Gross Anatomy Most striking feature is marked discrepancy in the

21 October 2015 shape of both

Arm Stability is sacrificed for mobility of the joint
Dr. Romeo Abiog (movement along sagittal + movement along
transverse axis = rotation + lateral bending)
Humerus Head - angular value of 153
Proximal Glenoid fossa - 75(shallower, larger radius)
o Head Stability of GH
o Anatomical neck - separate the head and o Negative atm pressure
trochanter o Upward direction of glenoid
o Surgical neck - below the constricted area, o Static stabilizers:
most common site of fracture Presence of glenoid labrum- makes
o Greater tubercle S(upper) I(Middle) T(Lower) fossa deeper
o Lesser tubercle Subscapularis (IR) Ligaments and capsules
o Intertubercular groove (bicipital groove) o Dynamic Stabilizers:
contains the tendon of biceps long head, Musculotendinous cuff muscles (SITS)
transverse humeral ligament, the tendons
move instead of the groove Shaft
o Crests of the tubercles (lips of the groove) o Borders
Lateral lip (Cr of GT) Lateral
Medial lip (Cr of GT) Medial
o SPACES o Surfaces
Quadrangular/Quadrilateral space Anterolateral
contains the axillary nerve and posterior Anteromedial
humeral circumflex artery (Lat: surgical neck Posterior
of the humerus, Med: triceps brachii, Sup: o Radial sulcus (radial groove, humeromuscular
teres minor Inf: Teres major) tunnel)
Sd Axillary nerve injury during anterior o Deltoid tuberosity insertion of the deltoid
dislocation of the glenohumeral joint muscle
Triangular space contains the circumflex
scapular vessels, radial nerve, deep brachial Humeromuscular tunnel
artery and brachial vein (Sup: teres minor Formed by 3 heads of triceps brachii and radial
Inf: teres major Lat: triceps long head) sulcus of the humerus for the radial nerve
Triangular Interval contains the radial Extends downwards from the medial to the lateral
nerve and deep brachial artery side of the back of middle part of humerus
Transmits the radial nerve and the deep brachial
vessels (profunda brachii artery) __________ vein

Glenohumeral Joint
Formed by the ball shaped head of humerus and
shallow concave glenoid fossa Distal
o Lateral & Medial supracondylar ridges
 Lateral: origin of muscle flexor - o Musculocutaneous nevre becomes sensory
brachioradialis in function after innervating the anterior
o Lateral & Medial epicondyles compartment Lateral cutaneous forearm
Lateral: extensor common origin nerve
o Radial fossa o Long head of the biceps can abduct during
o Coronoid fossa external rotation cheating motion of the
o Capitulum (capitellum) biceps
o Trochlea o POPEYE MUSCLE ruptured biceps brachii
o Olecranon fossa
o Ulnar sulcus (groove) posterior aspect of the
medial epicondyle of the humerus, contains Anterior Compartment Posterior Compartment
the ulnar nerve Coracobrachialis Triceps brachii
o Cubital tunnel formed by the tendinous arch Biceps brachii (+) Anconeus
joining the humeral and ulnar heads of Brachialis because of its
attachment of the FCU (ulnar nerve may be action not based on
compressed here) its anatomical class
o Spiral groove fracture at this site would (forearm)
injure the radial nerve causing wrist drop
Lateral head of triceps brachii
lateral to the sulcus
Medial head of triceps brachii
below and posterior to the
sulcus

Anterior Compartment

Posterior Compartment

BRACHIAL REGION
o Divided by the intermuscular septum into
anterior and posterior compartment
o Bicipital aponeurosis - (lacertus fibrosus)
superficial attachment of the biceps into the
forearm fascia

Peculiarities
Biceps is in a position to act on 3 joints i.e.
glenohumeral, humeroulnar and proximal
radioulnar joints
FLEXION (best muscle for flexion when forearm
is..)
o Supinated - biceps
o Pronated - brachioradialis
o Neutral position - brachialis
In the shoulder it can flex, or abduct; at the
humeroulnar it can flex the elbow and at the
prox. Radioulnar, it can supinate
That makes it polyarticular, multijointed muscle
When the forearm is in supination, the biceps
acts in flexion of the elbow both with or without a
load, in slow as well as in fast movements, and
regardless whether it acts in shortening
(concentric contraction) or lengthening
(eccentric contraction) capacity
Biceps acts most effectively as a supinator when
the elbow is 90 degree flexed. At 90 degrees,
Fick calculated, the biceps is 4 times as effective
as the supinator muscle
Only twice that of the supinator on an extended
elbow. However, the effectiveness of supinator
muscle is not influenced by the elbow angle
What is the most effective position of the
forearm when doing chin-ups or pull-ups?
o Answer: In supinated position, biceps
becomes a strong elbow flexor; further, the
biceps is aided by the brachialis that equally
gives a strong flexion force in that position
too. However, when the forearm is flexed in
pronation, the effectiveness of the biceps is
reduced by the vain attempt to supinate the
forearm as it tries to flex the elbow
Brachialis known as flexor par excellence or the
workhorse among the elbow flexors as it is
uninfluenced by the position of the forearm in its
strength of elbow flexion (bec it is the shortest)
Studies by Basmajian showed that brachialis is
always active as an elbow flexor with or without
a load and whether the motion is rapid or slow
Lateral part of the brachialis often receives a
branch from the radial nerve, though functional
significance is not clear (still innervated by the
musculocutaneous nerve motor)
This branch helps supply the elbow joint but
there is disagreement on whether it provides any
motor fibers to the brachialis
Harnessing the 2 joint mechanism can enhance
action of triceps or biceps long head tendon
portion.
The head tendon of triceps is elongated when
the shoulder is flexed. So elbow extension
combined with shoulder flexion enhances the
strength capability of triceps and is used to
advantage in pushing activity bec of its 2 joint
mechanism
The extension and flexion combination are used
alternately in the following activities: sanding,
polishing, pulling the beater of a loom, using a
carpet sweeper, sawing wood, throwing a ball
Biceps and triceps acting simultaneously as
synergists, though they are antagonistic with
each other.
This can be verified and felt when screwing with
screwdriver
Strongest head of triceps Medial, closest to
the elbow joint.
Medial winging Serratus anterior Long
thoracic nerve
Lateral winging trapezius CN 11