Bones of The Upper

Limb
With
Gabriel Idoko
 Introduction
Consists of four segments, which are further subdivided
into regions:
 Shoulder: The deltoid, pectoral, scapular, and lateral part
of lateral cervical region. The pectoral(shoulder) girdle is
a bony ring, incomplete posteriorly, formed by the
scapulae and clavicles and completed anteriorly by the
manubrium of the sternum.
 Arm (L. brachium): Between the shoulder and the elbow
and is centered around the humerus.
 Forearm (L. antebrachium) is between the elbow and the
wrist and contains the ulna and radius.
 Hand (L. manus) is distal to the forearm and contains the
 Clavicle
• The clavicle (collar bone) connects the upper limb to
the trunk. Its sternal end articulates with the
manubrium of the sternum at the sternoclavicular
(SC) joint.
• Its acromial end articulates with the acromion of the
scapula at the acromioclavicular (AC) joint.
• The medial two thirds of the shaft of the clavicle are
convex anteriorly,
• The lateral third is flattened and concave anteriorly.
• These curvatures increase the resilience of the clavicle
and gives it the appearance of an elongated capital S
 Clavicle
• Its lateral 1/3rd is flattened rom above downward
while the medial 2/3rd is rounded or prismatic
• The lat. 1/3rd has upper and lower surfaces and
anterior & posterior borders.
• The upper surface is flat, rough and marked by
impressions for attachment of Trapezius muscle
behind and Deltoid in front.
• In humans the female clavicle is shorter, thinner,
less curved and smoother than the male.
 Unique Characteristics of The Clavicle
 It is the only long bone in the human body that lies
horizontally in a natural position.
 It is the most commonly fractured bone in the
human body.
 Although designated as a long bone, it has no
medullary cavity
 The weakest part of the clavicle is the junction
between its lateral 1/3rd and Medial 2/3rd.
 It is usually the first bone to commence ossification
at 5-6th week of IUD and the last to complete
ossification at 25years.
 The Scapula
• The scapula (shoulder blade) is a triangular flat bone that
lies on the posterolateral aspect of the thorax, overlying the
2nd through 7th ribs.
• It has 2 surfaces:
-The convex posterior surface which is unevenly divided
by the spine of the scapula into a small supraspinous fossa
and a much larger infraspinous fossa,
-The concave costal surface which has a large subscapular
fossa.
• 3 borders: medial (axillary), lateral (vertebral), and superior
borders
• 3 angles: superior and inferior angles and 3 processes.
 Scapula
• 3 processes: spine, acromion and coracoid
• The lateral border of scapula is the thickest part of
the bone, which, superiorly, includes the head of
the scapula where the glenoid cavity is located.
• The neck of the scapula is just medial to the head
• The superior border of the scapula is marked near
the junction of its medial two thirds and lateral third
by the suprascapular notch.
• The thickest part of the scapula is at the lateral
angle.
 The Humerus
• The humerus (arm bone) is the largest bone in the
upper limb, articulates with the scapula at the
glenohumeral joint and the radius and ulna at the
elbow joint.
• It is divided into: Two ends and a body .
• The superior end consists of a large rounded head
joined to the body by a constricted portion called
the anatomical neck and 2 eminences, the greater
and lesser tubercles.
• The intertubercular sulcus (bicipital groove) of the
proximal end of the humerus separates the lesser
tubercle from the greater tubercle.
• Distal to the tubercles is the narrow surgical neck of
the humerus.
• The shaft of the humerus has two prominent
features:
• The deltoid tuberosity laterally and the radial
groove(spiral groove) posteriorly for the radial
nerve and profunda brachii artery.
 Humerus
• The inferior end of the humeral shaft widens as the
sharp medial and lateral supra-epicondylar
(supracondylar) ridges and then end distally in the
prominent medial epicondyle and lateral epicondyle.
• The distal end of the humerus, including the trochlea,
capitulum, olecranon, coronoid, and radial fossae,
makes up the condyle of the humerus.
• The Humeral condyle has two articular surfaces:
a lateral capitulum (L. little head) for articulation with
the head of the radius and a medial trochlea (L.
pulley)
for articulation with the trochlear notch of the ulna.
 Humerus
• Superior to the trochlea anteriorly is the coronoid
fossa, which receives the coronoid process of the
ulna during full flexion of the elbow.
• Posteriorly, the olecranon fossa accommodates the
olecranon of the ulna during extension of the
elbow.
• Superior to the capitulum anteriorly, the shallow
radial fossa accommodates the edge of the head of
the radius when the elbow is fully flexed.
 Ulna and Radius
• The ulna is the medial and longer of the two forearm
bones.
• It is the stabilizing bone of the forearm.
• Its proximal end has two prominent projections: The
olecranon posteriorly and the coronoid process
anteriorly
• These two form the walls of the trochlear notch.
• The trochlear notch of the ulna articulates with the
trochlea of the humerus.
• On the lateral side of the coronoid process is a
smooth, rounded concavity, the radial notch, which
 The Ulnar
• Distal to the radial notch is a prominent ridge, the
supinator crest
• Between it and the distal part of the coronoid
process is a concavity, the supinator fossa.
• Proximally, the shaft of the ulna is thick, but it
tapers, diminishing in diameter distally. At its
narrow distal end is the rounded head of ulna with
the small, conical ulnar styloid process
• The ulna does not articulate directly with the carpal
bones. It is separated from the carpals by a
fibrocartilaginous articular disc.
 The Radius
• The radius is the lateral and shorter of the two
forearm bones.
• Its proximal end consists of a cylindrical head, a short
neck, and a projection from the medial surface, the
radial tuberosity.
• Proximally, the smooth superior aspect of the head
of the radius is concave for articulation with the
capitulum of humerus.
• The head also articulates medially with the radial
notch of ulna.
• The neck of the radius is the narrow part between
the head and the radial tuberosity.
• The medial aspect of the distal end of the radius
forms a concavity, the ulnar notch, which
accommodates the head of the ulna
• Its lateral aspect terminates distally as the radial
styloid process.
• The dorsal tubercle of the radius lies between two
of the shallow grooves for passage of the tendons
of forearm muscles and serves as a trochlea
( pulley) for the tendon of the long extensor of the
thumb.
 Bones of the Hand
• The wrist, or carpus, is composed of eight carpal
bones (carpals) arranged in proximal and distal rows
of four augmenting movement at the wrist
• The two rows of carpals glide on each other; each
carpal bone also glides on those adjacent to it.
• The proximal surfaces of the proximal row of carpals
articulate with the inferior end of the radius and the
articular disc of the wrist joint.
• The distal surfaces of these bones articulate with
the distal row of carpals.
• From lateral to medial, the four bones in the
proximal row of carpals are:
 Scaphoid
 Lunate
 Triquetrum
 Pisiform
From lateral to medial, the four bones in the distal row
of carpals are the
 Trapezium
 Trapezoid
 Capitate
 Hamate (has a hooked process, the hook of hamate,
 Metacarpals
• The metacarpus forms the skeleton of the palm of
the hand between the carpus and the phalanges.
• There are five metacarpal bones (metacarpals) each
of which consists of a base, shaft, and head.
• The proximal bases of the metacarpals articulate
with the carpal bones, and the distal heads of the
metacarpals articulate with the proximal phalanges
and form the knuckles
• The 1st metacarpal (of the thumb) is the thickest
and shortest of these bones
 The Phalanges
• Each digit has three phalanges (proximal, middle,
and distal) except for the first (thumb), which has
only two (proximal and distal).
• Each phalanx has a base proximally, a shaft (body),
and a head distally.
• The distal phalanges are flattened and expanded at
their distal ends, which underlie the nail beds.
 Clinical Correlates
 Fracture of the Clavicle
 Ossification of the Clavicle
 Fracture of the Scapular
 Fracture of the Humerus
 Fracture of the Ulna and Radius
 Fracture of the Hand
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