Date post: | 06-Apr-2018 |
Category: |
Documents |
Upload: | johnrev-fundal-lopez-lorenzo |
View: | 226 times |
Download: | 0 times |
of 83
8/3/2019 (Gen Ana) Arm and Cubital Fossa
1/83
ARM
andCUBITAL FOSSA
By: Neil Dolendo
Marian Dale Escalona
Ma. Andrea Indadao
Monnel Loise Ordinario
8/3/2019 (Gen Ana) Arm and Cubital Fossa
2/83
Arm
is the part of the upper limb between the shoulderand the elbow joints.
It is adapted for precise positioning of the hand and thus assist in the
hand's manipulative tasks.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
3/83
Brachial Fascia
o Deep fascia of the arm
o It is a sleeve of connective tissue that continuous at proximal end with the
pectoral fascia, the axillary fascia and the deep fascia that covers the
deltoid and latissimus dorsi muscles.
o It is connected to the medial and lateral sides of the humerus by the
intermuscular septa, creating an anterior compartment and a posterior
compartment for the muscles of the arm.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
4/83
Brachial Fascia
Brachial Fascia
8/3/2019 (Gen Ana) Arm and Cubital Fossa
5/83
Anterior (flexor) Compartment of Arm
Muscles: Biceps Brachii, coracobrachialis, and brachialis.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
6/83
Blood Supply: Brachial artery
Anterior (flexor) Compartment of Arm
8/3/2019 (Gen Ana) Arm and Cubital Fossa
7/83
8/3/2019 (Gen Ana) Arm and Cubital Fossa
8/83
Anterior (flexor) Compartment of Arm
Structures passing through the compartments: Musculocutaneous, medianand ulnar nerves; brachial artery and basilic vein.
Musculocutaneous Nerve
Median Nerve
Ulnar Nerve
Brachial Artery
Basilic
Vein
8/3/2019 (Gen Ana) Arm and Cubital Fossa
9/83
Anterior (flexor) Compartment of Arm
8/3/2019 (Gen Ana) Arm and Cubital Fossa
10/83
Muscles of the Anterior Compartment
Biceps Brachii
a two-headed muscle located on the upper arm.
Both of its heads arise on the scapula and join to form a single
muscle belly which is attached to the upper forearm.
While the biceps crosses both the shoulderand elbow joints,
its main function is at the latter where it flexes the elbowand supinates the forearm.
Both these movements are used when opening a bottle with a
corkscrew: first biceps unscrews the cork (supination), then it
pulls the cork out (flexion).
8/3/2019 (Gen Ana) Arm and Cubital Fossa
11/83
Muscles of the Anterior Compartment
Biceps Brachii
Origin:long head: supraglenoid tubercle
short head: coracoid process (apex)
long head:
supraglenoidtubercle
short head:
coracoidprocess (apex)
8/3/2019 (Gen Ana) Arm and Cubital Fossa
12/83
Insertion:
radial tuberosity
Muscles of the Anterior Compartment
Biceps Brachii
Radial Tuberosity
8/3/2019 (Gen Ana) Arm and Cubital Fossa
13/83
Muscles of the Anterior Compartment
Biceps Brachii
Innervation:musculocutaneous nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
14/83
8/3/2019 (Gen Ana) Arm and Cubital Fossa
15/83
Muscles of the Anterior Compartment
Lond head
Short head
Biceps Brachii
8/3/2019 (Gen Ana) Arm and Cubital Fossa
16/83
Muscles of the Anterior Compartment
Coracobrachialis
Origin:
coracoid process (apex)
Origin
8/3/2019 (Gen Ana) Arm and Cubital Fossa
17/83
Muscles of the Anterior Compartment
Coracobrachialis
Insertion:
mid-shaft of humerus (medial side)
Insertion
mid-shaft of
humerus
(medial side)
8/3/2019 (Gen Ana) Arm and Cubital Fossa
18/83
Muscles of the Anterior Compartment
Coracobrachialis
Innervation:musculocutaneous nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
19/83
Muscles of the Anterior Compartment
Coracobrachialis
Function:helps flex and adduct arm
stabilize glenohumeral joint
8/3/2019 (Gen Ana) Arm and Cubital Fossa
20/83
8/3/2019 (Gen Ana) Arm and Cubital Fossa
21/83
It makes up part of the floor of the region known as the cubital
fossa.
Muscles of the Anterior Compartment
Brachialis
The brachialis (brachialis anticus) is a muscle in the upper arm that
flexes the elbow joint.
It lies deeper than the biceps brachii, and is a synergist that assists
the biceps brachii in flexing at the elbow.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
22/83
Muscles of the Anterior Compartment
Brachialis
Origin:
distal half of humerus (anterior)
distal half of
humerus
(anterior)
8/3/2019 (Gen Ana) Arm and Cubital Fossa
23/83
Muscles of the Anterior Compartment
Insertion:tuberosity of ulna
Brachialis
tuberosity of ulna
8/3/2019 (Gen Ana) Arm and Cubital Fossa
24/83
Muscles of the Anterior Compartment
Innervation:musculocutaneous nerve
Brachialis
8/3/2019 (Gen Ana) Arm and Cubital Fossa
25/83
Muscles of the Anterior Compartment
Function:
pure flexor of forearm, in all directions
Brachialis
8/3/2019 (Gen Ana) Arm and Cubital Fossa
26/83
Muscles of the Anterior Compartment
Brachialis
8/3/2019 (Gen Ana) Arm and Cubital Fossa
27/83
Muscles of the Anterior Compartment
8/3/2019 (Gen Ana) Arm and Cubital Fossa
28/83
Structures Passing through the Anterior Compartment
Brachial Artery
o It begins at the lower border of the teres major muscle as a
continuation of the axillary artery.
o It provides the arterial supply of the arm.
o It terminates opposite neck of the radius by dividng into the radial
and ulnar arteries.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
29/83
Structures Passing through the Anterior Compartment
8/3/2019 (Gen Ana) Arm and Cubital Fossa
30/83
Structures Passing through the Anterior Compartment
Brachial Artery
8/3/2019 (Gen Ana) Arm and Cubital Fossa
31/83
Brachial Artery
Structures Passing through the Anterior Compartment
Branches:
Muscular branches to the anterior compartment of the upper arm.
Nutrient Artery to the humerus.
Profunda Artery arises near the beginning of the brachial artery and
follows the radial nerve into the spiral nerve of the humerus.
Superior Ulnar Collateral Artery arises near the middle of the middle arm
and follows the ulnar nerve.
Inferior Ulnar Collateral Artery arises near the termination of the arteryand takes part in the anastomosis around the elbow joint.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
32/83
Structures Passing through the Anterior Compartment
or Profunda Artery
8/3/2019 (Gen Ana) Arm and Cubital Fossa
33/83
8/3/2019 (Gen Ana) Arm and Cubital Fossa
34/83
Structures Passing through the Anterior Compartment
8/3/2019 (Gen Ana) Arm and Cubital Fossa
35/83
Structures Passing through the Anterior Compartment
Musculocutaneous
Nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
36/83
Structures Passing through the Anterior Compartment
Branches:
Musculocutaneous Nerve
Muscular branches to the biceps, coracobrachialis, and brachialis.
Cutaneous branches the lateral cutaneous nerve of the forearmsupplies the skin of the front and lateral aspects of the forearm down
as far as the root of the thumb.
Articular branches to the elbow joint.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
37/83
Structures Passing through the Anterior Compartment
Median Nerve
It runs downward on the lateral side of the brachial artery
Halfway down the upper arm, it brachial artery and continuous downward
on its medial side.
It has no branches in the upper arm, except for a small vasomotor nerve
to the brachial artery.
Nerve origin C5-T1, which is a branch of the lateral and medial cords of
the brachial plexus.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
38/83
Structures Passing through the Anterior Compartment
8/3/2019 (Gen Ana) Arm and Cubital Fossa
39/83
Structures Passing through the Anterior Compartment
Median Nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
40/83
Structures Passing through the Anterior Compartment
Ulnar Nerve
It runs downward on the medial side of the brachial artery as far as
the middle of the arm.
At the insertion of the coracobrachialis, the nerve pierces the medial
fascial septum, accompanied by the superior ulnar collateral artery
and enters posterior compartment of the arm.
It has no branches in the anterior compartment of the upper arm.
Its origin C8-T1, is a continuation of the medial cord of the brachial
plexus.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
41/83
Structures Passing through the Anterior Compartment
8/3/2019 (Gen Ana) Arm and Cubital Fossa
42/83
Structures Passing through the Anterior Compartment
UlnarNerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
43/83
Structures Passing through the Anterior Compartment
Radial Nerve
The radial nerve is a nerve in the human body that supplies theupper limb.
It supplies the medial and lateral head triceps brachii muscle of
the arm, as well as all 12 muscles in the posterior osteofascial
compartment of the forearm, as well as the associated joints and
overlying skin.
It originates from the posterior cord of the brachial plexus with
roots from C5, C6, C7, C8 & T1.
It supplies the dorsal muscles, such as triceps brachii, the
extrinsic extensors of the wrist and hands, and the cutaneous nerve
supply to most of the back of the hand.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
44/83
Structures Passing through the Anterior Compartment
8/3/2019 (Gen Ana) Arm and Cubital Fossa
45/83
Structures Passing through the Anterior Compartment
Radial Nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
46/83
Posterior (Extensor) Compartment of Arm
8/3/2019 (Gen Ana) Arm and Cubital Fossa
47/83
Posterior Compartment of Arm
Muscles: the three heads of the triceps muscle.
Lateral Head of Triceps
Long Head of Triceps
Median Head of Triceps
8/3/2019 (Gen Ana) Arm and Cubital Fossa
48/83
Posterior Compartment of Arm
Blood Supply: Profunda brachii and ulnar collateral arteries.
Profunda brachii artery
Anterior ulnar collateral artery
Posterior ulnar collateral artery
8/3/2019 (Gen Ana) Arm and Cubital Fossa
49/83
Posterior Compartment of Arm
Nerve Supply of the Muscles: Radial nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
50/83
Posterior Compartment of Arm
Structures passing through the compartments: Radial nerve and ulnar
nerve.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
51/83
Origin:
long head: infraglenoid tubercle
lateral head: humerus (posterior,
superior to radial groove)
medial head: humerus (posterior)
Muscles of the Posterior Compartment
Triceps
8/3/2019 (Gen Ana) Arm and Cubital Fossa
52/83
Insertion: Olecranon
Muscles of the Posterior Compartment
Triceps
8/3/2019 (Gen Ana) Arm and Cubital Fossa
53/83
Innervation:radial nerve
Muscles of the Posterior Compartment
Triceps
Radial nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
54/83
Function:extensor of forearm
long head: extend and adduct arm,
shunt muscle
Muscles of the Posterior Compartment
Triceps
8/3/2019 (Gen Ana) Arm and Cubital Fossa
55/83
Muscles of the Posterior Compartment
Triceps
8/3/2019 (Gen Ana) Arm and Cubital Fossa
56/83
Structures Passing through the Posterior Compartment
Radial Nerve
Its origin is from the posterior cord of the brachial plexus in the axilla.
The nerve winds around the back of the arm, first between the long
and medial heads of the triceps, then the spiral groove on the back of
the humerus, between the lateral and medial heads of the triceps.
It pierces the lateral fascial septum above the elbow and continuous
downward into the cubital fossa in front of the elbow, between the
brachialis and brachioradialis muscles.
In the spiral groove, the nerve is accompanied by the profundavessels, and lies directly in the contact with the shaft of the humerus.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
57/83
Structures Passing through the Posterior Compartment
Radial Nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
58/83
Structures Passing through the Posterior Compartment
Radial Nerve
Branches:
In the axilla: Branches are given to the long and medial heads of the
triceps, and the posterior cutaneous nerve of the arm is given off.
In the spiral groove: Branches are given to the lateral and medial heads of
the triceps and to the anconeus. The lower lateral nerve of the arm supplies the skin over the
lateral and the anterior aspects of the lower parts of the arm.
The posterior cutaneous nerve of the forearm runs down the
middle of the back of the forearm as far as the wrist.
In the anterior compartment of the arm: After the nerve has piearced
the lateral fascial septum, it gives branches to the brachialis,
brachioradialis, and the extensor carpi radialis longus muscle. It also
gives articular branches.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
59/83
Structures Passing through the Posterior Compartment
Ulnar Nerve
Having pierced the medial fascial septum halfway down the upper arm,the ulnar nerve descends behind the septum, covered posteriorly by the
medial head of the triceps.
The nerve is accompanied by the superior ulnar collateral vessels.
At the elbow, it lies behind the medial epicondyle of the humerus on
the medial ligamentof the elbow joint.
It continuous downward to enter the forearm between the two heads
of the origin of the flexor carpi ulnaris.
It has an articular branch to the elbow joint.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
60/83
Structures Passing through the Posterior Compartment
UlnarNerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
61/83
Structures Passing through the Posterior Compartment
Profunda Brachii Artery
Arises from the brachial artery near its origin.
It accompanies the radial nerve through the spiral groove.
Supplies the triceps muscle.
Takes part in the anastomosis around the elbow joint.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
62/83
Structures Passing through the Posterior Compartment
Profunda Brachii Artery
8/3/2019 (Gen Ana) Arm and Cubital Fossa
63/83
Structures Passing through the Posterior Compartment
Superior and Inferior Ulnar Collateral Arteries
Arise from the brachial artery.
Takes part in the anastomosis around the elbow joint
8/3/2019 (Gen Ana) Arm and Cubital Fossa
64/83
Structures Passing through the Posterior Compartment
Superior Collateral Artery
Inferior Collateral Artery
8/3/2019 (Gen Ana) Arm and Cubital Fossa
65/83
Cubital FossaIs a depression in the anterior part of the elbow.
Clinically important because it contains superficial veins that are used
foe venipuncture.
Large nerves and vessels pass through this region to enter the forearm.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
66/83
Bounderies of the Cubital Fossa
Lateral boundary- brachioradialis
8/3/2019 (Gen Ana) Arm and Cubital Fossa
67/83
Medial boundary- pronator tere muscle
Bounderies of the Cubital Fossa
8/3/2019 (Gen Ana) Arm and Cubital Fossa
68/83
Bounderies of the Cubital Fossa
Superior boundary- an imaginary line connecting the medial and lateral
epicondyles of the humerus.
Lateral Epicodyle Medial Epicodyle
8/3/2019 (Gen Ana) Arm and Cubital Fossa
69/83
Superficial boundary (roof of the cubital fossa) - antebrachial fascia
reinforced by the bicipital aponeurosis.
Bounderies of the Cubital Fossa
8/3/2019 (Gen Ana) Arm and Cubital Fossa
70/83
Deep boundary (floor of the cubital fossa) brachialis and supinator
muscles.
Bounderies of the Cubital Fossa
Contents
8/3/2019 (Gen Ana) Arm and Cubital Fossa
71/83
Contents
The cubital fossa contains four main vertical structures (from lateral to medial):
The radial nerve is in the vicinity of the cubital fossa, located
between brachioradialis and brachialis muscles. It is often but not
always considered part of the cubital fossa.
Radial nerve
Contents
8/3/2019 (Gen Ana) Arm and Cubital Fossa
72/83
The biceps brachii tendon
Contents
Contents
8/3/2019 (Gen Ana) Arm and Cubital Fossa
73/83
The brachial artery. The artery usually bifurcates near the apex
(inferior part) of the cubital fossa into the radial artery (superficial)
and ulnar artery (deeper).
Contents
Brachial artery
Contents
8/3/2019 (Gen Ana) Arm and Cubital Fossa
74/83
The median nerve
Contents
Median nerve
8/3/2019 (Gen Ana) Arm and Cubital Fossa
75/83
Skeleton of the Arm and Cubital Region
Humerus
It is the bone of the arm that joins with the scapula above inthe shoulder at the glenohumeral joint and with the ulna and radius
below at the elbow.
The elbow joint is the hinge joint between the distal end of the
humerus and the proximal ends of the radius and ulna.
It cannot be broken easily. Its strength allows it to handle loading up
to 300 pounds (140 kg.).
Skeleton of the Arm and Cubital Region
8/3/2019 (Gen Ana) Arm and Cubital Fossa
76/83
Medial Epicondyle
Skeleton of the Arm and Cubital Region
Humerus
Medial
Epicondyle
- Is larger and more prominent than the
lateral epicondyle, is directed a little
backward.
8/3/2019 (Gen Ana) Arm and Cubital Fossa
77/83
Lateral Epicondyle
Skeleton of the Arm and Cubital Region
Lateral Epicondyle
Humerus
is a small, tuberculated eminence, curved a
little forward, and giving attachment to the radial
collateral ligament of the elbow-joint, and to a
tendon common to the origin of the Supinator
and some of the Extensor muscles.
Skeleton of the Arm and Cubital Region
8/3/2019 (Gen Ana) Arm and Cubital Fossa
78/83
Olecranon Fossa
Skeleton of the Arm and Cubital Region
Humerus
Olecranon Fossa
- Above the back part of the trochlea
of the humerus is a deep triangular
depression, the olecranon fossa, in
which the summit of the olecranon is
received in extension of the forearm.
Sk l t f th A d C bit l R i
8/3/2019 (Gen Ana) Arm and Cubital Fossa
79/83
Skeleton of the Arm and Cubital Region
Radius
Headis the bone of the forearm that extendsfrom the lateral side of the elbow to the
thumb side of the wrist. The radius is
situated on the lateral side of the ulna,
which exceeds it in length and size. It is a
long bone, prism-shaped and slightly
curved longitudinally.
Sk l t f th A d C bit l R i
8/3/2019 (Gen Ana) Arm and Cubital Fossa
80/83
Skeleton of the Arm and Cubital Region
Radius
Neck
Sk l t f th A d C bit l R i
8/3/2019 (Gen Ana) Arm and Cubital Fossa
81/83
Skeleton of the Arm and Cubital Region
Radius
RadialTuberosity
Sk l t f th A d C bit l R i
8/3/2019 (Gen Ana) Arm and Cubital Fossa
82/83
Skeleton of the Arm and Cubital Region
Ulna
Olecranon Olecranon
Olecranon
- the inner and longer of the two bones of
the human forearm which is fused to the
radius
8/3/2019 (Gen Ana) Arm and Cubital Fossa
83/83