Surface Marking & OSPEs
of upper limb
Anatomical snuff box
Auscultation triangle
LATISSIMUS
DORSI
EXTERNAL OBLIQUE
ILIAC CREST
Superficial palmar arch
Thenar eminence
Centre of palm
(distal border of extended thumb)
Hook of hamate
Pisiform bone
Deep palmar arch
Horinzontal line
(1 finger breadth proximal to
superficial palmar arch)
Distal to hook of hamate
Hook of hamate
Axillary ,Brachial &
Radial artery
Anatomical snuff box Midpoint of clavicle
Neck of radius
Y . A
RADIAL.A L L AR
BRACHIAL AXI
.A
Anterior border of lower end of radius
Lateral wall of axilla between the anterior & posterior axillary folds
Cephalic vein
Middle of delto-pectoral groove
Lateral side of elbow
Anatomical Snuff box
Basilic vein
Medial side of arm
(midway between axilla &
medial epicondyle)
CUBITAL FOSSA
Anterior surface of forearm
(below medial part of elbow)
Medial part of dorsum of hand near ulnar head
MEDIAN CUBITAL VEIN
2cm below lateral epicondyle
CUBITAL FOSSA
1.5cm above medial epicondyle
OSPE
Q1
a. Identify the clinical condition.
b. Explain the anatomical basis of
avascular necrosis in it.
c. Name the carpal bones.
SHE LOOKS TOO PRETTY
TRY TO CATCH HER
• The scaphoid is supplied by branches of the radial artery.
• The artery enters the scaphoid in a retrograde manner from
the distal pole to the proximal pole.
• Hence, fractures can compromise the blood supply, leading
to avascular necrosis (AVN)
• The more proximal the scaphoid fracture,the higher the risk
of AVN.
DISTAL PROXIMAL
Q2
a. Identify the procedure.
b. On which muscle is this procedure
[Link] its innervation.
c. Which is the ideal site for this
procedure.
Q3
a. Name the clinical condition.
b. What is the nerve Involved.
c. What is the deformity
produced in the hand.
• Wrist drop
• Extension of elbow is lost when triceps is paralysed.
• Loss of sensation over the dorsum of the hand
Q4
a. Identify this procedure.
b. Which is the vein usually selected
for this procedure.
c. Which are the veins connected by it.
Why is Median cubital vein selected?
• Accessability: The prominent superficial upper limb vessel.
• It is larger and has a lower tendency to move or roll when the
needle is inserted.
Q5
a. Identify the clinical condition.
b. Which is the nerve involved.
c. Name the muscles innervated by
this nerve in the hand.
LUMBRICALS
HYPOTHENAR EMINENCE
4 3 2 1
THENAR EMINENCE
• Median nerve (Labourer’s nerve)
i. Thenar muscles
ii. Lumbricals 1 & 2
• Ulnar nerve (Musician’s nerve)
i. Hypothenar muscles
ii. Lumbricals 3 & 4
iii. Dorsal interossei
iv. Palmar Interossei
v. Adductor pollicis
Q6
[Link] the clinical condition.
[Link] is the nerve involved.
[Link] the clinical features of
this condition.
FLEXOR RETINACULUM
CARPAL BONES
• Weakness and wasting of thenar muscles.
• Loss of power of opposition.
• Loss of cutaneous sensation of the palmar surface
( lateral 3 & 1/2 digits)
Q7
a. Identify the clinical condition.
b. Explain the mechanism of Injury
and the bone involved.
c. What is the type of deformity
produced.
Q8
a. Identify the clinical condition
b. Which is the nerve involved.
Long thoracic nerve
c. Name the muscle involved.
Unapposed action of trapezius
& rhomboids
Q9
a. Identify the clinical condition
b. Enumerate the fascial spaces of the
palm.
c. How can the pus in this space be
drained.
• Infection in the pulp space is called whitlow
• Pulp spaces of the digits: Subcutaneous spaces on the palmar
side of the tips of the fingers and thumb.
Fascial spaces of the hand
• Mid palmar
• Thenar
• Pulp space of digits
Q10
a) Identify the clinical condition.
b) Where is the point of injury ?
c) Describe the clinical features of this
condition.
• Arm: Adducted and medially rotated.
• Forearm: Extended and pronated
Q11
a. Identify the clinical condition
b. Why is this caused?
c. Describe the lymphatic drainage
of the breast.
Peau’d orange
Retraction of Hair follicles over the lump
Oedema of the skin around the hair follicles.
Obstruction of cutaneous lymphatics and stagnation of Lymph
SUPERFICIAL
LYMPHATICS:
Lymphatic drainage of
the overlying skin
