Laboratory Identifications and Relations -- Upper Limb (updated 1998)
The Structural Basis of Medical Practice -
Human Gross Anatomy
The Pennsylvania State University College of Medicine
Shoulder Region - Posterior View: Scapular anastomosis,
nerves, and related structures
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transverse cervical a. (superficial branch): lateral
to levator scapula, anterior surface of trapezius
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spinal accessory n. - lateral to levator scapula, anterior
surface of trapezius
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dorsal scapular n. - medial to levator scapula, anterior
surface of rhomboids
-
dorsal scapular a. - medial to levator scapula, anterior
surface of rhomboids
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dorsal scapular a. and n. - along medial border of scapula
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suprascapular n. a. - medial to transverse scapular
notch
-
suprascapular n. - lateral and just inferior to transverse
scapular ligament (shown passing through foramen)
-
suprascapular a. - superior to transverse scapular lagament
(shown not passing through foramen)
-
suprascapular n. a. - in infraspinous fossa
-
lateral branch intercostal a. - entering serratus anterior
near medial border of scapula
-
circumflex scapular a. - posterior view in triangular
space
-
circumflex scapular a. - in infraspinous fossa within
teres minor
-
end to end anastomosis between suprascapular a. and
circumflex scapular a.
-
circumflex scapular a. tagged - tag reads "direction
of blood flow when 2nd part axillary a. is ligated."
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dorsal scapular n. - tag reads "actions of innervated
muscles?"
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serratus anterior indicated near vertebral border of
scapular at insertion - tag reads "action of indicated structure"
-
upper subscapular n. - window dissected through serratus
anterior to show subscapularis (diabolical)
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axillary n. branch to teres minor - tag reads "fuctional
deficit following damage to the indicated structure"
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axillary n. within quandrangular space
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posterior humeral circumflex a. within quandrangular
space
Shoulder capsule, joint, and related structures
-
corocoid process - tag reads "what muscle(s) inserts
here?"
-
corocoacromial lig. - from corocoid process to acromion,
ligamentous part of coracoacromial arch
-
subacromial bursa - separated from synovial cavity of
joint by the supraspinatus tendon
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supraspinatus tendon - shown blending with joint capsule
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subscapularis tendon - shown blending with joint capsule
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infraspinatus tendon - shown blending with joint capsule
-
teres minor tendon - shown blending with joint capsule
-
corococlavicular ligs. (conoid and trapezoid) - tag
reads "rupture of the indicated structures is called?"
-
long head biceps tendon - within joint capsule of intact
capsule (a window dissection through supraspinatus tendon)
-
glenohumeral ligaments - three ligaments (superior,
middle, and inferior) all related to the supraglenoid tubercle and the
anterior joint capsule
-
glenoid labrum - deepening the circumference of the
glenoid fossa
-
anterior humeral circumflex a. - show near lesser tubercle
-
posterior humeral circumflex a. - shown near greater
tubercle
Axilla
-
lateral cord - at level of clavical
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lateral pectoral n. - entering pectoralis minor or major
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lateral root median n. - shown as leg of "M"
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musculotaneous n. - entering coracobrachialis
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medial cord - at level of clavical
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medial brachial cutaneous n. - in axilla
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medial antebrachial cutaneious n. - in axilla
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medial root of median n. - shown as "leg" of "M"
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median N. - distal apex of "M"
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posterior cord - at level of clavical
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upper subscapular n. - medial in axilla entering subscapularis
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middle subscapular n. (thoracodorsal n.) - in axilla
entering latissimus dorsi
-
lower subscapular n. - posterior course sending lateral
branch past subscapularis to teres major
-
lower subscapular n. branch to teres major - shown from
a posterior view
-
axillary n. - entering the quadrangular space
-
posterior humeral circumflex a. - show in quadrangular
space with accompanying axillary n.
-
radial n. - crossing anterior aspect of teres major
as it leaves axilla
-
supreme thoracic a. - at first and second intercostal
region
-
thoracoacromial trunk - deep to overlying pectoralis
minor
-
lateral thoracic a. - either from axillary or subscapular
arteries, applied to lateral surface of serratus anterior
-
anterior humeral circumflex a. - often a group of two
or more aa.
-
subscapular a. - perhaps the largest branch off axillary
artery (brachial excepted)
-
circumflex scapular a. - entering triangular space,
terminal branch of subscapular artery
-
thoracodorsal a. - coursing inferiorly along anterior
border of lattissimus dorsi
-
latertal thoracic a. - branching from thoracodorsal
a. in some cases
Arm - Anterior Compartment
-
transverse humeral ligament
-
tendon long head biceps - through window in transverse
humeral ligament
-
brachial a. - at level of inferior free edge of teres
major
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profunda brachaii - at origin
-
ascending branch of profunda brachaii - at origin
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radial n. - entering triangular interval
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superior ulnar collateral a. - at origin
-
inferior ulnar collateral a. - at origin
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musculocutaneous n. - emerging from the lateral side
of coracobrachialis
-
lateral antebrachial cutaneous n. - between biceps and
brachialis
-
lateral antebrachial cutaneous n. - piercing deep fascia
lateral to insertion of biceps
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ulnar n. - piercing medial intermuscular septum
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ulnar n. - entering ulnar groove
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ulnar n. - between heads of flexor carpi ulnaris
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radial n. - piercing lateral intermuscular septum
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radial n. - between brachialis and brachioradialis
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median n. - crossing the brachial a.
-
bicipital aponeurosis - blending with fascia of flexor
carpi ulnaris
-
median n. - in cubital fossa medial to brachial artery
and medial to biceps tendon
-
brachial a. - in cubital fossa lateral to median nerve
and medial to biceps tendon
-
median n. - leaving cubital fossa between heads of pronator
teres
-
brachial a. - in cubital fossa
-
biceps tendon - inserting on radial tuberosity
-
brachialis insertion - at coronoid process
Arm - Posterior Compartment
-
posterior humeral circumflex a. - on neck of humerus
-
ascending branch profunda brachii - on surface of lateral
head triceps
-
profunda brachii - sprial groove
-
middle collateral a. - terminal branch of profunda brachii
-
radial collateral a. - terminal branch of profunda brachii
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radial collateral a. - lateral intermuscular septum
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radial n. - triangular interval
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radial n. - spiral groove
-
radial n. - lateral intermuscular septum
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medial head triceps - origin inferior to spiral groove
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lateral head triceps - origin superior to spiral groove
Elbow Anastomosis
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radial collateral a. - between brachioradialis and brachialis
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radial recurrent a. - between biceps tendon and brachioradialis
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middle collateral a. - related to lateral head triceps
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interosseous recurrent a. - deep to anconeus on posterior
surface of superior radioulnar ligament
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inferior ulnar collateral a. - between brachialis and
humeral head of pronator teres
-
anterior ulnar ulnar recurrent a. - between brachialis
and humeral head of pronator teres
-
superior ulnar collateral a. - coursing with ulnar nerve
toward the ulnar groove.
-
posterior ulnar recurrent a. - between humeral and ulnar
head of flexor carpi ulnaris
-
each of the previous 8 arteries at their origin.
Cubital Fossa
-
median cubital vein - communicating branch between basilic
and cephalic vein, superficial to bicipital aponeurosis
-
bicipital aponeurosis - medial expansion of biceps tendon,
roof of cubital fossa (anterior boundary)
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brachioradialis - lateral boundary of cubital fossa
-
pronator teres (superficial head) - medial boundary
of cubital fossa, crossing deep to brachioradialis and forming inferior
boundary of cubital fossa
-
median nerve - medial to brachial a., leaving cubital
fossa between heads of pronator teres
-
brachial artery - lateral to median n., dividing into
radial and ulnar arteries
-
ulnar artery - leaving cubital fossa deep to deep heard
of pronator teres (not through heads of pronator teres)
-
radial artery - leaving cubital fossa superficial to
pronator teres and deep to brachioradialis
-
radial nerve - branching into deep and superficial radial
nerves, between brachioradialis and brachialis
-
deep radial nerve - leaving floor of cubital fossa passing
deep to superior edge of supinator
-
superficial radial nerve - exiting cubital fossa with
radial artery
Forearm - Anterior Compartment (flexor compartment)
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lateral antebrachial cutaneous nerve - terminal branch
of musculocutaneous n., lateral aspect of forearm, intermingling with branches
of cephalic v.
-
radial artery - between brachioradialis and flexor carpi
radialis, traveling with superficial radial n.
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median nerve - traveling distally between flexor digitorum
superficialis and flexor digitorum profundus
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anterior interosseous nerve - branching from median
n. in proximal forearm, traveling between flexor digitorum profundus and
flexor pollicis longus
-
anterior interosseous artery - on interosseous membrane,
entering deep surface of pronator quadratus
-
ulnar nerve - between flexor carpi ulnaris and flexor
digitorum profundus, lateral branch to half of flexor digitorum profundus,
medial branch to flexor carpi ulnaris
-
ulnar artery - between flexor carpi ulnaris and flexor
digitorum profundus, entering wrist lateral to pisiform bone
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medial antebrachial n. - related to basilic vein along
medial aspect of forearm
Forearm - Posterior Compartment (extensor compartment)
-
deep radial nerve - seen through window in
supinator muscle, visible in posterior compartment immediately inferior
to supinator
-
posterior interosseous nerve - continuation
of deep radial nerve extending along posterior surface of "outcropping"
muscles (not on interosseous membrane)
-
interosseous recurrent artery - radial side
of ulnar deep to anconeus muscle
-
posterior interosseous artery - entering posterior
compartment superior to superior free edge of interosseous membrane and
inferior to oblique cord
-
anterior interosseous artery - piercing interosseous
membrane in distal forearm to supply distal aspect of posterior forearm
Hand - Palmar Aspect
-
radial a - lateral to flexor carpi radialis and medial
to abductor pollicis longus
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median n. - medial to flexor carpi radialis
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median n. - entering carpal tunnel
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tendon of palmaris longus - at wrist
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flexor retinaculum - attaching to hook of hamate, pisiform
bone, scaphoid tubercle, ?
-
tendon of flexor carpi ulnaris - attaching to pisiform
bone
-
ulnar n. - lateral to pisiform bone
-
ulnar n. - medial to hook of the hamate
-
deep branch ulnar n. - crossing third palmar interosseous
-
deep palmar arch - anastomosis between deep branch ulnar
a. and radial a.
-
palmar metacarpal a. - anterior surface of metacarpal
bone
-
ulnar a. - lateral to pisiform bone
-
superficial branch ulnar n. - palmar surface of flexor
digiti minimi
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recurrent median n. - entering thenar muscles
-
superficial palmar branch of radial a. - contributing
to superficial palmar arch
-
median n. - branch to first dorsal interosseous
-
vincula longa - tag reads "significance of the indicated
structure"
-
vincula breva - from flexor digitorum profundus tendon
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superficial transvers metacarpal ligament - distal aspect
of palmar aponeurosis
-
deep transverse metacarpal ligament - supporting heads
of metacarpals
-
collateral ligament - lateral support of interphalangeal
joint capsule
Hand - Dorsum
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radial a. - in snuff box
-
extensor pollicis brevis - anterior border of snuff
box
-
extensor pollicis longus - posterior border of snuff
box
-
first lumbrical tendon - inserting onto extensor hood
-
first dorsal interosseous tendon - inserting onto extensor
hood
-
first palmar interosseous tendon - inserting onto extensor
hood
-
extensor indicis tendon - inserting onto extensor hood
-
extensor digitorum tendon - inserting onto extensor
hood of index finger
-
oblique bands of extensor hood
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central band of extensor hood
-
superficial radial n. - crossing superficial to extensor
pollicis longus
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dorsal branch of ulnar n.
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dorsal venus arch - connecting cephalic v. (lateral)
and basilic v. (medial)
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dorsal carpal branch of radial a. - contributing to
dorsal carpal arch (rete)
-
radial a. - between heads of first dorsal interosseous
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princeps pollicis - terminal branch of radial a.
-
princeps pollicis - between adductor pollicis and first
dorsal interosseous
-
deep palmar arch - terminal branch of radial a.
-
extensor carpi radialis longus tendon - base of second
metacarpal
-
extensor carpi radialis brevis tendon - base of third
metacarpal
-
extensor carpi ulnaris tendon - base of fifth metacarpal
The Structural Basis of Medical Practice
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