上下肢.ppt

Regional anatomy of upper limb  Regions and Components Shoulder region－junction of arm and trunk Arm－between should and elbow Elbow－bend of arm, joint between arm and forearm Forearm－between elbow and hand Wrist and Hand Surface anatomy Shoulder region: acromion, spine of scapula, coracoid process, greater tubercle, anterior and posterior axillary folds Arm－medial and lateral biceps brachii furrow, deltoid tuberosity Elbow－medial and lateral epicondyles, head of radius, olecranon, tendon of biceps brachii Forearm－between elbow and hand Hand－styloid process, dorsal tubercle Axilla (Axillary fossa 腋窝) The axillary fossa is a pyramid-shaped space through which major neurovascular structures pass between the thorax and upper extremity Boundaries The apex is a triangular space limited by the first rib, the scapula, and the middle third of clavicle. The base－skin and fascia of the axillary fossa The anterior wall Pectoralis major, pectoralis minor and subclavius muscles Clavipectoral fascia 锁胸筋膜 The deep fascia which extends between subclavius, coracoid process and pectoralis minor muscles The structures pass through Cephalic v. Thoracoacromial a. Lateral pectoral n. The posterior wall－teres major, latissimus dorsi, subscapularis and scapula Trilangular and quadrangular spaces三边孔和四边孔 Between the subscapularis and teres major, there is a long triangular space whose lateral side is surgical neck of humerus. The long head of triceps brachii subdivides this space into a medial triangularl space and a lateral quadrangular space. The posterior humeral circumflex a. and axillary n. pass through the quadrangular space. The circumflex scapular a. passes through the triangular space The broad medial wall－serratus anterior,intercostal muscles and upper four ribs The narrow lateral wall－coracobrachialis, biceps brachii and intertubercular groove Contents Brachial plexus, axillary a. and principal branches, axillary v. and tributaries, axillary lymph node