The Skeleton of the

Upper Limb
 Scapula
◼ Large, flat, triangular
bone
◼ Overlaps in part 2-7
ribs on posterolat
thoracic aspect
◼ Costal surface
◼ Dorsal surface
◼ Sup, lat, med borders
◼ Inf, sup, lat angles
Processes
◼ Spinous
◼ Acromial
◼ Coracoid
 Lateral angle
◼ Truncated by
glenoid cavity, for
articulation with
humerus
 Dorsal surface

◼ Spine of scapula
(divides small upper,
large lower area)
 Lat border

◼ Covered by muscles
◼ Can not be palpated
◼ Superiorly widens into
rough, triangular
infraglenoid tubercle
 Medial border

◼ Inf 2/3; easily felt

◼ Upper 1/3; too deep
Superior border

◼ Separated laterally from

coracoid process by
suprascapular notch
 Angles
◼ Inf angle: Overlies 7th
rib or intercostal space,
palpable
◼ Sup angle: At the
junction of sup & med
borders, at the level of
2nd rib
◼ Lat angle: Truncated,
broad, forms
glenohumeral joint with
humerus
 Supraglenoid
tubercle
◼ Just above lat angle
◼ Small & rough
◼ Encroaches on the root
of coracoid process
 Spine of
scapula
◼ Projects from upper
dorsal surface
◼ Triangular
◼ Supraspinous fossa
◼ Infraspinous fossa
◼ Trigonum spinae:
Trianguler area in
between med border &
spine
◼ Linea interspinalis: Line
joining two spines, at the
level of 4th thoracic
vertebra
Acromion
◼ Projects forwards, almost
at right angles, from lat
end of spine
◼ Visible subcutaneous
landmark
◼ Med acromial border :
Short, articulates with
clavicle’s lateral end
◼ Lat border, tip & sup
surface; easily palpable
Coracoid process
◼ Hooks slightly laterally &
forwards
◼ Enlarged tip; palpable
(covered by ant part of
deltoid m)
◼ Dorsal aspect :
Impression for conoid
part of coracoclavicular
lig
 Clavicle
◼ Extends laterally &
almost horizontally
across the neck from
manubrium to acromion
◼ Wholly subcutaneous
◼ Flat, lat, acromial end
articulates with med
aspect of acromion
◼ Enlarged, med, sternal
end articulates with
manubrial clavicular facet
& 1st costal cartilage
 Shaft
◼ Sinuous
◼ Med 2/3 convex
forwards
◼ Lat 1/3 concave
forwards
 Lat third
◼ Flat
◼ Sup & inf surfaces
◼ Ant & post borders
◼ Small, oval, articular
facet, for articulation
with medial aspect of
acromion faces laterally
& slightly downwards
 Lat third
◼ Ant border : Deltoid
tubercle
◼ Inf surface :
◼ conoid tubercle (for
conoid part of
coracoclavicular lig)
◼ Trapezoid line (for the
lig’s trapezoid part)
 Medial 2/3
◼ Surfaces: Ant, post, sup
& inf
◼ Inf surface : Marked
near sternal end by a
rough oval area; for
costoclavicular lig
◼ Sternal end : Articulates
with clavicular notch of
manubrium
 Humerus
◼ Longest & largest bone
of upper limb
◼ Expanded ends
◼ Shaft
◼ Proximal end
◼ Head
◼ Neck
◼ Greater tubercle
◼ Lesser tubercle
 Head
◼ Articular surface
covered by hyaline
cartilage, thicker
centrally
◼ Directed
posteromed &
upwards
 Anatomical neck
◼ Adjoins articular head’s
margin
◼ Slight constriction, least
apparent near greater tubercle
◼ Indicates line of capsular
attachment of shoulder joint
(except at intertubercular
sulcus, where long tendon of
biceps emerges)
◼ Medially; capsular attachment
diverges from anatomical
neck, descending 1 cm or
more onto the shaft
 Greater & lesser
tubercles

◼ Greater tubercle; most

lat part of proximal end,
covered by deltoid m
◼ Lesser tubercle; anterior,
just beyond anatomical
neck, subscapularis m
attaches
◼ Intertubercular sulcus;
between tubercles
 Surgical neck
◼ Proximal end
tapers into shaft
as an ill-defined
surgical neck
◼ Medial to it;
axillary n & post
humeral
circumflex a
 Impressions on
greater tubercle

◼ Supraspinatus m
◼ Infraspinatus m
◼ Teres minor m
 Shaft
◼ Cylindirical proximally
◼ Prismatic distally
◼ Not palpable
◼ Ant, med, lat borders
◼ Ant border; descends
from front of greater
tubercle, almost to
distal end
◼ Surfaces:
◼ anterolat (deltoid
tuberosity)
◼ behind (radial groove)
◼ anteromed
◼ posterior
 Distal end
◼ Modified condyle, wider
transversely
◼ Articular & non-articular
parts
◼ Articular part joints with
radius & ulna
◼ Articular part
◼ Capitulum (lat, convex)
◼ Trochlea (med, pulley-
shaped)
◼ Non-articular part
◼ Med & lat epicondyles
◼ Olecranon
◼ Coronoid & radial fossae
◼ Capitulum; articulates with
radial head
◼ Trochlea; articulates with
trochlear notch (ulna)
◼ Med epicondyle;
subcutaneous, visible in
passive flexion, post
surface crossed by ulnar n
◼ Med supracondylar ridge;
distal part of medial
border
◼ Lat epicondyle; lat border
ends
◼ Lat supracondylar ridge
 Radius
◼ Lat in forearm
◼ Expanded prox & distal
ends (distal much
broader)
◼ Shaft widens rapidly
towards distal end
◼ Proximal end
◼ Shaft
◼ Distal end
 Proximal end
◼ Head
◼ Discoid
◼ Smooth articular periphery
◼ Prox surface; shallow cup for
humeral capitulum
◼ Medially contacts radial notch (ulna)
◼ Neck
◼ Constriction distal to head
◼ Tuberosity
◼ Distal to medial part of neck
 Shaft
◼ Lateral convexity
◼ Interosseous border;
sharp
◼ Interosseous membrane;
attached to distal ¾ of
interosseous border
◼ Ant border: Obvious at
both ends, rounded &
indefinite in between
them
◼ Post border: Well-
defined in middle 1/3
 Surfaces
◼ Anterior
◼ Between ant &
interosseous borders
◼ near mid-point; nutrient
foramen & canal
◼ Posterior
◼ Between post &
interosseous borders
◼ Lateral
◼ Convex, due to obliquity
of ant and post borders
 Distal end
◼ Widest part
◼ Four sided
◼ Lat surface; slightly
rough, projecting distally
as styloid process
◼ Distal; smooth carpal
articular surface
◼ Ant, post, med & lat
surfaces
◼ Med surface: Ulnar
notch
Carpal articular surface
◼ Divided by a ridge into
med & lat areas
◼ Med; quadrangular
◼ Lat; triangular
 Ulna
◼ In supinated forearm;
medial to radius
◼ Slightly convex
posteriorly
◼ Olecranon enters
humeral olecranon fossa
(extension)
◼ Extension; olecranon can
be felt near a line joining
humeral epicondyles
◼ Flexion; olecranon
descends ⇒ 3 points
form isosceles triangle
 Proximal end
◼ Olecranon
◼ Coronoid process
◼ Projects anteriorly distal to olecranon
◼ Trochlear notch
◼ Articulates with trochlea of humerus
◼ Radial notch
◼ Lat surface
◼ Articulates with periphery of radial
head
◼ Separated from trochlear notch by
smooth ridge
◼ Tuberosity of ulna
◼ On distal part of coronoid process
◼ Brachialis m attaches
 Shaft
◼ Ant, post, med surfaces
◼ Ant, post, interosseous
borders
◼ Interosseous border:
Conspicious lat crest in
middle 2/4, proximally
continuous with supinator
crest
◼ Ant border: Commences
medial to ulnar tuberosity
◼ Post border: Palpable,
descends from apex of
olecranon’s post aspect,
curves laterally to reach
styloid process
 Surfaces
◼ Anterior
◼ Between ant &
interosseous borders
◼ Prox to its mid-point;
nutrient foramen (branch
of ant interosseous a)
◼ Medial
◼ Between ant & post
borders
◼ Posterior
◼ Between post &
interosseous borders
 Distal end
◼ Head
◼ Lat convex articular
surface fits ulnar notch
(radius)
◼ Smooth distal surface
separated from carpus
by articular disc
◼ Styloid process
◼ Short, round, posterolat
projection
◼ Palpable
◼ 1 cm prox to the plane
of radial styloid
Wrist and Hand
◼ Carpus
◼ Metacarpus
◼ Phalanges
 Carpus
◼ 8 bones; 4 prox row, 4 distal
row
◼ Prox: Scaphoid, lunate,
triquetral, pisiform
◼ Distal: Trapezium, trapezoid,
capitate, hamate
◼ Pisiform articulates with
palmar surface of triquetral
◼ Dorsal carpal surface; convex
◼ Palmar carpal surface forms
carpal groove (deeply
concave)
Carpal tunnel
◼ Carpal groove is made
into an osseo-fibrous
carpal tunnel by a fibrous
retinaculum attached to
its margins
Carpal bones
◼ Scaphoid; largest in prox
carpal row
◼ Lunate; semilunar
◼ Triquetral; has oval isolated
facet for articulation with
pisiform
◼ Capitate; central & largest
◼ Hamate; cuneiform, with an
unciform hamulus (hook)
◼ Scaphoid; most frequently
fractured carpal bone
 Metacarpus
◼ 5 in number
◼ Distal head, shaft,
expanded base
◼ Rounded heads articulate
with prox phalanges
◼ Metacarpal bases
articulate with distal
carpal row
 Phalanges
◼ 14 in number
◼ 3 in each finger, 2 in
thumb
◼ Head
◼ Shaft
◼ Proximal base