Upper Limb Objectives

These objectives are meant to assist you in learning the anatomy of the upper limb. It is assumed you are familiar with the anatomical components (i.e., bones, muscles, nerves, arteries, etc.).

1. Define the venous drainage (both superficial and deep).
2. Recall the cutaneous innervation of the arm, forearm and hand. Compare and contrast a dermatome with the cutaneous innervation of specific nerves.
3. Describe the relationships of structures found in the posterior triangle. For example, the anterior scalene separates the subclavian vein from the subclavian artery. (Entrapment of the subclavian artery between the anterior and middle scalenes has potentially important clinical ramifications.) Another example is the relationship of the roots of the brachial plexus to the scalene muscles.
4. List all of the components of the brachial plexus.
5. Illustrate that each part the upper limb (arm, forearm, hand) has compartments formed by the deep fascia.
6. Summarize the functions of muscles in each of the compartments. Knowing the functions helps you learn the attachments (origins and insertions) of individual muscles.
7. Explain the rotator cuff.
8. Recall which spinal segments contribute to each peripheral nerve (e.g., axillary = C5,6).
9. Describe the innervation of each compartment and the specific deficits that occur with lesions of individual nerves at different parts along the course of each nerve. What actions will test the musculocutaneous, median, ulnar and radial nerve functions? Where can the above nerves be checked for sensory loss? Which part of the limb is most severely crippled in upper brachial plexus lesion?Which in lower? What is the significance of "winged scapula", wrist drop, claw hand, scalenus anticus syndrome, carpal tunnel syndrome?
10. Describe the vascular pattern and major arteries. Describe the major anastomoses around each joint.
11. Describe the lymphatic drainage in this area? Remember CLASP.
12. Define the bony components of the wrist and carpal tunnel.
13. Compare and contrast intrinsic and extrinsic muscles of the hand.
14. Define terms for each of the joints (capsule, collateral ligaments, bursae, etc).
15. Recognize the most common congenital anomalies.
16. Identify anatomic structures in radiographic studies including X-ray, CT scans and MRI films.