Lab Manual - Imaging Studies of the Upper and Lower Limbs and Clinical Considerations

Learning Objectives:

Upon completion of this session, the student will be able to:

  1. Identify the bony landmarks (classification of joints) of the upper and lower limbs
  2. Identify and demonstrate the areas of the distribution of the major cutaneous nerves of the upper and lower limbs.
  3. Identify and demonstrate the major superficial veins of the upper and lower limbs.
  4. Identify major arterial vasculature of the upper and lower extremities (concept / design of collateral circulation)
  5. Identify the pattern / organization / terminal nerves of the brachial plexus and the lumborsacral plexus
  6. Identify muscles (muscular compartments) of the upper and lower limbs
  7. Define the fascial planes of the lower and upper limbs.

Readings and Modules:

Procedure:

1. Review the bony landmarks of the upper limb

                 (N419, 420, 421, 452     TG 2-03A,B   2-04A,B)

    Review the bony landmarks of the lower limb

                 (N486, 489. 513. 523     TG  3-04 A,B  3-05 A,B   306. 307. 308. 309)

 

 

2. Review the joints of the upper limb

                  Shoulder              N423                    TG 2-42A, B

                  Elbow                  N436, 438            TG 2-43 A, B, C

                  Wrist and Hand   N454, 455. 458    TG 2-44, 2-45)

 

                  Hip                       N487                   TG 3-54, 3-55

                  Knee                    N508, 509, 511    TG 3-59

                  Ankle and Foot    N527, 528            TG 3-60

 

 

 

3. Identify the major cutaneous nerves of the upper limb

    (medial brachial cutaneous, lateral antebrachial cutaneous, medial antebrachial cutaneous,

     posterior antebrachial cutaneous, superficial branch of the radial nerve,

     dorsal cutaneous branch of the ulnar nerve   N479, 480   TG 2-02)

 

    Identify the major cutaneous nerves of the lower limb

   (lateral femoral cutaneous, anterior femoral cutaneous,  posterior femoral cutaneous nerve,

    greater Saphenous, sural nerve, lateral sural cutaneous nerve,  medial sural nerve, 

    superficial fibular     N544, 545   TG 3-02, 3-03)

 

    Dermatomes of the upper limb  N481, 482   TG 2-51, 2-52

    Dermatomes of the lower limb  N543           TG 3-68, 3-69

 

 

4. Identify the major, superficial veins of the upper limb 

    (Basilic, Cephalic, Median Cubital, and Dorsal Arch of the Hand  N479, 480    TG 2-02, 2-53)

 

    Identify the major superficial veins of the lower limb

    (Superficial Epigastric, Superficial Circumflex Iliac, Femoral, Greater Saphenous,

    Lesser Saphenous            N544, 545     TG 3-02, 3-03, 3-70)

 

   Identify the lymphatic drainage of the upper limb  N483  TG 2-53

   Identify the lymphatic drainage of the lower limb  N546  TG 3-70

 

 

5. Identify the arterial blood supply to the upper limb   N434    TG 2-46

    Identify the arterial blood supply to the lower limb   N512    TG 3-62

 

 

6. Identify the organization and branches of the Brachial Plexus 

    N429, 430   TG 2-14, 2-20, 2-27)

 

    Identify the organization and branches of the Lumbrosacral Plexus

    N497. 498. 499     TG 3 -14, 3-25, 3-28)

 

 

7. Identify the muscles (compartments) of the upper limb – give their general function and nerve supply * See Anatomy Tables

                                                    Arm (anterior and posterior compartments)

                                                    Forearm (ventral [ant] and dorsal [post.] compartments)

                                                    Hand (intrinsic:  thenar, hypothenar, lumbricals, interossei)

 

 

Identify the muscles (compartments) of the lower limb – give their general function and nerve supply

* See Anatomy Tables   N505, 522       TG 3-15, 3-32

                                                   Anterior, Medial, Lateral Thigh Compartments

                                                   Gluteal (posterior thigh)

                                                   Leg ( anterior, lateral, and posterior (superficial, deep)

                                                   Foot (intrinsic muscles – 4 layers)

 

 

8. Identify fascial planes of the upper limb        N433, 439   TG 3-15

    Identify the fascial planes of the lower limb  N505, 522   TG 3-32

 

 

9. Review Radiographs

 

    Upper Limb               Shoulder                              N427   TG 2-05A

                                       Elbow                                  N437   TG 2-05B

                                       Wrist & Hand                      N457   TG 2-05C

                                       CT Arteriogram of UL        N484

                                       Arteriogram of Shoulder                 TG 2-09

 

 

    Lower Limb               Hip                                       N488   TG 3-10A

                                       Knee                                     N510   TG 3-10B

                                       Ankle & Foot                       N526   TG 3-11A, B

                                       CT Angiogram of LL           N547

 

 

10. Clinical Considerations

Upper Limb

                        Erb-Duhennne Palsy

                        Klumpke’s Palsy

                        Radial Nerve Palsy

                        Rotator Cuff Impingement (Painful Arc Syndrome)

                        Rotator Cuff Tear

                        Lateral Epicondylitis (Tennis Elbow)

                        Cubital Tunnel Syndrome

                        Carpal Tunnel Syndrome

           

Lower Limb

                        Sciatica

                        Radiculopathy

                        Avascular necrosis of the Femoral head (AVN)

                        Trendelenburg Sign / Gluteal Gait

                        Ischial Bursitis

                        Trochanteric Bursitis

                        Popliteal Artery Aneurysm

Housemaid’s Knee

Genu Varum (Bowleg)

Genu Valgum (Knock-knee)

                        Meniscal Tear

                        ACL Tear

                        Terrible Triad of the Knee

Foot Drop

Clubfoot (Talipes Equinovarus)

                        Hip Prosthesis  (Joint Arthroplasty)

                        Hallux Valgus (Bunion Deformity)