Anatomical Spaces of upper limb

Type of joint: hinge synovial joint Degrees of freedom: one Motion possibilities: flexion and extension Osteokinematics: flexion & extension occur in the sagittal plane, around a medial-lateral axis

Type of joints: both are pivot synovial joints Degrees of freedom: one (both joints have one degree of freedom) Motion possibilities: pronation and supination of the radius upon the ulna

Posterior shoulder spaces – 3 small spaces posterior to the glenohumeral joint Axilla – armpit Cubital fossa – anterior to the elbow Carpal tunnel – anterior aspect of wrist Anatomical snuff box – posterolateral aspect of the thumb Ulnar Canal (tunnel of Guyon) – anteromedial wrist

• Quadrangular space • Lateral triangular space • Medial triangular space

Contents • Axillary nerve • Posterior circumflex humeral artery & vein Borders • Teres minor • Teres major • Long head of triceps brachii • Surgical neck of humerus

Contents • Radial nerve • Deep artery of the arm (and deep vein of the arm) Borders • Teres major • Long head of triceps brachii • lateral head of triceps brachii

Contents -Circumflex scapular artery Borders • Teres minor • Teres major • Long head triceps

• Pyramidal anatomical space inferior to the glenohumeral joint • Provides safe passageway for the neurovascular structures of the upper limb Apex – cervicoaxillary canal (space bound by rib 1, clavicle, scapula) Base (axillary fossa/armpit) – concave skin, subcutaneous tissue, axillary (deep) fascia

Anterior wall- Pectoralis Major & Minor, deep fascia Posterior wall- Scapula, Subscapularis, Teres Major, Latissimus Dorsi Medial wall – Ribs 1- 4 & intercostal muscles, Serratus Anterior Lateral wall- intertubercular (bicipital) groove of humerus

• Axillary artery and its branches • Axillary vein and its tributaries • Cords of the brachial plexus and their branches • Axillary lymph vessels and nodes • Fat (adipose tissue)

• Triangular anatomical space • Anterior to the elbow joint • Passageway for neurovascular structures between the arm and forearm

Superior - imaginary line between medial and lateral epicondyles (also known as the base of the space) Medial - pronator teres muscle Lateral - brachioradialis muscle Floor - brachialis and supinator muscle Roof - brachial fascia, bicipital aponeurosis, superficial fascia and skin

• Median nerve • Brachial artery, as it divides into radial & ulnar arteries • Brachial vein (formed by union of radial and ulnar veins) • Biceps brachii tendon • Radial nerve

Veins lie superficial to the cubital fossa • Median cubital vein • Basilic vein • Cephalic vein

An osseofibrous tunnel formed by the carpal bones & flexor retinaculum of the wrist. It is found: • Anterior to the carpals • Deep to flexor retinaculum Clinical relevance – common location of median nerve compression ‘carpal tunnel syndrome

• Flexor digitorum superficialis tendons (4) • Flexor digitorum profundus tendons (4) • Flexor pollicis longus tendon • Median nerve • Synovial sheaths of above muscles

• Anterior: Abductor Pollicis Longus and Extensor Pollicis Brevis tendons • Posterior: tendon of Extensor Pollicis Longus • Floor: Scaphoid and trapezium bones. Radial artery & vein (pulse is palpable) • Roof: Skin and fascia, Superficial branch of the radial nerve

Boundaries: • Pisiform • Hamate • Pisohamate ligament Contents: • Ulnar nerve • Ulnar Artery