Upper Limb Radiology and Test Yourself

Upper Limb Radiology
& Test Yourself
Dr. Jamie Wikenheiser

Assistant Professor
Director of Medical Gross Anatomy
& Surgical Anatomy
University of California, Irvine
School of Medicine
Main Menu
Main Menu
I. Shoulder
II. Arm
III. Elbow
IV. Forearm
V. Wrist & Hand
Please Read: Interactive PowerPoint functions like a web-page. Click on the underlined text to go
directly to that topic. You must be in Slide Show mode for the hyperlinks to work. All images are
copyrighted by the authors listed on the References slide. DO NOT DISTRIBUTE! For educational
purposes only. Non-graphical content & organization Copyright 2011-14 Dr J Wikenheiser.
Main Menu
Shoulder Overview
The shoulder is the region of upper limb also known as the
glenohumeral joint. This is primarily an articulation between the
humerus bone and glenoid cavity of the scapula. This joint is a
multiaxial ball-and-socket type synovial joint.
The shoulder girdle is made up of the glenohumeral,

sternoclavicular & acromioclavicular joints.
There are numerous muscles that help support the shoulder girdle
but the rotator cuff muscles protect the joint and give it stability.
These muscles include subscapularis, supraspinatus,
infraspinatus & teres minor.
The shoulder/axilla region contains the axillary artery and its

numerous branches as well as the brachial nerve plexus.
Shoulder Skeleton: Scapula & Clavicle Articulation Main Menu
apula
Spine of Sc
Acromion process
Coracoid process
Acromioclavicular joint
Clavicle
Superior View
Identify
Identify
Identify
Identify
Identify
Superior View
Shoulder Skeleton: Scapula and Processes Main Menu
Superior angle Acromion process Superior angle

Suprascapular notch Suprascapular notch
s fossa
a s pino u
c a pula
r S
Sup pi n e of
S
o s sa Subscapular fossa
usf
in o Coracoid process
sp
n fra
I
Inferior angle
Posterior View Anterior View

Identify Identify Identify

Identify Identify
tify
Iden ti f y
Iden
Identify
ti fy Identify
n
Ide
Identify

Shoulder: Rotator Cuff Muscles (4) Main Menu
Supraspinatus muscle
Acromion process
Coracoid process
Humerus
Infraspinatus muscle Teres minor muscle Subscapularis muscle

Identify
Acromion process
Coracoid process
Humerus

Shoulder: Rotator Cuff Muscles Main Menu
Infraspinatus Supraspinatus muscle

muscle Glenoid cavity
Subscapularis
muscle
Posterior Anterior
Side Side
Teres minor
muscle
Humerus Humerus removed
Lateral View
Identify
Identify
Glenoid cavity
Identify
Posterior Anterior
Side Side
Identify
Lateral View
Shoulder: Ligaments Main Menu
Acromioclavicular
ligament Coracoclavicular
Acromion
Coracoacromial ligament
process Clavicle
ligament
Humerus
Coracoid process
Glenohumeral ligament
(joint capsule)
Anterior View
Identify
Acromion Identify
process Clavicle
Identify
Humerus
Coracoid process
Identify
Anterior View
Shoulder AP CR Main Menu
Scapula
Spine of scapula
Glenoid cavity
Acromion process
Coracoid process
Clavicle
Anterior View
Humerus
Head
Anatomical neck
Surgical neck
Greater tubercle
Lesser tubercle
Shaft of humerus
Anterior View
Acromion process
Coracoid process
Clavicle
Acromioclavicular ligament
Coracoclavicular ligament
Anterior View
Shoulder Coronal MRI Main Menu
Humeral head
Acromion process
Glenoid cavity
Glenohumeral joint
Superior labrum
Inferior labrum
Shoulder Coronal MRI Main Menu
Deltoid muscle
Trapezius muscle
Subacromial/subdeltoid bursa
Major Arterial Supply: Axillary Artery Branches Main Menu
Axillary Artery:
Divisions & Branches
1st part 1
Superior/supreme thoracic 2
2nd part
Thoracoacromial 3
Lateral thoracic
3rd part
Subscapular
Anterior humeral circumflex
Posterior humeral circumflex
Anterior View
Major Arterial Supply: Axillary Artery Branches Main Menu
1st part of axillary

2nd part of axillary
3rd part of axillary
Superior/supreme thoracic
Thoracoacromial
Lateral thoracic
Subscapular
Anterior View
Shoulder: Axillary Arteriogram Main Menu
1st part of axillary

2nd part of axillary
3rd part of axillary
Superior/supreme thoracic
Thoracoacromial
Lateral thoracic
Subscapular
Brachial
Left Shoulder/Anterior View

Shoulder/Axilla: Brachial Plexus Main Menu
The brachial plexus is

formed by the union of the
ventral rami of C5-T1
nerves.
The brachial plexus is

divided into:
5 roots
3 trunks
6 divisions (3 anterior
& posterior divisions
each)
3 cords
5 terminal branches
3 Trunks (superior,
middle & inferior) Ventral Rami
(C5-T1)
3 anterior
divisions
Axillary
nerve
Musculocutaneous
nerve
3 posterior
divisions
Radial Median Ulnar 3 Cords (lateral,
Posterior & medial)
nerve nerve nerve
Identify
Identify
Identify
Identify
Identify
Identify
Identify Identify Identify Identify

Main Menu
Arm Overview
The arm or brachium extends from the shoulder down to the
elbow and contains one bone, the humerus.
Muscles are divided into an anterior flexor compartment

containing 3 muscles (bicep brachii, brachialis &
coracobrachialis) and a posterior extension compartment
containing one muscle (tricep brachii).
The brachial artery and its branches supply the arm with the
terminal branches of the brachial plexus coursing through it.
Humerus Lesser Main Menu
tubercle
Greater
tubercle Head
Anatomical neck
Intertubercular sulcus Surgical neck

(Bicipital groove) Radial
groove
Deltoid Medial condyle

tuberosity
Lateral condyle Coronoid

fossa Lateral
Lateral epicondyle
epicondyle Trochlea
Medial
Capitulum epicondyle Olecranon
Anterior View Posterior View fossa
Humerus Main Menu
Identify
Identify
Identify
Identify
Identify Identify
Identify
Identify Identify
Identify
Identify
Identify
Identify
Identify
Identify
Identify Identify
Anterior View Posterior View
Humerus AP CR Main Menu
Humerus
Epiphysis
Metaphysis
Diaphysis
Arm Cross Sections Main Menu
Proximal Arm
Middle Arm
Distal Arm
Main Menu
Elbow Overview
The elbow joint is a hinge type, synovial joint. It involves
3 different articulations which share a common synovial
cavity. These articulations are the humeroulnar,
humeroradial & proximal radioulnar joints.
The cubital fossa is an important area of transition between

the arm and forearm and sits between the brachioradialis and
pronator teres muscles. The contents include the brachial
artery and veins, median nerve and the tendon of the bicep
brachii muscle.
Elbow Joint Main Menu
Humerus
Capitulum Olecranon
process
Trochlea
Radial
head
Radial
Coronoid Radius
neck
process
Radial Ulna
Ulnar
tuberosity
tuberosity

Identify
Identify
Identify
Identify
Identify
Identify
Identify Identify
Identify
Identify Identify

Elbow Joint: Lateral View Main Menu
Radial collateral
Radial ligament
head Radial Radial
neck tuberosity
Annular ligament
Olecranon of radius
process
Identify
Identify
Identify Identify
Identify
Identify
Elbow Joint: Medial View Main Menu
Radial
Radial head Annular ligament
tuberosity Radial of radius
neck
Coronoid Ulnar collateral ligament

Olecranon
process process
Identify
Identify Identify
Identify

Elbow AP CR Main Menu
Humerus
Ulna
Radius
Elbow/Humerus AP CR Main Menu
Humerus
Medial supracondylar ridge
Lateral supracondylar ridge
Medial epicondyle
Lateral epicondyle
Trochlea
Capitulum
Olecranon fossa
Elbow/Ulna AP CR Main Menu
Ulna
Olecranon process
Coronoid process
Shaft
Elbow/Radius AP CR Main Menu
Radius
Head
Neck
Shaft
Elbow Lateral AP CR Main Menu
Humerus
Ulna
Radius
Elbow Lateral AP CR Main Menu
Humerus
Capitulum
Ulna
Olecranon process
Head of radius
Elbow Cross Sections: Coronal (frontal) Section Main Menu
Humerus
Lateral Medial
Radius
Ulna
Sagittal Section through Sagittal Section through

Humerus/Radius Humerus/Ulna
Main Menu
Forearm Overview
The forearm or antebrachium extends from the elbow to the
wrist and contains 2 bones, the radius and ulna.
Muscles are divided into an anterior compartment which is

subdivided into a superficial, intermediate and deep group of
muscles which function in flexion of the wrist and pronation
of the forearm. The posterior compartment is subdivided
into superficial and deep muscles but function in extension of
the wrist and supination of the forearm.
The radial & ulnar arteries and their branches supply the
forearm blood supply while the median, ulnar & radial
nerves supply the innervation to the forearm muscles.
Radius Main Menu
Head
Neck
Radial
tuberosity
Shaft
Dorsal
tubercle
Styloid process

Radius Main Menu
Identify
Identify
Identify
Identify
Identify
Identify

Ulna Main Menu
Olecranon
Trochlear process
notch
Coronoid
Radial process
notch
Shaft
Styloid process
Ulna Main Menu
Identify
Identify
Identify
Identify
Identify
Identify
Forearm Articulated Main Menu
Proximal radioulnar joint
Radial Ulnar
tuberosity tuberosity
Interosseous
membrane
Distal radioulnar joint
Anterior View
Identify
Identify Identify
Identify
Identify
Anterior View
Left Anterior Forearm: AP CR Main Menu
Radius
Ulna
Left Anterior Forearm: AP CR Main Menu
Radius
Styloid process of radius
Ulna
Styloid process of ulna
Forearm Cross Sections Main Menu
Proximal Forearm
Middle Forearm
Distal Forearm
Forearm Blood Supply: Brachial Arteriogram Main Menu
Brachial artery
Radial artery
Ulnar artery
Common interosseous artery
Anterior interosseous artery
Posterior interosseous artery
Medial Lateral
Main Menu
Wrist & Hand Overview

The wrist is at the junction of the hand and forearm. The wrist
is technically called the radiocarpal joint and is a condyloid,
synovial joint. Additional joints of the wrist & hand include;
intercarpal, midcarpal, carpometacarpal, intermetacarpal,
metacarpophalangeal, interphalangeal, proximal
interphalangeal & distal interphalangeal. The skeleton of the
hand consists of 8 carpals, 5 metacarpals & 14 phalanges.
The hand is divided into 5 compartments (hypothenar, thenar,

central, adductor & interosseous) according to your text. This may
vary from text to text however. The hand has multiple joints;
The blood supply to the hand consists of the ulnar artery

contributing mostly to the superficial palmar arch while the
radial artery contributes mainly to deep palmar arch.
Right Hand: Anterior (Palmer) View Main Menu
Pisiform
Triquetrum
Lunate
Scaphoid
Hamate
Capitate
Trapezoid
Trapezium
Metacarpal
Proximal phalange
Middle phalange
Distal phalange
Right Hand: Posterior (Dorsal) View Main Menu
Pisiform
Triquetrum
Lunate
Scaphoid
Hamate
Capitate
Trapezoid
Trapezium
Metacarpal
Proximal phalange
Middle phalange
Distal phalange
Left Hand: Dorsopalmer View Radiograph Main Menu
Pisiform
Triquetrum
Lunate
Scaphoid
Hamate
Capitate
Trapezoid
Trapezium
Metacarpal
Proximal phalange
Middle phalange
Distal phalange
Right Hand: Palmardorsal View/Arteriogram Main Menu
Ulnar artery
Superficial palmar arch
Radial artery
Deep palmar arch
Common palmar artery
Proper palmar digital artery
Ventral View
Right Hand: Coronal Section through Wrist & Hand Main Menu
Distal interphalangeal
joint (DIP)
Proximal interphalangeal
joint (PIP)
Metacarpophalangeal
joint (MCP)
Interphalangeal
joint (IP) Carpometacarpal joint (CMC)
Intermetacarpal Midcarpal joint (blue)

Joint (IM)
Intercarpal joint Radiocarpal joint (green)
Radius Ulna
Carpal Tunnel Main Menu
Carpal tunnel
Median nerve
Flexor pollicis longus muscle
Flexor digitorum superficialis tendons
Flexor digitorum profundus tendons
Flexor retinaculum
Main Menu
THE END!
If you found this Interactive PowerPoint file
helpful, please let me know.
Dr Jamie Wikenheiser
Email: jwikenhe@uci.edu
Main Menu
References
The images were adapted and modified from the following sources:
Moore, KL and Dalley, AF. (1999). Clinically Orientated Anatomy.

Baltimore, MD: Lippincott Williams & Wilkins.
Schuenke, M, Schulte, E and Schumacher, U. (2007). Thieme Atlas of Anatomy: Neck

and Internal Organs. New York, NY: Thieme.
Schuenke, M, Schulte, E and Schumacher, U. (2007). Thieme Atlas of Anatomy:

General Anatomy and Musculoskeletal System. New York, NY: Thieme.
Schuenke, M, Schulte, E and Schumacher, U. (2007). Thieme Atlas of Anatomy:

Head and Neuroanatomy. New York, NY: Thieme.
Agur, AMR and Lee MJ. (1999). Grants Atlas of Anatomy. Baltimore, MD:
Lippincott Williams & Wilkins.
Netter, F. (2006). Atlas of Human Anatomy. Philadelphia, PA. Saunders/Elsevier
Weir, J and Abrahams, PH. (2003). Imaging Atlas of Human Anatomy.

Philadelphia, PA. Mosby/Elsevier Science
Additional radiographs, CT and MRI images provided by Dr Michael Zucker (UCLA)

Main Menu
Hyperlink Slide Bank

BACK
Acromion process
Superior View
BACK
apula
Spine of Sc
Superior View
BACK
Superior View
BACK
Coracoid process
Superior View
BACK
Clavicle
Superior View
BACK
Superior angle

BACK
Suprascapular notch

BACK
Acromion process

BACK
Suprascapular notch

BACK
Superior angle

BACK
Coracoid process

BACK
us fossa
o
ra spin
Sup

BACK
c a pula
e of S
Spin

BACK
o s sa
usf
in o
sp
n fra
I

BACK
Subscapular fossa

BACK
Inferior angle

BACK
Acromion process
Coracoid process
Humerus

BACK
Acromion process
Coracoid process
Humerus
Infraspinatus muscle

BACK
Acromion process
Coracoid process
Humerus
Teres minor muscle

BACK
Acromion process
Coracoid process
Humerus
Subscapularis muscle

Infraspinatus BACK
muscle
Lateral View
Supraspinatus muscle BACK
Lateral View
BACK
Subscapularis
muscle
Lateral View
BACK
Teres minor
muscle
Lateral View
BACK
Acromion
process Clavicle Coracoacromial
ligament
Humerus
Coracoid process
Anterior View
Acromioclavicular
ligament BACK
Acromion
process Clavicle
Humerus
Coracoid process
Anterior View
BACK
Coracoclavicular
Acromion
ligament
process Clavicle
Humerus
Coracoid process
Anterior View
BACK
Acromion
process Clavicle
Humerus
Coracoid process
Glenohumeral ligament
(joint capsule)
Anterior View
BACK
Musculocutaneous
nerve
BACK
Axillary
nerve
BACK
3 anterior
divisions
3 Trunks (superior, BACK

middle & inferior)
BACK
Ventral Rami
(C5-T1)
BACK
3 posterior
divisions
BACK
3 Cords (lateral,
Posterior & medial)
BACK
Ulnar
nerve
BACK
Median
nerve
BACK
Radial
nerve
Humerus Main Menu
Greater BACK
tubercle
Greater
tubercle

Humerus Main Menu
BACK
Intertubercular sulcus
(Bicipital groove)

Humerus Main Menu
BACK
Deltoid
tuberosity

Humerus Main Menu
BACK
Lateral
epicondyle

Humerus Main Menu
BACK
Lateral condyle

Humerus Main Menu
BACK
Capitulum
Humerus Lesser Main Menu
tubercle
BACK

Humerus Main Menu
BACK
Head

Humerus Main Menu
BACK
Anatomical neck

Humerus Main Menu
BACK
Surgical neck

Humerus Main Menu
BACK
Medial condyle

Humerus Main Menu
BACK
Coronoid
fossa

Humerus Main Menu
BACK
Trochlea

Humerus Main Menu
BACK
Medial
epicondyle
Humerus Main Menu
BACK
Olecranon
Anterior View Posterior View fossa
Humerus Main Menu
BACK
Lateral
epicondyle

Humerus Main Menu
BACK
Radial
groove

Cross Sections: Proximal Arm Main Menu
BACK
Deltoid
Pectoralis major
Bicep brachii (long head)
Bicep brachii (short head)
Coracobrachialis
Humerus
Teres major
Tricep brachii (long head)
Tricep brachii (lateral head)
Cross Sections: Middle Arm Main Menu
BACK
Bicep brachii
Brachialis
Tricep brachii (medial head)
Tricep brachii (lateral head)
Tricep brachii (long head)
Brachial artery and veins
Median nerve
Musculocutaneous nerve
Ulnar nerve
Radial nerve
Cross Sections: Distal Arm Main Menu
BACK
Bicep brachii
Brachialis
Brachioradialis
Extensor carpi radialis longus
Tricep brachii muscle and tendon
Brachial artery and veins
Median nerve
Ulnar nerve
Radial nerve
Lateral antebrachial
cutaneous nerve
BACK
Capitulum

BACK
Radial
head

BACK
Radial
neck

BACK
Radial
tuberosity

BACK
Ulnar
tuberosity

BACK
Coronoid
process

BACK
Trochlea

BACK
Humerus

BACK
Olecranon
process

BACK
Radius

BACK
Ulna

BACK
Olecranon
process
BACK
Radial
head
BACK
Radial
neck
BACK
Radial
tuberosity
BACK
Radial collateral
ligament
BACK
Annular ligament
of radius
BACK
Radial
tuberosity
BACK
Radial
neck
BACK
Radial
head
BACK
Coronoid
process
BACK
Olecranon
process
BACK
Annular ligament
of radius
BACK
Ulnar collateral ligament

BACK
Humerus
Radius
Brachialis muscle
Capitulum
MRI
BACK
Humerus
Trochlea
Ulna
Coronoid process
Olecranon process
Brachialis muscle
MRI
Radius Main Menu
Head BACK

Radius Main Menu
BACK
Neck

Radius Main Menu
BACK
Radial
tuberosity

Radius Main Menu
BACK
Shaft

Radius Main Menu
BACK
Styloid process

Radius Main Menu
BACK
Dorsal
tubercle

Ulna Main Menu
Trochlear BACK
notch

Ulna Main Menu
BACK
Radial
notch

Ulna Main Menu
Olecranon
process BACK

Ulna Main Menu
BACK
Coronoid
process

Ulna Main Menu
BACK
Shaft

Ulna Main Menu
BACK
Styloid process
BACK
Proximal radioulnar joint
Anterior View
BACK
Radial
tuberosity
Anterior View
BACK
Ulnar
tuberosity
Anterior View
BACK
Distal radioulnar joint
Anterior View
BACK
Interosseous
membrane
Anterior View
Cross Sections: Proximal Forearm Main Menu
Select Structures
BACK
Radius
Ulna
Brachioradialis muscle
Supinator muscle
Pronator teres muscle
Extensor carpi ulnaris muscle
Flexor carpi ulnaris muscle
Ulnar nerve
Ulnar artery & median nerve
Radial artery & superficial
branch of radial nerve
Cross Sections: Middle Forearm Main Menu
Select Structures
BACK
Radius
Ulna
Brachioradialis muscle
Extensor carpi ulnaris muscle
Flexor carpi ulnaris muscle
Ulnar artery & nerve
Median nerve
Radial artery & superficial
branch of radial nerve
Cross Sections: Distal Forearm Main Menu
Select Structures
BACK
Median nerve
Flexor digitorum superficialis m.
Flexor digitorum profundus m.
Radial artery
Pronator quadratus muscle
Ulnar artery and nerve
Radius
Ulna

Upper Limb Radiology and Test Yourself

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Upper Limb Radiology and Test Yourself

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Upper Limb Radiology

& Test Yourself

Dr. Jamie Wikenheiser

The shoulder girdle is made up of the glenohumeral,

The shoulder/axilla region contains the axillary artery and its

Superior angle Acromion process Superior angle

Posterior View Anterior View

Identify Identify Identify

Posterior View Anterior View

Infraspinatus muscle Teres minor muscle Subscapularis muscle

Posterior View Anterior View

Identify Identify Identify

Posterior View Anterior View

Infraspinatus Supraspinatus muscle

Humerus Humerus removed

Humerus Humerus removed

1st part of axillary

1st part of axillary

Left Shoulder/Anterior View

The brachial plexus is

The brachial plexus is

Identify Identify Identify Identify

Muscles are divided into an anterior flexor compartment

Intertubercular sulcus Surgical neck

Deltoid Medial condyle

Lateral condyle Coronoid

The cubital fossa is an important area of transition between

Anterior View Posterior View

Anterior View Posterior View

Coronoid Ulnar collateral ligament

Identify Identify Identify

Sagittal Section through Sagittal Section through

Muscles are divided into an anterior compartment which is

Anterior View Posterior View

Anterior View Posterior View

Proximal radioulnar joint

Wrist & Hand Overview

The hand is divided into 5 compartments (hypothenar, thenar,

The blood supply to the hand consists of the ulnar artery

Intermetacarpal Midcarpal joint (blue)

Moore, KL and Dalley, AF. (1999). Clinically Orientated Anatomy.

Schuenke, M, Schulte, E and Schumacher, U. (2007). Thieme Atlas of Anatomy: Neck

Schuenke, M, Schulte, E and Schumacher, U. (2007). Thieme Atlas of Anatomy:

Schuenke, M, Schulte, E and Schumacher, U. (2007). Thieme Atlas of Anatomy:

Netter, F. (2006). Atlas of Human Anatomy. Philadelphia, PA. Saunders/Elsevier

Weir, J and Abrahams, PH. (2003). Imaging Atlas of Human Anatomy.

Additional radiographs, CT and MRI images provided by Dr Michael Zucker (UCLA)

Hyperlink Slide Bank

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Posterior View Anterior View

Teres minor muscle

Posterior View Anterior View

Posterior View Anterior View