Surface Anatomy of the Upper Extremity - Revision history

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	The '''[[Deltoideus]]''' with the prominence of the upper end of the [[humerus]] produces the rounded contour of the shoulder; it is rounded and fuller in front than behind, where it presents a somewhat flattened form. Above, its [[anterior]] border presents a slightly curved eminence which forms the lateral boundary of the infraclavicular fossa; below, it is closely united with the [[Pectoralis major]]. Its [[posterior]] border is thin, flattened, and scarcely marked above, but is thicker and more prominent below. The insertion of [[Deltoideus]] is marked by a depression on the lateral side of the middle of the arm.		The '''[[Deltoideus]]''' with the prominence of the upper end of the [[humerus]] produces the rounded contour of the shoulder; it is rounded and fuller in front than behind, where it presents a somewhat flattened form. Above, its [[anterior]] border presents a slightly curved eminence which forms the lateral boundary of the infraclavicular fossa; below, it is closely united with the [[Pectoralis major]]. Its [[posterior]] border is thin, flattened, and scarcely marked above, but is thicker and more prominent below. The insertion of [[Deltoideus]] is marked by a depression on the lateral side of the middle of the arm.

			[[File:Gray1231.png\|thumb\|FIG. 1231– Front of right upper extremity. (''Picture From the Classic Gray's Anatomy'')]]
	~~<center>http~~:~~//www~~.~~wikimd.org/images/gray/large/image1231.gif </center>~~


	FIG. 1231– Front of right upper extremity. (''Picture From the Classic Gray's Anatomy'')
	Of the scapular muscles the only one which influences surface form is the '''[[Teres major]]''' it assists the [[Latissimus dorsi]] in forming the thick, rounded, posterior axillary fold.		Of the scapular muscles the only one which influences surface form is the '''[[Teres major]]''' it assists the [[Latissimus dorsi]] in forming the thick, rounded, posterior axillary fold.

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	~~<center>http~~:~~//www~~.~~wikimd.org/images/gray/large/image1232.gif </center>~~		[[File:Gray1232.png\|thumb\|FIG. 1232– Back of right upper extremity. (''Picture From the Classic Gray's Anatomy'')]]


	FIG. 1232– Back of right upper extremity. (''Picture From the Classic Gray's Anatomy'')
	On the front and medial aspects of the arm is the prominence of the '''[[Biceps brachii]]''' bounded on either side by an intermuscular depression. It determines the contour of the front of the arm and extends from the anterior axillary fold to the bend of the elbow; its upper tendons are concealed by the [[Pectoralis major]] and [[Deltoideus]], and its lower tendon sinks into the anticubital fossa. When the muscle is fully contracted it presents a globular form, and the lacertus fibrosus attached to its tendon of insertion becomes prominent as a sharp ridge running downward and medialward.		On the front and medial aspects of the arm is the prominence of the '''[[Biceps brachii]]''' bounded on either side by an intermuscular depression. It determines the contour of the front of the arm and extends from the anterior axillary fold to the bend of the elbow; its upper tendons are concealed by the [[Pectoralis major]] and [[Deltoideus]], and its lower tendon sinks into the anticubital fossa. When the muscle is fully contracted it presents a globular form, and the lacertus fibrosus attached to its tendon of insertion becomes prominent as a sharp ridge running downward and medialward.

Deepika vegiraju at 02:37, 13 June 2020

2020-06-13T02:37:23Z

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[[Anatomy]] > [[Gray's Anatomy| Gray's Anatomy of the Human Body]] > XII. Surface Anatomy and Surface Markings > 11. Surface Anatomy of the Upper Extremity

[[Henry Gray]] (1821–1865). Anatomy of the Human Body. 1918.

== '''Surface Anatomy of the Upper Extremity''' ==
=== '''Skin''' ===
The skin covering the shoulder and arm is smooth and very movable on the underlying structures. In the [[axilla]] there are numerous hairs and many [[sudoriferous]] and [[sebaceous glands]]. Over the medial side and front of the forearm the skin is thin and smooth, and contains few hairs but many sudoriferous glands; over the lateral side and back of the arm and forearm it is thicker, denser, and contains more hairs but fewer sudoriferous glands.

In the region of the [[olecranon]] it is thick and rough, and is very loosely connected to the underlying tissue so that it falls into transverse wrinkles when the forearm is extended. At the front of the wrist there are three transverse furrows in the skin; they correspond respectively from above downward to the positions of the [[styloid process]] of the [[ulna]], the wrist-joint, and the [[midcarpal joint]].

The skin of the palm of the hand differs considerably from that of the forearm. At the wrist it suddenly becomes hard and dense and covered with a thick layer of [[epidermis]]; on the thenar eminence these characteristics are less marked than elsewhere. In spite of its hardness and density the skin of the palm is exceedingly sensitive and very vascular, but it is destitute of hairs and sebaceous glands.

It is tied down by fibrous bands along the lines of [[flexion]] of the digits, exhibiting certain furrows of a permanent character. One of these, starting in front of the wrist at the [[tuberosity]] of the [[navicular bone]], curves around the thenar eminence and ends on the radial border of the hand a little above the [[metacarpophalangeal]] joint of the index finger. A second line begins at the end of the first and extends obliquely across the palm to reach the ulnar border about the middle of the fifth [[metacarpal bone]].

A third line begins at the ulnar border about 2.5 cm. distal to the end of the second and extends across the heads of the fifth, fourth, and third metacarpal bones. The proximal segments of the fingers are joined to one another on the volar aspect by folds of skin constituting the “web” of the fingers; these folds extend across about the level of the centers of the proximal phalanges and their free margins are continuous with the transverse furrows at the roots of the fingers. Since the web is confined to the volar aspect the fingers appear shorter when viewed from in front than from behind.
Over the fingers and thumb the skin again becomes thinner, especially at the [[flexures]] of the joints (where it is crossed by transverse furrows) and over the terminal [[phalanges]]; it is disposed on numerous ridges in consequence of the arrangement of the [[papillæ]] in it. These ridges form, in different individuals, distinctive and permanent patterns which can be used for purposes of identification. The [[superficial]] fascia in the palm of the hand is made up of dense fibro-fatty tissue which binds the skin so firmly to the palmar [[aponeurosis]] that very little movement is permitted between the two.

On the back of the hand and fingers the [[subcutaneous]] tissue is lax, so that the skin is freely movable on the underlying parts. Over the [[interphalangeal]] joints the skin is very loose and is thrown into transverse wrinkles when the fingers are extended.

=== '''Bones''' ===
The '''[[clavicle]]''' can be felt throughout its entire length. The enlarged [[sternal]] extremity projects above the upper margin of the [[sternum]] at the side of the [[jugular]] notch, and from this the body of the bone can be traced lateralward immediately under the skin. The medial part is [[convex]] forward, but the surface is partially obscured by the attachments of [[Sternocleidomastoideus]] and [[Pectoralis major]]; the lateral third is concave forward and ends at the [[acromion]] of the [[scapula]] in a slight enlargement. The [[clavicle]] is almost horizontal when the arm is lying by the side, although in muscular subjects it may incline a little upward at its [[acromial]] end, which is on a plane posterior to the [[sternal]] end.

The only parts of the '''[[scapula]]''' that are truly [[subcutaneous]] are the spine and [[acromion]], but the [[coracoid process]], the vertebral border, the [[inferior]] angle, and to a lesser extent the axillary border can also be readily defined. The [[acromion]] and spine are easily recognizable throughout their entire extent, forming with the [[clavicle]] the arch of the shoulder.

The acromion forms the point of the shoulder; it joins the clavicle at an acute angle—the acromial angle—slightly medial to, and behind the tip of the acromion. The spine can be felt as a distinct ridge, marked on the surface as an oblique depression which becomes less distinct and ends in a slight dimple a little lateral to the [[spinous processes]] of the vertebræ. Below this point the vertebral border can be traced downward and lateralward to the [[inferior]] angle, which can be identified although covered by [[Latissimus dorsi]].

From the [[inferior]] angle the axillary border can usually be traced upward through its thick muscular covering, forming with its enveloping muscles the [[posterior]] fold of the [[axilla]]. The [[coracoid process]] is situated about 2 cm. below the junction of the intermediate and lateral thirds of the [[clavicle]]; it is covered by the [[anterior]] border of [[Deltoideus]], and thus lies a little lateral to the infraclavicular fossa or depression which marks the interval between the Pectoralis major and Deltoideus.

The '''[[humerus]]''' is almost entirely surrounded by muscles, and the only parts which are strictly [[subcutaneous]] are small portions of the medial and lateral [[epicondyles]]; in addition to these, however, the tubercles and a part of the head of the bone can be felt under the skin and muscles by which they are covered. Of these, the greater [[tubercle]] forms the most prominent bony point of the shoulder, extending beyond the [[acromion]]; it is best recognized when the arm is lying passive by the side, for if the arm be raised it recedes under the arch of the shoulder. The lesser tubercle, directed forward, is medial to the greater and separated from it by the intertubercular groove, which can be made out by deep pressure.

When the arm is abducted the lower part of the head of the [[humerus]] can be examined by pressing deeply in the [[axilla]]. On either side of the elbow-joint and just above it are the medial and lateral [[epicondyles]]. Of these, the former is the more prominent, but the medial supracondylar ridge passing upward from it is much less marked than the lateral, and as a rule is not palpable; occasionally, however, the hook-shaped supracondylar process (page 211) is found on this border. The position of the lateral epicondyle is best seen during [[semiflexion]] of the forearm, and is indicated by a depression; from it the strongly marked lateral supracondylar ridge runs upward.

The most prominent part of the '''[[ulna]]''' the [[olecranon]], can always be identified at the back of the elbow-joint. When the forearm is flexed the upper quadrilateral surface is palpable, but during extension it recedes into the olecranon fossa. During extension the upper border of the olecranon is slightly above the level of the medial [[epicondyle]] and nearer to this than to the lateral; when the forearm is fully flexed the olecranon and the epicondyles form the angles of an equilateral triangle. On the back of the olecranon is a smooth triangular [[subcutaneous]] surface, and running down the back of the forearm from the [[apex]] of this triangle the prominent [[dorsal]] border of the ulna can be felt in its whole length: it has a sinuous outline, and is situated in the middle of the back of the limb above; but below, where it is rounded off, it can be traced to the small subcutaneous surface of the [[styloid process]] on the medial side of the wrist.

The styloid process forms a prominent [[tubercle]] continuous above with the dorsal border and ending below in a blunt [[apex]] at the level of the wrist-joint; it is most evident when the hand is in a position midway between [[supination]] and [[pronation]]. When the forearm is pronated another prominence, the head of the [[ulna]], appears behind and above the [[styloid process]].

Below the lateral [[epicondyle]] of the [[humerus]] a portion of the head of the '''[[radius]]''' is [[palpable]]; its position is indicated on the surface by a little dimple, which is best seen when the arm is extended. If the finger be placed in this dimple and the semiflexed forearm be alternately [[pronated]] and [[supinated]] the head of the radius will be felt distinctly, rotating in the radial notch. The upper half of the body of the bone is obscured by muscles; the lower half, though not subcutaneous, can be readily examined, and if traced downward is found to end in a lozenge-shaped convex surface on the lateral side of the base of the [[styloid process]]; this is the only [[subcutaneous]] part of the bone, and from its lower end the [[apex]] of the styloid process bends medialward toward the wrist.

About the middle of the [[dorsal]] surface of the lower end of the radius is the dorsal radial [[tubercle]], best perceived when the wrist is slightly flexed; it forms the lateral boundary of the oblique groove for the [[tendon]] of [[Extensor]] pollicis longus.
On the front of the wrist are two [[subcutaneous]] eminences, one, on the radial side, the larger and flatter, produced by the [[tuberosity]] of the '''[[navicular]]''' and the ridge on the '''[[greater multangular]]''' the other, on the ulnar side, by the '''[[pisiform]]'''

The tuberosity of the navicular is distal and medial to the [[styloid process]] of the [[radius]], and is most clearly visible when the wrist-joint is extended; the ridge on the greater multangular is about 1 cm. distal to it. The [[pisiform]] is about 1 cm. distal to the lower end of the [[ulna]] and just distal to the level of the styloid process of the radius; it is crossed by the uppermost crease which separates the front of the forearm from the palm of the hand. The rest of the [[volar]] surface of the bony carpus is covered by [[tendons]] and the transverse carpal ligament, and is entirely concealed, with the exception of the hamulus of the '''[[hamate bone]]''' which, however, is difficult to define. On the dorsal surface of the carpus only the '''[[triangular bone]]''' can be clearly made out.

Distal to the [[carpus]] the [[dorsal]] surfaces of the '''[[metacarpal bones]]''' covered by the [[Extensor]] tendons, except the fifth, are visible only in very thin hands; the dorsal surface of the fifth is, however, subcutaneous throughout almost its whole length. Slightly lateral to the middle line of the hand is a prominence, frequently well-marked, but occasionally indistinct, formed by the [[styloid process]] of the third [[metacarpal bone]]; it is situated about 4 cm. distal to the [[dorsal]] radial [[tubercle]]. The heads of the metacarpal bones can be plainly seen and felt, rounded in contour and standing out in bold relief under the skin when the fist is clenched; the head of the third is the most prominent.

In the palm of the hand the [[metacarpal]] bones are covered by muscles, [[tendons]], and [[aponeuroses]], so that only their heads can be distinguished. The base of the metacarpal bone of the thumb, however, is prominent dorsally, distal to the [[styloid process]]of the [[radius]]; the body of the bone is easily palpable, ending at the head in a flattened prominence, in front of which are the [[sesamoid bones]].

The enlarged ends of the '''[[phalanges]]''' can be easily felt. When the digits are bent the [[proximal]] phalanges form prominences, which in the joints between the first and second [[phalanges]] are slightly hollow, but flattened and square-shaped in those between the second and third.

=== '''Articulations''' ===
The '''[[sternoclavicular joint]]''' is [[subcutaneous]], and its position is indicated by the enlarged [[sternal]] extremity of the clavicle, lateral to the long cord-like sternal head of [[Sternocleidomastoideus]]. If this muscle be relaxed a depression between the end of the [[clavicle]] and the [[sternum]] can be felt, defining the exact position of the joint.

The position of the '''[[acromioclavicular joint]]''' can generally be ascertained by determining the slightly enlarged acromial end of the [[clavicle]] which projects above the level of the [[acromion]]; sometimes this enlargement is so considerable as to form a rounded eminence.

The '''[[shoulder-joint]]''' is deeply seated and cannot be palpated. If the forearm be slightly flexed a curved crease or fold with its convexity downward is seen in front of the elbow, extending from one [[epicondyle]] to the other; the '''[[elbow-joint]]''' is slightly distal to the center of the fold. The position of the '''[[radiohumeral joint]]''' can be ascertained by feeling for a slight groove or depression between the head of the radius and the [[capitulum]] of the [[humerus]], at the back of the elbow-joint.

The position of the '''proximal [[radioulnar joint]]''' is marked on the surface at the back of the elbow by the dimple which indicates the position of the head of the [[radius]]. The site of the '''distal [[radioulnar joint]]''' can be defined by feeling for the slight groove at the back of the wrist between the prominent head of the [[ulna]] and the lower end of the radius, when the forearm is in a state of almost complete [[pronation]]. '

Of the three transverse skin furrows on the front of the wrist, the middle corresponds fairly accurately with the '''[[wrist-joint]]''' while the most distal indicates the position of the '''[[midcarpal articulation]]'''

The '''[[metacarpophalangeal]]''' and '''[[interphalangeal joints]]''' are readily available for surface examination; the former are situated just distal to the prominences of the knuckles, the latter are sufficiently indicated by the furrows on the [[volar]], and the wrinkles on the [[dorsal]] surfaces.

=== '''Muscles ''' ===
(Figs. 1194, 1231, 1232)
The [[anterior]] border of the '''[[Trapezius]]''' presents as a slight ridge running downward and forward from the superior [[nuchal line]] of the [[occipital bone]] to the junction of the intermediate and lateral thirds of the [[clavicle]].

The [[inferior]] border of the muscle forms an undulating ridge passing downward and medialward from the root of the spine of the [[scapula]] to the spinous process of the twelfth [[thoracic vertebra]].

The lateral border of the '''[[Latissimus dorsi]]''' (Fig. 1215) may be traced, when the muscle is in action, as a rounded edge starting from the [[iliac crest]] and slanting obliquely forward and upward to the [[axilla]], where it takes part with the [[Teres major]] in forming the posterior axillary fold.

The '''[[Pectoralis major]]''' (Fig. 1219) conceals a considerable part of the thoracic wall in front. Its [[sternal]] origin presents a border which bounds, and determines the width of the sternal furrow. The upper margin is generally well-marked medially and forms the medial boundary of a triangular depression, the [[infraclavicular fossa]], which separates the Pectoralis major from the [[Deltoideus]]; it gradually becomes less marked as it approaches the [[tendon]] of insertion and is closely blended with the Deltoideus. The lower border of Pectoralis major forms the rounded [[anterior]] axillary fold. Occasionally a gap is visible between the [[clavicular]] and [[sternal]] parts of the muscle.

When the arm is raised the lowest slip of origin of '''[[Pectoralis minor]]''' produces a fulness just below the anterior axillary fold and serves to break the sharp outline of the lower border of Pectoralis major.

The origin of the '''[[Serratus anterior]]''' (Figs. 1215, 1219) causes a very characteristic surface marking. When the arm is abducted the lower five or six serrations form a zigzag line with a general convexity forward; when the arm is by the side the highest visible serration is that attached to the fifth rib.

The '''[[Deltoideus]]''' with the prominence of the upper end of the [[humerus]] produces the rounded contour of the shoulder; it is rounded and fuller in front than behind, where it presents a somewhat flattened form. Above, its [[anterior]] border presents a slightly curved eminence which forms the lateral boundary of the infraclavicular fossa; below, it is closely united with the [[Pectoralis major]]. Its [[posterior]] border is thin, flattened, and scarcely marked above, but is thicker and more prominent below. The insertion of [[Deltoideus]] is marked by a depression on the lateral side of the middle of the arm.

<center>http://www.wikimd.org/images/gray/large/image1231.gif </center>

FIG. 1231– Front of right upper extremity. (''Picture From the Classic Gray's Anatomy'')
Of the scapular muscles the only one which influences surface form is the '''[[Teres major]]''' it assists the [[Latissimus dorsi]] in forming the thick, rounded, posterior axillary fold.

When the arm is raised the '''[[Coracobrachialis]]''' reveals itself as a narrow elevation emerging from under cover of the [[anterior]] axillary fold and running medial to the body of the [[humerus]].

<center>http://www.wikimd.org/images/gray/large/image1232.gif </center>

FIG. 1232– Back of right upper extremity. (''Picture From the Classic Gray's Anatomy'')
On the front and medial aspects of the arm is the prominence of the '''[[Biceps brachii]]''' bounded on either side by an intermuscular depression. It determines the contour of the front of the arm and extends from the anterior axillary fold to the bend of the elbow; its upper tendons are concealed by the [[Pectoralis major]] and [[Deltoideus]], and its lower tendon sinks into the anticubital fossa. When the muscle is fully contracted it presents a globular form, and the lacertus fibrosus attached to its tendon of insertion becomes prominent as a sharp ridge running downward and medialward.

On either side of the [[Biceps brachii]] at the lower part of the arm the '''[[Brachialis]]''' is discernible. Laterally it forms a narrow eminence extending some distance up the arm; medially it exhibits only a little fulness above the elbow.

On the back of the arm the long head of the '''[[Triceps brachii]]''' may be seen as a longitudinal eminence, emerging from under cover of [[Deltoideus]] and gradually passing into the flattened plane of the tendon of the muscle at the lower part of the back of the arm. When the muscle is in action the medial and lateral heads become prominent.

On the front of the elbow are two muscular elevations, one on either side, separate above but converging below so as to form the medial and lateral boundaries of the [[anticubital]] fossa. The medial elevation consists of the [[Pronator teres]] and the [[Flexors]], and forms a [[fusiform mass]], pointed above at the medial [[epicondyle]] and gradually tapering off below. The '''[[Pronator teres]]''' is the most lateral of the group, while the '''[[Flexor carpi radialis]]''' lying to its medial side, is the most prominent and may be traced downward to its tendon, which is situated nearer to the radial than to the ulnar border of the front of the wrist and medial to the radial artery. The '''[[Palmaris longus]]''' presents no surface marking above, but below, its tendon stands out when the muscle is in action as a sharp, tense cord in front of the middle of the wrist.

The '''[[Flexor digitorum sublimis]]''' does not directly influence surface form; the position of its four [[tendons]] on the front of the lower part of the forearm is indicated by an elongated depression between the tendons of [[Palmaris longus]] and Flexor [[carpi ulnaris]].

The '''[[Flexor carpi ulnaris]]''' determines the contour of the medial border of the forearm, and is separated from the [[Extensor]] group of muscles by the [[ulnar]] furrow produced by the subcutaneous dorsal border of the [[ulna]]; its [[tendon]] is evident along the ulnar border of the lower part of the forearm, and is most marked when the hand is flexed and [[adducted]].

The elevation forming the lateral side of the anticubital fossa consists of the [[Brachioradialis]], the [[Extensors]] and the [[Supinator]]; it occupies the lateral and a considerable part of the dorsal surface of the forearm in the region of the elbow, and forms a [[fusiform]] mass which is altogether on a higher level than that produced by the medial elevation.

Its apex is between the [[Triceps brachii]] and [[Brachialis]] some distance above the elbow-joint; it acquires its greatest breadth opposite the lateral [[epicondyle]], and below this shades off into a flattened surface. About the middle of the forearm it divides into two diverging longitudinal eminences. The lateral eminence consists of the '''[[Brachioradialis]]''' and the '''[[Extensores carpi radiales longus]]''' and '''[[brevis]]''' and descends from the lateral supracondylar ridge in the direction of the styloid process of the radius. The medial eminence comprises the '''Extensor digitorum communis, Extensor digiti quinti proprius''' and the '''Extensor carpi ulnaris''' it begins at the lateral epicondyle of the humerus as a tapering mass which is separated above from the Anconæus by a well-marked furrow, and below from the Pronator teres and Flexor group by the ulnar furrow.

The medial border of the '''[[Brachioradialis]]''' starts as a rounded elevation above the lateral epicondyle; lower down the muscle forms a prominent mass on the radial side of the upper part of the forearm; below it tapers to its tendon, which may be traced to the [[styloid process]] of the radius. The '''[[Anconæus]]''' presents as a triangular slightly elevated area, immediately lateral to the [[subcutaneous]] surface of the [[olecranon]] and differentiated from the [[Extensor]] group by an oblique depression; the upper angle of the triangle is at the dimple over the lateral [[epicondyle]].

At the lower part of the back of the forearm in the interval between the two diverging eminences is an oblique elongated swelling; full above but flattened and partially subdivided below; it is caused by the '''[[Abductor pollicis longus]]''' and the '''[[Extensor pollicis brevis]]''' It crosses the dorsal and lateral surfaces of the [[radius]] to the radial side of the wrist-joint, whence it is continued on to the [[dorsal]] surface of the thumb as a ridge best marked when the thumb is extended.

The tendons of most of the [[Extensor]] muscles can be seen and felt on the back of the wrist. Laterally is the oblique ridge produced by the Extensor pollicis longus. The Extensor carpi radialis longus is scarcely palpable, but the Extensor carpi radialis brevis can be identified as a vertical ridge emerging from under the ulnar border of the tendon of the Extensor pollicis longus when the wrist is extended. Medial to this the Extensor tendons of the fingers can be felt, the Extensor digiti quinti proprius being separated from the tendons of the Extensor digitorum communis by a slight furrow.

The muscles of the hand are principally concerned, as regards surface form, in producing the [[thenar]] and [[hypothenar]] eminences, and cannot be individually distinguished; the thenar eminence, on the radial side, is larger and rounder than the hypothenar, which is a long narrow elevation along the ulnar side of the palm. When the '''[[Palmaris brevis]]''' is in action it produces a wrinkling of the skin over the hypothenar eminence and a dimple on the ulnar border. On the back of the hand the '''[[Interossei dorsales]]''' give rise to elongated swellings between the [[metacarpal bones]]; the first forms a prominent fusiform bulging when the thumb is adducted, the others are not so marked.

=== '''Arteries''' ===
Above the middle of the [[clavicle]] the pulsation of the '''[[subclavian artery]]''' can be detected by pressing downward, backward, and medialward against the first rib. The pulsation of the '''[[axillary artery]]''' as it crosses the second rib can be felt below the middle of the clavicle just medial to the [[coracoid process]]; along the lateral wall of the [[axilla]] the course of the artery can be easily followed close to the medial border of [[Coracobrachialis]].

The '''[[brachial artery]]''' can be recognized in practically the whole of its extent, along the medial margin of the Biceps; in the upper two-thirds of the arm it lies medial to the [[humerus]], but in the lower third is more directly on the front of the bone. Over the lower end of the radius, between the [[styloid process]] and [[Flexor]] carpi radialis, a portion of the '''[[radial artery]]''' is superficial and is used clinically for observations on the pulse.

=== '''Veins''' ===
The [[superficial]] veins of the upper extremity are easily rendered visible by compressing the proximal trunks; their arrangement is described on pages 660 to 662.

=== '''Nerves''' ===
The uppermost trunks of the '''[[brachial plexus]]''' are [[palpable]] for a short distance above the clavicle as they emerge from under the lateral border of [[Sternocleidomastoideus]]; the larger nerves derived from the plexus can be rolled under the finger against the lateral axillary wall but cannot be identified. The '''[[ulnar nerve]]''' can be detected in the groove behind the medial [[epicondyle]] of the [[humerus]].
==Further reading==
* {{cite book|last1=Frederick|first1=Roland Becker|last2=Wilson|first2=James Walter|last3=Gehweiler|first3=John A.|title=The anatomical basis of medical practice|publisher=Williams and Wilkins|year=1971|edition=illustrated}}
* {{cite book|last=Lumley|first=John S. P.|title=Surface Anatomy: The Anatomical Basis of Clinical Examination|date=2008|publisher=Elsevier Health Sciences|isbn=978-0-7020-4776-3|url=https://books.google.com/books?id=NCSY4EvsDhYC&printsec=frontcover|edition=4th|accessdate=28 February 2014}}
* {{cite book|last1=Rohen|first=Johannes Wilhelm|authorlink1=Johannes W. Rohen|last2=Yokochi|first2=Chihiro|last3=Lütjen-Drecoll|first3=Elke|year=2011|title=Color Atlas of Anatomy – A Photographic Study of the Human Body|url=https://archive.org/details/coloratlasanatom00rohe|url-access=limited|edition=7th|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|isbn=978-1-58255-856-1|pages=[https://archive.org/details/coloratlasanatom00rohe/page/n217 204]–5, 476–7}}
* {{cite book|last=Sheppard|first=Joseph|year=1991|title=''Drawing the Living Figure''|isbn=0-486-26723-7|publisher=Dover Publications, Incorporated}}

{{Anatomy}}
{{Human regional anatomy}}
{{Superficial axial anatomy}}
{{Superficial anatomy of limbs}}

[[Category:Anatomy]]
[[Category:Human anatomy]]
[[Category:Human body]]
[[Category:Human surface anatomy]]

{{grays}}

← Older revision		Revision as of 01:01, 18 March 2025
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	=== '''Nerves''' ===		=== '''Nerves''' ===
	The uppermost trunks of the '''[[brachial plexus]]''' are [[palpable]] for a short distance above the clavicle as they emerge from under the lateral border of [[Sternocleidomastoideus]]; the larger nerves derived from the plexus can be rolled under the finger against the lateral axillary wall but cannot be identified. The '''[[ulnar nerve]]''' can be detected in the groove behind the medial [[epicondyle]] of the [[humerus]].		The uppermost trunks of the '''[[brachial plexus]]''' are [[palpable]] for a short distance above the clavicle as they emerge from under the lateral border of [[Sternocleidomastoideus]]; the larger nerves derived from the plexus can be rolled under the finger against the lateral axillary wall but cannot be identified. The '''[[ulnar nerve]]''' can be detected in the groove behind the medial [[epicondyle]] of the [[humerus]].
	~~==Further reading==~~
	* {{cite book\|last1=Frederick\|first1=Roland Becker\|last2=Wilson\|first2=James Walter\|last3=Gehweiler\|first3=John A.\|title=The anatomical basis of medical practice\|publisher=Williams and Wilkins\|year=1971\|edition=illustrated}}<!--couldn't find an ISBN -->
	* <!--Lumley, JSP. (2002) ''Surface Anatomy: The Anatomical Basis of Clinical Examination'' 3rd edn. published by Churchill Livingstone in Edinburgh
	~~*Let's give them a fresh version*~~
	-->{{cite book\|last=Lumley\|first=John S. P.\|title=Surface Anatomy: The Anatomical Basis of Clinical Examination\|date=2008\|publisher=Elsevier Health Sciences\|isbn=978-0-7020-4776-3\|url=https://books.google.com/books?id=NCSY4EvsDhYC&printsec=frontcover\|edition=4th\|accessdate=28 February 2014}}
	* {{cite book\|last1=Rohen\|first=Johannes Wilhelm\|authorlink1=Johannes W. Rohen\|last2=Yokochi\|first2=Chihiro\|last3=Lütjen-Drecoll\|first3=Elke\|year=2011\|title=Color Atlas of Anatomy – A Photographic Study of the Human Body\|url=https://archive.org/details/coloratlasanatom00rohe\|url-access=limited\|edition=7th\|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins\|isbn=978-1-58255-856-1\|pages=[https://archive.org/details/coloratlasanatom00rohe/page/n217 204]–5, 476–7}}
	* {{cite book\|last=Sheppard\|first=Joseph\|year=1991\|title=''Drawing the Living Figure''\|isbn=0-486-26723-7\|publisher=Dover Publications, Incorporated}}<!--[http://www.josephsheppard.com/ website]-->

	{{Anatomy}}		{{Anatomy}}
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	[[Category:Human body]]		[[Category:Human body]]
	[[Category:Human surface anatomy]]		[[Category:Human surface anatomy]]


	{{grays}}		{{grays}}
	~~__NOINDEX__~~