HUMAN ANATOMY
First Year MBBS
Note: Underlined and bold
words are important and
often asked by teachers in
vivas. Some frequently
asked questions are also
mentioned here.
These are maximum clinicals
of Upper limb put together
from different books and
internet by Umer Shehroz
Khan (Kemcolian)
Upper Limb:
Bones of Upper Limb:
Clavicle:
Types of fractures:
Clavicle fractures are classified into three types based on the location of the fracture:
1) near the sternum (least common)
2) near the acromioclavicular joint (AC) joint (second most common)
3) in the middle of the bone between the sternum and AC joint (most common)
, Most common fracture:
The fracture in the middle of the bone between the sternum and AC joint which is the junction
between two curvatures of the bone is the most common fracture of clavicle.
Cause:
Fracture of the clavicle results from a fall on the shoulder or outstretched hand.
When the infant presses against the maternal pubic symphysis during its passage through
the birth canal.
Effects:
Its results in upward displacement of the proximal
fragment by the sternocleidomastoid muscle and
downward displacement of the distal fragment by
the deltoid muscle and gravity. It may cause
1) injury to the brachial plexus (lower trunk), causing
paresthesia (sensation of tingling, burning, and
numbness) in the area of the skin supplied by medial
brachial and antebrachial cutaneous nerves and
2) It may also cause fatal hemorrhage from the subclavian vein.
3) It is responsible for thrombosis of the subclavian vein, leading to pulmonary embolism.
Cleidocranial dysostosis (CCD):
Cleidocranial dysostosis (CCD), also called Cleidocranial dysplasia, is a birth defect that mostly
affects the bones and teeth. The clavicles may be congenitally absent, or imperfectly developed
in this disease which allows the shoulders to droop or to be brought close together in front of
chest.
, Scapula:
Winging of scapula (Back palsy):
When serratus anterior gets paralyzed due to damage to the long thoracic nerve, the patient
is unable to do the pushing actions and he cannot abduct his arm beyond 90o. Any attempt
to do these movements makes the medial border and inferior angle of scapula unduly
prominent, this is called winging of scapula.
In a developmental anomaly called scaphoid scapula, the medial border is concave.
Humerus:
Fracture of the greater tuberosity occurs by direct trauma or by violent contractions of the
supraspinatus muscle. The bone fragment has the attachments of the SITS.
Fracture of the lesser tuberosity accompanies posterior dislocation of the shoulder joint,
and the bone fragment has the insertion of the subscapularis tendon.
The head of the humerus normally dislocates anteroinferiorly due to the laxity of joint
capsule of shoulder at this point.
The three bony points of the normal elbow form the equilateral triangle in a flexed
elbow and are in one line in an extended elbow.
Types of fractures:
1) Fracture of the surgical neck may injure the axillary nerve and the posterior humeral circumflex
artery.
First Year MBBS
Note: Underlined and bold
words are important and
often asked by teachers in
vivas. Some frequently
asked questions are also
mentioned here.
These are maximum clinicals
of Upper limb put together
from different books and
internet by Umer Shehroz
Khan (Kemcolian)
Upper Limb:
Bones of Upper Limb:
Clavicle:
Types of fractures:
Clavicle fractures are classified into three types based on the location of the fracture:
1) near the sternum (least common)
2) near the acromioclavicular joint (AC) joint (second most common)
3) in the middle of the bone between the sternum and AC joint (most common)
, Most common fracture:
The fracture in the middle of the bone between the sternum and AC joint which is the junction
between two curvatures of the bone is the most common fracture of clavicle.
Cause:
Fracture of the clavicle results from a fall on the shoulder or outstretched hand.
When the infant presses against the maternal pubic symphysis during its passage through
the birth canal.
Effects:
Its results in upward displacement of the proximal
fragment by the sternocleidomastoid muscle and
downward displacement of the distal fragment by
the deltoid muscle and gravity. It may cause
1) injury to the brachial plexus (lower trunk), causing
paresthesia (sensation of tingling, burning, and
numbness) in the area of the skin supplied by medial
brachial and antebrachial cutaneous nerves and
2) It may also cause fatal hemorrhage from the subclavian vein.
3) It is responsible for thrombosis of the subclavian vein, leading to pulmonary embolism.
Cleidocranial dysostosis (CCD):
Cleidocranial dysostosis (CCD), also called Cleidocranial dysplasia, is a birth defect that mostly
affects the bones and teeth. The clavicles may be congenitally absent, or imperfectly developed
in this disease which allows the shoulders to droop or to be brought close together in front of
chest.
, Scapula:
Winging of scapula (Back palsy):
When serratus anterior gets paralyzed due to damage to the long thoracic nerve, the patient
is unable to do the pushing actions and he cannot abduct his arm beyond 90o. Any attempt
to do these movements makes the medial border and inferior angle of scapula unduly
prominent, this is called winging of scapula.
In a developmental anomaly called scaphoid scapula, the medial border is concave.
Humerus:
Fracture of the greater tuberosity occurs by direct trauma or by violent contractions of the
supraspinatus muscle. The bone fragment has the attachments of the SITS.
Fracture of the lesser tuberosity accompanies posterior dislocation of the shoulder joint,
and the bone fragment has the insertion of the subscapularis tendon.
The head of the humerus normally dislocates anteroinferiorly due to the laxity of joint
capsule of shoulder at this point.
The three bony points of the normal elbow form the equilateral triangle in a flexed
elbow and are in one line in an extended elbow.
Types of fractures:
1) Fracture of the surgical neck may injure the axillary nerve and the posterior humeral circumflex
artery.
