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Good morning. posterior compartment of arm. Dr. Qudsia Sultana. Arm /Brachium. Deep fascia of arm extends to the humerus as medial and lateral intermuscular septa and divides it into Anterior compartment Posterior compartment. Posterior compartment of arm. Muscles: Triceps Brachii

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  1. Good morning

  2. posterior compartment of arm Dr. Qudsia Sultana

  3. Arm /Brachium • Deep fascia of arm extends to the humerus as medial and lateral intermuscular septa and divides it into • Anterior compartment • Posterior compartment

  4. Posterior compartment of arm • Muscles: • Triceps Brachii • Nerve: • Radial Nerve. • Artery: • Profunda brachii Artery.

  5. Triceps • Origin – • Long head –infra glenoid tubercle of the scapula. • Lateral head –lateral lip of the radial groove • Medial head – posterior surface of humerus below radial groove. • Medial and lateral intermascular septa.

  6. lateral • Insertion – superior surface of the olecrenon process of ulna. long medial

  7. Actions – • Powerful extensor of the elbow. • Long head supports the head of the humerus in the abducted position

  8. Muscle examination Patient is asked to extend his elbow, against resistance applied by examiner & other hand, feel for triceps contraction.

  9. Radial nerve • It is the continuation of posterior cord of brachial plexus • Largest branch • Root value:C5 to C8 & T1 • Course: In the Axilla - passes downward behind 3rd Part of axillary artery

  10. In the upper part of arm lies behind brachial artery. • Accompanied with Profunda brachii artery- enters spiral or radial groove.

  11. Brachialis • Appears in front of the arm after piercing lateral intermuscular septa. • runs downwards b/w Brachioradialis & Extensor Carpi Radialis Longus on lateral side, Brachialis on medial side of the nerve. • It terminates – • Cubital fossa -superficial and deep branch. Deep sup Brachioradialis

  12. Branches • Muscular • Cutaneous • Articular • Muscular- • Above spiral groove – • Long head of triceps and • medial head of triceps. • In the spiral groove- • Lateral head of triceps • medial head of triceps • Anconeus.

  13. Below the radial groove • Brachioradialis, • Extensor carpiradilaislongusaand • lateral part of Brachialis(propreoceptive).

  14. Cutaneous branches • Above the radial groove – • Posterior cutaneous nerve of the arm. • In the radial groove – • Lower lateral cutaneous nerve of the arm. • Posterior cutaneous nerve of the forearm. • Articular branches – • Elbow joint

  15. Branches of the radial nerve in radial groove Muscular branches • Lateral head of triceps • medial head of triceps • Anconeus. Cutaneous branches • Lower lateral cutaneous nerve of the arm. • Posterior cutaneous nerve of the forearm Articular branches • Elbow joint

  16. Teres Major Lateral Head of Triceps Long Head of Triceps Lateral Head of Triceps Radial Nerve Medial Head of Triceps Posterior cutaneous nerve of forearm

  17. Applied anatomy • Radial nerve injuries at different levels

  18. Radial nerve injury in the axilla causes Crutch Road traffic accident

  19. Effect of the injury in the axilla • Patient is unable to extend the elbow joint. • Wrist drop. • Supination is lost. • Loss of sensation. • Loss of gripping.

  20. RADIAL NERVE INJURY IN THE SPIRAL GROOVE CAUSES • Fracture of the shaft of the humerus • Saturday night palsy

  21. Effect of injury in the spiral groove Paralysis of triceps muscle except long head & part of medial head. Wrist drop. Loss of sensation. Supination is lost 4. Loss of gripping. High radial nerve palsy

  22. Radial Nerve injury in the lower part of arm • Paralysis of brachioradialis, extensor carpi radialis longus & brachialis (lateral part) muscles. • Wrist drop. • Loss of sensation • Loss of gripping

  23. Profunda brachii artery • Large branch of brachial artery. • Accompanies the radial nerve in the radial groove. • Terminates by dividing into • radial collateral and • middle collateral branches.

  24. Branches 1.Radial collateral/Anterior descending artery. • Ends by anastomosing with the radial recurrent artery in front of the lateral epicondyle of the humerus.

  25. 2.Middle collateral/posterior descending artery. • Largest terminal branch. Ends by anastomosing with the interosseous recurrent artery behind the lateral epicondyle of the humerus.

  26. 3.Deltoid/Ascending branch • ascends up and anastomose with posterior circumflex humeral artery • 4.Nurtrient artery to the humerus.

  27. RADIAL NERVE DAMAGE • CRUTCH PARALYSIS: • Site of injury: Axilla • Etiology: Prolonged use of Crutch • Manifestations: • Motor effects: ● Paralysis of triceps- loss of extension of elbow ● Paralysis of extensor muscles of forearm- “WRIST DORP” (inability to extend wrist & fingers at metacarpophalangeal joints) ● sensory loss on the back of the forearm and dorsum of the hand.

  28. Injury in Arm • Site: Radial groove/ Spiral groove • Causes: • Fracture of shaft of humerus. • Improper I.m injection. • Prolonged pressure (Saturday night paralysis) Sleeping in the armchair with the limb hanging by the side. • Manifestation: • Extension of elbow is possible- triceps is not paralyzed. • Wrist drop, • sensory loss Saturday Night Palsy

  29. Teres Major Lateral Head of Triceps Long Head of Triceps Lateral Head of Triceps Radial Nerve Medial Head of Triceps Posterior cutaneous nerve of forearm

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