Bones and Fractures of the Upper Limb

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Upper Limb and Shoulder Osteology:

1. Clavicle.
2. Scapula.
3. Humerus.
4. Ulna.
5. Radius.
6. Carpus, Metacarpus and Phalanges.

Fracture of the clavicle:

The clavicle is fractured due to a forceful blow to the point of the shoulder. It may result from a fall on outstretched hands, the force being transmitted from hand to radius to humerus and then to shoulder girdle. The fractures commonly occur in the middle third of the shaft, medial to the attachment of the coracoclavicular ligament. The coracoclavicular ligament is made up of trapezoid and conoid ligaments. The medial clavicular segment of the clavicle is displaced upward due to tug from the sternocleidomastoid muscle (head and neck course) and the lateral segment pulled downward by gravity, with inability of the trapezius to elevate it.

Mid shaft fracture of the humerus:

The radial nerve runs spirally around the posterior surface of the humerus as it descends to the elbow. A mid-shaft fracture can injure the radial nerve. This injury would be expected to weaken the extensor muscles of the forearm and produce a "wrist drop" or inability to hold the wrist in a position midway between true flexion and extension. In addition with sensory loss on dorsal forearm and the dorsal side of the lateral 3 1/2 digits of the hand.

Fracture of the humeral head:

This injury is more common in children or young adults where a humerus fracture displaces the head of the humerus along its epiphyseal line. In severe cases the humeral head slides anteriorly, and the edge of the humeral shaft is palpable posteriorly along the proximal end of the humerus. The surgical neck is crossed anteriorly by the radial nerve which can tear or get stretched by a surgical neck fracture. The axillary nerve can be injured during surgical neck fracture causing weakness of the deltoid and teres minor muscles and sensory loss on the lateral surface of the skin over the shoulder.

The shoulder girdle consists of two bones which attach the thoracic wall (scapula and clavicle) to the upper limb.

Chapters on Shoulder Anatomy:

1. Arteries of the Axilla
2. Arteries of the Shoulder Girdle
3. Axillary Artery Aneurysm
4. Axillary Fat and Fascia
5. Axillary Nerve Block
6. Bones and Fractures of the Upper Limb
7. Boundaries of the Axilla
8. Breast Cancer and Axillary Lymph Nodes
9. Erb-Duchenne Palsy
10. Joints of the Shoulder Girdle
11. Klumpke's Paralysis
12. Lymph Nodes of the Axilla
13. Muscles of the Axilla
14. Muscles of the Shoulder Girdle
15. Notes on Shoulder Bursae
16. Roots and Trunks of the Brachial Plexus
17. Winged Scapula in Computer Programmer
18. Transient Axillary Paralysis
19. Variation of Brachial Plexus Structure
20. Veins of the Axilla

Additional Reading:

Histology and Cytology

1. Cell Components
2. Nervous Tissue
3. Muscle Tissue
4. Lymphoid Tissue
5. Integument
6. Respiratory System
7. Gastrointestinal System
8. Renal/Urinary System
9. Male Reproductive System
10. Female Reproductive System

Gross Anatomy

1. Back and Nervous System
2. Thorax
3. Abdomen, Pelvis, and Perineum
4. Upper Limb
5. Lower Limb
6. Head and Neck
7. Chest Wall
8. Shoulder

Anatomy Videos

1. Video of Musculoskeletal Examination in a Clinical Setting
1. Video of HEENT Examination in a Clinical Setting

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1. Jugular Venous Distention Workup

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