Joints and Ligaments of the Shoulder
4 Tendon of supraspinatus muscle
(attached to the articular capsule)
6 Tendon of long head of biceps brachii muscle
7 Tendon of subscapularis muscle
(attached to the articular capsule)
9 Articular capsule of shoulder joint
14 Shoulder joint (joint cavity)
21 Suprascapular artery, vein, and nerve
23 Circumflexa scapular artery and vein
26 Tendon of long head of triceps brachii muscle
Right shoulder joint. The anterior part of the articular capsule has
been removed and the head of the humerus has been slightly rotated
outward to show the cavity of the joint.
Coronal section of the right shoulder joint
Coronal section of the right shoulder joint (MRI scan; from Heuck et al.,
2 Lateral epicondyle of humerus
6 Tendon of biceps brachii muscle
7 Medial epicondyle of humerus
Ligaments of the elbow joint (anterior aspect).
Elbow joint with collateral ligaments (medial aspect).
Elbow joint with ligaments (anterior
aspect). Articular capsule has been
removed to show the anular ligament.
Coronal section of the elbow joint
(MRI scan, courtesy of Prof. Dr. A. Heuck, Munich).
380 Ligaments of the Hand and Wrist
4 Ulnar carpal collateral ligament
6 Dorsal carpometacarpal ligaments
11 Dorsal radiocarpal ligament
13 Articular capsule and dorsal intercarpal ligaments
14 Palmar radiocarpal ligament
15 Tendon of flexor carpi radialis muscle (cut)
17 Palmar carpometacarpal ligaments
20 Tendon of flexor carpi ulnaris muscle (cut)
23 Palmar metacarpal ligaments
25 Articular disc (ulnocarpal)
32 Second and third metacarpal bones
Ligaments of hand and wrist (dorsal aspect).
Ligaments of hand and wrist (palmar aspect).
Coronal section of the hand and wrist (MRI scan;
from Heuck et al., MRT-Atlas, 2009). Note the location of
Ligaments of the Hand and Wrist 381
4 Tendon of flexor carpi radialis muscle (cut)
6 Articular capsule of carpometacarpal
7 Articular capsule of metacarpophalangeal
8 Palmar ligaments and articular capsule
9 Palmar ligaments and articular capsule
16 Pisiform bone with tendon of flexor
20 Deep transverse metacarpal ligament
21 Tendons of extensor muscles and
22 Collateral ligament of interphalangeal joint
Ligaments of right forearm, hand, and fingers (palmar aspect).
The arrow indicates the location of the carpal tunnel.
382 Muscles of the Shoulder and Arm: Dorsal Muscles
1 Descending fibers of trapezius muscle
2 Spinous processes of thoracic vertebrae
3 Ascending fibers of trapezius muscle
7 Transverse fibers of trapezius muscle
9 Posterior fibers of deltoid muscle
10 Infraspinatus muscle and infraspinous fascia
11 Teres minor muscle and fascia
12 Long head of triceps brachii muscle
14 Lateral head of triceps brachii muscle
15 Medial head of triceps brachii muscle
16 Medial intermuscular septum
1 Trapezius muscle (reflected)
10 Cut edge of trapezius muscle
11 Intrinsic muscles of back with fascia
17 Long head of triceps brachii muscle
18 Lateral head of triceps brachii muscle
19 Medial head of triceps brachii muscle
20 Medial intermuscular septum
21 Tendon of triceps brachii muscle
Muscles of shoulder and arm, superficial layer (right side, dorsal aspect).
Muscles of shoulder and arm, deeper layer
(right side, dorsal aspect). The trapezius
muscle has been cut near its origin at the
vertebral column and reflected upward.
Muscles of the Shoulder and Arm: Dorsal Muscles 383
3 Trapezius muscle (reflected)
4 Lateral supraclavicular nerves
12 Axillary nerve and posterior
15 Long head of triceps brachii muscle
3 Levator scapulae muscle (red)
Muscles of shoulder and arm, deeper layer (right side, dorsal aspect).
The trapezius and deltoid muscles have been divided and reflected.
Shoulder muscles, schematic diagram illustrating the course of
the main muscles of the dorsal aspect of the shoulder.
Muscles of the Shoulder and Arm: Pectoral Muscles
4 Clavicular part of deltoid muscle
5 Acromial part of deltoid muscle
6 Clavicular part of pectoralis major muscle
7 Sternocostal part of pectoralis major muscle
8 Short head of biceps brachii muscle
9 Long head of biceps brachii muscle
10 Abdominal part of pectoralis major muscle
13 External abdominal oblique muscle
20 Anterior layer of sheath of rectus
2 Pectoralis minor muscle (blue)
3 Pectoralis major muscle (red)
5 Coracobrachialis muscle (red)
6 Serratus anterior muscle (green)
Shoulder, arm, and pectoral muscles, superficial layer (ventral aspect).
Arrangement of pectoral and shoulder muscles (ventral aspect).
Muscles of the Shoulder and Arm: Pectoral Muscles
Shoulder, arm, and pectoral muscles, deep layer (ventral aspect).
2 Clavicular part of deltoid muscle
3 Pectoralis major muscle (reflected)
5 Short head of biceps brachii muscle
6 Deltoid muscle (insertion on humerus)
7 Long head of biceps brachii muscle
17 Pectoralis major muscle forming the anterior axillary fold
18 Anterior cutaneous branches of intercostal nerves
19 Lateral cutaneous branches of intercostal nerves
22 Latissimus dorsi muscle forming the posterior axillary fold
23 Serratus anterior muscle forming the medial wall of the axilla
24 External abdominal oblique muscle
Axillary fossa and serratus anterior muscle
Muscles of the right arm (lateral aspect).
Position and course of flexors of arm (schematic drawing).
2 Coracobrachialis muscle (blue)
Sagittal section of the right arm (MRI scan;
from Heuck et al., MRT-Atlas, 2009).
Muscles of the right arm (ventral aspect). Part of the
biceps brachii muscle has been removed. Arrow: tendon
of long head of biceps brachii muscle.
Muscles of the right arm (ventral aspect). The arm with the scapula
and attached muscles has been removed from the trunk.
1 Acromial part of deltoid muscle (central fibers)
2 Scapular part of deltoid muscle (posterior fibers)
4 Tendon of triceps brachii muscle
6 Clavicular part of deltoid muscle (anterior fibers)
11 Extensor carpi radialis longus muscle
14 Medial intermuscular septum with vessels and nerves
15 Lateral intermuscular septum
16 Tendon of biceps brachii muscle
21 Latissimus dorsi muscle (divided)
22 Medial intermuscular septum
23 Medial epicondyle of humerus
24 Brachial artery and median nerve
26 Tendon of short head of biceps
28 Distal part of biceps brachii muscle
30 Long head of triceps brachii muscle
31 Medial head of triceps brachii muscle
388 Muscles of the Forearm and Hand: Flexor Muscles
Flexor muscles of forearm and hand, superficial layer
Flexor muscles of forearm and hand, superficial layer
(ventral aspect). The palmaris longus and flexor carpi ulnaris
4 Flexor carpi radialis muscle
6 Flexor digitorum superficialis muscle
8 Antebrachial fascia and tendon of palmaris longus muscle
9 Tendon of abductor pollicis longus muscle
10 Tendon of extensor pollicis brevis muscle
11 Abductor pollicis brevis muscle
13 Superficial head of flexor pollicis brevis muscle
14 Tendon of flexor pollicis longus muscle
15 Medial intermuscular septum
16 Medial epicondyle of humerus
17 Humeral head of pronator teres muscle
19 Flexor carpi ulnaris muscle
21 Tendon of flexor carpi ulnaris muscle
Muscles of the Forearm and Hand: Flexor Muscles
Flexor muscles of forearm and hand, middle layer (ventral aspect).
The palmaris longus, flexor carpi radialis, and ulnaris muscles have
been removed. The flexor retinaculum has been divided.
Position of flexors of fingers and hand (schematic drawing).
A Deep layer B Superficial layer
23 Abductor digiti minimi muscle
24 Transverse fasciculi of palmar aponeurosis
25 Digital fibrous sheaths of tendons of flexor digitorum muscle
27 Flexor pollicis longus muscle
28 Carpal tunnel (canalis carpi, probe)
30 Flexor digitorum superficialis muscle
32 Opponens digiti minimi muscle
33 Flexor digiti minimi brevis muscle
34 Tendons of flexor digitorum superficialis muscle
36 Extensor carpi radialis brevis muscle
37 Flexor pollicis longus muscle
38 Tendon of flexor carpi radialis muscle
39 Pronator teres muscle (insertion of radius)
40 Flexor digitorum profundus muscle
42 Tendons of flexor digitorum profundus muscle
43 Tendons of flexor digitorum profundus muscle having passed
through the divided tendons of the flexor digitorum superficialis
6 Flexor digitorum superficialis
390 Muscles of the Forearm and Hand: Flexor Muscles
6 Tendon of flexor carpi radialis muscle
7 Tendon of abductor pollicis longus muscle
10 Tendon of flexor pollicis longus muscle
12 Medial intermuscular septum
13 Medial epicondyle of humerus
14 Common flexor mass (divided)
18 Tendon of flexor carpi ulnaris muscle
20 Abductor digiti minimi muscle
21 Flexor digiti minimi brevis muscle
22 Tendons of flexor digitorum profundus muscle
23 Tendons of flexor digitorum superficialis muscle
27 Common synovial sheath of flexor tendons
28 Synovial sheath of tendon of flexor pollicis
29 Digital synovial sheaths of flexor tendons
Flexor muscles of forearm and hand, deep layer (ventral aspect).
All flexors have been removed to display the pronator quadratus
and pronator teres muscles together with the interosseous
membrane. Forearm in supination.
Synovial sheaths of flexor tendons (palmar aspect of
right hand, semischematic drawing).
Muscles of the Forearm and Hand: Flexor Muscles 391
Right supinator and elbow joint
(ventral aspect). Forearm in pronation.
Synovial sheaths of flexor tendons
(palmar aspect of right hand). Blue PVA
solution has been injected into the sheaths.
Diagram illustrating the two axes of the elbow joint.
2 Lateral epicondyle of humerus
4 Position of capitulum of humerus
7 Entrance of deep branch of radial nerve to extensor muscles
8 Radius and insertion of pronator teres muscle
13 Tendon of biceps brachii muscle
16 Tendon of pronator teres muscle
19 Tendon of flexor carpi radialis muscle
21 Synovial sheath of tendon of flexor pollicis longus muscle
22 Fibrous sheath of flexor tendons
23 Digital synovial sheath of flexor tendons
24 Flexor digitorum superficialis muscle
25 Tendon of flexor carpi ulnaris muscle
26 Common synovial sheath of flexor tendons
A = axis of flexion and extension
392 Muscles of the Forearm and Hand: Extensor Muscles
tendons. The sheaths have been
right wrist (indicated in blue).
Notice the six tunnels for the
Extensor muscles of forearm and hand, superficial layer
(dorsal aspect). Tunnels for extensor tendons indicated by
1 Lateral intermuscular septum
2 Tendon of triceps brachii muscle
3 Lateral epicondyle of humerus
6 Extensor carpi ulnaris muscle
8 Extensor digiti minimi muscle
10 Tendons of extensor digiti minimi muscle
11 Tendons of extensor digitorum muscle
14 Extensor carpi radialis longus muscle
15 Extensor carpi radialis brevis muscle
16 Abductor pollicis longus muscle
17 Extensor pollicis brevis muscle
18 Tendon of extensor pollicis longus muscle
19 Tendons of both extensor carpi radialis longus
and extensor carpi radialis brevis muscles
20 Tendon of extensor indicis muscle
21 First tunnel: Abductor pollicis longus muscle,
extensor pollicis brevis muscle
22 Second tunnel: Extensor carpi radialis longus and brevis muscles
23 Third tunnel: Extensor pollicis longus muscle
24 Fourth tunnel: Extensor digitorum muscle,
25 Fifth tunnel: Extensor digiti minimi muscle
26 Sixth tunnel: Extensor carpi ulnaris muscle
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