Upper Limb | Anatomy | FARRE 2.0 | MBBS Prof 1 | Dr. Pradeep

0:25 so hello students am I audible so let us start with the Upper Limb uh a short time I'll try to cover most of the topics and this I'm audible now properly okay so let us start let us start the upper Li okay look at this model what are important from exam point of view I'll tell H it will be a quick revision just sit back relax and listen to the lecture all this will be available for you okay

1:10 hello to all of you and now we begin okay this muscle pectoral is Major what is the origin of this muscle it begins from the medial 2/3 of the clavicle half the breadth of Manu sternai the body of the sternum the second to six costal cartilages and there's a muscle of the abdomen here what's that external oblique aponeurosis external oblique aponeurosis so origin of pectoral is Major the metal 2/3 of the clavicle the manuum sty the body of the sternum the second to sixth costal cartilages and the external oblique aponeurosis now where is this muscle inserted that's the hum this muscle is inserted on the

1:56 lateral lip the lateral lip of the bicipital group the lateral lip of the bicipital group okay I ask ask you some questions in between if you can answer you answer that which muscle is in attached to the medal lip of the bicipital group yes come on the muscle attached to the metal lip of the bicipital group is good evening good evening hi hii the muscle attached to the medal lip of the bicipital group come on come on what you can you please answer so let it be an interactive session the muscle attached to the medal Li of bpal group will be the Theus major lateral lip of bpal grou that's a pectoralis major the Met of the Bisal group is the terus major and in the bicipital group is the lmus dorsene lmus dors the origin is here the

2:41 insertion is on the humoris when this muscle contracts what do it do so what is the action of pectoris major it takes the arm towards the body that's adduction it takes the arm forwards that's flexion and it also turns the arm inwards inwards that's medal rotation at the shoulder joint so so action of pectoralis major adduction flexion and medial rotation at the shoulder joint this pectoralis major is supplied by two different nerves one is the medial pectoral nerve and the other one is the lateral pectoral nerve and when a muscle receives nerve Supply from two different nerves we call this muscle as a composite muscle composite or a hybrid muscle composite muscle or a hybrid

3:31 muscle here about the pectoris major okay just one moment tell me what is attached here what is attached to this this is the Lesser Tule of the umus we just finish this what is attached to the lesser tubic the muscle is subscapularis subscapularis the action of subscapularis is medial rotation at the shoulder joint this is the greater chicle three muscles attached here one is supraspinatus the second is infraspinatus and the third one is terus minor tus minor action of supraspinatus it does abduction from 0 to 15° that is initiation of abduction 0 to 15° of abduction and what is the action of infraspinatus and turus minor it does

4:19 lateral rotation at the shoulder joint the subscapularis does metal rotation suas spinus does abduction infraspinatus and turis minus lateral rotation together this four muscles are known as as rotator cuff muscles rotator cuff muscles okay we'll come to that later now this is fascia and this fascia lies deep to the pector major what is the name of this fascia the clav pectoral fasia clav pectoral fascia where does this clavipectoral begin from where does it begin from it begins from the clavical and it is inserted into the axela begins from the clavicle inserted into the axela there are two muscles um enclosed by this clavipectoral fasia two

5:06 muscles are enclosed by this the first muscle is the subclavius and the second muscle is the pectoris minor pectoralis minor so two muscles enclosed by the clavipectoral fish are the sub clavus and the pectoris minor and what are the structures pierced by the clav pector structures piercing the clavipectoral FAS what are the structures piercing the clavipectoral fasia yes number one I'll just point it out for you number one yeah what is this vein the calic vein calic vein number two is this artery here what is this artery here that's the thoracoacromial artery thoracoacromial artery number three is a nerve here that's the lateral pectoral nerve lateral pectoral nerve and number four are the lymphatics from the breast

5:54 lymphatics from the breast clear so clav pectoral fasia begins from the clavical inserts into the axilla encloses two muscles the pectoral minor and the subclavius structures pierced by the clavipectoral fasia the calic vein the thoracoacromial artery the lateral pectoral nerve and the lymphatics from the breast lymphatics from the breast clear students very good now just tell me this can come as a um you know visual for you what is this muscle that's the deltoid what is this muscle here that's a pectoris nature what is this Groove known as that's the deltopectoral groove deltopectoral groove between the deltoid and the pectoris major there's a Groove name the

6:41 deltopectoral group deltopectoral group and who lies in this deltopectoral group hello hello who lies in this Delta pectoral group any guesses come on students structure lying in the Delta pectoral group a very important McQ for you you can see the structure hereu line in the Delta vectoral Group come on you can answer this the calic vein calic vein So calic Vein lies in the Delta pectoral group the same calic vein is going to pierce the clavipectoral fasia and this calic vein is going to open into axillary vein it opens in the axillary vein yeah so just try to understand everything that I'm telling you listen to the lecture okay many of the things would be clear I'll try to correlate many

7:28 things okay uh coming to this clav clav if you quick tell clavicle uh I'll just make the slide for you this is a clav here so the anterior 2/3 is convex uh in its medial 2/3 medial 2/3 is convex anteriorly and lateral 1/3 is concave anteriorly yes so what is the muscle attached here the muscle attached here if this is anterior and that's posterior we take the bone separately in the last lecture so the muscle attached here to the anterior aspect of the medal 2/3 that's vectoral major the muscle attached here to the lateral 1/3 is the Del yeah the muscle attached here to the posterior 1/3 what's this what's this

8:17 that's the trape that's the yes any guess and the muscle which begins from here a muscle which has got two heads the sternal head and the clavical head what's that sternomastoid so that's a sternomastoid and there's a group here on the inferior surface there a Groove here that's the groove for sub clavus muscle okay the groove for subclavia muscle so that's about the clavicle the important muscle attachments on the clavicle we'll be taking the bones separately but so just just try to understand this coming to this if you can quickly tell me that's a scapula here we go through the scapula that's a spine and that's the acromium process so this is the dorsal aspect of the scapula dorsal

9:04 aspect what is the muscle attached here this fosa is the supraspinal fosa the muscle attached here is the supraspinatus the muscle attach here in the infraspinous fosa is the infraspinatus infraspinatus the muscle attached to the inferior border of the spine and to the lateral border of acromion what is this hi hi hi all of you the muscle attached to the inferior part of the spine and the lateral body of the acroman what is this muscle that's the trapezius trapezius the muscle attached to the superior border of the spine and the medial border of the acromial okay so this is the deltoid sorry this is the deltoid number three is the deltoid I'm so sorry yeah this is the delto yeah so the

9:49 muscle attached to the inferior B of the spine and the lateral part of the acrom is the delin the muscle attached to the Superior part of the spine and the metal part of the acromion this is a trapezi okay that's a trapezius muscle very good very good what is this muscle attached here to the lateral border of this scapula leral B scapula I just put numbers here this is number four what is this terus minor terus minor and what is this number five that's a terus major terus minor terus major right what is this muscle a quick go through the scula what is this muscle from the superior angle to the spine this is the leus C opposite to the spine that's the ridus

10:36 minor and below the spine that's the ridus major and there's a small muscle here that's the laus D sign lausus D sign okay so the important muscle attachments on the scapula again I'm telling you bone will be taking separately I'm just telling you so if that's the costal surface of the scapula that's the choroid process what is the muscle ATT here that's the subscapularis subscapularis okay what is a muscle attached to the infraglenoid tubic that's a long head of triceps the muscle attached to the supr glenoid Tule that's the long head of biceps break ey the muscle attached to the coracoid proces are three muscles one are two muscles

11:23 one is the coraco balis and the second one is the short head of biceps coraco brais and the short head of biceps now what is this muscle attached here here here here on the costal surface medial border any guesses come on students costal surface meal border what is this muscle yes costal surface meal border that's the seratus Anor muscle attached to the fil surface meal border Theus an very good very good hello coming to the next muscle what is this muscle this muscle is the deltoid deltoid has got three types of of fibers the one which begins from the clavicle these are the clavicular fibers of deltoid or the

12:08 anterior fibers of deltoid the one which begins from the inferior border of the spine this are the posterior fibers of deltoid and the third fibers which begins from the acromium process what are these fibers these are the acromial fibers of deltoid so anterior fibers posterior fibers acromial fibers anterior fibers begins from the clavicle the posterior fibers begins from the inferior border of the spine and the lact and the acromial fibers begin from the acroman process very important person deltoid what is the action of the anterior fibers of deltoid they do flexion and metal rotation the posterior fibers they do extension and lateral rotation and the acromial fibers they do abduction from 15 to

12:53 90° right which is the nerve which supplies the deltoid axillary nerve where axillary nerve supplies two muscles one is the deltoid the second one come on answer this axillary ner supplies two muscles one is the deltoid the second one is answer answer answer I'm waiting yes the terus minor deltoid and terus minor and the axillary nerve gives a cutaneous Branch cutaneous Branch what is this cutaneous Branch going to supply IT Supplies the skin on the upper lateral aspect of the arm the skin on the upper lateral aspect of the arm that is known as the upper lateral cutaneous nerve of arm so understand this axillary nerve supplies deltoid Theus minor and gives a

13:40 cutaneous Branch the upper lateral cutaneous nerve arm injury to this nerve leads to loss of sensations of the skin on the upper lateral aspect of the arm what do we call this as the regimen batch sign regimen batch sign fine so just remember this axillary nerve because this axillary nerve gets involved in Earth paralysis hers paralysis okay so aary ner supplies deltoid and turus minor so in hers paralysis deltoid is paralyzed so abduction is lost so the arm is adducted Theus minor is paralyzed Theus minor does lateral rotation so the arm is medially rotated in OBS paralysis what happens arm is adducted arm is medially

14:26 rotated plus there is regimen batch sign that's involvement of axillary nerve okay we'll see the UPS paralysis later fine so that's about the deltoid you can see the spect me you can see the structure here that's the calic vein calic vein perfect students clear now what is this muscle arises as digitations here a muscle which arises as digitations from the lateral aspect of the ribs yes greatest St hand a which arres digitations from the upper eight RPS from the L Al aspect of the upper Atri it arises as digitations what's that seratus anterior that's seratus anterior where is the insertion

15:11 of catus anterior it gets inserted on what is this surface of the SC this is the costal surface which border is this that's medial border so costal surface medial border hi snit so seratus anterior begins from the lateral aspect of the ribs as digitations upper eight ribs gets inserted on the costal surface medial border when this muscle contracts it is going to pull the scapula forwards along the chest wall and this is what we call as protraction of scapula protraction of scapula clear hello is the voice clear now protraction of scapula is done by whom seratus anterior seratus anterior also

15:58 does abduction above 90° what do we call this as B overhead Abduction of arm now see abduction from 0 to 15° is done by whom Supras spinus 15 to 90° is done by deltoid acromial fibers of deltoid and 90 and above is done by huh okay 90 and above is done by seratus anterior trapezius and the lateral rotation of scapula seratus anterior trapezius and the lateral rotation of scapula that's overhead Abduction of arm so what is the action of seratus anterior very important but very important seratus anterior comes as a short note for you so origin I've told you insertion is on the conal surface medial border action is it pulls the scapula along the chest

16:45 wall That's protraction second it it uh yes it also pulls the arm up that is overhead Abduction of arm along with trapezius yes and the lateral rotation of scapula now what is the nerve supplying the seratus anteria that's the long thoracic nerve or the nerve to seratus anterior or the nerve of bell the root value is C5 C6 C7 and injury to this nerve would lead to winging of scapula winging of scapula right so what happens is the metal border of scapula becomes prominent that's winging of scapula but yes winging of scapula is caused due to paralysis of two muscles one is the seratus anterior and second is the trapezius now how do we differentiate

17:31 this so we tell the person to go and touch the wall so when the person begins a movement when the person attempts a movement and that's winging of the scapula yes this is due to paralysis of seratus anterior so winging on attempting moment on beginning moment seratus anterior paralysis and winging at rest the person is at rest not doing anything the person is at rest and still the winging that's due to paralysis of trapezius so just remember this you get visuals on this winging of scap shown the person is performing some mov that is because of paralysis of seratus anterior and second person is just sitting winging

18:18 aesus perfect seratus anterior is also known as boxers muscle very good hello very good very good very good fine now I just draw you must have seen the slide you tell me this is the mandum stern that's the body of the sternum okay this is the clavicle front clavicle that's the scapula from behind that's the superior border of scapula this is the humus here and this is the first first okay so this area is the Axel ax okay so so uh what is this in front clavical this is the scapula that's the umbris this area

19:06 is the axela the anterior wall of axela the anterior boundary of Axel is formed by pectoris major pectoris minor and the subclavius pectoris major Pectus minus subus but axela comes as an lq so anterior anterior boundaries formed by pectoris major pectoris minor and the subclavius the posterior wall of the Axel or the posterior bound of the axela is formed by come on if anyone can answer this three muscles forming the posterior wall of axela anyone anyone anyone anyone three muscles forming the posterior wall of axela the first one subscapularis the second one anyone answer this subscapularis terus major and below the

19:53 terus major is the laus dors side so subscapularis Theus major and the laus dot side this three muscles together are going to form the posterior wall of axela very good very good excellent so the anterior wall of axela is formed by Pectus major Pectus minor and the sub cavus excellent the medial boundary of the axela is formed by what these are the ribs and the muscle which begins from the ribs as digitations what's that seratus anterior so medial boundaries formed by the ribs and the seratus anterior the lateral boundary is formed by the umbris so this becomes the axilla now what is this B what is this known as look what is this area known as this is what we

20:39 call as the Epic of the axela oh very important McQ for you B very important McQ this is also known as the survivo axillary canal suro aary canal or the epex of the axela yes clav yes because spect minor yes F so what is this this is the cico axillary Canal you get MCU on this boundaries of cical axillary Canal anteriorly is the clavicle posteriorly is the scapula the superior border of scapula meally is the outer border of the first rib correct outer border of the first so this is what we call as the epex of the axela or the cervico axillary canal cervico axil

21:25 canal what are the structures which are entering into this so but what is this behind the manum sty that's the arch of aota arch of aota and what is this artery which arises from the arch on the left side that's the subclavian artery the subclavian artery crosses the outer border of the first rib B what is this now the axillary artery the axillary artery enters the epex and now comes into the Axel clear students how the subclavian Ary has become the axillary artery so subclavian artery arises from the arch on the left side on the right side it arises from the braic trunk both the sub artery cross the outer part of the first

22:11 rib enters the epex and comes into the axilla here so this is the axillary artery axillary artery is a continuation of the subclavian artery at the outer border of the first rib now if you can tell me what is this muscle that's the med lip of the bicep through lip of the bicep it do this muscle is Major this musle is that is major muscle is Major what is this artery now brachial artery brachial artery right yes brachial artery very good very good so axillary artery is a continuation of subclavian artery at the outer B of the first St axillary artery continues as the breal

22:58 artery below the lower border of ter major this is a very important Landmark below the lower border of Theus major that's the corid versus of scapula and what is this muscle the pectoralis minor pectoralis minor so the pectoralis minor divides the axillary artery into three parts correct that's the first part behind the muscle is the second part and that's the third part of the axillary artery so axillary arteries divided into three parts by the pect minina muscle relations of axillary arter are important what are the branches of axillary artery first part one branch Superior thoracic artery second part gives two branches lateral thoracic and thoracoacromial artery and third part gives three branches anterior circumflex

23:46 humal posterior circumflex humal and the subscapular artery subscapular artery okay I'll just now just let me know now just let me know if it's if it's clear so what are the branches of Accel the Ary first part Superior thoracic second part is lateral thoracic and thoracoacromial and the third part gives anterior circumflex umbral posterior circumflex umbral and the subscapular artery subscapular artery fine perfect so that's about the axillary artery the subscapular artery subscapular AR it gives a branch what is this Branch known as any guesses any guesses buto what is this artery what is this Branch known as this

24:31 is the subscapular I'll mention this as the subscapular Ary this subscapular artery gives a brch any guesses this artery passes to the upper triangular space come on come on if you can answer this this is what we call as the circumflex capillar artery very good this is the circumflex cap artery and this circumflex capillar artery passes to the upper triangular space it takes takes part in anastomosis on the dorsal aspect of scapula very good very good very good very good okay you can quickly identify this muscles this number one is the pus major

25:16 here cut oh sorry this is the pectoralis major which is cut here this number two is the pectoralis minor which is cut here and this number three is the subious muscle so that's the second part of the axillary AR this is the first part first part second part third part clear okay now coming to the break plexes go through the break plexes yes yes anastomosis with the yes shantanu very good so anastomosis on the dorsal aspect of scap between the third part of the axillary artery and the first part of the subclavian artery right now breal plexus how is the breel plexus formed it

26:01 is formed by the ventral RI of C5 to T1 the ventral R of C5 to T1 sometimes C4 takes part in the formation of bre plexes what do you call this as prefixed and sometimes T2 takes part in the formation that is known as postfixed postfixed breal plexus okay so this is C5 okay I'll quick through this C5 C6 relations important relations important relations important I tell you relations important posterior relations posterior relation is the posterior wall of axela posterior wall I I'll tell you the break plexes then I'll tell you the relations let me finish the break plexes this is C5 C6 C7 C8 and T1 relations you'll understand once you understand the break flexes so what are these are these These

26:50 are the roots roots in short I'll tell you huh relations because that's a full lecture okay okay so Roots so what are Roots roots are the ventral r of C5 to T1 the vental r of C5 to T1 that's Roots Roots will join from what trunk trunk will divide into divisions divisions join to the and will branches bres okay the roots TRS division cords and nerves or the branches I'll start so C5 C6 joins to form what is this upper trunk C7 as the middle trunk C and T1 joins to form the lower trunk that's a lower trunk so C5 C6

27:37 joins to form the upper trunk C7 is the middle trunk c81 from the lower what is the root value of upper trunk C5 C6 root value of middle trunk C7 root value of C8 T1 now each of this trunks will divide into a dorsal and ventral divisions so this I draw the dorsal division dorsal dorsal and ventral ventral ventral divisions so each of the trunk divides into a dorsal ventral dorsal ventral divisions now the ventral division of the upper trunk and the vental division of middle trunk joins to form the lateral cord lateral cord the vental division of lower trunk continues as the medial cord medial cord and the dorsal division of all the three trunks

28:25 joins to form the posterior cor yeah yes joints to form the posterior what is the root value okay just try to remember it like this very rarely try to understand the neonics so what is the branch of lateral cord I mean what is the root value of lateral card it's C5 C6 C7 what is the root value of lateral card it's C5 C6 C7 what is the root value of medial C that's C1 C and T1 and what is the root value of poster that's T to T1 s are there all the roots that's C5 to T1 clear to all of you okay now what are the branches of

29:10 lateral cord branches of lateral cord number one lateral pectoral nerve second lateral root of metan nerve third lateral yes and the third one is muscular cutaneous what are the branches of lateral C lateral pectoral lateral root of metal ner and muscular cutaneous nerve what are the branches of Medal C the medal pectoral the medal root of medial nerve the medial cutaneous nerve of arm the medial cutaneous nerve of forarm and finally alar nerves alar nerve yes very good and what is the root

29:56 value of the posterior card I mean what is the branches of posterior card upper subscapular lower subscapular the nerve to lmus dorsi also known as thoracodorsal nerve radial and axillary radial and axillary this you should know braal plexure should be on the tip of your tongue so these are the branches of the cords of the brael plexus what are the branches from the roots of the brail plexus from the roots of the brael plexes uh from the roots of break plexes from C5 what is the what is this nerve yes anyone from C5 what is the nerve which arises from C5 root of the bra plexus come on come on come on come on the branch which arises from CI root

30:46 of the breal plexus anyone long thoracic that's a nerve to roids that's a dorsal scapular nerve dorsal scapular nerve or the nerve toids and this Nerf toids is going to supply the lus capill the ridus minor and the rid is Major perfect there's another n which arises from C5 C6 and C7 C5 C6 C7 that's the nerve to seratus anterior or the long thoracic nerve nerve to seratus anterior on the long thoracic nerve now occasionally sometimes there's a nerve which arises from C root there one more nerve which arises from CI root any guesses any guesses CI the dorsal capillar nerve is there already but

31:32 there's one more nerve which arises from C5 root of the breil plexus what is this any guesses if you answer very well long long it's a different nerve frener root value frenic nerve root value is C3 C4 C5 C3 C4 C5 is frenic nerve no but sometimes there's an extra frenic nerve extra frenic nerve what do you call this as accessory frenic nerve accessory frenic nerve and this accessory frenic nerve arises from C5 root of the breal plexus remember the main frenic nerve is C3 C4

32:18 C5 okay so this is accessory frenic excellent very good very good now there are two branches which arise from the upper trunk one is the suprascapular nerve the second one is the nerve subclavius suprascapular nerve and the nerve to sub clavus what is the suprascapular nerve Supply IT Supplies the supraspinatus and infraspinatus and what is the nerve to subclavia supply subclavius okay is this clear that's the breel plexus now what are the parts of the breel plexus The Roots look The Roots the trunks the division carts and N now out of this The Roots the Trunks and the divisions where do they lie they lie in the neck they lie in the neck the roots and trunks

33:03 they lie in the neck some books mention the divisions lie behind the clavicle behind the clavicle okay so normally when we say the root strs and divisions they lie in the neck what lies in the axela in the axela lies the cords and the nerves so Axel Cs and nerves okay now we know axillary artery is divided into three parts students if this is the first part of the aary artery that's the second part of the aary and that's the third part of the aary artery I'll just in short tell you the relation tell me now in which part of the axillary artery do we get the cords and which part of the aary artery do we get the nerves come on answer

33:49 this in which part of the axillary artery do we get the cords we get the cords in the first part and the second part of the break plexes we get the C first and second part we get the cords and in the third part of the axillary artery what do we get the nerves the nerves the branches the branches CS of a only Cs and nerves so out of this the cords are present in the first and the second part of the axillary artery and the nerves are present in the third part the cords are placed according to the names in which part can anyone answer this the cords are placed according according to the names in which

34:36 part is who was asking me this uh Boer man H yes tell me the cords are placed according to the names in the second part of the axillary artery in the second part of the axillary artery B if that's the second part of the axillary artery see you know this this short I tell you if that's the second part the axillary artery the cord which is lateral to the axillary artery is the lateral cord the cord which is medal to the axillary artery is the medal cord and the cord behind the axillary artery is the posterior cord clear so you get the relations of the second part of the aary artery lateral side by lateral cord medial side is the medial cord and behind is the posterior cord and behind the posterior cord are those three

35:23 muscles subscapularis Theus major L side and in the third part we will be getting what the branches third part branches so lateral cord you'll be getting branches of lateral cord in the third part the branches of medial cord and the branches of posterior cord in the third part so anterior relation of axillary artery pectoris major in the second part pectoris minor right clear fine you get an orientation to this see because this is a revision I'll just quickly touch the topics and go if anything you need extra I'll take a separate lecture okay fine okay now coming to the arm now coming to the arm come on now quickly what is this

36:09 muscle number one this is a biceps Brea and the biceps Brea has got two heads this is what we call as the long head of the biceps brei and the short head the long head of biceps brei arises from the supraglenoid tubercle of scapula the short head of biceps break ey arises from the choroid Press along with the coraco balis along with the Coralis short head arises from the coroco proces long head arises from the supraglenoid tubic you should be quickly able to recollect revise this where is the insertion of biceps breakout where's the insertion of the biceps break that's the head of the radius that's the head of the radius that's the neck of the radius and what is this for the radius that's the radial tuity so where is the

36:54 insertion of biceps bre ey it is inserted on the posterior aspect of the radial tuity posterior aspect of the radial tuberosity what is the nerve supply of biceps what is the nerve of this compartment the muscular cutaneous nerve muscular cutaneous nerve yes what is the action ofs the main action of biceps is supination at the radioa joint supination in a mid flexed elbow in a mid flexed elbow supination is done by biceps in an extended elbow the suin is done by subor muscle subor muscle right so what is the action of bicep SPI it's a chinator in a mid Flex position it is a flexor of the

37:41 elbow joint it's a flexor of the shoulder joint C that's about the biceps brei in addition the long head of biceps brei prevents the upward dislocation of the humorus it prevents the upward dislocation of the humorus clear very good coming to the next muscle the next muscle is number two that's the Coralis number three that's a COR Coralis origin It arises from the tip of the cor along with the short head of biceps brei where is the insertion of Coralis insertion is on the humis if that's the humis here if that's a humus we divide the humorus

38:28 into two half it is insert Ed on the middle half of the shaft of the humus on which aspect on which aspect yes on the medial aspect medial aspect so where is the insertion of Coralis it is inserted on the medial aspect of the middle half of the shaft of the humus medial aspect of the middle half of the shaft of the umbris right what is the action of Coralis it's a weak flexor it's a weak flexor of the El of the shoulder joint it's a very weak flexor of the shoulder joint coming to the next muscle B what is this muscle number four this is bra

39:15 what is the origin of breis the origin of breis it arises from the anomal and the anol lateral aspect of the shaft of the humus below the insertion of coraco balis but where the coraco brais ends that is the beginning of brais so it arises from the anom medial and the anal aspect of the shaft of the humorus below the insertion of coraco brais yes where is the in where is the incision of breis but where is the incision of breis I draw this as the alna here and what is this for the alna the alar Tubity and this bra Alis is inserted on the alar

40:01 tuity insertion is on the alar tuberosity what is the action of bre Alis it is a chief flexor of the elbow joint it's a chief flexor of the elbow joint right that's balis perfect which is the nerve of this compartment the nerve is muscular cutaneous nerve now but you tell me muscular cutaneous nerve is a branch of which cord muscular cutanous nerve is a branch of lateral cord of bre plexus what is the root value of muscular cutaneous nerve that's C5 C6 C7 root value is C5 C6 C7 this muscular cutaneous nerve is going to pierce muscle that's a very important McQ for you that's a visual slide for you that's a slide which is kept in the ospie

40:48 examination yes the visuals the muscular cutanous is going to pierce a muscle what muscle is that the Coralis the Coralis now this muscular in nerv is lying on this muscle what is this muscle the balis and it lies below a muscle it's the biceps the nerve lies between two muscles it lies between the biceps and the balis and this nerve now continu as B what is this this is the lateral cutaneous nerve of forarm it continues as the lateral cutaneous nerve of forarm it's supplies the skin on the lateral aspect of the forarm Clearo right are you able to

41:35 correlate you must be done with your prelims no you must have revised everything this is a quick you know go through session perfect very good very good come on now tell me if you can answer this McQ I put one McQ for you very good very good yes all of you make it a attempt to answer this answer is muscular very good very

42:20 good numbness along the lateral aspect of the forearm okay numbness along the lateral aspect of the forearm which is the nerve the lateral cutaneous nerve forearm yes it's a continuation of muscular cutaneous nerve it's a continuation of muscular kous nerve very good very good very good this is an O slide for you huh yes visual slide for you tell me what is this what is this slide showing yes rul good evening what is this slide showing this is herbs paralysis yes herbs paralysis show ofs paralysis injury to the upper trunk of the braal plexus what are the roots involved C5 C6

43:06 roots of the braal plexes are involved and C5 C6 they mainly present in two nerves mainly concentrated in two nerves one the aary nerve and the other one is the muscular kitous nerve C5 C6 are present in many nerves okay but the main main main concentration is in the axillary and the muscular cutaneous nerve now tell me but what is the a nerve Supply one is deltoid deltoid and the second one is minor okay actually appes delto and tius minor deltoid is paralyzed tius minor is paralyzed so how would the arm be Del does abduction so the arm is adducted abduction is lost tus minor does lateral rotation so the arm is medially rotated so how is the position of arm adopted

43:52 and medially rotated plus there's a loss of Sensations on the upper lateral aspect of the arm what is that Reg bat sign regimen bat sign perfect the muscular cutanous nerve is involved muscular cutanous nerve supplies the biceps the brais coraco breis and IT Supplies the skin so the brais is gone what is the action of brais extension breis sorry the action of break Alis is flexion so flexion is lost so the forearm is extended biceps is paralyzed what is the action of biceps supination so supination is lost the forearm is pronated and the a loss of Sensations on the lateral aspect of the forearm when when the arm and forearm is like this the fingers becomes like this and this

44:37 is what we call as policeman STP hand policeman STP hand so how is the position of arm the arm is adapted arm is medially rotated plus regimen bat sign the forarm is extended the forarm is pronated and there's a loss of Sensations on the lateral aspect with pocan tip hand this is 's paralysis are you able to follow this yes answer all the following are seen in

45:23 hers paralysis except huh answer this loss of flection correct loss ofation loss ofation is correct no loss of abduction huh answer is a answer is a loss of medial rotation it will be loss of lateral rotation no it would be loss of lateral

46:09 rotation in fact the arm is going to be medially rotated arm medially rotated there'll be no loss of medial rotation there'll be a loss of lateral rotation are you able to follow this MC see the option properly see the stem properly I know you all must be knowing things perfectly so there is loss ofation no that is why there is pronation that's right

46:55 okay pronation why is there pronation because there's loss of supination right okay very good Chell great now but tell me what is this injury that's clumpy paralysis injury to which trunk of the bre plexus lower trunk of the break plexus right and which roots are involved C8 and T1 and this C8 and T1 are mainly mainly mainly present in two nerves one is the median nerve and the other one is the alna nerve so C8 and T1 is mainly present in median and ala nve and this C8 and T1 are going to supply the intrinsic muscles of the hand the small small muscles of the hand so what does the person get the person gets a claw hand claw hand the small muscles in the hand are gone paralyzed so the person gets a claw

47:43 hand right in addition T1 carries sympathetic fibers yes so the person gets a Horus syndrome involvement of cervical sympathetics leads to horness syndrome yes very good youve joined very good okay okay that's great excellent but this is clumpy paralysis remember this B A very important topic Clum paralysis yes coming to The Forum yes coming to The Forum now we quickly go through the Forum The Superficial muscles and the Forum but what is this we'll start with the muscles this is again an Opie slide for you so what is this number one that's the pries number two is the flexy radi

48:30 number three is the palaris long number four is the flexor Dum superficialis and number five is the flexis flexis so the first muscle is pron ties the next is flexor capy ralis the palmaris longus the flexor digitorum superficialis and the flexor capy Alaris now SNES now now see like a Alaris right can anyone tell me what is this muscle I put a star on this what is this muscle any guesses what is this

49:17 muscle Associated movement G that's basil ganglia these are associated movements by the Upper Limb moves that is basil ganglia this are known as Associated moments yes this is the braal braal right so this is the braal here this is pronated here and this is the imaginary line joining the two Epicon this is the cubital fosa so what are the boundaries of cual fora the latal boundaries byis the metal boundaries formed by the pries the bases formed by the imaginary line joining the two epicondilite fosa is formed by two muscles one is the bra Alis and the supinator break Alis and supinator

50:03 contents of cubital fora medial to lateral the medial nerve the brachial artery the tendon of biceps and the radial nerve some books mention superficial branch of radial nerve right so metal nerve the brachial artery the tendon of biceps and the radial nerve yes very good mbbr right perfect now coming to the Deep muscles can anyone tell me which are the Deep muscles in the front of the forarm the Deep muscles is one okay I'll just make a slide for you this is the radius that's the AL mbbr so what is this muscle here superficial branch of radial nve or

50:48 radial nerve you say that's fine so what is this this deep muscle is a pron quadratus Pronto quadrus right the deepest muscle is the Pronto quadrus what what is this muscle these are the two muscles here one is the flexor flexor yeah what is that flexor longus flexor digitus the muscle which begins from the radial that's the flexor polies longus and the muscle which begins from the alna is a flexor digitorum profundus and P superficial muscles these are the five superficial muscles here this is the pr the flex of the long the flex dig superal and the fle Alaris

51:34 Flex Alaris okay so pronus sub deep about that is the flexor pois longest the flexor digit profundus and the five superficial muscles now but what is this nerve can anyone tell me what is this nerve and what is this nerve this is the AL nerve and what is this no that's me so what is the AL going to supply what is the AL going to supply the aler supplies one the flexy Alaris and the AL is going to supply the M half of the flexum profundus AL is lying between what and what ala n is lying

52:19 between the flexor copy Alaris and the flexor Dum profundas so Al is going to supply the flexor cap Alaris and the middle half of flexor Dum profundas clear muscles rest all the muscles will be supplied by whom metan nerve rest all the muscles will be supplied by metor nerve have a look now this four muscles the flex the RoR flexmar long and The fle Superficial this is supplied by the medi nerve okay Med n and the media nve gives a branch can even tell me what is this branch and this branch is going to supply the flexis longus the lateral

53:06 half of profus and the what is this nerve this is a anterior intous nerve anterior intous nerve is a deep branch of median nerve deep branch of metal nerve so but this is extremely important from practical point of view when we discuss the median nerve and the AL nerve in the forarm we will be seeing the medior nerve lies on the flexor digitorum profundus and the medor nerve lies below the flexer digitorum superficialis and the Ala nerve is lying on the flexer digitorum profundus and below the flex ofi Alaris so this we are going to write in the course of the median and

53:53 Al yes okay clear to all of you nerve Supply clear so two muscles supplied by Ala nerve in the forearm flexo Alaris and the medial half of profundus four muscles supplied by the medial nerve and the D branch of median n supplies The rest of the muscles the flexopoly is longus the pron quadratus and the lateral half of profundus so students we have got a composite muscle here the composite muscle is flexa digitorum profundus supplying back to nerves the second composite muscle was pectoris major and pectoris minor the nerve suppli medial and lateral pectoral nerve the third composite muscle is brais brais the medial half is supplied by muscular kitous nerve and the lateral

54:39 half is supplied by the radial nerve breis composite muscle is suppli by radial ner okay that's good okay okay okay okay can tell me identify this slide for you come on if you can quickly tell me what is this number one what is this number two and what is this number three Come on B come on quickly you answer okay that's okay B that's okay what is number one okay okay B what is number one number one is biceps break eye you

55:25 got this right very good biceps break ey number two number two is the break Alis very good B very good break Alis number three number three is the muscular cutaneous nerve that's awesome that's awesome so number one is the biceps break ey we are in the arm number two is the braak Alis number three is the muscular cous now B examiner The Examiner is going to lift the biceps and what are we going to see the musculocutaneous nve just remember this remember this okay fine fine fine fine fine fine fine who's this number four can anyone tell me what is this number four and what is this number five number four who's number four number four is the metor nerve

56:13 right number four is the meter nerve and who's number five number five is the Alan nerve very good and if anyone can tell me what is this number six what's that number six number six is the F number six is the fle what's this muscle number seven seven seven muscle what's seven number seven very good shantanu you also answering very well number seven seven no no no look no seven muscle is the one in which the median and the

57:01 lying on number seven who's number seven it's the flexer digitorum profundus seven is profundus seven is profundus but s is profas what is this number eight what is this number eight number eight it's the lateral most content of the cubital fora that's number eight who's that that's a radial nerve eight is radial nerve what is this number nine n n what is this number nine and what is this number 10 ner number eight is radial nerve number n number 10 number n and 10 are branches of the radial ner these are the branches

57:48 of radial ner the radial nerve divides in the cubal for so what is this number nine number nine is The Superficial branch of real n and number 10 is the Deep branch of radial nerve number seven is The Superficial branch of radial nerve and number and that's a deep branch of radial nerve what's the Deep branch of radial nerve known as what's the Deep branch of radial nerve known as it's the posterior intous nerve one moment the the branch of radial nerve is known as posterior inous nerve right that's a posterior inter system so superficial branch and deep branch of retail clear to all of you okay 10A 10A

58:35 is the Deep Branch b 10 10 is the Deep branch and what is this number 11 if anyone tell what is this number 11 what is this number 11 just one moment Charing Charing charged okay come on what is this number 11 can any tell meor number 11 is that's a deep branch of radi which is piercing it the Deep branch of radial is

59:21 piercing it so what is that that's a posterior that's a supinator number 11 theator supinator just there no charging just one moment number number 11 is you can have a look 11 isine

1:00:25 okay 11 is here to all of you okay I'll tell you this later charger is not working [Music]

1:01:13 okay fine one proceed now tell me what is this this a cble tunnel it's a car tell me what are the which Tak the these are thees I'll just make this carple bones for you uh 1 to 10 1 to 10 a minute I I'll tell you just one moment

1:02:08 okay look here once again uh number one number one is the biceps number one is the biceps number two is the brais number three is the muscular kitous nerve okay number four is the medial nerve number five is the alar nerve number six is the flexor copy Alaris number seven is the flexor digital profus number eight is the radial nerve number nine is The Superficial branch of radial nerve number 10 is the D branch of radial nerve and the muscle 11 is the supinator supinator what is the suine begin from that's the radius see this is the radius that's the Stylo process of the radius that's the alna here this is the styler verus of

1:02:55 ala now tell me B where do the where does the supinator begin from can anyone tell me the supinator begins from the alna there's a small Crest there on the supinator which is known as the on there's a small Crest on the alna which is known as the supinator crest supinator crest of the alna and this supinator begins from the alna it goes behind the radius okay it goes behind the radius and it gets inserted on the lateral aspect of radius okay very good it begins from the subin crest of the it goes behind the radius and gets inserted on the lateral aspect of the radius so this muscle is the supinator here okay fine now coming to this carel tunnel

1:03:42 Carle tunnel we'll start with the carple tel just have a look at this this are the carple bones these are are the four Carle bones four and four I'm just drawing four and the four is on the other side in front now buto if this is medial and this is lateral what is this which is covering the carpal bones that's the flexor retinaculum and this flexor retinaculum divides on the lateral side the flexor retinaculum splits on the lateral side it splits on the lateral side C it splits on the lateral side now tell

1:04:28 me between the flex tacum and the caral bones what is this tunnel which is formed here known as that's the carpal tunnel it's between the flexum and the caral bones this is the caral tunnel now what is this structure which passes through the split of the flexed racum can anyone tell me this this is the flexy ralis flexy ralis these are the four tendons of flexor digitorum superficialis these are the four tendons of flexor digitorum profundus and this is the tendon of flexis longus flexis longus the tendon of flexis longus is enclosed in a Bersa what is this Bersa that's the radial Bersa that's a radial baa with the

1:05:15 tendon of flex ofis longest radial BSA with the tendon of flexis longest the BSA which encloses the tendon of flexor digit from superficialis and profundus what is this B known as this is the alar BSA and this alar BSA encloses which tendon this is a very very important McQ but very important McQ the alar Versa is going to enclose the tendance of flexor digit superficialis and the flexer digit profundus okay flexor Dum superficialis and profundus and the radial BSA is going to enclose which tendon it encloses the tendon of flexis longus Flex AIS longus clear to all of you okay and now you tell me what is this

1:06:01 structure here what is this nerve here what is this nerve can anyone tell me what is this nerve here that's a median nerve that's a meteor nerve right so meteor nerve encloses the tendons of I I mean meteor nerve lies between what and what the Met of lies between the alar Vera and the FX retinaculum between the Alara and the flex retinaculum lies the me okay fine now you tell me what is this tendon off look the flexor retinaculum on the medial side sends an extension the flexor retinaculum on the medial side

1:06:47 sends an extension what is this extension known as this is known as the W carpal ligament this is known as a wer ligament okay so the on the medial side the flexor retinaculum sends an extension what is that extension known as the VOA caral ligament and between the V caral ligament and the flex tacum we get a tunnel here what is this tunnel known as this tunnel is known as the gion tunnel G tunnel okay but what are the structures which are passing through the Gan tunnel can anyone tell me what are this structure passing through the Gan tunnel anyone structures passing through the Gan tunnel are the alar nerve and

1:07:35 the alar artery alar nerve and the alar artery passes through the G tunnel okay Al and alar Ary passes to the Gans Tunnel right now what is this tendon of sorry that charger was not working sorry for the disturbance what is this what is this what is this ton come on the 10 which goes above the flexor retinaculum any guesses the tendon which goes above the flexor retinaculum what is this tendon any guesses that's the tendon of Fus longus that's the tendon of Fus longus now what is this there's a nerve here there's a nerve here and there's an artery here buto can anyone tell me what is this nerve known as this nerve I'll just write this for you this

1:08:22 nerve is known as the Palmar to ous branch of alar no and this is the PMA cutaneous branch of median nerve and what is this artery this is The Superficial this you should know huh this you should know superficial Palmar branch of radial artery superficial PMA branch of radial artery my dear children you get this McQ structures passing above the flex retinaculum so what are the structures going above the flex retinaculum number one is the alna nerve

1:09:08 and vessels they pass through the Gan tunnel number two is the pharmac cutaneous branch of alar nerve can anyone tell me what is this nerve going to supply the palac cutaneous branch of alna nerve supplies the skin over the hypothenar Eminence hypothenar Eminence then is the tendon of Palmer is longest then is the PAC cutanous branch of median nerve what is this nerve Supply the skin over the penar Eminence and finally we have got the superficial Palmar branch of radial artery superficial Palmar branch of radial artery clear to all of you so this is the carpal tunnel a very important uh diagram which is asked and what is carpal tunnel syndrome

1:09:54 so compression of medior nerve compression of Med of in the caral tunnel is known as caral tunnel syndrome so water median of supplies in the hand will all be lost except the skin over the thear Eminence are going to be intact okay the skin over the thear Eminence are going to be intact here fine about this flexor retinaculum CH a short go through this you tell me what is this number one number two number three and number four come on answer this come on come on come on answer this what is this 1 2 3 4 these are small small muscles in the

1:10:40 hand these are the lumbal lumbrical so the lumbrical arise from the tendons of what are these tendons of the flexer digitorum profundus the lri lri inter here they arise from the tendon of flexa digitorum profundus right so the first and the second lles are known as uniate uniate the first and second lumbrical are uniate the third and the fourth lumbrical are said to be binate they arise from two tendons no so that is binate right now but where is the insertion of lles can anyone tell me the lles are inserted on the palar aspect of the lateral aspect of the base of the proximal falling of the fingers right

1:11:27 but this is the proximal fings this is the thumb so which aspect would this be lateral aspect so the first insertion of lumbrical is the lateral aspect carel syndrome you'll understand only if you understand the hand H so this is the proximal fallings this is the lateral aspect lateral aspect and this is the base of the proximal palings so the lles are inserted on the latal aspect of the base of the proximal fallings and from here the lumle goes on the distal aspect distal aspect and they get inserted on the base of distal fallings base of distal fallings look I'll just draw this B I'll draw one

1:12:14 finger for you this is the proximal fallings that's the middle fallings and that's the distal falling proximal middle that's distal F so if this is lateral and this is medial aspect Where is the attachment of lumbal it's inserted on the base of the proximal fallings of the fingers it's inserted on the base of the proximal fallings of the fingers lateral aspect and now it goes to the dorsal aspect and it is inserted on the base of distal fallings of the fingers base of distal fings ASP I'm drawing I'm drawing so look what I've drawn I've drawn one finger for you this is the lateral aspect of the base

1:13:00 of the proximal fings and from here it goes backside it gets inserted on the base of distal fallings of the fingers now is it clear now is it clear so what is the action of lumbal what is the action of lumbal when this part contracts it does this what is this flexion at the metaco fenial joints and when this part contracts what will it do it will do extension at the inter fenal joints extension at inter fenal joints so what is the action of lumbrical it does flexion at metaco fenial joints and extension at interal joints yes NE aspirant clear fine I hope this is clear to all of you

1:13:49 what is the action of lles now the first and the second lumle the first and the second lumle are supplied by which nerve the first and the second lles are supp by medial nerve the third and the fourth lumbrical are supplied by the alar nerve yes rishit clear to all of you who all are there rest all of you pram fine clear this is clear so the first and the second lles are supplied by meteor nerve the third and the fourth lumbal are supplied by allaha nerve when this lumbal are paralyzed now what does the person get what is the action of lumbrical flexion at metaco fenial joints and extension at interal joint Co now when this lumbrical are paralyzed we get a exactly opposite action and this is what we call as a claw hand this is

1:14:35 what we call as claw hand so claw hand is due to paralysis of lumbal clear to all of you the first insertion clear the first insertion is this is lateral no but this is lateral and this is medial so that's the base of proximal falling so the first insertion is here on the lateral aspect and then it goes to the dorsal aspect and gets inserted into the base of distal fallings on the dorsal aspect yes an very good another is there good fine clear to all of you so that's about the lumill now coming to this muscle this muscles can anyone tell me this is an opic question this is a visual slide for you children tell me what is this number one number two number three and

1:15:21 number four these are the muscles which arise from the bones any yes es b b I'll tell you I'll tell you just wait just wait tell me what is this what is this number 1 2 3 4 these are the intai and what intai this because this intr are are arising from one bone they're arising from the palar they're arising from medial aspect of first and second lateral aspect of third and fourth what are these These are the parar int and this is what we call as uni Pate muscles this is what we call as uniate so palar intai are uniate compared to this what are these

1:16:07 intr this intr are arising from two bones they they arise from two bones like this they arise from two bones so what are these in known as B these are what we call as the dorsal intai dorsal in right so can you differentiate between a palar inosi and dorsal inro the the Palmer inai are uniate that arise from one bone and dorsal inai are bipen they arise from two bones what is the action of palar in palar Ina does adduction adduction of fingers and dorsal in does Abduction of fingers dsal in does Abduction of

1:16:55 Fes clear so Palmer in does adduction dsal IND does Abduction of fingers the Palmer and dsal IND all are supplied by whom the Palmer and dsal in are supplied by any guesses the Palmer and dorsal in are supplied by alar nerve alar nerve the lumbal the first and the second is supplied by metor nerve the third and the fourth is supplied by alar ner xray XR don't see the mus you see only the bones perfect but come on come on come on coming to the hand now see to understand the caral tunel syndrome you should

1:17:41 understand the muscles and the Hand come on students here I start what is this Eminence known as the thar Eminence what is this Eminence known as hypothenar Eminence who supplies the skin over the thar Eminence the Pama cutaneous branch of median nerve who supplies the skin over the hypothenar Eminence the Pama cutaneous branch of alar nerve and both these nerves were going above the flexor retinaculum right they were going above the flexor retinaculum now what is this for the fingers this is asked in surface anatomy but the actions of muscles are asked in surface anatomy so what is this for the fingers even this I was asking my students also during the prelims exams what is this for the fingers anyone this

1:18:26 is ction for the fingers what is this for the fingers this is extension for the fingers what is this for the fingers abduction and what is this for the fingers adduction of fingers right now the first metac copal bone the thumb the thumb is not in line with the other fingers thumb the first metac bone is turned by 90° it is rotated by 90° so the movements of the thumb would be at right angles to the fingers this is Extreme important so what was this for the fingers abduction what is this for the fingers adduction so for the thumb at right angles to this this is abduction and this is adduction remember students moments of the thumb are asked in the

1:19:14 exams so yeah abduction yeah adduction right what was this for the fingers flexion and what was this for the fingers extension so for the thumb this is going to be flexion and this is going going to be extension and what is this okay and what is this opposition of thumb opposition of thumb so what are the moments of thumb this is flexion this is extension this is abduction this is adduction and what's that opposition of thumb clear now what is this Eminence Eminence muscles small small musle MUSC so all the small muscles are known as

1:20:00 intrinsic muscles intrinsic muscles and all the small muscles will end with breis brevis like long muscles end with longest no but so short muscle will end with brevis okay I start three muscles two superficial one deep the first muscle does this what's this buto abduction so what is this muscle abductor ficis breis the second muscle does this what's this flexion so what is this muscle flexor policis brevis and we remove this to the third one is going to do this opposition name opponent polies opponents policies so what are the muscles of the Thea

1:20:47 remnance abduct pois brev Flex pois breev heads superficial head and Deep head and the third one is opponent policies so this muscles are supplied by median nerve the thar muscles which abductor polies prev I'll just mention this for you look abductor abduct pois brevis flexa pois brevis The Superficial head superficial head of flexa pois brevis and the opponent polies this three muscles are supplied which nerve metan nerve and the first and the second

1:21:32 lumbs the first and the second lles okay ah okay so this five muscles are supplied by medial nerve in the hand right so medial nerve supplies the abduct apsis breev the flex of policis superficial head the third muscle is opponents polies and the first and the second lumbrical so but if there a carpal tunnel syndrome caral tunnel syndrome is the compression of metor nerve in the caral tunnel so what Medan of supplies in the hand is all lost so these three muscles are paralyzed the thumb which is rotated by 90° now now comes in line with the other fingers this is seen in

1:22:19 monkeys and this is what we call as the AP thumb deformity AP thumb deformity right plus there'll be a claw hand of the index and the middle finger claw hand because first two lumbricals are paralyzed so this is what we call as a partial claw hand so the when the me when there's a Carle Tel syndrome this you'll be getting this two lumbrical are intact plus the med of is compressed in the compel tunnel so what is the median of Supply in the hand it supplies the skin on the Palmer aspect of three and a half fingers matter okay now coming to what are the muscles supplied by alar in the

1:23:05 hand what is the alar supply in the hand now B what is this Eminence here hypothenar Eminence three muscles to superficial 1D the first one does this what is this abduction so the name of the muscle is abductor dig minim the second muscle the second muscle does this what is this flexion so name Flex dig minimi breev and the third one does this what

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