Bones , together with
shoulder girdles, that compose the human arm. The
humerus is one of the three
long bones of the arm. It joins with the
scapula at the
shoulder joint and with the other long bones of the arm, the
ulna and
radius at the
elbow joint. The elbow is a complex
hinge joint between the end of the humerus and the ends of the radius and ulna.
Muscles The arm is divided by a
fascial layer (known as lateral and medial
intermuscular septa) separating the muscles into two
osteofascial compartments: the
anterior and the
posterior compartments of the arm. The fascia merges with the
periosteum (outer bone layer) of the humerus. The anterior compartment contains three muscles:
biceps brachii,
brachialis and
coracobrachialis muscles. They are all innervated by the
musculocutaneous nerve. The posterior compartment contains only the
triceps brachii muscle, supplied by the
radial nerve.
Nerve supply The
musculocutaneous nerve, from C5, C6, C7, is the main supplier of muscles of the anterior compartment. It originates from the lateral cord of the
brachial plexus of nerves. It pierces the
coracobrachialis muscle and gives off branches to the muscle, as well as to
brachialis and biceps brachii. It terminates as the
anterior cutaneous nerve of the forearm. The radial nerve, which is from the fifth cervical spinal nerve to the first thoracic spinal nerve, originates as the continuation of the posterior cord of the brachial plexus. This nerve enters the
lower triangular space (an imaginary space bounded by, amongst others, the shaft of the humerus and the triceps brachii) of the arm and lies deep to the triceps brachii. Here it travels with the
deep artery of the arm, which sits in the
radial groove of the humerus. This fact is very important clinically as a fracture of the shaft of the bone here can cause
lesions or even transections in the nerve. Other nerves passing through give no supply to the arm. These include: • The
median nerve, nerve origin C5-T1, which is a branch of the lateral and medial cords of the
brachial plexus. This nerve continues in the arm, travelling in a plane between the biceps and triceps muscles. At the cubital fossa, this nerve is deep to the
pronator teres muscle and is the most medial structure in the fossa. The nerve passes into the
forearm. • The
ulnar nerve, origin C8-T1, is a continuation of the medial cord of the
brachial plexus. This nerve passes in the same plane as the
median nerve, between the biceps and triceps muscles. At the elbow, this nerve travels posterior to the
medial epicondyle of the humerus. This means that
condylar fractures can cause lesion to this nerve.
Blood supply The main artery in the arm is the
brachial artery. This artery is a big continuation of the
axillary artery. The point at which the axillary becomes the brachial is distal to the lower border of teres major. The
brachial artery gives off an unimportant branch, the
deep artery of arm. This branching occurs just below the lower border of
teres major. The brachial artery continues to the
cubital fossa in the anterior compartment of the arm. It travels in a plane between the
biceps and
triceps muscles, the same as the
median nerve and
basilic vein. It is accompanied by
venae comitantes (accompanying veins). It gives branches to the muscles of the anterior compartment. The artery is in between the
median nerve and the tendon of the
biceps muscle in the
cubital fossa. It then continues into the
forearm. The deep artery of the arm travels through the
lower triangular space with the
radial nerve. From here onwards it has an intimate relationship with the radial nerve. They are both found deep to the triceps muscle and are located on the spiral groove of the
humerus. Therefore,
fracture of the bone may not only lead to lesion of the
radial nerve, but also
haematoma of the internal structures of the arm. The artery then continues on to
anastamose with the
recurrent radial branch of the
brachial artery, providing a diffuse blood supply for the
elbow joint.
Veins The veins of the arm carry blood from the extremities of the limb, as well as drain the arm itself. The two main veins are the
basilic and the
cephalic veins. There is a connecting vein between the two, the
median cubital vein, which passes through the
cubital fossa and is clinically important for
venepuncture (withdrawing blood). The basilic vein travels on the medial side of the arm and terminates at the level of the seventh rib. The cephalic vein travels on the lateral side of the arm and terminates as the axillary vein. It passes through the
deltopectoral triangle, a space between the deltoid and the pectoralis major muscles. ==Society and culture==