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The  appendicular  skeleton  consists of the pectoral girdle, upper extremities, pelvic girdle, and lower extremities.
In this lecture we will focus just on the  pectoral girdle and upper limbs
The  pectoral girdle  is not a complete girdle
The  pectoral girdle  provides for attachment of the arms and many of the arms associated muscles.  It is a delicate structure.
The only bones that keep the scapulae and the shoulders laterally are the delicate  clavicles .
Congenital absence of clavicles
Clavicle  (collar bone) Inferior view Superior view
Epaulettes  were originally designed as armor to help protect the delicate clavicle.
Currently  epaulettes  are minimal and just used for attachment of symbols of military rank.
Sternoclavicular joint Acromioclavicular joint (A-C joint).
Note the  conoid tubercle  on the inferior, lateral end of the clavicle that serves as an attachment site for several ligaments. Superior view Inferior view
Master Long is going to easily  fracture his opponents right clavicle  so his opponent will be unable to use that arm.
ACCORDING TO THE CLINICAL VIEW IN YOUR TEXT, WHY IS A  POSTERIOR FRACTURE  OF THE CLAVICLE POTENTIALLY MORE SERIOUS THAN AN ANTERIOR FRACTURE? A MORE LIKELY TO BREAK THE SKIN B MORE LIKELY TO DAMAGE BLOOD VESSELS C MORE LIKELY TO ENTER HEART D MORE LIKELY TO INJURE ULNAR NERVE E MORE LIKELY TO TEAR DIAPHRAGM
The  scapula  normally lays over ribs #2-#7 on the  posterior  aspect of the rib cage.
Left scapula
Anterior Posterior
The head of the humerus articulates with the  glenoid cavity .
Subscapular fossa  on  anterior  surface of scapula.
Humerus clavicle Scapula
The  humerus  is the longest bone of the upper extremity. groove
The  distal end of the humerus  is modified to articulate with the two bones of the forearm.
油
The  radial fossa  accommodates the head of the radius and the  coronoid fossa  of the humerus receives the coronoid process of the ulna when the elbow is flexed. Anterior view
The  olecranon fossa  of the humerus receives the olecranon of the ulna when the elbow is extended Posterior view
WHICH OF THE FOLLOWING  IS CORRECT  ABOUT THE DISTAL MEDIAL END OF THE HUMERUS? A NEAR THE ULNAR NERVE B SHAPED LIKE A PULLEY C ARTICULATES WITH THE ULNA D FORMS A FIRM HINGE JOINT WITH THE  FOREARM E ALL OF THE ABOVE
The antebrachium contains the  ulna  on the medial side and the  radius  on the lateral (thumb) side.
Note the  head  of the radius and the  radial notch  in nearby ulna
The  radius  is lateral to the ulna. Note the  head ,  neck , the  radial tuberosity , the  shaft , and the  styloid process  on the lateral tip. Trochlear notch
Note  styloid processes  on distal radius and ulna  and  ulnar notch  on medial distal end of the radius
The proximal end of the ulna forms the  trochlear notch .  Note the anterior  coronoid process  and the posterior  olecranon . The  radial notch , mentioned earlier, accommodates the nearby head of the radius
The distal end of the  ulna  is called the  head .  It has a medial projection called the  styloid process . The distal ulna also once again articulates with the nearby radius. Trochlear notch
The  styloid processes  of the distal ulna and radius create a U-shaped arrangement to help stabilize the bones of the wrist.
The  interosseous membrane  helps keep the radius and ulna a fixed distance from one another and also allows rotation of the forearm.
Crucifixion is NOT normally performed in the hand
Crucifixion  is properly performed in the wrist  or   between distal ends of radius and ulna
The Governor of California shown  properly crucified  with nails in wrist or between distal end of radius and ulna.  Note the vulture perched on arm that is soon to be lunch.
It damages  median nerve
油
Shroud of Turin black and white image.
Color image of blood
In the Shroud of Turin the tibia and fibula are NOT  broken.
There are 8  carpal bones  in the wrist.
The bones of the  manus  at work on a keyboard
Kermit gets a surprise!
The palm of the manus is composed of  5 metacarpals  numbered 1-5 with #1 leading to the thumb.
The fingers (digits) contain  phalanges .  All the digits have three phalanges, except for the thumb (finger #1) that only has two.
What specific phalanges have been nailed?
In this posterior x-ray of a childs right hand, what specific bone has been fractured?
What specific bone(s) of this persons left hand have been forked?
WHAT BONE  IS ENCIRCLED BY A WEDDING RING? A METACARPAL #3 OF RIGHT HAND B PROXIMAL BONE OF POLLEX C DISTAL PHALANX OF FINGER #5 OF RIGHT  HAND D BONE MEDIAL TO METACARPAL #4 AND  MIDDLE PHALANX #4 E MIDDLE PHALANX OF FINGER #3 OF LEFT HAND
One of many ways to fracture the delicate  clavicle .
Crack the whip
Left clavicular fracture
Matt Crivellos fractured clavicle from football
Jagged ends of a fractured clavicle  can easily damage underlying arteries and veins  unless the injured arm is quickly immobilized.
Matt Crivellos fractured clavicle from football  after repair
Blows strong enough to  fracture the scapula  may also result in fracture of the underlying ribs.
油
Scapular fracture through the glenoid cavity
Blows or falls on the tip of the shoulder can lead to dislocation of the acromion process of the scapula from the clavicle (A/C separation).
When examining patient it is a good idea to palpate the  normal  shoulder and compare to  bad  shoulder. Normal
Acromioclavicular separation  (A/C separation) in the right shoulder
油
油
One way to reposition bones of a dislocated shoulder.
Fracture of the shaft of the humerus  may damage nearby nerves.
Open fracture of humeral shaft.
油
Supracondylar fracture of the humerus.
Supracondylar fracture  and  midline fracture of distal humerus.
Anterior view of repair of fracture shown in previous slide
Lateral view of repair of fracture shown in previous slide.
油
Dislocation of the elbow.
The muscular tendons which attach to the  lateral epicondyle of the humerus  are put under tremendous stress during the backhand stroke.
油
Note vibration-stopping rubber bands on racquet and support band on forearm
油
A child who lived next door to me did this by falling off the trampoline
油
遺看鉛鉛艶壊f姻温界岳顎姻艶.   Fracture of the distal end of the radius causing a silver fork deformity.
Fracture of the distal end of the radius results in a characteristic silver fork deformity.  This type of fracture is called a  Colles fracture .
IF YOU WERE LAYING IN THE PARK PROPPED UP BY ONE  FULLY EXTENDED ARM  AND A HEAVY CHILD RAN INTO THE POSTERIOR OF THIS SAME EXTENDED ARM,  WHAT WOULD MOST LIKELY OCCUR ? A FRACTURE OF THE OLECRANON B A-C SEPARATION C COLLES FRACTURE D SCAPULAR FRACTURE E FRACTURE OF A SESAMOID BONE

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06 Appendicular Skeleton Pectoral Girdle And Upper Limbs

  • 1. The appendicular skeleton consists of the pectoral girdle, upper extremities, pelvic girdle, and lower extremities.
  • 2. In this lecture we will focus just on the pectoral girdle and upper limbs
  • 3. The pectoral girdle is not a complete girdle
  • 4. The pectoral girdle provides for attachment of the arms and many of the arms associated muscles. It is a delicate structure.
  • 5. The only bones that keep the scapulae and the shoulders laterally are the delicate clavicles .
  • 7. Clavicle (collar bone) Inferior view Superior view
  • 8. Epaulettes were originally designed as armor to help protect the delicate clavicle.
  • 9. Currently epaulettes are minimal and just used for attachment of symbols of military rank.
  • 11. Note the conoid tubercle on the inferior, lateral end of the clavicle that serves as an attachment site for several ligaments. Superior view Inferior view
  • 12. Master Long is going to easily fracture his opponents right clavicle so his opponent will be unable to use that arm.
  • 13. ACCORDING TO THE CLINICAL VIEW IN YOUR TEXT, WHY IS A POSTERIOR FRACTURE OF THE CLAVICLE POTENTIALLY MORE SERIOUS THAN AN ANTERIOR FRACTURE? A MORE LIKELY TO BREAK THE SKIN B MORE LIKELY TO DAMAGE BLOOD VESSELS C MORE LIKELY TO ENTER HEART D MORE LIKELY TO INJURE ULNAR NERVE E MORE LIKELY TO TEAR DIAPHRAGM
  • 14. The scapula normally lays over ribs #2-#7 on the posterior aspect of the rib cage.
  • 17. The head of the humerus articulates with the glenoid cavity .
  • 18. Subscapular fossa on anterior surface of scapula.
  • 20. The humerus is the longest bone of the upper extremity. groove
  • 21. The distal end of the humerus is modified to articulate with the two bones of the forearm.
  • 22.
  • 23. The radial fossa accommodates the head of the radius and the coronoid fossa of the humerus receives the coronoid process of the ulna when the elbow is flexed. Anterior view
  • 24. The olecranon fossa of the humerus receives the olecranon of the ulna when the elbow is extended Posterior view
  • 25. WHICH OF THE FOLLOWING IS CORRECT ABOUT THE DISTAL MEDIAL END OF THE HUMERUS? A NEAR THE ULNAR NERVE B SHAPED LIKE A PULLEY C ARTICULATES WITH THE ULNA D FORMS A FIRM HINGE JOINT WITH THE FOREARM E ALL OF THE ABOVE
  • 26. The antebrachium contains the ulna on the medial side and the radius on the lateral (thumb) side.
  • 27. Note the head of the radius and the radial notch in nearby ulna
  • 28. The radius is lateral to the ulna. Note the head , neck , the radial tuberosity , the shaft , and the styloid process on the lateral tip. Trochlear notch
  • 29. Note styloid processes on distal radius and ulna and ulnar notch on medial distal end of the radius
  • 30. The proximal end of the ulna forms the trochlear notch . Note the anterior coronoid process and the posterior olecranon . The radial notch , mentioned earlier, accommodates the nearby head of the radius
  • 31. The distal end of the ulna is called the head . It has a medial projection called the styloid process . The distal ulna also once again articulates with the nearby radius. Trochlear notch
  • 32. The styloid processes of the distal ulna and radius create a U-shaped arrangement to help stabilize the bones of the wrist.
  • 33. The interosseous membrane helps keep the radius and ulna a fixed distance from one another and also allows rotation of the forearm.
  • 34. Crucifixion is NOT normally performed in the hand
  • 35. Crucifixion is properly performed in the wrist or between distal ends of radius and ulna
  • 36. The Governor of California shown properly crucified with nails in wrist or between distal end of radius and ulna. Note the vulture perched on arm that is soon to be lunch.
  • 37. It damages median nerve
  • 38.
  • 39. Shroud of Turin black and white image.
  • 40. Color image of blood
  • 41. In the Shroud of Turin the tibia and fibula are NOT broken.
  • 42. There are 8 carpal bones in the wrist.
  • 43. The bones of the manus at work on a keyboard
  • 44. Kermit gets a surprise!
  • 45. The palm of the manus is composed of 5 metacarpals numbered 1-5 with #1 leading to the thumb.
  • 46. The fingers (digits) contain phalanges . All the digits have three phalanges, except for the thumb (finger #1) that only has two.
  • 47. What specific phalanges have been nailed?
  • 48. In this posterior x-ray of a childs right hand, what specific bone has been fractured?
  • 49. What specific bone(s) of this persons left hand have been forked?
  • 50. WHAT BONE IS ENCIRCLED BY A WEDDING RING? A METACARPAL #3 OF RIGHT HAND B PROXIMAL BONE OF POLLEX C DISTAL PHALANX OF FINGER #5 OF RIGHT HAND D BONE MEDIAL TO METACARPAL #4 AND MIDDLE PHALANX #4 E MIDDLE PHALANX OF FINGER #3 OF LEFT HAND
  • 51. One of many ways to fracture the delicate clavicle .
  • 54. Matt Crivellos fractured clavicle from football
  • 55. Jagged ends of a fractured clavicle can easily damage underlying arteries and veins unless the injured arm is quickly immobilized.
  • 56. Matt Crivellos fractured clavicle from football after repair
  • 57. Blows strong enough to fracture the scapula may also result in fracture of the underlying ribs.
  • 58.
  • 59. Scapular fracture through the glenoid cavity
  • 60. Blows or falls on the tip of the shoulder can lead to dislocation of the acromion process of the scapula from the clavicle (A/C separation).
  • 61. When examining patient it is a good idea to palpate the normal shoulder and compare to bad shoulder. Normal
  • 62. Acromioclavicular separation (A/C separation) in the right shoulder
  • 63.
  • 64.
  • 65. One way to reposition bones of a dislocated shoulder.
  • 66. Fracture of the shaft of the humerus may damage nearby nerves.
  • 67. Open fracture of humeral shaft.
  • 68.
  • 70. Supracondylar fracture and midline fracture of distal humerus.
  • 71. Anterior view of repair of fracture shown in previous slide
  • 72. Lateral view of repair of fracture shown in previous slide.
  • 73.
  • 75. The muscular tendons which attach to the lateral epicondyle of the humerus are put under tremendous stress during the backhand stroke.
  • 76.
  • 77. Note vibration-stopping rubber bands on racquet and support band on forearm
  • 78.
  • 79. A child who lived next door to me did this by falling off the trampoline
  • 80.
  • 81. 遺看鉛鉛艶壊f姻温界岳顎姻艶. Fracture of the distal end of the radius causing a silver fork deformity.
  • 82. Fracture of the distal end of the radius results in a characteristic silver fork deformity. This type of fracture is called a Colles fracture .
  • 83. IF YOU WERE LAYING IN THE PARK PROPPED UP BY ONE FULLY EXTENDED ARM AND A HEAVY CHILD RAN INTO THE POSTERIOR OF THIS SAME EXTENDED ARM, WHAT WOULD MOST LIKELY OCCUR ? A FRACTURE OF THE OLECRANON B A-C SEPARATION C COLLES FRACTURE D SCAPULAR FRACTURE E FRACTURE OF A SESAMOID BONE