Lecture on Anatomy: Upper Limb

Introduction

• Greetings and interaction with students
• Mention of different universities and year groups
• Focus on teaching anatomy relevant for life and exams
• Encouragement to take notes and focus during the session

Upper Limb Anatomy

Introduction to Anatomy

• Anatomy teaching relevant for life and exams, covering question banks like DAMS, Marrow, etc.
• PDF notes to be shared post-session via Telegram

Clavicle

• Key Points:
  • S-shaped bone
  • Horizontal bone, subcutaneous throughout
  • First bone to ossify in the body, ossifies during the 5th and 6th week of intrauterine life
• Fractures:
  • Most commonly fractured bone
  • Updated fracture site: Medial 3/5th and lateral 2/5th
  • No medullary cavity
• Joints:
  • Sternoclavicular Joint: Saddle joint
  • Acromioclavicular Joint: Plane synovial joint

Scapula

• Features:
  • Superior and inferior angles, medial and lateral borders
  • Spine of scapula, acromion process, coracoid process, glenoid cavity
• Fractures:
  • Lateral border is the thickest
  • Clavicle palpable in the infraclavicular fossa
• Clinical Points:
  • Winged scapula from issues with serratus anterior or trapezius
  • Congenital high scapula (Sprengel deformity) associated with Klippel-Feil syndrome

Humerus

• Parts:
  • Head, neck (anatomical and surgical), shaft
  • Greater and lesser tuberosity
• Fracture Points:
  • Surgical neck fracture affects axillary nerve and circumflex vessels
  • Shaft fracture affects radial nerve
  • Medial epicondyle fracture affects ulnar nerve
  • Supracondylar region fracture affects median nerve

Radius and Ulna

• Fracture Types:
  • Colles' Fracture: Distal radius end upward (dinner fork deformity)
  • Smith's Fracture: Distal radius end downward (garden spade deformity)
  • Barton Fracture: Involves radiocarpal displacement
  • Monteggia Fracture: Upper 1/3 ulna fracture with radial head dislocation
  • Galeazzi Fracture: Lower 1/3 radius fracture with inferior radioulnar joint dislocation

Carpal Bones

• Mnemonic: "She Likes To Play, Try To Catch Her"
  • Scaphoid, Lunate, Triquetrum, Pisiform, Trapezius, Capitate, Hamate
• Fractures:
  • Most common fracture: Scaphoid
  • Most common dislocation: Lunate
  • Largest carpal bone: Capitate
  • First to ossify: Capitate
• Metacarpals:
  • Bennett's fracture (first metacarpal base)
  • Boxer's fracture (fifth metacarpal neck)

Muscles of the Pectoral Region

• Pectoralis Major and Minor
  • Major: Flexion, medial rotation, adduction of arm
• Subclavius and Serratus Anterior
  • Serratus Anterior: Protraction of scapula, innervated by long thoracic nerve
  • Key muscle of axilla: Support and division for axillary artery
• Clinical Points:
  • Poland syndrome: Absence of pectoralis major muscle
  • Winging of scapula: Long thoracic nerve injury

Clavipectoral Fascia

• Located between clavicle and pectoralis minor
• Structures piercing it: Thoracoacromial artery, cephalic vein, lateral pectoral nerve, lymphatics

Breast Anatomy

• Location: Superficial fascia, lies from 2nd to 6th rib
• Quadrants: Highest cancer risk in superior lateral quadrant
• Muscles in relation: Pectoralis major, serratus anterior, external oblique
• Blood Supply: Internal thoracic artery (internal mammary), lateral thoracic artery, acromiothoracic artery, posterior intercostal arteries
• Lymphatic Drainage: Primarily to axillary lymph nodes

Summary

• Session includes a detailed discussion of upper limb anatomy
• Future sessions will continue with topics and integrate clinical contexts

Note: The notes include key anatomical points, clinical relevance, and frequently asked exam questions.