Laboratory Identifications by Region - Namjoshi et. al.

Suboccipital Region

• vertebral artery (1)
  • through foramen transversum C1-C6, segmental arteries of C-spine
  • dorsal ramus C1 (suboccipital n.)
  • subocciptial triangle
    • obliquus capitus superior; lateral border
      • origin = trans. process C1
      • inserts superior nuchal line
    • obliquus capitus inferior; inferior border
      • origin = spinous process C2
      • insertion = trans. process C1
    • rectus capitus posterior; medial border
      • spinous process C2
      • insertion = inf. nuchal line
• greater occipital n. (1); dorsal ramus C2
  • pierces trapezius, sepispinalus capitus
  • deep to splenius capitus
• ligamentum nuchae (1)
  • external occipital protuberance, C7
  • posterior tubercle atlas
  • spinous processes (basically a thickening of supraspinous superior to C7)

Vertebral Canal

• denticulate ligament (1)
  • extension of pia
  • sepsrates dorsal and ventral roots
• ligamentum flavum
  • pierced during lumbar punture "pop"
  • yellow
  • connects lamina of adjacent vertebrae
• dural sac (dura mater)
  • invagination of outermost meninges from foramen magnum to vertebral canal
  • ends S2
  • filum terminale externum continues beyond S2 to anchor to periosteum of Co1 *C7; vertebrae prominens
  • attach lig. nuchae
  • attach supraspinous lig
  • back muscles

Back

• iliocostalis (1)

Scapula

• circumflex scapular A. (5)
  • triangular space; seen on floor of triangular space
    • teres minor (1) ; superior border of tri. space
    • teres major; inferior border of tri. space
    • long head triceps; lateral border of tri. space
  • axillary A.; circum. scap. A. branches before the thoracodorsal A. from the subscapular A.
• levator scapula
  • dorsal scapular A. (5) approaches scapula from neck deep to levator scapula
    • from subclavian A. or from trans. cervical A.
  • dorsal scapular nerve (6) runs just lateral to dorsal scapular artery, from C5
    • both run deep to rhomboids
    • approaching the medial border of the scapula
• trapezius
  • spinal accessory nerve, CN XI (5)
    • runs lateral to levator scapula
    • with transverse cervical artery (1)
      • reflected surface of trapezius
• axillary n.
  • quandrangular space
    • teres major; posterior/inferior border of quad. space
    • teres minor (1); superior border of quad. space
    • lateral head tricpes; lateral border of quad. space
    • long head triceps; medial border of quad. space
  • posterior circumflex humeral A; exits quad. space with axillary n. superficial to triceps
  • posterior cord
• profunda brachial A.
  • triangular interval
    • teres major; forms superior border
    • lateral head triceps; forms lateral border
    • long head triceps; forms medial border
  • humerus; courses behind after medial axillary origin
  • teres major; originates inferior to
  • radial nerve (6)
    • posterior to brachial A. and humerus
    • travel in radial groove on post. surface humerus with A.
  • branches to radial collateral A. and middle collateral A.
    • radial collateral courses anterior to lateral epicondyle and capitulum
    • middle collateral course posterior to lateral epicondyle
• supraglenoid tubercle (1); origin of long head biceps
• winging at scapula (4)
  • serratus anterior
  • long thoracic n.
    • C5,6,7
• supraspinatus (4)
  • superior transverse scapular ligament (2); found deep to supraspinatus
    • suprascapular A. (1) Army under bridge
    • suprascapular nerve (8); Navy under bridge * both reach infraspinatus deep to spine of scapula * upper trunk (4) injury, Erb's Palsy, Waiter's tip hand (loss of lateral rotation)
  • omohyoid (1); posterior belly found about an inch medial to trans. scap. lig.
• acromion (1); most lateral projection of scapular spine, deltoid origin

Axilla, Brachial Plexus

• posterior cord brachial plexus (7)
  • upper subscapular n. (3); subscapularis (5)
  • thoracodorsal n. (3); latissimus dorsi
  • lower subscapular n. (1); teres major
  • axillary n. (5); teres minor, deltoid
  • radial n. (6)
    • all deep to axillary artery
    • all anterior to subscapularis (4) muscle in axilla
• medial cord brachial plexus (1);
  • ulnar n. (6); medial cord gives off ulnar n. as it's branch
  • median n. (7); lateral to ulnar n., from lateral and medial cords
    • branch posterior to teres minor
  • musculocutaneous n. (3); lateral still to median n., from lateral cord
    • • branches to: coracobrachialis, biceps brachii, brachialis, elbow joint???
      • continues as lateral antebrachial cutaneous n. * cephalic vein * brachialis
  • medial pectoral nerve (1)
• lateral pectoral n. (1); lateral cord
• axillary artery
  • three "parts"
  • proximal to teres major and distal to rib 1

• superior thoracic A. (1)
  • rib 1; inferior/lateral to
  • pectoralis minor; superior/medial to

• thoracoacromial trunk (1)
  • PACD
    • deltoid branch anastamoses with anterior humeral circumflex A. (4)
    • acromial branch anastamoses with posterior humeral circumflex A. (1)
  • pec minor; posterior and superior/medial to (although I didnt quite see the posterior relationship on my cadaver)
  • clavicle
• lateral thoracic A.
  • pectoralis minor; follows lateral border of pectoralis minor (somewhat posteriorly)

• subscapular A. (1)
  • thoracoadorsal A. (4)
  • circumflex scapular A. (5)
    • dives posteriorly between teres major and subscapularis
• anterior humeral circumflex; originates distal to subscapular A.
• posterior humeral circumflex; originates distal to subscapular A.

• acromion; origin deltoid
• long thoracic n.
  • to serratus anterior (1) from C 5, 6, 7
  • winging at scapula (4)
  • medial to thoracodorsal n.
• lower subscapular A. (2) ???
• serratus posterior superior (1)

Arm and Cubital Fossa

• anterior compartment arm * musculocutaneous n. (3) * biceps brachii (all heads ind and together)
  • • supraglenoid tubercle (1); origin long head biceps
    • transverse humeral ligament (3); tendon course thorugh before reaching glenohumeral joint
    • coracoid process scapula (1RAD); origin short head biceps
    • tendon most lateral strucuture in cubital fossa
  • brachialis (3)
    • lateral cutaneous n. of forearm * rests above the brachialis (below biceps) * cutaneous over lateral epicondyle * medial to superficial radial n. * continues superficial to supinator and brachioradialis * cephalic v.
• radial n.
  • radial/spiral groove on post. humerus
  • anterior aspect of arm lateral near lateral epicondyle
  • branches in forearm
    • deep into supinator
    • superficial course over supinator, under tendon of brachioradialis to antebrach. fasica near dorsal wrist
  • lateral to lat. cut. n. of forearm
• cephalic v. (2)
• medial cut. n. forearm
  • basilic v.
  • br. ulnar n.
• profunda brachii A.
• superior ulnar collateral A (3)
  • near branches of brachial artery to biceps (middle arm)
  • vena comitantes
• profunda brachii
  • radial collateral A.
    • course anteriorly over lateral epicondyle humerus
    • anast. with radial recurrent from rad. A.
  • middle collateral A. * courses posteriorly behind lateral epicondyle * anast. with interosseous recurrent
• pronator teres (3)
  • • medial epicondyle; superior to common flexor tendon
    • brachial A. (4); bifurcation occurs near posterior and superior to
    • ulnar artery; deep/posterior to
    • median n.; medial to ulnar/brachial aa.

Flexor Region Forearm

• medial epicondyle
  • pronator teres
  • flexor digitorum superficialis (tendon see hand) (3)
  • flexor carpi ulnaris (1)
    • ulnar nerve
  • palmaris longus
  • FCR
• pronator teres (3)
  • ulnar artery
    • posterior ulnar recurrent A. (4); anastamoses with inferior ulnar recurrent posterior to medial epicondyle
    • anterior ulnar recurrent A.; anastamoses with superior ulnar recurrent anterior to medial epicondyle
    • common interosseious A. (4)
• ulnar artery
  • interosseous membrane (2)
    • anterior interosseous A. (9); supplies deep flexors (FDP, Flex. pollicis longus, pron. quadratus)
    • posterior interosseous A. (5); supplies extensors
    • interosseous recurrent A. (2)
      • oblique cord
• radial artery (7)
  • radial recurrent A. (5); very near bifurcation of radial a. from brachial a. * brachioradialis is superior and lateral to * brachialis is posterior to * radial collateral at elbow * biceps brachii tendon is superior to * medial to radial nerve in its course anterior to lateral epicondyle
• (tendon) flex. digitorum profundus * median n.; superficial to * flex. dig. superficialis; deep to
  • • • ulnar A.; posterior to median n. in cubital fossa, also crosses under muscles before reaching medial side of forearm
• pronator quadratus
  • anterior interosseous n. (6); passes posterior to
  • anterior interosseous A.; passes posterior to
• superficial radial n.
  • brachioradialis; travels on deep surface
  • deep fascia of near wrist; becomes cutaneous
• deep radial n. (3) * split seen in flex. compartment * travels posteriorly (deep) to ext. compartment * supinator

Hand

• bones
  • articular disc (4); between lunate and ulna
  • capitate (3); articulates with 3rd metacarpal, hamate, scaphoid, lunate, trapezoid
  • scaphoid (3); articulates with radius, lunate, trapezoid, trapezium and capitate
  • deep transverse metacarpal ligament (3)
    • distal and deep to palmar aponeurosis
  • trapezoid
• carpal tunnel
  • flexor retinaculum (2)
    • median nerve; deep to
  • Guyon's canal; lateral to carpal tunnel
    • ulnar nerve/artery
• ulnar nerve; superficial to
  • • pisiform; lateral to
    • carpal tunnel; medial to
    • superficial or deep ulnar n. (9)
      • deep branches after pisiform after ulnar n. courses through Guyon's canal
    • lumbrical
      • extend fingers at MP and IP joints (2)
      • only 3 and 4 innervated by ulnar n.
    • 1st dorsal interosseous
• ulnar artery
  • superficial palmar arch (2); main contribution
    • common palmar digital A. (2)
      • proper palmar digital A. (1)
• radial artery
  • princeps pollics
  • deep palmar arch (7); main contribution
  • dorsal carpal arch (1)
  • snuff box
    • extensor pollicis longus; medial/ulnar
    • extensor pollicis brevis (1); lateral/radial
    • abductor pollicis longus (posterior) * dorsalis indicis A. (2)
• thenar muscles
  • recurrent median n. (6)
  • opponens pollicis (1)
• (tendon) flexor pollucis longus (2) * radial bursa * superior to adductor pollicis brevis (3) * distal phalnyx thumb; insertion
• tendon FDS
  • vinculum (4)
    • blood supply to tendon
• superficial branch median n. (1)
  • aka palmar branch
  • superficial to extensor retinaculum

Extensor Region Forearm/Dorsum

• posterior interosseuous n. (5)
• posterior interosseous A (5)
• extensor hood
• extensor digiti minimi (3)
• extensor carpi radialis brevis (2)
• extensor indicis (2)
• extensor pollucis longus tendon
• supinator (1)
• extensor carpi radialis longus
• extensor digitorum

Joints

• coronoid process ulna (1)
• radial collateral ligament (??)
• ulnar collateral ligament (3)
• transverse humeral ligament (2)
  • thin fibers coursing over tendon of long head as it exits glenohumeral joint cavity
  • superior to synovial membrane (not visible...)
  • lateral to subscapularis tendon
  • inferior to subdeltiod bursa (also not visible)
• glenoid labrum
• glenohumeral ligament
• MCL elbow
• radial notch ulna (1)
• coracoacromial ligament (6)
• coracoclavicular ligament (6)
• annular ligament of radius (6)
• capitulum (1)
• coronoid process ulna (1)
• ulnar collateral ligament (2)
• anterior longitudinal ligament (1)
• trochlear notch ulna (2)
• MP and IP joints (1)
• interspinous ligament (1)

Comments and Suggestions