Chapter VI - Human_Anatomy

Shoulder Girdle
The human upper arm, the shoulder joint is composed of three bones:the clavicle
(collarbone), the scapula (shoulder blade), and the humerus (upper arm
bone). Two joints facilitate shoulder movement. The acromioclavicular (AC) joint is located
between the acromion (part of the scapula that forms the highest point of the shoulder) and
the clavicle. The glenohumeral joint, to which the generic term "shoulder joint" usually
refers, is a ball-and-socket joint that allows the arm to rotate in a circular fashion or to
hinge out and up away from the body. (The "ball" is the top, rounded portion of the upper
arm bone or humerus; the "socket," or glenoid, is a dish-shaped part of the outer edge of
the scapula into which the ball fits.) Arm movement is further facilitated by the ability of the
scapula to slide both laterally and vertically along the rib cage. The capsule is a soft tissue
envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial
membrane.
The bones of the shoulder are held in place by muscles, tendons, and ligaments. Tendons
are tough cords of tissue that attach the shoulder muscles to bone and assist the muscles in
moving the shoulder. Ligaments attach shoulder bones to each other, providing stability. For
example, the front of the joint capsule is anchored by three glenohumeral ligaments.
The rotator cuff is a structure composed of tendons that, with associated muscles, holds the
ball at the top of the humerus in the glenoid socket and provides mobility and strength to
the shoulder joint.
Two filmy sac-like structures called bursae permit smooth gliding between bone, muscle,
and tendon. They cushion and protect the rotator cuff from the bony arch of the acromion.
RIBCAGE
The human rib cage. In anatomy, ribs (Latin costae) are the long curved bones, which form
the rib cage. Ribs surround the chest (Latin thorax) of land vertebrates, and protect the
lungs, heart, and other internal organs of the thoracic cavity.
Types of Ribs
The human skeleton has 24 ribs, 12 on each side. (A small proportion may have one pair
more or fewer.) They are attached behind the vertebral column. The first seven pairs are
connected to the sternum in front and are known as true ribs (costae verae, I-VII). The
eighth, ninth, and tenth are attached in front to the cartilaginous portion of the next rib
above and are known as false ribs (costae spuriae, VIII-X). The lower two, that is the
eleventh and twelfth, are not attached in front and are called floating ribs (costae fluitantes,
XI-XII). The spaces between the ribs are known as intercostal spaces; they contain the
intercostal muscles, nerves, and arteries. The rib cage allows for breathing due to its
elasticity. In some humans, the rib remnant of the 7th neck vertebra on one or both sides is
replaced by a free extra rib called a cervical rib, which can cause trouble for the nerves
going to the arm.
Rib Anatomy
Typical ribs
The third through ninth ribs are "typical ribs" since they share the same structure. They
each have a head that has two facets separated by a crest. One head articulates with the
rib's corresponding vertebra and one head articulates with the vertebra superior (above) to

if it is broken serious damage can occur to the brachial plexus of nerves and the subclavian vessels. A lower rib fracture has the complication of potentially injuring the diaphragm. The 10th to 12th ribs have only one facet on their head. . and curved. flat. Rib Fractures and Associated Injuries The first rib is rarely fractured because of its protected position behind the clavicle (collarbone). convex forward. neurological difficulties. it is the least marked of all the curves. thoracic. especially from the breast or prostate. which correspond to the different regions of the column. Fractures usually occur from direct blows or from indirect crushing injuries. The concave (inside) surface has a groove to protect the intercostal nerve and vessels. Bifid rib. less curved.it. The middle ribs are the ones most commonly fractured. begins at the apex of the odontoid (tooth-like) process. bifurcated rib A Bifid rib or bifurcated rib is a congenital abnormality occurring in about 1% of the population. Effects of this neuroskeletal anomaly can include respiratory difficulties. It is usually unilateral. Atypical ribs The atypical ribs are the 1st. and has the sharpest curve of the seven true ribs. and are calledcervical. Rib fractures are painful because the ribs have to move for inspiration and expiration of air. The weakest part of a rib is just anterior to its angle. but a fracture can occur anywhere. lumbar. The first rib has a shaft that is wide and nearly horizontal. Vertebral column The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. They have a neck that connects the head with the shaft. which could result in a diaphragmatic hernia. and ends at the middle of the second thoracic vertebra. and pelvic. and longer than the first rib. 2nd. which are separated by the scalene tubercle. and a tubercle for muscles to attach to. Rib pain may also be associated with metastasis of cancer. Cervical curve: The cervical curve. and 10th to 12th. The shaft is thin. limitations. The neck meets the shaft at a tubercle. and limited energy from the stress of needing to compensate for the neurophysiological difficulties. It has two facets to articulate with T2 and T1. It houses the spinal cord in its spinal canal. Curves Viewed laterally the vertebral column presents several curves. The curve is most prominent at the costal angle. However. The sternal end of the rib is cleaved into two. and the 11th and 12th ribs are short with no necks or tubercles. Its head has a single facet to articulate with the first thoracic vertebra (T1). It also has two grooves for the subclavian vessels. The second rib is thinner.

when the body is curved to the right side. concave forward. the convexity was to the left side. the latter at twelve or eighteen months. In support of this explanation it has been found that in one or two individuals who were left-handed. The vertebral column also has a slight lateral curvature. when the child begins to walk. the former when the child is able to hold up its head (at three or four months). and ends at the sacrovertebral angle. and to sit upright (at nine months). This curvature is regarded by others as being produced by the aortic arch and upper part of the descending thoracic aorta – a view which is supported by the fact that in cases where the viscera are transposed and the aorta is on the right side.Thoracic curve: The thoracic curve. Posterior surface The posterior surface of the vertebral column presents in the median line the spinous processes. and by the laminae and transverse processes in the thoracic region. and in the lower part they are nearly horizontal. the convexity of which is directed toward the right side. It is convex anteriorly. Surfaces Anterior surface When viewed from in front. because they alone are present during fetal life. it begins at the middle of the last thoracic vertebra. Lumbar curve: The lumbar curve is more marked in the female than in the male. On either side of the spinous processes is the vertebral groove formed by the laminae in the cervical and lumbar regions. and ends at the point of the coccyx. Occasionally one of these processes deviates a little from the median line — a fact to be remembered in practice. Pelvic curve: The pelvic curve begins at the sacrovertebral articulation. The cervical and lumbar curves are compensatory or secondary. The spinous processes are separated by considerable intervals in the lumbar region. by narrower intervals in the neck. where it is . and are closely approximated in the middle of the thoracic region. In the cervical region (with the exception of the second and seventh vertebrae) these are short and horizontal. the vertebral column is C-shaped. In the lumbar region they are nearly horizontal. the width of the bodies of the vertebrae is seen to increase from the second cervical to the first thoracic. This may be produced by muscular action. the convexity of the curve is directed to the left side. especially in making long-continued efforts. The thoracic and pelvic curves are termed primary curves. with bifid extremities. as irregularities of this sort are attendant also on fractures or displacements of the vertebral column. in the middle they are almost vertical. and are developed after birth. begins at the middle of the second and ends at the middle of the twelfth thoracic vertebra. and the cervical and lumbar curvatures are not yet present in a newborn infant. From this point there is a rapid diminution. below this there is again a gradual and progressive increase in width as low as the sacrovertebral angle. most persons using the right arm in preference to the left. its concavity is directed downward and forward. there is then a slight diminution in the next three vertebrae. In the early embryo. to the apex of the coccyx. In the upper part of the thoracic region they are directed obliquely downward. where it is shallow. Its most prominent point behind corresponds to the spinous process of the seventh thoracic vertebra. the convexity of the lower three vertebrae being much greater than that of the upper two.

on a plane considerably behind that of the same processes in the cervical and lumbar regions. and in front of them in the thoracic and lumbar regions. . and by the transverse processes in the thoracic region. marked in the thoracic region by the facets for articulation with the heads of the ribs. and generally of the spinal cord (medulla spinalis) itself. where motion is more limited. This produces the so-called "humpback". takes place. Lateral to the vertebral grooves are the articular processes. in front. This condition is most common in the lumbosacral region. It is more common among females and may result from unequal growth of the two sides of one or more vertebrae. and still more laterally the transverse processes. or any muscular hydrostat similar to a tentacle. it is large and triangular in those parts of the column which enjoy the greatest freedom of movement. through which a protrusion of the spinal membranes (dura mater and arachnoid). Scoliosis.deep and broad. "swayback". smallest in the cervical and upper part of the thoracic regions. Arm In anatomy. Lordosis is an exaggerated anterior curvature of the lumbar region. intervertebral foramina. lateral to the pedicles and between the intervertebral foramina. but behind the intervertebral foramina. Abnormalities Occasionally the coalescence of the laminae is not completed. as seen on some cephalopods. the arm is the upper limb of a bipedal mammal.5% of the population. In the thoracic region they are posterior to the pedicles. oval in shape. and is small and rounded in the thoracic region. In the lumbar region they are in front of the articular processes. the sides of the bodies of the vertebrae. In the thoracic region. In the cervical region. specifically the segment between the shoulder and the elbow. Arm can also refer to any analogous structure. constituting the malformation known as spina bifida. the transverse processes stand backward. these grooves lodge the deep muscles of the back. More posteriorly are the intervertebral foramina. but it may occur in the thoracic or cervical region. the transverse processes are placed in front of the articular processes. and articular processes. and consequently a cleft is left in the arches of the vertebrae. such as octopuses. lateral curvature. and gradually increasing in size to the last lumbar. They transmit the spinal nerves and are situated between the transverse processes in the cervical region. or the arches throughout the whole length of the canal may remain incomplete. is the most common abnormal curvature. Temporary lordosis is common among pregnant women. The following abnormal curvatures may occur in some people: Kyphosis is an exaggerated posterior curvature in the thoracic region. such as the cervical and lumbar regions. They present. occurring in 0. such as one of the paired forelimbs of a quadruped. Vertebral canal The vertebral canal follows the different curves of the column. formed by the juxtaposition of the vertebral notches. Lateral surfaces The lateral surfaces are separated from the posterior surface by the articular processes in the cervical and lumbar regions.

Anatomy of the human arm The human arm contains bones. This compartment is also known as the "extensor compartment". There are clinical uses for the arm. which has nervous origins of C5. Shoulder joint The shoulder is the ball-and-socket joint between the proximal end of the humerus and the clavicle and scapula. The compartments contain muscles which are innervated by the same nerve and perform the same action. a huge muscle which contains three heads. Muscles of this compartment are: Triceps brachii. the segment between the elbow and wrist is properly called the forearm. Elbow joint The elbow joint is the hinge joint between the distal end of the humerus and the proximal ends of the radius and ulna. Anconeus. C7 (see brachial plexus). Many of these muscles are used for everyday tasks. Anatomically. nerves and blood vessels. medial and middle. which are all supplied by the radial nerve. The fascia merges with the periosteum (outer bone layer) of the humerus. while the presence of two forearm bones which can rotate around each other allows for additional range of motion at this level. the lateral. This huge muscle is the main adductor of the upper limb and extends over the shoulder. The ball and socket shoulder joint allows for movement of the arms in a wide circular plane. including venepuncture and peripheral venous cannulation in the cubital fossa. It articulates with the scapula above at the glenohumeral joint (shoulder) and with the ulna and radius below as the elbow joint. manipulative tasks. which some embryologists suggest may be the fourth head of the . In primates the arms are richly adapted for both climbing and for more skilled. muscles. The deltoid muscle is considered to have part of its body in the anterior compartment. joints. C6. a tiny muscle. The brachioradialis muscle originates in the arm but inserts into the forearm. Bony structure and joints The humerus is the (upper) arm bone. The muscles contained therein are: Biceps brachii Brachialis Coracobrachialis They are all supplied by the musculocutaneous nerve. The anterior compartment is known as the "flexor compartment" as flexion is its main action. The posterior compartment contains muscles. Osteofascial compartments The arm is divided by a fascial layer (known as lateral and medical intermuscular septa) separating the muscles into an anterior and posterior osteofascial compartments.The term arm also refers to the entire upper limb in an organism. extension being its main action. This muscle is responsible for supination.

the lateral border of pronator teres muscle. Lymph nodes Nervous supply Important nerves related to arms: 1. The point at which the axillary becomes the brachial is distal to the lower border of teres major. which passes through the cubital fossa and is clinically important for venepuncture (withdrawing blood). 6. Cubital fossa This important area is clinically important for venepuncture and for blood pressure measurement. This branching occurs just below the lower border of teres major. the profunda brachii (deep artery of the arm). Brachial artery 3. .triceps brachii muscle. The basilic travels on the medial side of the arm and terminates at the level of the 7th rib. Medially. as well as drain the arm itself. which has four heads. which starts to branch 2. Median cubital vein . It is an imaginary triangle with borders being: Laterally.this important vein is where venepuncture occurs. the intercondylar line. The brachial artery gives off an important brach. From here onwards it has an intimate relationship with the radial nerve. The profunda brachii travels through the lower triangular space with the radial nerve. the medial border of brachioradialis muscle. Ulnar nerve Blood supply and venous drainage The main artery in the arm is the brachial artery. The veins of the arm carry blood from the extremities of the limb. Radial nerve 5. Tendon of the biceps brachii muscle 4. This artery is a continuation of the axillary artery. The order from which they pass into the forearm are as follows. from medial to lateral: 1. As the upper and lower limbs have similar embryological origins and the lower limb contains the quadriceps femoris muscle (the lower limb equivalent of the triceps). an imaginary line between the two condyles of the humerus The floor is the brachialis muscle The roof is the skin and fascia of the arm and forearm The structures. It connects the basilic and cephalic veins. It passes through the deltopectoral triangle. Radial nerve 3. the median cubital vein. which pass through the cubital fossa. this would seem to make sense. Median nerve. are vital. a space between the deltoid and the pectoralis major muscles. There is a connecting vein between the two. Superiorly. This muscle stabilizes the elbow joint during movements. Musculocutaneous nerve 2. Median nerve 4. The two main veins are the basilic and the cephalic veins. The cephalic travels on the lateral side of the arm and terminates as the axillary vein.