Upper arm

This article is about the upper part of the human upper limb. For a device used to harm or kill people in a battle or fight, see Weapon. For other uses, see Arm (disambiguation).

Arm
The human arm (with a small scar)
Cross-section through the middle of upper arm.
Latin Brachium
Artery Axillary artery
Vein Axillary vein
Nerve Brachial plexus
MeSH Arm

In human anatomy, the arm is the part of the upper limb between the shoulder and the elbow joints.[1][2]

Definition Of Arm

In other animals, the term arm can also be used for analogous structures, (such as one of the paired forelimbs of a four-legged animal or the arms of cephalopods). In anatomical usage, the term arm refers specifically to the segment between the shoulder and the elbow,[3][4] while the segment between the elbow and wrist is the forearm. However, in common, literary, and historical usage, arm refers to the entire upper limb from shoulder to wrist. This article uses the former definition; see upper limb for the wider definition.

In primates the arm is adapted for precise positioning of the hand and thus assist in the hand's manipulative tasks. The ball and socket shoulder joint allows for movement of the arms in a wide circular plane, while the structure of the two forearm bones which can rotate around each other allows for additional range of motion at that level.

Skeleton

The humerus is the bone of the arm. It joins with the scapula above in the shoulder at the glenohumeral joint and with the ulna and radius below at the elbow. The elbow joint is the hinge joint between the distal end of the humerus and the proximal ends of the radius and ulna. The humerus cannot be broken easily. Its strength allows it to handle loading up to 300 pounds (140 kg).

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 compartments contain muscles which are innervated by the same nerve and perform the same action.

Two other muscles are considered to be partially in the arm:

  • The large deltoid muscle is considered to have part of its body in the anterior compartment. This muscle is the main abductor muscle of the upper limb and extends over the shoulder.
  • The brachioradialis muscle originates in the arm but inserts into the forearm. This muscle is responsible for rotating the hand so its palm faces forward (supination).

Nerve and blood supply

The cubital fossa (colloquially known as the elbow pit) is clinically important for venepuncture and for blood pressure measurement.

Innervation

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 a deep artery of the arm (the profunda brachii), which sits in the radial groove of the humerus. This fact is very important clinically as a fracture of the bone at 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.

Arteries

The main artery in the arm is the brachial artery. This artery is a 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 important branch, the profunda brachii (deep artery of the 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 profunda brachii 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.

See also

References

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