND A LIGAMENT THAT COVERS THIS( FLEXOR RETINACULAM)
TENDONS OF THE FLEXORS PASS THROUGH
MEDIAN NERVE ALSO PASSES THROUGH
CROWDED TUNNEL
CARPAL TUNNEL SYNDROME
CAUSED DUE TO COMPRESSION OF THE NERVE IN THE TUNNEL
CAUSES-
1. SWELLING OF THE TEDONS( OVERUSE)
2. PREGNANCY( EDEMA)
3. ARTHRITIS
SYMPTOMS- TINGLING OR NUMBNESS-LATERAL PART OF HAND, WEAKNESS IN THUMB MOVEMENT
TREATMENT- REST, SPLINTING,ANTI-INFLAMMATORY DRUGS, SURGERY

23. LINE BETWEEN EPICONDYLES
CUBITAL FOSSA
TRIANGULAR DEPRESSION ON THE ANTERIOR ASPECT OF ELBOW
BOUNDARIES
-BASE- LINE DRAWN BETWEEN THE EPICONDYLES OF THE HUMERUS
LATERAL BOUNDARY-BRACHIORADIALIS
MEDIAL BOUNDARY- PRONATOR TERES
APEX- WHERE THE MEDIAL AND LATREAL BOUNDARY MEET
CONTENTS
MEDIAL CUBITAL VEIN
BRACHIAL ARTERY
TENDON OF THE BICEPS
LINE BETWEEN EPICONDYLES
PRONATOR TERES
BRACHIORADIALIS

24. CUTANEOUS INNERVATION OF HAND( ANTERIORLY)
LATREAL 31/2 FINGERS AND LATERAL PALM – MEDIAN NERVE
MEDIAL 11/2 FINGERS AND MEDIAL PALM- ULNAR NERVE

25. CUTANEOUS NERVE SUPPLY HAND ( POSTERIORLY)
MEDIAL 11/2 FINGERS AND HAND- ULNAR NERVE
TIPS OF FINGERS LATERAL 31/2 FINGERS- MEDIAN NERVE
REST OF LATERAL 31/2 FINGERS AND HAND - RADIAL NERVE