The arm plus forearm contain two regions-anterior and posterior surfaces In between are cubital regions-anterior and posterior Below the forearm-carpal region

1. UPPER LIMB
Obaje SG
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2. Machine learning improves prosthetic limb in
amputation
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3. Learning objectives
1.List the main regions of the upper limb
2.Name the important terms, describe various
parts
3. List bones, nerves, vessels, and muscles of
upper limb
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4. GENERAL INTRODUCTION OF
UPPER LIMB
◦Let us look in details the main bones, muscles
vessels, and nerves
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5. Regions of the upper limb
◦Upper limb (UL) divides into-4 main parts
i. Shoulder
ii. Arm
iii. Forearm
iv. Hand
◦Two regions
i. Deltoid region
ii. Axillary region
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6. Regions of the upper limb
◦The arm plus forearm contain two regions-anterior and
posterior surfaces
◦In between are cubital regions-anterior and posterior
◦Below the forearm-carpal region
i. Connects the hands
◦Hand consists-palm (anterior) and dorsum (posteriorly)
i. Further divides into-metacarpal and digit regions
ii. Digits numbered-1 to 5 from thumb to little finger
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7. Upper of the upper limb
◦ Only 5 bones-clavicle, scapula, humerus, radius, and ulna
◦ Forearm bones-radius and ulna
◦ Hand bones-27 bones known as carpal, metacarpal, and
phalanges
i. Carpal bones-scaphoid, lunate, triquetral, pisiform,
trapezium, trapezoid, capitate, hamate
ii. Metacarpal (1-5)
iii. Phalanges-proximal (5) middle (4), and distal (5)
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8. Main joints of UL
◦Acromioclavicular
◦Glenohumeral
◦Elbow
◦Wrist
◦Carpal
◦Carpometacarpal
◦Metacarpophalangeal
◦interphalangeal
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9. FOREARM
◦Carpal tunnel
◦Flexor retinaculum
◦Palmar aponeurosis
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10. Carpal tunnel
◦Narrow osteo-fibrous canal
i. Located in the palmar side of wrist
ii. Roof-found deep to flexor retinaculum/transverse
carpal ligament
iii. Floor composed of carpal bones
iv. Serves as passage way for structures between
forearm and hand
v. Transmits median nerve and 4 tendons of flexors-
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11. CARPAL TUNNEL
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12. Carpal tunnel
◦Structures that refused to pass through the carpal tunnel
are;
◦Tendons of carpal radialis
◦ . Passing though its synovial sheath (tubular
compartment)
◦II. Ulnar artery
◦ .passing through Guyon canal
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13. Carpal tunnel
◦ III. Ulnar nerve
◦ .passing through Guyon canal
◦ IV. Palmaris longus
◦ ……GUYON CANAL
◦ .LOCATED superficial to flexor retinaculum
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14. Issues
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15. Carpal tunnel syndrome
◦Group of signs an symptoms
i. Compression of median nerve
ii. Factors-narrow tunnels, fracture, trauma, swollen of
tendons/lig
iii. Risk factors
i. .diabetes
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16. Carpal tunnel syndrome
◦Pregnancy
◦Obesity
◦Occupational activity/biomechanical
◦Symptoms
◦Pain on the skin of palm except radial aspect being
supplied by palmar cutaneous branch of median
nerve that travel superficially.
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17. Flexor retinaculum
◦Also called transverse carpal ligament
◦Strong and fibrous
◦Rectanular ligt
◦Attaches bones near wrist
. Ulnar ide, FR attached to pisiform and hook of
hamate
.Radial side, FR attached to tubercle of scaphoid
bone
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18. Flexor retinaculum
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19. Palmar aponeurosis
◦Continuation of flexor retinaculum
◦Consist of sheet of connective fibers
◦Located near the distal wrist and radiate to fingers
◦PA attaches to muscles, ligaments, digital sheaths, and
forearm tendon
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20. Palmar aponeurosis
◦Function
◦Gives firm attachment to skin of palm and strength
◦Protects underlying structures
◦Clinical
◦ .Dupuytren’s contracture-hyperflxed proximal and
distal phalanx of fingers (3rd and 4th fingers)
◦ .terminal phalanx remans unaffected
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21. Forearm
◦Class work
.muscles in the compartment of forearm, arm,
and hands
◦students are classified into 10 groups
◦Discusses muscles and graded in class
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22. Sciatic nerve
Learning objectives
i. Describe the general pathway
ii. Major branches
iii. Areas of supply
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23. Sciatic nerve
◦Largest nerve in human body
◦Arises from the lumbosacral plexus in lower back (L4-
S3)
◦Travels through buttock, pelvis, piriformis, posterior
thigh, knee, leg, ankle, and foot
◦Divisions-common fibular nerve and tibial nerve
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24. Sciatic nerve
◦Tibial nerve supplies posterior part of leg, heel, and
plantar surface of foot
◦Common fibular nerve wraps around the head of
fibular bones, dividing into;
◦I. superficial branch
◦II. Deep branch
◦Both supply anterior and lateral compartments of
leg, ankle, and dorsum of foot
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25. Sciatic nerve
◦Supply at levels:
◦Posterior thigh-innervation of hip joint, hamstring
muscles, and ischio-condylar part of adductor
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26. Sciatica
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27. Sciatica
◦Pain going down the leg from the lower back
◦Symptoms
I. Pain going down the leg from the lower back
II. Weakness or numbness of the affected leg
III. Loss of bowel or bladder control
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