Scapula

1. Anatomy
   • Triangular bone - glenoid fossa, spine of scapula, acromion process, coracoid process
2. Function
   • Covered by muscles
   • Rarely fractured (only by direct and severe violence)

Clavicle

1. Unusual features
   • No medullary cavity
   • First to ossify
   • Membranous ossification (not cartilaginous)
   • Most commonly fractured bone in the body
2. Function
   • Transmit forces of upper limb to axial skeleton
   • Acts as strut holding arm free from trunk
   • Provide attachment for muscles
3. Anatomy

   
   

   • Medial 2/3 convex anteriorly; lateral 1/3 flat and convex posteriorly
   • Medially articulates with sternum at manubriosternal joint (with articular disc)
   • Laterally articulates with acromion at acromioclavicular joint (contains incomplete articular disc) + attached to coracoid process by coracoclavicular ligament
   • 3rd part of subclavian vessles + trunks of brachial plauxus pass behind medial 1/3 of shaft of clavicle

Surface Anatomy

Palpable landmarks

1. Acromion
2. Head of humerus
3. Coracoid ("crow's beak") process
4. Clavicle

Superficial Veins

1. Cephalic vein
   • Begins at wrist
   • Pierces clavipectoral fascia at upper end of deltopectoral groove to enter axillary vein
2. Basilic vein
   • Begins at wrist on medial/ulnar side
   • Pierces fascia in medial mid arm to join the venae commitantes to become axillary vein (at inferior border of terest major)

Cubital Fossa

1. Boundaries
   • intercondylar line
   • pronator teres
   • brachioradialis
2. Contents
   • Median nerve
   • brachial artery
   • veins
   • Biceps tendon
   • radial / posterior interossesous nerve

[Flexor retinaculum]

Tubercle of scaphoid + Ridge of trapezium
Pisiform + hook of hamate

Superifical: ulnar nerve, artery (in canal of guyon)

Deep: FDP, FDS, FPL

Order of structures across wrist from radial side to ulnar side

1. Superificial branch of ulnar nerve (emerges posteriorly to brachioradialis)
2. Brachioradialis
3. Radial artery
4. Flexor carpi radialis
5. Median nerve (with palmar cutaneous branch of median nerve)
6. Palmaris longus
7. FDS
8. Ulnar artery
9. Ulnar nerve with palmar cutaneous branch
10. Flexor carpi ulnaris

Anatomical Snuffbox

Boundaries

1. Extensor pollicis longus (base of distal phalanx)
2. Extensor pollicis brevis (base of proximal phalanx)
3. Abductor pollicis longus (base of 1st metacarpal)

Contents: 1st thumb metacarpal, trapezium, scaphoid, radial artery, superficial branch of radial nerve

Palmar arterial arches

1. Deep palmar arch
   • From radial artery + connects to ulnar artery
   • On a horizontal line 1 finger's breadth proximal to the superficial palmar arch
2. Superficial palmar arch
   • Deep to palmar aponeurosis
   • On a horizontal line at the level of the base of outstretched thumb

Autonomous sensory areas of right hand

1. Median nerve = index finger
2. Ulna nerve = little finger
3. Radial nerve = 1st webspace