Going Out on a Limb: The Anatomy of the Upper Limb

In the first six weeks of the course, we begin with an introduction to the parts of the upper limb and a discussion of the anatomic position, including the three-dimensional planes in which body movements are performed. Next, we cover the osteology of the upper limb by describing the bones of the extremity, how they articulate at synovial joints, and the movements that are possible at these joints. We explore the blood supply and innervation to the upper limb. We then discuss the major muscles that act at each joint, pointing out what muscles allow us to shrug our shoulders, row a boat, make a fist, and rotate our hand forwards or backwards.

In the final three weeks of the course, we investigate nerve injuries that occur in the upper limb and their clinical effects. We also explore common pathologies that appear in the extremity, such as rheumatoid arthritis, osteoarthritis, gout, and Dupuytren's contracture. We finish with a description of the embryologic development of the upper limb and common causes of limb malformations and deformations.

Please note that some lectures in this course contain graphic medical images, including illustrations of the human body, and photographs of birth defects and other medical conditions. Discretion is advised.

Unit 1: Normal Anatomy of the Upper Limb (Weeks 1-6)
Week 1 - The Language of Anatomy

1. Overview
2. Anatomic Terminology and Limb Regions
3. Osteology and Skeletal Anatomy; Muscle Action
4. Origins and Insertions; Planes of Motion

Week 2 - Innervation and Blood Supply of the Upper Limb

1. The Nervous System: Overview
2. The Brachial Plexus: Motor Innervation
3. The Brachial Plexus: Sensory Innervation; Blood Supply to the Upper Limb

Week 3 - The Scapula

1. Elevation and Depression
2. Protraction, Retraction, Medial Rotation, and Lateral Rotation

Week 4 - The Glenohumeral Joint

1. Structure of the Joint; Flexion and Extension
2. Abduction, Adduction, and the Rotator Cuff

Week 5 - The Elbow and Wrist

1. Elbow: Flexion, Extension, Supination, and Pronation
2. Wrist: Structure of the Joint; Flexion and Extension

Week 6 - The Hand

1. Bony Structure, the Carpal Tunnel, and Extrinsic Muscles of the Hand
2. Intrinsic Muscles of the Hand
3. Extrinsic and Intrinsic Muscles of the Thumb

Unit 2: Pathology of the Upper Limb (Weeks 7-9)
Week 7 - Nerve Injuries

1. Nerve Injuries 1: Brachial Plexopathies
2. Nerve Injuries 2: The Arm and Forearm
3. Nerve Injuries 3: The Hand

Week 8 - Rheumatology

1. Rheumatoid Arthritis
2. Osteoarthritis
3. Septic Arthritis and Gout

Week 9 - Connective Tissue Disease and Embryology

1. Connective Tissue Diseases: Dupuytren's Contracture, De Quervain Tenosynovitis, and Trigger Finger
2. Embryology 1: Intrinsic Causes of Limb Malformation
3. Embryology 2: Extrinsic Causes of Limb Deformation