Fundamental Philosophy Surgery Series
Upper Limb
Topographic Anatomy | Upper Limb
Anterior view
Trapezius muscle
Clavicle
Acromion
Deltoid muscle
Cephalic vein
Biceps brachii muscle
Cubital fossa
Cephalic vein
Median cubital vein
Brachioradialis muscle
Flexor carpi radialis tendon
Thenar eminence
Radial longitudinal crease
Pectoralis major muscle
Serratus anterior muscle
Triceps brachii muscle (long head)
Basilic vein
Intermediate (median) antebrachial vein
Palmaris longus tendon
Flexor digitorum superficialis tendons
Flexor carpi ulnaris tendon
Hypothenar eminence
Proximal palmar crease
Proximal digital crease
Middle digital crease
Distal digital crease
Posterior view
Deltoid muscle
Triceps brachii muscle Long head
Triceps brachii muscle Lateral
Triceps brachii muscle Tendon
Brachioradialis longus muscle
Extensor carpi radialis longus muscle
Extensor carpi radialis brevis muscle
Extensor pollicis longus tendon
Extensor indicis tendon
Olecranon of ulna
Flexor carpi ulnaris muscle
Extensor carpi ulnaris muscle
Cephalic vein
Extensor digitorum tendons
Site of proximal interphalangeal (PIP) joint
Site of distal interphalangeal (DIP) joint
Shoulder and Axilla | Clavicle and Sternoclavicular Joint
Right clavicle
Superior surface
Acromial end
Shaft body
Right Clavicle Posterior
Right Clavicle Anterior
Sternal end
Inferior surface
Acromial facet
Trapezoid line
Right Clavicle Anterior
Right Clavicle Posterior
Conoid tubercle
Subclavian groove (for subclavian muscle)
Impression for costoclavicular ligament
Sternal facet
Muscle origins
Muscle insertions
Ligament attachments
Superior surface
Trapezius muscle insertion
Deltoid muscle origin
Right clavicle Posterior
Right clavicle Anterior
Sternocleidomastoid muscle origin
Pectoralis major muscle origin
Inferior surface
Deltoid muscle origin
Subclavius muscle insertion
Right Clavicle Anterior
Right Clavicle Posterior
Pectoralis major muscle origin
Costoclavicular ligament attachment
Sternohyoid muscle origin
Coracoclavicular ligament attachments
Coracoclavicular ligament Trapezoid ligament attachment
Coracoclavicular ligament Conoid ligament attachment
Sternoclavicular joint
Interclavicular ligament
Anterior sternoclavicular ligament
Clavicle
Subclavius muscle
Costoclavicular ligament
1st rib
Costal cartilages
2nd rib
Radiate sternocostal ligament
Articular disc of sternoclavicular joint
Articular cavities of sternoclavicular joint
Costoclavicular ligament
Synchondrosis of 1st rib
Manubrium
Sternocostal (synovial) joint
Manubriosternal synchondrosis
Shoulder and Axilla | Humerus and Scapula: Anterior Views
Scapula
Inferior angle
Lateral border
Infraglenoid tubercle
Subscapular fossa
Medial border
Neck
Suprascapular notch
Superior border
Superior angle
Clavicle (cut)
Coracoid process
Acromion
Acromial angle
Supraglenoid tubercle
Glenoid cavity of scapula
Humerus
Head of humerus
Medial epicondyle
Trochlea
Coronoid fossa
Capitulum
Lateral epicondyle
Radial fossa
Medial Condyles
Lateral Condyles
Lateral supracondylar ridge
Medial supracondylar ridge
Deltoid tuberosity
Crest of lesser tubercle
Crest of greater tubercle
Intertubercular sulcus
Surgical neck
Lesser tubercle
Greater tubercle
Anatomical neck
Scapula
Triceps brachii muscle origin(long head)
Subscapularis muscle origin
Serratus anterior muscle insertion
Omohyoid muscle origin
Pectoralis minor muscle insertion
Trapezius muscle insertion
Deltoid muscle origin
Biceps brachii muscle origin (long head)
Coracobrachialis muscle origin
Biceps brachii muscle origin (short head)
Humerus
Supraspinatus muscle insertion
Subscapularis muscle insertion
Pectoralis major muscle insertion
Latissimus dorsi muscle insertion
Teres major muscle insertion
Deltoid muscle insertion
Coracobrachialis muscle insertion
Brachialis muscle origin
Brachioradialis muscle origin
Extensor carpi radialis longus muscle origin
Common extensor tendon origin (extensor carpi radialis brevis, extensor digitorum with extensor digiti minimi, and extensor carpi ulnaris muscles)
Common flexor tendon origin (flexor carpi radialis, palmaris longus, flexor carpi ulnaris and flexor digitorum superficialis [humeroulnar head] muscles)
Supinator muscle insertion
Biceps brachii muscle insertion
Brachialis insertion
Flexor digitorum superficialis muscle origin (humeroulnar head)
Pronator teres muscle origin (ulnar head)
Flexor pollicis longus muscle origin (ulnar head)
Shoulder and Axilla | Humerus and Scapula: Posterior Views
Scapula
Inferior angle
Lateral border
Medial border
Infraspinous fossa
Neck
Spine
Supraspinous fossa
Superior angle
Superior border
Suprascapular notch
Clavicle (cut)
Coracoid process
Acromion
Acromial angle
Notch connecting supraspinous and infraspinous fossae
Groove for circumflex scapular vessels
Humerus
Greater tubercle
Head of humerus
Anatomical neck
Surgical neck
Infraglenoid tubercle
Deltoid tuberosity
Radial groove
Medial supracondylar ridge
Lateral supracondylar ridge
Olecranon fossa
Lateral epicondyle
Trochlea
Groove for ulnar nerve
Medial epicondyle
Triceps brachii muscle insertion
Common flexor tendon origin
Anconeus muscle origin
Common extensor tendon origin
Triceps brachii muscle (medial head) origin
Brachialis muscle origin
Deltoid muscle insertion
Triceps brachii muscle (lateral head) origin
Teres minor muscle insertion
Infraspinatus muscle insertion
Supraspinatus muscle insertion
Deltoid muscle origin
Trapezius muscle insertion
Supraspinatus muscle origin
Levator scapulae muscle insertion
Rhomboid minor muscle insertion
Rhomboid major muscle insertion
Infraspinatus muscle origin
Latissimus dorsi muscle (small slip of origin) origin
Teres major muscle origin
Teres minor muscle origin
Triceps brachii muscle (long head) origin
Shoulder and Axilla | Shoulder: Anteroposterior Radiograph
A Acromion
AN Anatomical neck of humerus
C Clavicle
CP Coracoid process
G Glenoid cavity of scapula
GT Greater tubercle
H Humerus
HH Head of humerus
LT Lesser tubercle
S Scapula (lateral border)
SN Surgical neck of humerus
SS Spine of scapula
Shoulder and Axilla | Shoulder (Glenohumeral Joint)
Anterior view
Capsular ligaments
Biceps brachii tendon (long head)
Subscapularis tendon (cut)
Intertubercular tendon sheath (communicantes with synovial cavity)
Transverse humeral ligament
Greater tubercle of humerus
Lesser tubercle of humerus
Coracohumeral ligament
Supraspinatus tendon (cut)
Coracoacromial ligament
Acromion
Acromioclavicular joint capsule (incorporating acromioclavicular ligament)
Clavicle
Trapezoid ligament of Coracoclavicular ligament
Conoid ligament of Coracoclavicular ligament
Superior transverse scapular ligament and suprascapular notch
Coracoid process
Communication of subtendinous bursa of subscapularis
Broken line indicates position of subtendinous bursa of subscapularis
Anterior view
Deltoid muscle (reflected)
Capsular ligament
Supraspinatus muscle
Subdeltoid bursa fused with subacromial bursa
Subscapularis muscle
Joint opened: lateral view
Opening of subtendinous bursa of subscapularis
Synovial membrane (cut edge)
Teres minor tendon (fused to capsule)
Glenoid cavity (cartilage)
Infraspinatus tendon (fused to capsule)
Subdeltoid bursa
Supraspinatus tendon (fused to capsule)
Acromion
Coracoacromial ligament
Coracoid process
Coracohumeral ligament
Biceps brachii tendon (long head)
Superior glenohumeral ligament
Subscapularis tendon (fused to capsule)
Middle glenohumeral ligament
Inferior glenohumeral ligament
Coronal section through joint
Glenoid cavity of scapula
Axillary recess
Glenoid labrum
Deltoid muscle
Subdeltoid bursa
Supraspinatus tendon capsular ligament
Synovial membrane
Acromion
Acromioclavicular joint
Shoulder and Axilla | Muscles of Shoulder
Posterior view
Triangle of auscultation
Infraspinatus fascia
Deltoid muscle
Trapezius muscle
Semispinalis capitis muscle Not connected to upper limb
Splenius capitis muscle Not connected to upper limb
Spinous process of C7 vertebra
Levator scapulae muscle
Rhomboid minor muscle
Acromion
Supraspinatus muscle
Spine of scapula
Infraspinatus muscle
Teres minor muscle
Teres major muscle
Latissimus dorsi muscle
Long head of triceps brachii muscle
Lateral head of triceps brachii muscle
Spinous process of T12 vertebra
Anterior view
Acromion
Deltopectoral triangle
Deltoid muscle
Deltoid branch of thoracoacromial artery
Cephalic vein
Long head of Biceps brachii muscle
Short head of Biceps brachii muscle
Triceps brachii muscle (lateral head)
Latissimus dorsi muscle
Serratus anterior muscle
External oblique muscle
Trapezius muscle
Omohyoid muscle and investing layer of deep cervical fascia
Sternocleidomastoid muscle
Clavicle
Clavicular head of Pectoralis major muscle
Sternocostal head of Pectoralis major muscle
Abdominal part of Pectoralis major muscle
Sternum
6th costal cartilage
Anterior layer of rectus sheath
Shoulder and Axilla | Muscles of Rotator Cuff
Superior view
Trapezoid ligament of Coracoclavicular ligament
Conoid ligament of Coracoclavicular ligament
Coracoid process
Subscapularis tendon
Coracoacromial ligament
Acromioclavicular joint
Supraspinatus tendon
Infraspinatus tendon
Teres minor tendon
Acromion
Infraspinatus muscle
Spine of scapula
Supraspinatus muscle
Subscapularis muscle
Superior border of scapula
Clavicle
Anterior view
Subscapularis muscle
Biceps brachii tendon (long head)
Supraspinatus tendon
Acromion
Coracoacromial ligament
Coracoid process
Superior transverse scapular ligament and suprascapular notch
Posterior view
Supraspinatus muscle
Spine of scapula
Acromion
Supraspinatus tendon
Infraspinatus muscle
Teres minor muscle
Axillary nerve
Shoulder and Axilla | Scapulohumeral Dissection
Lateral view
Long thoracic nerve
Teres major muscle
Subscapularis muscle
Scapula (retracted)
Accessory nerve (XI)
Levator scapulae muscle
Phrenic nerve
Anterior Scalene muscles
Middle Scalene muscles
Posterior Scalene muscles
Brachial plexus
Subclavian artery and vein
Superior thoracic artery
External intercostal membrane anterior to internal intercostal muscle
Perforating branch of internal thoracic artery and anterior cutaneous branch of intercostal nerve
Intercostobrachial nerve
External intercostal muscle
Lateral thoracic artery
Lateral cutaneous branches of intercostal nerves and posterior intercostal arteries
Serratus anterior muscle
Anterior view
Acromion
Supraspinatus tendon
Greater tubercle of humerus
Subscapularis tendon
Intertubercular tendon sheath
Anterior circumflex humeral artery
Biceps brachii tendon (long head) (cut)
Axillary nerve and posterior circumflex humeral artery
Quadrangular space
Radial nerve
Long head Biceps brachii muscle
Short head Biceps brachii muscle
Coracobrachialis muscle
Triangular space
Latissimus dorsi muscle
Coracoacromial ligament
Coracoid process
Suprascapular artery and nerve
Superior transverse scapular ligament and suprascapular notch
Pectoralis minor tendon (cut)
Biceps brachii tendon (short head) (cut) and coracobrachialis tendon (cut)
Subscapularis muscle
Subscapular artery
Lower subscapular nerve (to teres major muscle)
Circumflex scapular artery
Thoracodorsal artery and nerve (to latissimus dorsi muscle)
Subscapularis muscle
Teres major muscle
Posterior view
Superior transverse scapular ligament and suprascapular notch
Supraspinatus muscle (cut)
Spine of scapula
Infraspinatus muscle (cut)
Triangular space with circumflex scapular artery deep to space
Teres major muscle
Suprascapular artery and nerve
Acromion
Infraspinatus tendon (reflected)
Joint capsule of shoulder
Deltoid muscle (reflected)
Teres minor muscle
Quadrangular space transmitting axillary nerve and posterior circumflex humeral artery
Superior lateral brachial cutaneous nerve
Profunda brachii (deep brachial) artery
Radial nerve
Lateral head of triceps brachii muscle
Long head of triceps brachii muscle
Shoulder and Axilla | Axilla Artery and Anastomoses around Scapula
Anterior view
Transverse cervical artery
Suprascapular artery
Acromion and acromial anastomosis
Dorsal scapular artery
Coracoid process
Anterior circumflex humeral artery
Posterior circumflex humeral artery
Subscapular artery
Circumflex scapular artery
Brachial artery
Thoracodorsal artery
Lateral thoracic artery
Ascending cervical artery
Inferior thyroid artery
Thyrocervical trunk
Subclavian artery
Anterior scalene muscle
Clavicle (cut)
Superior thoracic artery
Thoracoacromial artery
Clavicular branch
Acromial branch
Deltoid branch
Pectoral branch
1st part ot axillary artery
2nd part of axillary artery
3rd part of axillary artery
Posterior view
Levator scapulae muscle
Dorsal scapular artery
Supraspinatus muscle (cut)
Superior transverse scapular ligament and suprascapular notch
Spine of scapula
Infraspinatus muscle (cut)
Teres minor muscle (cut)
Teres major muscle
Omohyoid muscle (inferior belly)
Suprascapular artery
Acromial branch of thoracoacromial artery
Acromion and acromial plexus
Infraspinous branch of suprascapular artery
Posterior circumflex humeral artery (in quadrangular space) and ascending and descending branches
Circumflex scapular artery
Lateral head of Triceps brachii muscle
Long head of Triceps brachii muscle
Shoulder and Axilla | Pectoral, Clavipectoral, and Axillary Fasciae
Anterior view
Thoracoacromial artery
Coracoid process
Cephalic vein
Deltoid muscle
Pectoralis major muscle (cut)
Short head of Biceps brachii muscle
Long head of Biceps brachii muscle
Brachial fascia (cut edge) over coracobrachialis and biceps brachii muscles
Trapezius muscle
Omohyoid muscle invested by fascia of infrahyoid muscles
Clavicle
Fascia investing subclavius muscle*
Costocoracoid ligament*
Costoclavicular ligament
Costocoracoid membrane*
Fascia investing pectoralis minor muscle*
Suspensory ligament of axilla*
Pectoralis major muscle and pectoral fascia (superficial and deep layers)
Latissimus dorsi fascia
Serratus anterior fascia
Axillary fascia (anterior part)
Oblique parasagittal section of axilla
Trapezius muscle
Lateral cord of Brachial plexus
Posterior cord of Brachial plexus
Medial cord of Brachial plexus
Supraspinatus muscle
Spine of Scapula
Body of Scapula
Infraspinatus muscle
Subscapularis muscle
Teres minor muscle
Teres major muscle
Latissimus dorsi muscle
Central Axillary lymph nodes
Pectoral (anterior) Axillary lymph nodes
Omohyoid muscle
Clavicle
Subclavius muscle and fascia*
Costocoracoid ligament*
Thoracoacromial artery and cephalic vein
Costocoracoid membrane*
Lateral pectoral nerve
Axillary artery and vein
Pectoralis major muscle and fascia
Pectoralis minor muscle and fascia*
Medial pectoral nerve
Suspensory ligament of axilla
Axillary fascia (fenestrated)
*Components of clavipectoral fascia
Shoulder and Axilla | Axilla (Dissection):: Anterior View
Omohyoid muscle
Sternocleidomastoid muscle
Anterior scalene muscle
Transverse cervical artery
Dorsal scapular artery and nerve
Suprascapular artery and nerve
Trapezius muscle
Clavicle and subclavius muscle (cut)
Axillary artery
Pectoral branch
Clavicular branch
Deltoid branch
Acromial branch
Thoracoacromial artery
Pectoralis minor tendon (cut)
Coracoid process
Acromion
Cephalic vein
Musculocutaneous nerve
Anterior circumflex humeral artery
Axillary nerve and posterior circumflex humeral artery
Pectoralis major muscle (cut)
Coracobrachialis muscle
Deltoid muscle
Biceps brachii muscle
Musculocutaneous nerve
Brachialis muscle
Profunda brachii (deep brachial) artery
Radial nerve
Triceps brachii muscle
Brachial veins
Ulnar nerve
Median nerve
Brachial nerve
Medial antebrachial cutaneous nerve
Basilic vein
Ulnar nerve
Medial brachial cutaneous nerve
Intercostobrachial nerve
Circumflex scapular artery
Lower subscapular nerve
Teres major muscle
Subscapular artery
Latissimus dorsi muscle
Thoracodorsal artery and nerve
Upper subscapular nerve
Serratus anterior muscle
Lateral thoracic artery and long thoracic nerve
Ansa pectoralis
Pectoralis minor (cut)
Medial pectoral nerve
Lateral pectoral nerve
Superior thoracic artery
Brachial plexus
1st rib
Subclavian artery and vein
Shoulder and Axilla | Brachial Plexus: Schema
Note: Usual composition shown. Prefixed plexus has large C4 contribution but lacks T1. Postfixed plexus lacks C5 but has T2 contribution
Terminal branches
Ulnar nerve (C7, 8, T1)
Median nerve (C5, 6, 7, 8, T1)
Radial nerve (C5, 6, 7, 8, T1)
Axillary nerve (C5, 6)
Musculocutaneous nerve (C5, 6, 7)
3 cords
Lateral pectoral nerves (C5, 6, 7)
Lateral
Posterior
Lower subscapular nerve (C5, 6)
Thoracodorsal (middle subscapular) nerve (C6, 7, 8)
Upper subscapular nerve (C5, 6)
Medial
Medial pectoral nerve (C8, T1)
Medial brachial cutaneous nerve (T1)
Medial antebrachial cutaneous nerve (C8, T1)
3 anterior divisions
3 posterior divisions
3 trunks
Suprascapular nerve (C5, 6)
To subclavius nerve (C5, 6)
Superior
Middle
Inferior
1st rib
5 roots (ventral rami of spinal nerves)
To phrenic nerve
Dorsal scapular (C5)
Contribution from C4
Dorsal ramus
C5
C6
C7
C8
T1
Contribution T2
To longus colli and scalene muscles (C5, 6, 7, 8)
1st intercostal nerve
Long thoracic nerve (C5, 6, 7)
Arm | Muscles of Arm: Anterior Views
Superficial layer
Coracoacromial ligament
Subdeltoid bursa
Greater tubercle of humerus
Lesser tubercle of humerus
Intertubercular tendon sheath
Deltoid muscle (reflected)
Pectoralis major muscle (reflected)
Anterior circumflex humeral artery
Long head of Biceps brachii muscle
Short head of Biceps brachii muscle
Brachial artery (cut)
Median nerve (cut)
Brachialis muscle
Lateral antebrachial cutaneous nerve
Bicipital aponeurosis
Biceps brachii tendon
Brachioradialis muscle
Pronator teres muscle
Flexor carpi radialis muscle
Acromion
Coracoid process
Pectoralis minor tendon (cut)
Subscapularis muscle
Musculocutaneous nerve (cut)
Coracobrachialis muscle
Circumflex scapular artery (cut)
Teres major muscle
Latissimus dorsi muscle
Deep layer
Short head of Biceps brachii tendons (cut)
Long head of Biceps brachii tendons (cut)
Coracobrachialis muscle
Musculocutaneous nerve
Branch to biceps brachii (cut)
Deltoid muscle (cut)
Brachialis muscle
Medial intermuscular septum
Medial epicondyle of humerus
Tuberosity of ulna
Lateral intermuscular septum
Lateral epicondyle of humerus
Lateral antebrachial cutaneous nerve
Head of radius
Biceps brachii tendon
Radial tuberosity
Arm | Muscles of Arm: Posterior Views
Superficial layer
Acromion
Supraspinatus muscle
Greater tubercle of humerus
Infraspinatus muscle
Teres minor muscle
Axillary nerve and posterior circumflex humeral artery
Deltoid muscle (cut and reflected)
Superior lateral brachial cutaneous nerve
Long head of Triceps brachii muscle
Lateral head of Triceps brachii muscle
Tendon of Triceps brachii muscle
Brachioradialis muscle
Teres major muscle
Posterior brachial cutaneous nerve (from radial nerve)
Medial intermuscular septum
Ulnar nerve
Medial epicondyle of humerus
Olecranon of ulna
Flexor carpi ulnaris muscle
Anconeus muscle
Extensor carpi radialis longus muscle
Extensor carpi ulnaris muscle
Posterior antebrachial cutaneous nerve (from radial nerve)
Extensor digitorum muscle
Extensor carpi radialis brevis muscle
Deep layer
Capsule of shoulder joint
Supraspinatus tendon
Infraspinatus
Teres minor tendons (cut)
Axillary nerve
Posterior circumflex humeral artery
Superior lateral brachial cutaneous nerve
Profunda brachii (deep brachial) artery
Radial nerve
Middle collateral artery
Radial collateral artery
Inferior lateral brachial cutaneous nerve
Lateral intermuscular septum
Nerve to anconeus and medial head of triceps brachii muscle
Posterior antebrachial cutaneous nerve
Lateral epicondyle of humerus
Teres major muscle
Long head of triceps brachii muscle
Lateral head of triceps brachii muscle (cut)
Medial head of triceps brachii muscle
Medial epicondyle of humerus
Ulnar nerve
Olecranon of ulna
Anconeus muscle
Arm | Brachial Artery in Situ
Coracoid process
Deltoid muscle
Anterior circumflex humeral artery
Humerus
Pectoralis major muscle and tendon (cut)
Long head of Biceps brachii muscle
Short head of Biceps brachii muscle
Coracobrachialis muscle
Brachial artery
Muscular branch
Median nerve
Muscular branch
Biceps brachii muscle
Brachialis muscle
Radial recurrent artery
Biceps brachii tendon
Radial artery
Axillary artery
Pectoralis minor muscle (cut)
Lateral cord of brachial plexus
Medial cord of brachial plexus
Musculocutaneous nerve
Subscapularis muscle
Anterior and posterior circumflex humeral arteries
Teres major muscle
Latissimus dorsi muscle
Profunda brachii (deep brachial) artery
Medial brachial cutaneous nerve
Ulnar nerve
Medial antebrachial cutaneous nerve
Long head of Triceps brachii muscle
Medial head of Triceps brachii muscle
Superior ulnar collateral artery
Medial intermuscular septum
Inferior ulnar collateral artery
Medial epicondyle of humerus
Bicipital aponeurosis
Pronator teres muscle
Ulnar artery
Flexor carpi radialis muscle
Brachioradialis muscle
Arm | Brachial Artery and Anastomoses around Elbow
Pectoral branch
Clavicular branch
Acromial branch
Deltoid branch
Thoracoacromial artery
Axillary artery
Anterior circumflex humeral artery
Posterior circumflex humeral artery
Brachial artery
Profunda brachii (deep brachial) artery
Radial collateral artery
Middle collateral artery
Radial recurrent artery
Recurrent interosseous artery
Posterior interosseous artery
Radial artery
Superior thoracic artery
Lateral thoracic artery
Subscapular artery
Circumflex scapular artery
Thoracodorsal artery
Level of lower margin of teres major muscle is landmark for name change from axillary to brachial artery
Superior ulnar collateral artery
Inferior ulnar collateral artery
Anterior ulnar recurrent artery
Posterior ulnar recurrent artery
Common interosseous artery
Anterior interosseous artery
Ulnar artery
Arm | Arm: Serial Cross Sections
Pectoralis major muscle and tendon
Cephalic vein
Short head of Biceps brachii muscle
Long head of Biceps brachii muscle
Coracobrachialis muscle
Humerus
Deltoid muscle
Lateral head of Triceps brachii muscle
Long head of Triceps brachii muscle
Biceps brachii muscle
Musculocutaneous nerve
Brachialis muscle
Brachialis muscle
Cephalic vein
Radial nerve
Posterior antebrachial cutaneous nerve (from radial nerve)
Radial collateral artery
Middle collateral artery
Lateral intermuscular septum
Medial head of Triceps brachii muscle
Lateral head of Triceps brachii muscle
Long head of Triceps brachii muscle
Biceps brachii muscle
Cephalic vein
Brachialis muscle
Brachioradialis muscle
Radial nerve
Extensor carpi radialis longus muscle
Posterior antebrachial cutaneous nerve (from radial nerve)
Musculocutaneous nerve
Median nerve
Medial antebrachial cutaneous nerve
Brachial artery and veins
Basilic vein
Profunda brachii (deep brachial) artery
Ulnar nerve
Radial nerve
Medial brachial cutaneous nerve
Latissimus dorsi tendon
Teres major muscle
Brachial fascia
Median nerve
Brachial artery and veins
Medial antebrachial cutaneous nerve
Basilic vein
Medial brachial cutaneous nerve
Neurovascular compartment
Ulnar nerve
Superior ulnar collateral artery
Medial intermuscular artery
Medial intermuscular septum
Brachial fascia
Lateral antebrachial cutaneous nerve (from musculocutaneous nerve)
Medial antebrachial cutaneous nerve
Basilic vein
Median nerve
Ulnar nerve
Brachial artery and veins
MEdial intermuscular septum
Humerus
Triceps brachii muscle and tendon
Lateral intermuscular septum
Elbow and Forearm | Bones of Elbow
Right elbow
In extension: anterior view
Medial Condyle
Lateral Condyle
Lateral supracondylar ridge
Radial fossa
Lateral epicondyle
Capitulum
Head
Neck
Tuberosity
Radius
Humerus
Medial supracondylar ridge
Coronoid fossa
Medial epicondyle
Trochlea
Coronoid process
Radial notch of ulna
Tuberosity
Ulna
In extension: posterior view
Humerus
Olecranon fossa
Medial epicondyle
Groove for ulnar nerve
Ulna
Lateral epicondyle
Olecranon
Head
Neck
Tuberosity
Radius
In extension: lateral view
Humerus
Radius
Ulna
In extension: medial view
Radius
Ulna
Sublime tubercle
Humerus
In 90° flexion: lateral view
Humerus
Lateral epicondyle
Capitulum
Head
Neck
Tuberosity
Olecranon of ulna
Trochlear notch of ulna
Coronoid process of ulna
Radial notch
In 90° flexion: medial view
Humerus
Medial epicondyle
Capitulum
Trochlea
Head
Neck
Tuberosity
Tuberosity of ulna
Coronoid process of ulna
Trochlear notch of ulna
Olecranon of ulna
Elbow and Forearm | Elbow: Radiographs
Lateral radiograph
C Capitulum
CP Coronoid process of ulna
H Humerus
HR Head of radius
L Lateral epicondyle
O Olecranon
R Radius
T Trochlear notch
U Ulna
Anteroposterior radiograph
C Capitulum
CP Coronoid process of ulna
H Humerus
HR Head of radius
L Lateral epicondyle
M Medial of epicondyle
NR Neck of radius
O Olecranon
OF Olecranon fossa
R Radius
T Trochlea of humerus
RT Radial tuberosity
U Ulna
Elbow and Forearm | Ligaments of Elbow
Right elbow
Anterior view
Joint capsule
Lateral epicondyle
Radial collateral ligament
Annular ligament of radius
Biceps of brachii tendon
Radial
Humerus
Medial epicondyle
Ulnar collateral ligament
Insertion of brachialis muscle
Oblique cord
Ulna
In 90° flexion: lateral view
Humerus
Triceps brachii tendon
Subcutaneous olecranon bursa
Joint capsule
Radial collateral ligament
Annular ligament of radius
Biceps brachii tendon
Radius
Ulna
In 90° flexion: lateral view
Humerus
Joint capsule
Ulnar collateral ligament
Annular ligament of radius
Biceps brachii tendon
Oblique cord
Triceps brachii tendon
Subcutaneous olecranon bursa
Opened joint: anterior view
Humerus
Radius
Ulna
Joint capsule (cut edge)
Fat pads
Synovial membrane
Articular cartilage
Opened joint: posterior view
Humerus
Ulna
Radius
Elbow and Forearm | Bones of Forearm
Right radius and ulna in supination: anterior view
Head
Neck
Radial Tuberosity
Radius
Anterior surface
Anterior border
Interosseous border
Interosseous membrane
Olecranon
Trochlear notch
Coronoid process
Radial notch of ulna
Oblique cord
Ulna
Anterior surface
Anterior border
Interosseous border
Styloid process
Styloid process of ulna
Right radius and ulna in pronation: anterior view
Olecranon
Trochlear notch
Coronoid process
Oblique cord
Ulnar tuberosity
Radius
Ulna
Lateral surface
Posterior border
Posterior surface
Interosseous membrane
Groove for extensor pollicis longus muscle
Groove for extensor digitorum and extensor indicis muscles
Styloid process of ulna
Dorsal tubercle
Groove for extensor carpi radialis longus and brevis muscles
Area for extensor pollicis brevis and abductor pollicis longus muscles
Styloid process
Coronal section of radius demonstrates how thickness of cortical bone of shaft diminishes to thin layer over cancellous bone at distal end
Elbow and Forearm | Individual Muscles of Forearm: Rotators of Radius
Right forearm: anterior view
Supinated position
Lateral epicondyle
Radius
Medial epicondyle
Supinator
Pronator teres
Ulna
Pronator quadratus
Pronated position
Medial epicondyle
Lateral epicondyle
Supinator
Pronator teres
Ulna
Radius
Pronator quadratus
Elbow and Forearm | Individual Muscles of Forearm: Extensors of Wrist and Digits
Right forearm: posterior (dorsal) views
Medial epicondyle
Olecranon
Lateral epicondyle
Common extensor tendon
Ulna
Extensor indicis tendon
Note: Anconeus muscle not shown because it is extensor of elbow
Extensors of wrist
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor of digits (except thumb)
Extensor digitorum
Extensor digiti minimi
Extensor indicis
Extensors of thumb
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Medial condyle
Olecranon
Lateral epicondyle
Common extensor tendon
Extensor digitorum and extensor digiti minimi (cut away)
Interosseous membrane
Radius
Ulna
Elbow and Forearm | Individual Muscles of Forearm: Flexors of Wrist
Right forearm: anterior (palmar) view
Note: Brachioradialis muscle not shown because it is flexor of elbow
Lateral epicondyle
Medial epicondyle
Common flexor tendon
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Radius
Ulna
Pisiform
Hook of hamate
Palmar aponeurosis (cut)
Elbow and Forearm | Individual Muscles of Forearm: Flexors of Digits
Right forearm: anterior (palmar) views
Medial epicondyle
Lateral epicondyle
Coronoid process
Interosseous membrane
Radius
Radius
Common flexor tendon
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Ulna
Medial epicondyle
Lateral epicondyle
Common flexor tendon
Coronoid process
Interosseous membrane
Radius
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Radius
Ulna
Flexor digitorum superficialis tendons (cut away)
Elbow and Forearm | Muscles of Foreamr (Superficial Layer): Posterior View
Superior ulnar collateral artery (anastomoses distally with posterior ulnar recurrent artery)
Ulnar nerve
Medial epicondyle
Olecranon of ulna
Anconeus muscle
Flexor carpi ulnaris muscle
Extensor carpi ulnaris muscle
Extensor retinaculum (compartments numbered 1-6)
Dorsal branch of ulnar nerve
Extensor carpi ulnaris tendon
Extensor digitorum tendons
Extensor indicis tendon
5th metacarpal bone
Triceps brachii muscle
Brachioradialis muscle
Extensor carpi radialis longus muscle
Common extensor tendon
Extensor carpi radialis brevis muscle
Extensor digitorum muscle
Extensor digiti minimi muscle
Abductor pollicis longus muscle
Extensor pollicis brevis muscle
Extensor pollicis longus tendon
Extensor carpi radialis brevis tendon
Extensor carpi radialis longus tendon
Superficial branch of radial nerve
Abductor pollicis longus tendon
Extensor pollicis brevis tendon
Extensor pollicis longus tendon
Anatomical snuffbox
Elbow and Forearm | Muscles of Forearm (Deep Layer): Posterior View
Branches of Superior ulnar collateral
Branches of Inferior ulnar collateral (posterior branch)
Medial intermuscular septum
Ulnar nerve
Posterior ulnar recurrent artery
Medial epicondyle of humerus
Triceps brachii tendon (cut)
Olecranon of ulna
Anconeus muscle
Flexor carpi ulnaris muscle
Recurrent interosseous artery
Posterior interosseous artery
Ulna
Extensor pollicis longus muscle
Extensor indicis muscle
Anterior interosseous artery (termination)
Extensor carpi ulnaris tendon (cut)
Extensor digiti minimi tendon (cut)
Extensor digitorum tendons (cut)
Extensor retinaculum (compartments numbered)
5th metacarpal bone
Middle collateral branch of deep brachial artery
Lateral intermuscular septum
Brachioradialis muscle
Extensor carpi radialis longus muscle
Lateral epicondyle of humerus
Common extensor tendon (partially cut)
Extensor carpi radialis brevis muscle
Supinator muscle
Posterior interosseous nerve
Pronator teres muscle (slip of insertion)
Radius
Posterior interosseous nerve
Abductor pollicis longus muscle
Extensor pollicis brevis muscle
Extensor carpi radialis brevis tendon
Extensor carpi radialis longus tendon
Radial artery
1st metacarpal bone
2nd metacarpal bone
1st dorsal interosseous muscle
Elbow and Forearm | Muscles of Foramen (Superficial Layer): Anterior View
Biceps brachii muscle
Brachial artery and median nerve
Lateral antebrachial cutaneous nerve (terminal musculocutaneous nerve)
Brachialis muscle
Biceps brachii tendon
Radial artery
Bicipital aponeurosis
Brachioradialis muscle
Extensor carpi radialis brevis muscle
Flexor pollicis longus muscle and tendon
Radial artery
Median nerve
Palmar carpal ligament (continuous with extensor retinaculum
Thenar muscles
Palmar carpal ligament (continuous with extensor retinaculum)
Thenar muscles
Palmar aponeurosis
Medial antebrachial cutaneous nerve
Ulnar nerve
Triceps brachii muscle
Medial intermuscular septum
Ulnar artery
Medial epicondyle of humerus
Common flexor tendon
Flexor carpi radialis muscle of Superficial flexor muscles
Palmaris longus muscle of Superficial flexor muscles
Flexor carpi ulnaris muscle of Superficial flexor muscles
Flexor digitorum superficialis muscle of of Superficial flexor muscles
Palmaris longus tendon
Dorsal branch of ulnar nerve
Ulnar artery and nerve
Pisiform
Palmar branch of median nerve
Hypothenar muscles
Elbow and Forearm | Muscles of Forearm (Intermediate Layer): Anterior View
Biceps brachii muscle
Brachialis muscle
Lateral antebrachial cutaneous nerve (cut) (from musculocutaneous nerve)
Radial nerve
Deep branch
Superficial branch
Biceps brachii tendon
Radial recurrent artery
Radial artery
Supinator muscle
Brachioradialis muscle
Pronator teres muscle (cut)
Flexor digitorum superficialis muscle (radial head)
Flexor pollicis longus muscle
Palmar capital ligament (continuous with extensor retinaculum) with palmaris longus tendon (cut and reflected)
Flexor carpi radialis tendon (cut)
Superficial palmar branch of radial artery
Ulnar nerve
Median nerve
Brachial nerve
Medial intermuscular septum
Pronator teres muscle (humeral head) (cut and reflected)
Medial epicondyle
Flexor carpi radialis and palmaris longus tendons (cut)
Anterior ulnar recurrent artery
Flexor digitorum superficialis muscle (humeroulnar head)
Anterior ulnar recurrent artery
Flexor digitorum superficialis muscle (humeroulnar head)
Ulnar artery
Common interosseous artery
Pronator teres muscle (ulnar head) (cut)
Anterior interosseous artery
Flexor carpi ulnaris muscle
Flexor digitorum superficialis muscle
Ulnar artery
Ulnar nerve and dorsal branch
Median nerve
Palmar branches of median and ulnar nerves (cut)
Pisiform
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Superficial branch of ulnar nerve
Flexor retinaculum (transverse carpal ligament)
Elbow and Forearm | Muscles of Forearm (Deep Layer): Anterior View
Brachialis muscle
Musculocutaneous nerve
Lateral antebrachial cutaneous nerve
Lateral intermuscular septum
Radial nerve
Lateral epicondyle
Biceps brachii tendon (cut)
Radial recurrent artery
Radial artery
Supinator muscle
Posterior and anterior interosseous arteries
Flexor digitorum superficialis muscle (radial head) (cut)
Pronator teres muscle (cut and reflected)
Radial artery
Flexor pollicis longus muscle and tendon (cut)
Radius
Pronator quadratus muscle
Brachioradialis tendon (cut)
Radial artery and superficial palmar branch
Flexor pollicis longus tendon (cut)
Flexor carpi radialis tendon (cut)
Abductor pollicis longus tendon
Extensor pollicis brevis tendon
1st metacarpal bone
Ulnar nerve
Median nerve
Brachial artery
Medial intermuscular septum
Pronator teres muscle (humeral head cut and reflected)
Anterior ulnar recurrent artery
Medial epicondyle of humerus
Flexor carpi radialis, palmaris longus, flexor digitorum superficialis (humeroulnar head), and flexor carpi ulnaris muscles (cut)
Posterior ulnar recurrent artery
Ulnar artery
Common interosseous artery
Pronator teres muscle (ulnar head) (cut)
Median nerve (cut)
Flexor digitorum profundus muscle
Anterior interosseous artery and nerve
Ulnar nerve and dorsal branch
Palmar carpal branches of radial and ulnar arteries
Flexor carpi ulnaris tendon (cut)
Pisiform
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Hook of hamate
5th metacarpal bone
Elbow and Forearm | Forearm: Serial Cross Sections
Median antebrachial vein
Pronator teres muscle
Radial artery and superficial branch of radial nerve
Radius
Brachioradialis muscle
Cephalic vein and lateral antebrachial cutaneous nerve (from musculocutaneous nerve)
Supinator muscle
Deep branch of radial nerve
Extensor carpi radialis longus muscle
Extensor carpi radialis brevis muscle
Extensor digitorum muscle
Extensor digiti minimi muscle
Extensor carpi ulnaris muscle
Flexor carpi radialis muscle
Brachioradialis muscle
Radial artery and superficial branch of radial nerve
Flexor pollicis longus muscle
Extensor carpi radialis longus muscle and tendon
Radius
Extensor carpi radialis brevis muscle and tendon
Abductor pollicis longus muscle
Extensor digitorum muscle
Extensor digiti minimi muscle
Extensor carpi ulnaris muscle
Flexor carpi radialis tendon
Radial artery
Brachioradialis tendon
Abductor pollicis longus tendon
Superficial branch of radial nerve
Extensor pollicis brevis tendon
Extensor carpi radialis longus tendon
Extensor carpi radialis brevis tendon
Flexor pollicis longus muscle
Extensor pollicis longus tendon
Radius
Flexor digitorum superficialis muscle (radial head)
Anterior branch of medial antebrachial cutaneous nerve
Flexor pollicis longus muscle
Interosseous membrane
Flexor carpi radialis muscle
Ulnar artery and median nerve
Palmaris longus muscle
Flexor digitorum superficialis muscle (humeroulnar head)
Common interosseous artery
Ulnar nerve
Flexor carpi ulnaris muscle
Basilic vein
Flexor digitorum profundus muscle
Ulna and antebrachial fascia
Anconeus muscle
Posterior antebrachial cutaneous nerve (from radial nerve)
Palmaris longus muscle
Flexor digitorum superficialis muscle
Median nerve
Ulnar artery and nerve
Flexor carpi ulnaris muscle
Anterior interosseous artery and nerve (from median nerve)
Flexor digitorum profundus muscle
Ulna and antebrachial fascia
Interosseous membrane and extensor pollicis longus muscle
Posterior interosseous artery and nerve (continuation of deep branch of radial nerve)
Palmaris longus tendon
Median nerve
Flexor digitorum superficialis muscle and tendons
Flexor carpi ulnaris muscle and tendon
Ulnar artery and nerve
Dorsal branch of ulnar nerve
Flexor digitorum profundus muscle and tendons
Antebrachial fascia
Ulna
Extensor carpi ulnaris tendon
Pronator quadratus muscle and interosseous membrane
Extensor indicis muscle and tendon
Extensor digiti minimi tendon
Extensor digitorum tendons (common tendon to digits 4 and 5 at this level)
Elbow and Forearm | Attachments of Muscles of Forearm: Anterior View
Brachioradialis muscle
Extensor carpi radialis longus muscle
Supinator
Extensor carpi radialis brevis of Common extensor tendon
Extensor digitorum of Common extensor tendon
Extensor digiti minimi of Common extensor tendon
Extensor carpi ulnaris muscles of Common extensor tendon
Brachialis muscle
Biceps brachii muscle
Supinator muscle
Flexor digitorum superficialis muscle (radial head)
Pronator teres muscle
Flexor pollicis longus muscle
Radius
Pronator quadratus muscle
Brachioradialis muscle
Abductor pollicis longus muscle
Flexor carpi radialis muscle
Flexor pollicis longus muscle
Brachialis muscle
Pronator teres muscle (humeral head)
Pronator teres of Common flexor tendon
Flexor carpi radialis of Common flexor tendon
Palmaris longus of Common flexor tendon
Flexor carpi ulnaris of Common flexor tendon
Flexor digitorum superficialis (humeroulnar head) muscle of Common extensor tendon
Flexor digitorum superficialis muscle (humeroulnar head)
Pronator teres muscle (ulnar head)
Flexor digitorum profundus muscle
Ulna
Pronator quadratus muscle
Note: Attachments of intrinsic muscles of hand not shown
Flexor carpi ulnaris muscle
Extensor carpi ulnaris muscle
Flexor digitorum superficialis muscle
Flexor digitorum profundus muscle
Origins
Insertions
Elbow and Forearm | Attachments of Mucles of Forearm: Posterior View
Note: Attachments of intrinsic muscles of hand not shown
Triceps brachii muscle (medial head)
Triceps brachii tendon
Supinator
Anconeus muscle
Biceps brachii muscle
Supinator muscle
Abductor pollicis longus muscle
Pronator teres muscle
Extensor pollicis brevis muscle
Radius
Brachioradialis muscle
Abductor pollicis longus muscle
Extensor pollicis brevis muscle
Extensor pollicis longus muscle
Extensor indicis muscle
Flexor carpi ulnaris muscle (humeral origin via common flexor tendon)
Flexor carpi ulnaris muscle (ulnar origin)
Flexor digitorum profundus muscle
Extensor carpi ulnaris muscle (ulnar origin)
Extensor pollicis longus muscle
Extensor indicis muscle
Ulna
Extensor carpi radialis longus muscle
Extensor carpi radialis brevis muscle
Extensor carpi ulnaris muscle
Extensor digitorum muscle (central bands)
Extensor digiti minimi muscle
Extensor digitorum muscle (lateral bands)
Wrist and Hand | Carpal Bones
Anterior (palmar) view
Radius
Radial styloid process
Scaphoid
Tubercle of scaphoid
Trapezium
Tubercle of trapezium
Trapezoid
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Ulna
Ulnar styloid process
Lunate
Triquetrum
Pisiform
Hamate
Hook of hamate
Capitate
Posterior (dorsal) view
Ulna
Ulnar styloid process
Lunate
Triquetrum
Hamate
Capitate
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Radius
Dorsal tubercle of radius (Lister’s)
Scaphoid
Radial styloid process
Trapezium
Trapezoid
Wrist and Hand | Movements of Wrist
Position of carpal bones with hand in abduction: anterior (palmar) view
Radius
Scaphoid
Capitate
Trapezoid
Trapezium
Sesamoid bones
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Ulna
Lunate
Triquetrum
Pisiform
Hamate
Position of carpal bones with hand in adduction: anterior (palmar) view
Radius
Scaphoid
Capitate
Trapezium
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Sesamoid bones
Ulna
Lunate
Triquetrum
Pisiform
Hamate
Sagittal sections through wrist and middle finger
Hand in anatomical position
Radius
Wrist (radiocarpal) joint
Articular disc of wrist joint
Lunate
Midcarpal joint
Capitate
Carpometacarpal joint
3rd metacarpal bone
Dorsum
Palm
Hand in flexion
Radius
Wrist (radiocarpal) join
Midcarpal joint
Carpometacarpal joint
Palm
Hand in extension
Wrist (radiocarpal) joint
Midcarpal joint
Carpometacarpal joint
Palm
Wrist and Hand | Ligaments of Wrist
Carpal tunnel: palmar view
Radius
Palmaris longus tendon
Palmar carpal ligament (thickening of deep antebrachial fascia) (cut and reflected)
Radial artery and superficial palmar branch
Flexor carpi radialis tendon
Flexor pollicis longus tendon
Median nerve
Palmar aponeurosis
Tubercle of scaphoid
Tubercle of trapezium
Flexor retinaculum (transverse carpal ligament)
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Ulna
Interosseus membrane
Ulnar artery and nerve
Flexor carpi ulnaris tendon
Flexor digitorum profundus tendons
Flexor digitorum superficialis tendons
Pisiform
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Hook of hamate
Flexor retinaculum removed: palmar view
Long radiolunate ligament
Radioscaphocapitate ligament
Scaphotrapeziotrapezoid ligament
Scaphocapitate ligament
Trapeziotrapezoid ligament
Trapeziocapitate ligament
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Short radiolunate ligament
Palmar radiolunate ligament
Ulnolunate ligament
Ulnocapitate ligament
Ulnotriquetral ligament
Lunotriquetral ligament
Triquetrohamate ligament
Triquetrocapitate ligament
Capitohamate ligament
Wrist and Hand | Ligaments of Wrist (continued)
Posterior (dorsal) view
Dorsal radial metaphyseal arcuate ligament
Dorsal radiolunar ligament
Ulnotriquetral ligament (dorsal view)
Triquetrohamate ligament
Dorsal intercarpal ligament
Capitohamate ligament
Dorsal radiocarpal ligament
Scapholunate ligament
Trapeziotrapezoid ligament
Trapeziocapitate ligament
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Coronal section: dorsal view
Ulna
Distal radiolunar joint
Articular disc of wrist joint
Meniscus
Interosseous intercarpal ligaments
Triquetrum
Hamate
Capitate
Radius
Lunate
Wrist (radiocarpal) joint
Scaphoid
Midcarpal joint
Trapezoid
Trapezium
Carpometacarpal joint
Intermetacarpal joints
Metacarpal bone 1
Metacarpal bone 2
Metacarpal bone 3
Metacarpal bone 4
Metacarpal bone 5
Wrist and Hand | Bones of Wrist and Hand
Right hand: anterior (palmar) view
Scaphoid and Tubercle Carpal bones
Trapezium and Tubercle Carpal bones
Trapezoid Carpal bones
Lunate Carpal bones
Triquetrum Carpal bones
Pisiform Carpal bones
Capitate Carpal bones
Hamate and Hook Carpal bones
Sesamoid bones
Base of Metacarpal bone 1
Shaft of Metacarpal bone 1
Head of Metacarpal bone 1
Base of Metacarpal bone 2
Shaft of Metacarpal bone 2
Head of Metacarpal bone 2
Base of Metacarpal bone 3
Shaft of Metacarpal bone 3
Head of Metacarpal bone 3
Base of Metacarpal bone 4
Shaft of Metacarpal bone 4
Head of Metacarpal bone 4
Base of Metacarpal bone 5
Shaft of Metacarpal bone 5
Head of Metacarpal bone 5
Base of Proximal phalange 1
Shaft of Proximal phalange 1
Head of Proximal phalange 1
Base of Proximal phalange 2
Shaft of Proximal phalange 2
Head of Proximal phalange 2
Base of Proximal phalange 3
Shaft of Proximal phalange 3
Head of Proximal phalange 3
Base of Proximal phalange 4
Shaft of Proximal phalange 4
Head of Proximal phalange 4
Base of Proximal phalange 5
Shaft of Proximal phalange 5
Head of Proximal phalange 5
Base of Middle phalange 1
Shaft of Middle phalange 1
Head of Middle phalange 1
Base of Middle phalange 2
Shaft of Middle phalange 2
Head of Middle phalange 2
Base of Middle phalange 3
Shaft of Middle phalange 3
Head of Middle phalange 3
Base of Middle phalange 4
Shaft of Middle phalange 4
Head of Middle phalange 4
Base of Middle phalange 5
Shaft of Middle phalange 5
Head of Middle phalange 5
Base of Distal phalange 1
Shaft of Distal phalange 1
Tuberosity of Distal phalange 1
Head of Distal phalange 1
Base of Distal phalange 2
Shaft of Distal phalange 2
Tuberosity of Distal phalange 2
Head of Distal phalange 2
Base of Distal phalange 3
Shaft of Distal phalange 3
Tuberosity of Distal phalange 3
Head of Distal phalange 3
Base of Distal phalange 4
Shaft of Distal phalange 4
Tuberosity of Distal phalange 4
Head of Distal phalange 4
Base of Distal phalange 5
Shaft of Distal phalange 5
Tuberosity of Distal phalange 5
Head of Distal phalange 5
Right hand: posterior (dorsal) view
Triquetrum Carpal bone
Hamate Carpal bone
Lunate Carpal bone
Scaphoid Carpal bone
Capitate Carpal bone
Trapezoid Carpal bone
Trapezium Carpal bone
Base of Metacarpal bone 1
Shaft of Metacarpal bone 1
Head of Metacarpal bone 1
Base of Metacarpal bone 2
Shaft of Metacarpal bone 2
Head of Metacarpal bone 2
Base of Metacarpal bone 3
Shaft of Metacarpal bone 3
Head of Metacarpal bone 3
Base of Metacarpal bone 4
Shaft of Metacarpal bone 4
Head of Metacarpal bone 4
Base of Metacarpal bone 5
Shaft of Metacarpal bone 5
Head of Metacarpal bone 5
Base of Proximal phalange 1
Shaft of Proximal phalange 1
Head of Proximal phalange 1
Base of Proximal phalange 2
Shaft of Proximal phalange 2
Head of Proximal phalange 2
Base of Proximal phalange 3
Shaft of Proximal phalange 3
Head of Proximal phalange 3
Base of Proximal phalange 4
Shaft of Proximal phalange 4
Head of Proximal phalange 4
Base of Proximal phalange 5
Shaft of Proximal phalange 5
Head of Proximal phalange 5
Base of Middle phalange 1
Shaft of Middle phalange 1
Head of Middle phalange 1
Base of Middle phalange 2
Shaft of Middle phalange 2
Head of Middle phalange 2
Base of Middle phalange 3
Shaft of Middle phalange 3
Head of Middle phalange 3
Base of Middle phalange 4
Shaft of Middle phalange 4
Head of Middle phalange 4
Base of Middle phalange 5
Shaft of Middle phalange 5
Head of Middle phalange 5
Base of Distal phalange 1
Shaft of Distal phalange 1
Tuberosity of Distal phalange 1
Head of Distal phalange 1
Base of Distal phalange 2
Shaft of Distal phalange 2
Tuberosity of Distal phalange 2
Head of Distal phalange 2
Base of Distal phalange 3
Shaft of Distal phalange 3
Tuberosity of Distal phalange 3
Head of Distal phalange 3
Base of Distal phalange 4
Shaft of Distal phalange 4
Tuberosity of Distal phalange 4
Head of Distal phalange 4
Base of Distal phalange 5
Shaft of Distal phalange 5
Tuberosity of Distal phalange 5
Head of Distal phalange 5
Wrist and Hand | Wrist and Hand: Anteroposterior Radiograph
BM Base of Metacarpal
BP Base of proximal phalanx
C Capitate
DP Distal phalanx of thumb
DPR Distal phalanx of ring finger
H Hamate
HH Hook of hamate
HM Head of metacarpal
HP Head of proximal phalanx
L Lunate
M Metacarpal of index finger
MP Middle phalanx of middle finger
P Pisiform
PP Proximal phalanx of thumb
PPI Proximal phalanx of index finger
R Radius
S Scaphoid
SH Shaft of metacarpal
SP Styloid process of ulna
SPR Styloid process of radius
T Triquetrum
TP Trapezoid
TZ Trapezium
U Ulna
Wrist and Hand | Metacarpophalangeal and Interphalangeal Ligaments
Anterior (palmar) view
Trapezium
Joint capsule
Collateral ligaments
Cut margins of digital fibrous sheaths
Flexor digitorum superficialis tendons (cut)
Pisiform
Hook of hamate
Palmar carpometacarpal ligaments
Palmar metacarpal ligaments
Deep transverse metacarpal ligaments
Palmar ligaments (plates)
Flexor digitorum profundus tendons
In extension: medial view
Metacarpal bone
Dorsal surface
Metacarpophalangeal (MP) joint
Accessory collateral ligament
True collateral ligament
Proximal interphalangeal (PIP) joint
Distal interphalangeal (DIP) joint
Palmar surface
Proximal Phalanges
Middle Phalanges
Distal Phalanges
Palmar ligament (volar plate)
In flexion: medial view
Accessory collateral ligament
True collateral ligament
Palmar ligament (volar plate)
Note: Ligaments of metacarpophalangeal and interphalangeal joints are similar
Wrist and Hand | Wrist and Hand: Superficial Palmar Dissections
Anterior (palmar) views
Palmaris longus tendon
Branch of superficial radial nerve to skin of lateral thenar area
Palmar carpal ligament (thickening of deep antebrachial fascia continuous with extensor retinaculum)
Palmar branch of median nerve
Thenar muscles
Recurrent (motor) branch of median nerve to thenar muscles
Minute fasciculi attach palmar aponeurosis to dermis
Palmar branch of ulnar nerve
Pisiform
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Superficial branch of ulnar nerve
Ulnar artery
Palmaris brevis muscle
Hypothenar muscles
Palmar aponeurosis
Palmar aponeurosis
Transverse fasciculi
Palmar digital arteries and nerves
Superficial transverse metacarpal ligaments
Palmaris brevis muscle (reflected)
Palmar digital nerves from superficial branch of ulnar nerve to 5th and medial half of 4th fingers
Wrist and Hand | Wrist and Hand: Deeper Palmar Dissections
Anterior (palmar) views
Radial artery and venae comitantes
Flexor carpi radialis tendon
Tendinous sheath of flexor pollicis longus (radial bursa)
Median nerve
Palmaris longus tendon and palmar carpal ligament
Transverse carpal ligament (flexor retinaculum)
Thenar muscles
Proper palmar digital nerves of thumb
(Synovial) tendinous sheath of flexor pollicis longus (radial bursa)
Probe in 1st lumbrical fascial sheath
Common palmar digital artery
Proper palmar digital arteries
Septa from palmar aponeurosis forming canals
Palmar aponeurosis (reflected)
Ulnar artery with venae comitantes and ulnar nerve
Flexor carpi ulnaris tendon
Common flexor sheath (ulnar bursa) containing superficialis and profundus flexor tendons
Pisiform
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Superficial branch of ulnar nerve
Palmar digital nerves to 5th finger and medial half of 4th finger
Median nerve
Common flexor sheath (ulnar bursa)
Superficial palmar arterial and venous arches
2nd, 3rd, and 4th lumbrical muscles (in fascial sheaths)
(Synovial) flexor tendon sheaths of fingers
Superficial palmar branch of radial artery and recurrent branch of median nerve to thenar muscles
Ulnar artery and nerve
Common palmar digital branches of median nerve (cut)
Hypothenar muscles
Common flexor sheath (ulnar bursa)
5th finger (synovial) tendinous sheath
Probe in midpalmar space
Midpalmar space (deep to flexor tendons and lumbrical muscles)
Insertion of flexor digitorum superficialis tendon
Insertion of flexor digitorum profundus tendon
Proper palmar digital nerves of thumb
Fascia over adductor pollicis muscle
1st dorsal interosseous muscle
Probe in dorsal extension of thenar space deep to adductor pollicis muscle
Thenar space (deep to flexor tendons and 1st lumbrical muscle)
Septum separating thenar from midpalmar space
Common palmar digital artery
Proper palmar digital arteries and nerves
Annular and cruciform parts of fibrous sheath over (synovial) flexor tendon sheaths
Wrist and Hand | Flexor Tendons, Arteries, and Nerves at Wrist
Palmar view
Palmaris longus tendon
Median nerve
Radial artery
Flexor carpi radialis tendon
Flexor pollicis longus tendon in tendon sheath (radial bursa)
Palmar carpal ligament (reflected)
(Synovial) tendon sheath
Flexor retinaculum (transverse carpal ligament)
Trapezium
1st metacarpal bone
Opponens pollicis muscle
Abductor pollicis brevis muscle (reflected)
Flexor pollicis brevis muscle (reflected)
Adductor pollicis muscle
Flexor digitorum superficialis tendons
Flexor digitorum profundus tendons
Common flexor sheath (ulnar bursa)
Ulnar artery
Ulnar nerve
Flexor carpi ulnaris tendon
Pisiform
Abductor digiti minimi muscle
Flexor digiti minimi brevis muscle
Opponens digiti minimi muscle
Superficial palmar (arterial) arch
Lumbrical muscles
Transverse cross section of wrist demonstrating carpal tunnel
Flexor retinaculum (transverse carpal ligament)
Ulnar artery
Ulnar nerve
Flexor carpi ulnaris tendon
Flexor digitorum superficialis tendons
Flexor digitorum profundus tendons
Hamate
Capitate
Trapezoid
Trapezium
Radial artery
Flexor pollicis longus tendon in tendon sheath*
Flexor carpi radialis tendon
Median nerve*
Palmaris longus tendon
*Contents of carpal tunnel
Simple method of demonstrating arrangement of flexor digitorum superficialis tendons within carpal tunnel
Wrist and Hand | Bursae, Spaces, and Tendon Sheaths of Hand
Pronator quadratus muscle
Flexor carpi radialis tendon
Tendinous sheath of flexor pollicis longus (radial bursa)
Flexor retinaculum (transverse carpal ligament) (reflected)
Flexor digitorum profundus tendons
Tendinous sheath of flexor pollicis longus (radial bursa)
Fascia of adductor pollicis muscle
Common flexor sheath (ulnar bursa)
Flexor digitorum superficialis tendons
Common flexor sheath (ulnar bursa) (opened)
Lumbrical muscles in fascial sheaths
Thenar space (deep to flexor tendon and 1st lumbrical muscle)
(Synovial) tendon sheath of finger
Lumbrical muscles in fascial sheaths (cut and reflected)
Annular and cruciform parts (pulleys) of fibrous sheath over synovial sheath of finger
Midpalmar space (deep to flexor tendons and lumbrical muscles)
Fibrous and synovial (tendon) sheaths of finger (opened)
Flexor digitorum superficialis tendon
Flexor digitorum profundus tendon
Midpalmar space
Palmar aponeurosis
Common palmar digital artery and nerve
Lumbrical muscle in its fascial sheath
Flexor tendons to 5th digit in common flexor sheath (ulnar bursa)
Hypothenar muscles
Dorsal interosseous fascia
Dorsal subaponeurotic space
Dorsal fascia of hand
Dorsal subcutaneous space
Septa forming canals
Profundus and superficialis flexor tendons to 3rd digit
Septum between midpalmar and thenar spaces
Thenar space
Flexor pollicis longus tendon in tendon sheath (radial bursa)
Extensor pollicis longus tendon
Adductor pollicis muscle
Palmar interosseous fascia
Palmar interosseous muscles
Dorsal interosseous muscles
Extensor tendons
Wrist and Hand | Lumbrical Muscles and Bursae, Spaces, and Sheaths: Schema
Usual arrangement
Tendinous sheath of flexor pollicis longus (radial bursa)
Common flexor of sheath (ulnar bursa)
Thenar space
Midpalmar space
Lumbrical muscles (in fascial sheaths)
(Synovial) tendon sheaths of fingers
Common variation
Intermediate bursa (communication between common flexor sheath [ulnar bursa] and tendinous sheath of flexor pollicis longus [radial bursa])
Lumbrical muscles: schema
Flexor digitorum profundus tendons
1st and 2nd lumbrical muscles (unipennate)
Camper chiasm
3rd and 4th lumbrical muscles (bipennate)
Flexor digitorum superficialis tendons (cut)
Note: Flexor digitorum superficialis and profundus tendons encased in synovial sheaths are bound to phalanges by fibrous digital sheaths made up of alternating strong annular (A) and weaker cruciform © parts (pulleys)
Tendons of flexor digitorum superficialis and profundus muscles
(Synovial) tendon sheath
Palmar ligaments (plates)
A1
C1
A2
C2
A3
C3
A4
C4
A5
Wrist and Hand | Flexor and Extensor Tendons in Fingers
Posterior (dorsal) view
Insertion on extensor tendon to base of distal phalanx
Lateral bands
Interosseous tendon slip to lateral band
Lumbrical muscle
Part of interosseous tendon passes to base of proximal phalanx and joint capsule
Triangular aponeurosis
Insertion of central band of extensor tendon to base of middle phalanx
Slips of long extensor tendon to lateral bands
Extensor expansion (hood)
Extensor tendon
Interosseous muscles
Metacarpal bone
Finger in extension: lateral view
Insertion of extensor tendon to base of distal phalanx
Insertion of extensor tendon to base of middle phalanx
Lateral band
Central band
Extensor expansion (hood)
Extensor tendon
Metacarpal bone
Collateral ligaments
Vinculum breve
Vincula longa
Flexor digitorum superficialis tendon
Flexor digitorum profundus tendon
Lumbrical muscle
Interosseous muscles
Finger in flexion: lateral view
Interosseous muscles
Lumbrical muscle
Palmar ligament (plate)
Flexor digitorum superficialis tendon (cut)
Collateral ligaments
Flexor digitorum profundus tendon (cut)
Palmar ligament (plate)
Insertion of small deep slip of extensor tendon to proximal phalanx and joint capsule
Attachment of interosseous muscle to base of proximal phalanx and joint capsule
Insertion of lumbrical muscle to extensor tendon
Collateral ligament
Extensor tendon
Note: Black arrows indicate pull of long extensor tendon; red arrows indicate pull of interosseous and lumbrical muscles; dots indicate axis of rotation of joints
Wrist and Hand | Intrinsic Muscles of Hand
Anterior (palmar) view
Radial artery and palmar carpal branch
Radius
Superficial palmar branch of radial artery
Flexor retinaculum (transverse carpal ligament) (reflected)
Opponens pollicis muscle
Branches of median nerve to thenar muscles and to 1st and 2nd lumbrical muscles
Abductor pollicis brevis muscle (cut)
Flexor pollicis brevis muscle
Adductor pollicis muscle
1st dorsal interosseous muscle
Branches from deep branch of ulnar nerve to 3rd and 4th lumbrical muscles and to all interosseous muscles
Lumbrical muscles (reflected)
Pronator quadratus muscle
Ulnar nerve
Ulnar artery and palmar carpal branch
Flexor carpi ulnaris tendon
Palmar carpal arterial arch
Pisiform
Median nerve
Abductor digiti minimi muscle (cut)
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Flexor digiti minimi brevis muscle (cut)
Opponens digiti minimi muscle
Deep palmar (arterial) arch
Palmar metacarpal arteries
Common palmar digital arteries
Deep transverse metacarpal ligaments
Posterior (dorsal) view
Ulna
Abductor digiti minimi muscle
Radius
Radial artery
Abductor pollicis brevis muscle
Dorsal interosseous muscles (bipennate)
Anterior (palmar) view
Radius
Ulna
Palmar interosseous muscles (unipennate)
Deep transverse metacarpal ligaments
Tendinous slips to extensor expansions hoods
Note: Arrows indicate action of muscles
Wrist and Hand | Arteries and Nerves of Hand: Palmar Views
Radial artery
Median nerve and palmar branch
Superficial palmar branch of radial artery
Abductor pollicis brevis muscle (cut)
Opponens pollicis muscle
Flexor pollicis brevis muscle
Recurrent (motor) branch of median nerve to thenar muscles
Proper digital nerves and arteries to thumb
Adductor pollicis muscle
Branches of median nerve to 1st and 2nd lumbrical muscles
Flexor tendons, synovial and fibrous sheaths
Ulnar artery and nerve
Palmar carpal ligament (continuous with extensor retinaculum)
Flexor retinaculum (transverse carpal ligament)
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Superficial branch of ulnar nerve
Common flexor sheath (ulnar bursa)
Superficial palmar (arterial) arch
Common palmar digital nerves and arteries
Communicating branch of median nerve with ulnar nerve
Proper palmar digital nerves and arteries
Branches of proper palmar digital nerves and arteries to dorsum of middle and distal phalanges
Radial artery
Median nerve
Superficial palmar branch of radial artery
Deep palmar (arterial) arc h and deep branch of ulnar nerve
Princeps pollicis artery
Proper digital arteries and nerves of thumb
Distal limit of superficial palmar arch
Radialis indicis artery
Palmar metacarpal arteries
Common palmar digital arteries
Proper palmar digital arteries
Proper palmar digital nerves from median nerve
Ulnar artery and nerve
Palmar carpal branches of radial and ulnar arteries
Pisiform
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Branches to hypothenar muscles
Superficial branch of ulnar nerve
Hook of hamate
Deep palmar branch of ulnar nerve to 3rd and 4th lumbrical, all interosseous, adductor pollicis, and deep head of flexor pollicis brevis muscles
Communicating branch of median nerve with ulnar nerve
Proper palmar digital nerves from ulnar nerve
Wrist and Hand | Wrist and Hand: Superficial Radial Dissection
Lateral (radial) view
Extensor retinaculum
Dorsal carpal branch of radial artery
Extensor carpi radialis brevis tendon
Extensor carpi radialis longus tendon
Radial artery
1st dorsal interosseous muscle
Deep fascia (cut)
Superficial branch of radial nerve
Medial branch
Lateral branch
Dorsal digital branches of radial nerve
Scaphoid
Radial artery in anatomical snuffbox
Trapezium
Insertion of abductor pollicis longus tendon
1st metacarpal bone
Insertion of extensor pollicis brevis tendon
Insertion of extensor pollicis longus tendon
Fracture of middle third (waist) of scaphoid (most common)
Wrist and Hand | Wrist and Hand: Superficial Dorsal Dissection
Posterior (dorsal) view
Posterior antebrachial cutaneous nerve (from radial nerve)
Cephalic vein
Superficial branch of radial nerve
Extensor retinaculum (thickening of posterior antebrachial fascia)
Communicating branches of radial and ulnar nerves
Probe in dorsal subaponeurotic space (between opened dorsal fascia of hand and dorsal interosseous fascia)
Basilic vein
Dorsal branch of ulnar nerve
Dorsal venous network of hand
Dorsal metacarpal veins
Intercapitular veins
Dorsal digital nerves and veins
Dorsal branches of proper palmar digital nerves
Note: Lymphatic pathways shown in black; arrows indicate direction of drainage
Wrist and Hand | Wrist and Hand: Deep Dorsal Dissection
Posterior (dorsal) view
Medial antebrachial cutaneous nerve
Posterior antebrachial cutaneous nerve (branch of radial nerve)
Extensor retinaculum
Dorsal branch of ulnar nerve
Dorsal carpal branch of ulnar artery
Extensor carpi ulnaris tendon
Dorsal carpal (arterial) arch
Dorsal metacarpal arteries
Dorsal digital branches of dorsal branch of ulnar nerve
Lateral antebrachial cutaneous nerve (terminal part of musculocutaneous nerve)
Superficial branch of radial nerve
Extensor digitorum tendons
Extensor digiti minimi tendons
Extensor indicis tendons
Radial artery in anatomical snuffbox
Abductor pollicis longus tendon
Extensor pollicis brevis tendon
Extensor pollicis longus tendon
Extensor carpi radialis longus tendon
Extensor carpi radialis brevis tendon
Dorsal digital arteries
Dorsal digital branches of superficial branch of radial nerve to 1st, 2nd, 3rd, and radial half of 4th fingers
Dorsal branches of proper palmar digital branches of ulnar nerve and of proper palmar digital arteries to dorsum of middle and distal phalanges of 5th and ulnar half of 4th fingers
Dorsal branches of proper palmar digital branches of median nerve and of proper palmar digital arteries to dorsum of middle and distal phalanges of 2nd, 3rd, and radial half of 5th fingers
Wrist and Hand | Extensor Tendons at Wrist
Posterior (dorsal) view
Compartment 6
Extensor carpi ulnaris
Compartment 5
Extensor digiti minimi
Compartment 4
Extensor digitorum
Extensor indicis
Compartment 3
Extensor pollicis longus
Compartment 2
Extensor carpi radialis brevis
Extensor carpi radialis longus
Compartment 1
Abductor pollicis longus
Extensor pollicis brevis
Radial artery in anatomical snuffbox
Dorsal interosseous muscles
Plane of cross section shown below
Extensor retinaculum
Abductor digiti minimi muscle
Intertendinous connections
Transverse fibers of extensor expansions (hoods)
Cross section of most distal portion of firearm
Compartment 1
Extensor pollicis brevis
Abductor pollicis longus
Compartment 2
Extensor carpi radialis brevis
Extensor carpi radialis longus
Compartment 3
Extensor pollicis longus
Compartment 4
Extensor digitorum
Extensor indicis
Compartment 5
Extensor digiti minimi
Compartment 6
Extensor carpi ulnaris
Extensor retinaculum
Ulna
Radius
Wrist and Hand | Fingers
Sagittal section
Distal phalanx
Body of nail
Nail bed
Lunule
Eponychium (cuticle)
Nail root
Nail matrix
Epiphysis
Synovial membrane
Articular cartilage
Middle phalanx
Extensor mechanism
Extensor mechanism lateral band
Extensor mechanism central tendon
Flexor digitorum superficialis tendon
Fibrous tendon sheath of finger
Synovial (flexor tendon) sheath of finger
Flexor digitorum profundus tendon
Palmar ligament (plate)
Articular cavity
Cross section through distal phalanx
Subungual space
Minute arteries
Fine nerves
Body of nail
Nail bed
Distal phalanx
Fibrous septa and areolar tissue in anterior closed space (pulp)
Arteries and nerves
Dorsal branches of proper palmar digital arteries
Nerves to dorsum of middle phalanges
Nerves to dorsum of terminal phalanges
Nutrient branches to metaphysis
Nutrient branch to epiphysis
Proper palmar digital artery and nerve
Proper palmar digital artery to neighboring digit
Neurovasculature | Cutaneous Innervation of Wrist and Hand
Anterior (palmar) view
Musculocutaneous nerve
Lateral antebrachial cutaneous nerve
Radial nerve
Superficial branch
Median nerve
Palmar branch
Palmar digital branches
Medial and antebrachial cutaneous nerve
Ulnar nerve
Palmar branch
Palmar digital branches
Posterior (dorsal) view
Medial antebrachial cutaneous nerve
Division between ulnar and radial nerve innervation on dorsum of hand is variable
Ulnar nerve
Dorsal branch
Dorsal digital branches
Proper palmar digital branches
Musculocutaneous nerve
Lateral antebrachial cutaneous nerve
Radial nerve
Posterior antebrachial cutaneous nerve
Superficial branch and dorsal digital branches
Median nerve
Proper palmar digital branches
Neurovasculature | Arteries and Nerves of Upper Limb
Anterior view
Deltoid muscle
Coracobrachialis muscle
Short head of Biceps brachii muscle
Long head of Biceps brachii muscle
Musculocutaneous nerve
Brachialis muscle
Brachialis muscle
Biceps brachii muscle (cut) and tendon
Lateral antebrachial cutaneous nerve (from musculocutaneous nerve)
Deep branch of Radial nerve
Superficial branch of Radial nerve
Supinator muscle
Brachioradialis muscle
Radial artery
Pronator teres muscle (partially cut)
Median nerve
Flexor pollicis longus muscle
Flexor carpi radialis tendon (cut)
Flexor retinaculum (transverse carpal ligament)
Superficial branch of radial nerve
Recurrent (motor) branch of median nerve to thenar muscles
Common palmar digital branches of median nerve
Proper palmar digital branches of median nerve
Intercostobrachial nerve
Medial brachial cutaneous nerve
Radial nerve
Ulnar nerve
Medial antebrachial cutaneous nerve
Median nerve
Brachial nerve
Brachial artery
Bicipital aponeurosis
Pronator teres muscle
Humeral head (cut) of Pronator teres muscle
Ulnar head of Pronator teres muscle
Flexor carpi radialis muscle (cut)
Ulnar artery and nerve
Dorsal branch of ulnar nerve
Flexor digitorum superficialis tendons (cut)
Deep palmar branch of ulnar artery and deep branch of ulnar nerve
Superficial branch of ulnar nerve
Superficial branch of arch (cut)
Common palmar digital branch of ulnar nerve
Communicating branch of median nerve with ulnar nerve
Proper palmar digital branches of ulnar nerve
Neurovasculature | Musculocutaneous Nerve
Anterior view
Note: Only muscles innervated by musculocutaneous nerve shown
Musculocutaneous nerve C5
Musculocutaneous nerve C6
Musculocutaneous nerve C7
Coracobrachialis muscle
Biceps brachii muscle (retracted)
Brachialis muscle
Articular branch
Lateral antebrachial cutaneous nerve
Anterior branch
Posterior branch
Medial Cords of brachial plexus
Posterior Cords of brachial plexus
Lateral Cords of brachial plexus
Medial brachial cutaneous nerve
Medial antebrachial cutaneous nerve
Ulnar nerve
Median nerve
Radial nerve
Axillary nerve
Anterior (palmar) view
Posterior (dorsal) view
Cutaneous innervation (via lateral antebrachial cutaneous nerve)
Neurovasculature | Median Nerve
Note: Only muscles innervated by median nerve shown
Anterior view
Musculocutaneous nerve
Median nerve C5
Median nerve C6
Median nerve C7
Median nerve C8
Median nerve T1
Pronator teres muscle (humeral head)
Articular branch
Flexor carpi radialis muscle
Palmaris longus muscle
Pronator teres muscle (ulnar head)
Flexor digitorum superficialis muscle (turned up)
Flexor digitorum profundus muscle (lateral part supplied by median [anterior interosseous] nerve; medial part supplied by ulnar nerve)
Anterior interosseous nerve
Flexor pollicis longus muscle
Pronator quadratus muscle
Palmar branch of median nerve
Abductor pollicis brevis of Thenar muscles
Opponens pollicis of Thenar muscles
Superficial head of flexor pollicis brevis (deep head supplied by ulnar nerve) of Thenar muscles
1st lumbrical muscles
2nd lumbrical muscles
Dorsal branches to dorsum of middle and distal phalanges
Medial Cords of brachial plexus
Posterior Cords of brachial plexus
Lateral Cords of brachial plexus
Medial brachial cutaneous nerve
Medial antebrachial cutaneous nerve
Axillary nerve
Radial nerve
Ulnar nerve
Communicating branch of median nerve with ulnar nerve
Common palmar digital nerves
Proper palmar digital nerves
Cutaneous innervation
Palmar view
Posterior (dorsal) view
Neurovasculature | Ulnar Nerve
Note: Only muscles innervated by ulnar nerve shown
Anterior view
Ulnar nerve C7 (inconstant contribution)
Ulnar C8
Ulnar t1
Medial epicondyle
Articular branch (behind condyle)
Flexor digitorum profundus muscle (medial part only; lateral part supplied by anterior interosseous branch of median nerve)
Flexor carpi ulnaris muscle (drawn aside)
Dorsal branch of ulnar nerve
Palmar branch
Superficial branch
Deep branch
Palmaris brevis of Hypothenar muscles
Abductor digiti minimi of Hypothenar muscles
Flexor digiti minimi brevis of Hypothenar muscles
Opponens digiti minimi of Hypothenar muscles
Common palmar digital nerve
Communicating branch of median nerve with ulnar nerve
Palmar and dorsal interosseous muscles
3rd lumbrical muscle
4th lumbrical muscle
Proper palmar digital nerves (dorsal digital nerves are from dorsal branch)
Dorsal branches to dorsum of middle and distal phalanges
Adductor pollicis muscle
Flexor pollicis brevis muscle (deep head only; superficial head and other thenar muscles supplied by median nerve)
Cutaneous innervation
Palmar view of cutaneous innervation
Posterior (dorsal) view of cutaneous innervation
Neurovasculature | Radial Nerve in Arm and Nerves of Posterior Shoulder
Posterior view
Supraspinatus muscle
Levator scapulae muscle (supplied also by branches from C3 and C4)
Rhomboid minor muscle
Rhomboid major muscle
Infraspinatus muscle
Teres major muscle
Posterior brachial cutaneous nerve (branch of radial nerve in axilla)
Long head of Triceps brachii muscle
Lateral head of Triceps brachii muscle
Medial head of Triceps brachii muscle
Triceps brachii tendon
Medial epicondyle
Olecranon
Anconeus muscle
Extensor digitorum muscle
Extensor carpi ulnaris muscle
Deltoid muscle
Teres minor muscle
Superior lateral brachial cutaneous nerve
Inferior lateral brachial cutaneous nerve
Posterior antebrachial cutaneous nerve
Lateral intermuscular septum
Brachialis muscle (lateral; part remainder of muscle supplied by musculocutaneous nerve)
Brachioradialis muscle
Extensor carpi radialis longus muscle
Extensor carpi radialis brevis muscle
Dorsal scapular nerve (C5)
Suprascapular nerve (C5, C6)
Axillary nerve (C5, C6)
Radial nerve (C5, C6, C7, C8, T1*) (*inconstant contribution)
Lower subscapular nerve (C5, C6)
Neurovasculature | Radial Nerve in Forearm
Posterior view
Superficial terminal branch
Deep (terminal) branch
Lateral epicondyle
Anconeus muscle of Extensor-supinator group of muscles
Brachioradialis muscle of Extensor-supinator group of muscles
Extensor carpi radialis brevis muscle of Extensor-supinator group of muscles
Extensor carpi ulnaris muscle of Extensor-supinator group of muscles
Extensor digitorum muscle of Extensor-supinator group of muscles
Extensor digiti minimi muscle of Extensor-supinator group of muscles
Extensor indicis muscle of Extensor-supinator group of muscles
Extensor pollicis longus muscle of Extensor-supinator group of muscles
Abductor pollicis longus muscle
Extensor pollicis brevis muscle of Extensor-supinator group of muscles
Posterior interosseous nerve (continuation of deep branch of radial nerve to supinator muscle)
Superficial branch of radial nerve
Dorsal digital nerves
Cutaneous innervation from radial and axillary nerves
Superior lateral brachial cutaneous from axillary nerve
Inferior lateral brachial cutaneous nerve from radial nerve
Posterior brachial cutaneous nerve from radial nerve
Posterior antebrachial cutaneous nerve from radial nerve
Superficial branch of radial nerves and dorsal digital branches from radial nerve
Radial nerve (C5, C6, C7, C8, T1*) (*inconstant contribution)
Neurovasculature | Cutaneous Nerves and Superficial Veins of Shoulder and Arm
Anterior view
Medial Supraclavicular nerves (from cervical plexus)
Intermediate Supraclavicular nerves (from cervical plexus)
Lateral Supraclavicular nerves (from cervical plexus)
Acromial branches of thoracoacromial vein
Medial brachial cutaneous nerve
Intercostobrachial nerve
Superior lateral brachial cutaneous nerve (from axillary nerve)
Cephalic vein
Inferior lateral brachial cutaneous nerve (from radial nerve)
Posterior antebrachial cutaneous nerve (from radial nerve)
Accessory cephalic vein
Branches of medial antebrachial cutaneous nerve
Basilic vein
Lateral antebrachial cutaneous nerve (terminal part of musculocutaneous nerve)
Median cubital vein
Intermediate (median) antebrachial vein
Basilic vein
Perforating veins
Cephalic vein
Posterior view
Lateral supraclavicular nerve
Acromial branch of thoracoacromial vein
Superficial branches of posterior circumflex humeral vein
Intercostobrachial nerve
Medial brachial cutaneous nerve
Superior lateral brachial cutaneous nerve (from axillary nerve)
Posterior brachial cutaneous nerve (from radial nerve)
Inferior lateral brachial cutaneous nerve (from radial nerve)
Posterior antebrachial cutaneous nerve (from radial nerve)
Branches of medial antebrachial cutaneous nerve
Branches of lateral antebrachial cutaneous nerve (terminal part of musculocutaneous nerve)
Neurovasculature | Cutaneous Nerves and Superficial Veins of Forearm
Note: In 70% of cases, a median cubital vein (tributary to basilic vein) replaces median cephalic and median basilic veins (see Plate 479)
Anterior (palmar) view
Cephalic vein
Posterior antebrachial cutaneous nerve (from radial nerve)
Lateral antebrachial cutaneous nerve (from musculocutaneous nerve)
Accessory cephalic vein
Median cephalic vein
Cephalic vein
Median antebrachial vein
Superficial branch of radial nerve
Palmar branch of median nerve
Intercapitular veins
Basilic vein
Anterior branch of medial antebrachial cutaneous nerve
Posterior branch of medial antebrachial cutaneous nerve
Median basilic vein
Bicipital aponeurosis
Basilic vein
Perforating veins
Palmar branch of ulnar nerve
Dorsal branch of ulnar nerve
Palmar carpal ligament (continuous with extensor retinaculum)
Palmar aponeurosis
Superficial transverse metacarpal ligament
Proper palmar digital nerves and palmar digital veins
Posterior (dorsal) view
Posterior antebrachial cutaneous nerve (from radial nerve)
Accessory cephalic vein
Posterior branch of lateral antebrachial cutaneous nerve (from musculocutaneous nerve)
Cephalic vein
Extensor retinaculum
Superficial branch of radial nerve
Dorsal venous network
Posterior branch of medial antebrachial cutaneous nerve
Perforating veins
Basilic vein
Dorsal branch of ulnar nerve
Dorsal branch of ulnar nerve
Dorsal metacarpal veins
Intercapitular veins
Dorsal digital nerves and veins
Neurovasculature | Cutaneous Innervation of Upper Limb
Anterior (palmar) view
Supraclavicular nerves (from cervical plexus - C3, C4)
Axillary nerve
Superior lateral brachial cutaneous nerve (C5, C6)
Radial nerve
Inferior lateral brachial cutaneous nerve (C5, C6)
Lateral antebrachial cutaneous nerve (C5, C6, C7) (terminal part of musculocutaneous nerve)
Radial nerve
Superficial branch (C6, C7, C8)
Median nerve
Palmar branch and Palmar digital branches (C6, C7, C8)
Palmar branch of Ulnar nerve (C8, T1)
Palmar digital branches of Ulnar nerve (C8, T1)
Intercostobrachial nerve (T2) and medial brachial cutaneous nerve (C8, T1, T2)
Medial antebrachial cutaneous nerve C8, T1)
Posterior (dorsal) view
Supraclavicular nerve (from cervical plexus - C3, C4)
Axillary nerve
Superior lateral brachial cutaneous nerve (C5, C6)
Radial nerve
Posterior brachial cutaneous nerve (C5, C6, C7, C8)
Inferior lateral cutaneous nerve
Posterior antebrachial cutaneous nerve (C5, C6, C7, C8)
Lateral antebrachial cutaneous nerve (C5, C6, C7, C8) (terminal part of musculocutaneous nerve)
Radial nerve
Superficial branch and dorsal digital branches (C6, C7, C8)
Median nerve
Proper palmar digital branches
Dorsal branch and digital branches of Ulnar nerve (C8, T1)
Proper palmar digital branches of Ulnar nerve (C8, T1)
Intercostobrachial nerve (T2) and medial brachial cutaneous nerve (C8, T1, T2)
Medial antebrachial cutaneous nerve C8, T1)
Note: Division variable between ulnar and radial innervation on dorsum of hand and often aligns with middle of 3rd digit instead of 4th digit as shown
Neurovasculature | Dermatomes of Upper Limb
Note: Schematic demarcation of dermatomes (according to Keegan and Garrett) shown as distinct segments. There is actually considerable overlap between adjacent dermatomes. An alternative dermatome maps is provided by Foerster (see references).
Anterior view
C2
C3
C4
C5
C6
C7
C8
T1
Neurovasculature | Lymph Vessels and Nodes of Upper Limb
Deltopectoral node
Lateral axillary nodes (along axillary vein)
Cephalic vein
Basilic vein
Cubital nodes
Median cubital vein
Cephalic vein
Basilic vein
Vessels passing to dorsum of hand
Vessels passing to dorsum of hand
Vessels passing around web to dorsum of hand
Vessels passing to dorsum of fingers
Note: Arrows indicate direction of drainage
Regional Scans | CT Angiograms of Arteries of the Upper Limb
Subscapular artery
Axillary artery
Deep brachial artery
Radial artery
Deep palmar arterial arch
Princeps pollicis artery
Ulnar artery
Superficial palmar arterial arch
Common palmar digital artery
Anterior interosseous artery
Radial artery
Ulnar artery
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