1 ANTERIOR & POSTERIOR COMPARTMENTS OF ARM BY PROF. ANSARI 23/10/07, LECTURE- 2.30/3.30 PM.

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ANTERIOR & POSTERIORANTERIOR & POSTERIORCOMPARTMENTS OF COMPARTMENTS OF

ARMARM

BY BY

PROF. ANSARIPROF. ANSARI

23/10/07, LECTURE- 2.30/3.30 PM.23/10/07, LECTURE- 2.30/3.30 PM.

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ARMARM

Topography:- It lies between shoulder joint Topography:- It lies between shoulder joint and elbow joint.and elbow joint.

Anatomically it is also called brachium.Anatomically it is also called brachium. It has two fascial compartments, anterior It has two fascial compartments, anterior

and posterior.and posterior. The anterior compartment is called as flexor The anterior compartment is called as flexor

compartment of arm.compartment of arm. The posterior compartment is called as The posterior compartment is called as

extensor compartment of arm.extensor compartment of arm.

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ARM LOCATIONARM LOCATION

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IMPORTANT LAND-MARKSIMPORTANT LAND-MARKS

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SURFACE FEATURESSURFACE FEATURES

The tip of the shoulder is due to acromian process.The tip of the shoulder is due to acromian process. Head of the humerus, the greater tubercle & intertubercular Head of the humerus, the greater tubercle & intertubercular

sulcus and the whole length of shaft of humerus is sulcus and the whole length of shaft of humerus is palpable.palpable.

Medial epicondyle is more prominent and posterior to it Medial epicondyle is more prominent and posterior to it lies the ulnar nerve.lies the ulnar nerve.

Lateral epicondyle is palpable at the posterior aspect of Lateral epicondyle is palpable at the posterior aspect of elbow joint.elbow joint.

Axillary artery can be palpable in the axilla, brachial artery Axillary artery can be palpable in the axilla, brachial artery at the medial border of biceps brachii & radial and ulnar at the medial border of biceps brachii & radial and ulnar arteries at the cubital fossa. arteries at the cubital fossa.

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BRACHIAL FASCIABRACHIAL FASCIA

It is the deep fascia of the brachium/arm.It is the deep fascia of the brachium/arm. Superiorly it is continuous with the deep fascia of Superiorly it is continuous with the deep fascia of

deltoid, pectoral fascia & clavi -pectoral fascia.deltoid, pectoral fascia & clavi -pectoral fascia. Inferiorly it merges with the antebrachial fascia Inferiorly it merges with the antebrachial fascia

and forming the bicipital aponeurosis.and forming the bicipital aponeurosis. It is attached to the lateral and medial supra It is attached to the lateral and medial supra

condylar ridges forming the lateral and medial condylar ridges forming the lateral and medial intermuscular septa between the flexor and intermuscular septa between the flexor and extensor compartments of the arm.extensor compartments of the arm.

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MUSCLES OF THE ANTERIOR MUSCLES OF THE ANTERIOR COMPARTMENT OF ARMCOMPARTMENT OF ARM

Coracobrachialis.Coracobrachialis.

Brachialis.Brachialis.

Biceps brachii.Biceps brachii.

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THE NERVE OF THE ANTERIOR THE NERVE OF THE ANTERIOR COMPARTMENT OF ARMCOMPARTMENT OF ARM

Musculocutaneous nerve.Musculocutaneous nerve.

It supplies coracobrachialis, It supplies coracobrachialis, brachialis, and biceps brachialis, and biceps brachii.brachii.

It arises from lateral cord of It arises from lateral cord of the brachial plexus.the brachial plexus.

It pierces the It pierces the coracobrachialis.coracobrachialis.

It gives lateral cutaneous It gives lateral cutaneous nerve of forearm.nerve of forearm.

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ARTERIES OF THE ARMARTERIES OF THE ARM

The artery of the upper limb is the The artery of the upper limb is the subclavian artery.subclavian artery.

Right subclavian artery is the branch arising Right subclavian artery is the branch arising from right brachiocephalic trunk.from right brachiocephalic trunk.

Left subclavian artery is a direct branch from Left subclavian artery is a direct branch from the arch of aorta.the arch of aorta.

At the outer border of first rib it is renamed At the outer border of first rib it is renamed as axillary artery.as axillary artery.

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The axillary arteryThe axillary artery

It starts at the outer border of first rib and passes It starts at the outer border of first rib and passes through the axilla, as axillary artery.through the axilla, as axillary artery.

In relation with the pectoralis minor the axillary In relation with the pectoralis minor the axillary artery is divided in to three parts.artery is divided in to three parts.

First part lies proximal to pectoralis minor, second First part lies proximal to pectoralis minor, second part lies posterior to the muscle,& the third part part lies posterior to the muscle,& the third part lies distal to the muscle.lies distal to the muscle.

Branches are :- superior thoracic, acromio- Branches are :- superior thoracic, acromio- thoracic, lateral thoracic, anterior and posterior thoracic, lateral thoracic, anterior and posterior circumflex humeral and sub- scapular arteries.circumflex humeral and sub- scapular arteries.

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Branches from brachial artery/collateral circulation around elbow joint

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ATTACHMENTS OF THE MUSCLES OF THE ANTERIOR COMPARTMENT

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POSTERIOR COMPARTMENT OF POSTERIOR COMPARTMENT OF ARMARM

It is the extensor compartment of the arm.It is the extensor compartment of the arm. It includes the muscles, vessels and nerves.It includes the muscles, vessels and nerves. The muscles are triceps brachii, and The muscles are triceps brachii, and

anconeus.anconeus. The vessels are the profunda brachii.The vessels are the profunda brachii. The nerve is the radial nerve.The nerve is the radial nerve.

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The muscles of the posterior The muscles of the posterior compartmentcompartment

Triceps brachii.Triceps brachii. Anconeus.Anconeus.

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ANCONEUSANCONEUS

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RADIAL NERVE RADIAL NERVE

It is the nerve of the posterior compartment It is the nerve of the posterior compartment of arm.of arm.

It arises from the posterior cord of the It arises from the posterior cord of the brachial plexus.brachial plexus.

It supplies the triceps, anconeus, and It supplies the triceps, anconeus, and extensor muscles of the forearm.extensor muscles of the forearm.

Its root value is C5+6+7+8+T1.Its root value is C5+6+7+8+T1.

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RADIAL NERVE – SPIRAL RADIAL NERVE – SPIRAL GROOVEGROOVE

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WRIST DROP DUE TO INJURY TO WRIST DROP DUE TO INJURY TO RADIAL NERVERADIAL NERVE

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MUSCLE REFLEXESMUSCLE REFLEXES

BICEPS REFLEX:-It is a deep tendon reflex BICEPS REFLEX:-It is a deep tendon reflex to test the integrity of the nerve supply to the to test the integrity of the nerve supply to the muscle, the root value is C5+6.muscle, the root value is C5+6.

It is tested by tapping the tendon of biceps It is tested by tapping the tendon of biceps at the cubital fossa, there will be sudden jerk at the cubital fossa, there will be sudden jerk contraction by biceps muscle for flexion at contraction by biceps muscle for flexion at elbow joint. elbow joint.

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ELICITATION OF BICEPS REFLEXELICITATION OF BICEPS REFLEX

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TRICEPS REFLEXTRICEPS REFLEX

This tendon reflex is used to test the This tendon reflex is used to test the segmental integrity of radial nerve/root value segmental integrity of radial nerve/root value C7+8.C7+8.

It is done by tapping at the tendon of triceps It is done by tapping at the tendon of triceps at olecranon process of ulna.at olecranon process of ulna.

The result is extension of the elbow joint.The result is extension of the elbow joint.

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ELICITATION OF TRICEPS ELICITATION OF TRICEPS REFLEXREFLEX

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CROSS SECTIONAL ANATOMYCROSS SECTIONAL ANATOMYOF ARMOF ARM

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APPLIED ANATOMYAPPLIED ANATOMY

Fracture of humerus at surgical neck will damage Fracture of humerus at surgical neck will damage axillary nerve, resulting of paralysis of deltoid.axillary nerve, resulting of paralysis of deltoid.

Fracture of shaft of humerus will damage the Fracture of shaft of humerus will damage the radial nerve in spiral groove, resulting in wrist radial nerve in spiral groove, resulting in wrist drop/ Saturday night palsy.drop/ Saturday night palsy.

Erb-Duchenne palsy is due to injury to the superior Erb-Duchenne palsy is due to injury to the superior roots of the brachial plexus, (C5+6) resulting in roots of the brachial plexus, (C5+6) resulting in paralysis of supraspinatus, infraspinatus, deltoid, paralysis of supraspinatus, infraspinatus, deltoid, biceps, brachialis, coracobrachialis, biceps, brachialis, coracobrachialis, brachioradialis, teres minor and subscapularis.brachioradialis, teres minor and subscapularis.

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WRIST DROPWRIST DROP

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THANK YOUTHANK YOU