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1、The Anterior Region of the Upper Limb,Ling Shucai,Regional anatomy of upper limb,Parts and regions,Shoulder regionjunction of arm and trunk Armbetween should and elbowElbowbend of arm, joint between arm and forearmForearmbetween elbow and handHand,The Anterior Region of the Upper Limb,1. Surface ana
2、tomy 表面解剖 2. The superficial structures 浅层结构Superficial veins 浅淋巴管Superficial lymph vessels 浅静脉Cutaneous nerves 皮神经3. The deep structures 深层结构The deep fascia 深筋膜The muscles 肌肉The vessels 血管The nerves 神经4. Regional anatomy 局部解剖Cubital fossa 肘窝The carpal canal 腕管The palmar fascial space 手掌筋膜间隙,1.Surfa
3、ce anatomy,Surface anatomy,Shoulder region: acromion, spine of scapula, coracoid process, greater tubercle, anterior and posterior axillary folds Armmedial and lateral biceps brachii furrow, deltoid tuberosity Elbowmedial and lateral epicondyles, head of radius, olecranon, tendon of biceps brachiiFo
4、rearmbetween elbow and handHandstyloid process, dorsal tubercle,16501700,Carring angle 提携角,2.The superficial structures,Superficial veinsCephalic vein 头静脉 Basilic vein 贵要静脉Median cubital vein 肘正中静脉,The superficial structures,The lymphatic drainage of upper limb,Lymphatic vesselsSuperficialfollow the
5、 superficial veins, drain into supratrochlear(滑车上淋巴结） and axillary lymph nodes（腋淋巴结）Deepaccompany main vessels, end in axillary lymph nodes lymph nodesSuperficial cubital lymph node (Supratrochlear lymph node): 肘浅淋巴结（滑车上淋巴结）Axillary lymph nodearranged in five groups,3. The deep structures,Muscles of
6、 armAntererior groupBiceps brachii 肱二头肌Coracobrachialis喙肱肌Brachialis 肱肌Posterior group triceps brachii 肱三头肌,.The Muscles,Muscles of forearm,Superficial layerBrachioradialis 肱桡肌Pronator teres 旋前圆肌Flexor carpi radialis 桡侧腕屈肌Palmaris longus 掌长肌Flexor carpi ulnaris 尺侧腕屈肌,Second layer Flexor digitorum su
7、perficials 指浅屈肌,Third layerFlexor digitorum profundus 指深屈肌Flexor pollicis longus 拇长屈肌Fourth layer Pronator quadratus 旋前方肌,Muscles of handLateral groupthenar 鱼际 (4)Abductor pollicis brevis拇短展肌Flexor pollicis brevis 拇短屈肌Opponens pollicis 拇对掌肌Adductor pollicis 拇收肌Medial grouphypothenar (3)Abductor digi
8、ti minimi 小指展肌Flexor digiti minimi brevis 小指短屈肌Opponens digiti minimi小指对掌肌,Lumbricales 蚓状肌(4)Palmar interossei 骨间掌侧肌(3)Dorsal interossei 骨间背侧肌(4),Intermedial group,. The vessels,Arteries,Brachial arteryContinuation of axillary arteryDivides into radial and ulnar arteries at level of neck of radiusBr
9、anches Deep brachial a. 肱深动脉accompanies with radial nerveSuperior ulnar collaeral a. 尺侧上副动脉 accompanies with ulnar nerveInferior ulnar collateral a.尺侧下副动脉,Radial artery and branches Radial recurrent a. 桡侧返动脉Superfical palmar branch 掌浅支Principal artery of thumb 拇主要动脉Ulnar artery and branchesUlnar rec
10、urrent a. 尺侧返动脉Common interosseous artery 骨间总动脉Anterior interossous a. 骨间前动脉Posterior interosseous a. 骨间后动脉Deep palmar branch 掌深支,Superficial palmar arch 掌浅弓Formed by ulnar artery（尺动脉） and superficial palmar branch of radial artery（桡动脉）Curve of arch lies across the palm, level with the distal border
11、 of fully extended thumb Gives rise to three common palmar digital arteries（指掌侧总动脉） each then divides into two proper palmar digital arteries（指固有动脉）,Deep palmar arch 掌深弓Formed by radial artery and deep palmar branch of ulnar arteryCurve of arch lies across upper part of palmar at level with proximal
12、 border of extended thumbGives rise to three palmar metacarpal arteries,The deep veins of upper limb: accompany the arteries of the same region and bear similar names,Deep veins,Musculocutaneous 肌皮神经 Distribution: Biceps brachii, brachalis and coracobrachialis BBC nerve; skin on anterior aspect of f
13、orearm,. Nerves,Median nerve 正中神经Distribution:Injury: Apehand 猿掌 produces sign of benediction, in which the index and middle fingers cannot be flexed and the thumb cannot be opposed,Ulnar nerve Distribution: Injury: Clawhand 爪形手,Innervation of hand,Median n. Ulnar n. Radial n.,Median n. Ulnar n. Rad
14、ial n.,4. Regional anatomy,. Medial bicepital brachii furrow 肱二头肌内侧沟,. Cubiral fossa 肘窝,Boundaries Baseline drawn through epicondylesof humerus （肱骨上髁） Apexbrachioradialis laterally and pronator teres mediallyRoofskin, superficial faxcia, deep faxcia and aponeurosis of biceps（肱二头肌腱膜）Floorbrachialis,
15、supinator（旋后肌） and capsule of elbow joint,Contentsfrom lateral to medialBiceps brachii tendonBrachial a.divides into radial and ulnar a.,usually at apex of fossaMedian n.Lateral to the biceps brachii tendonradial n. and lateral antebrachial cutaneous n.,. Carpal tunnel 腕管,Flexor retinaculum 屈肌支持带Thi
16、ckening of deep fascia in the handAttached laterally to scaphoid and trapeziun and medially to pisiform and hamateCarpal tunnel 腕管Formed by flexor retinaculum and carpal grooveTransmitsMedian n.Flexor digitorum superficialis and flexor digitorum profundus enclosed by common flexor sheathFlexor pollicus longus enclosed by tendinous sheath of flexor pollicus longus,
