The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the shoulder, arm, elbow, forearm, wrist and hand, and is primarily used for climbing, lifting and manipulating objects. In anatomy, just as arm refers to the upper arm, leg refers to the lower leg.
Definition
In formal usage, the term "arm" only refers to the structures from the shoulder to the elbow, explicitly excluding the forearm, and thus "upper limb" and "arm" are not synonymous. However, in casual usage, the terms are often used interchangeably. The term "upper arm" is redundant in anatomy, but in informal usage is used to distinguish between the two terms.
Structure
In the human body, the muscles of the upper limb can be classified by origin, topography, function, or innervation. While a grouping by innervation reveals embryological and phylogenetic origins, the functional-topographical classification below reflects the similarity in action between muscles (with the exception of the shoulder girdle, where muscles with similar action can vary considerably in their location and orientation.
Musculoskeletal system
Shoulder girdle
thumb|Bones of the shoulder girdle
The shoulder girdle or pectoral girdle, composed of the clavicle and the scapula, connects the upper limb to the axial skeleton through the sternoclavicular joint (the only joint in the upper limb that directly articulates with the trunk), a ball and socket joint supported by the subclavius muscle which acts as a dynamic ligament. While this muscle prevents dislocation in the joint, strong forces tend to break the clavicle instead. The acromioclavicular joint, the joint between the acromion process on the scapula and the clavicle, is similarly strengthened by strong ligaments, especially the coracoclavicular ligament which prevents excessive lateral and medial movements. Between them these two joints allow a wide range of movements for the shoulder girdle, much because of the lack of a bone-to-bone contact between the scapula and the axial skeleton. The pelvic girdle is, in contrast, firmly fixed to the axial skeleton, which increases stability and load-bearing capabilities.
The large muscles acting at this joint perform multiple actions and seemingly simple movements are often the result of composite antagonist and protagonist actions from several muscles. For example, pectoralis major is the most important arm flexor and latissimus dorsi the most important extensor at the glenohumeral joint, but, acting together, these two muscles cancel each other's action leaving only their combined medial rotation component. On the other hand, to achieve pure flexion at the joint the deltoid and supraspinatus must cancel the adduction component and the teres minor and infraspinatus the medial rotation component of pectoralis major. Similarly, abduction (moving the arm away from the body) is performed by different muscles at different stages. The first 10° is performed entirely by the supraspinatus, but beyond that fibres of the much stronger deltoid are in position to take over the work until 90°. To achieve the full 180° range of abduction the arm must be rotated medially and the scapula most be rotated about itself to direct the glenoid cavity upward.
; Muscles: of the arm
Biceps is the major supinator (drive a screw in with the right arm) and pronator teres and pronator quadratus the major pronators (unscrewing) — the latter two role the radius around the ulna (hence the name of the first bone) and the former reverses this action assisted by supinator. Because biceps is much stronger than its opponents, supination is a stronger action than pronation (hence the direction of screws).
alt=3D Medical Animation still shot of Human Wrist|thumb|228x228px|3D medical animation still shot of human wrist
How muscles act on the wrist is complex to describe. The five muscles acting on the wrist directly — flexor carpi radialis, flexor carpi ulnaris, extensor carpi radialis, extensor carpi ulnaris, and palmaris longus — are accompanied by the tendons of the extrinsic hand muscles (i.e. the muscles acting on the fingers). Thus, every movement at the wrist is the work of a group of muscles; because the four primary wrist muscles (FCR, FCU, ECR, and ECU) are attached to the four corners of the wrist, they also produce a secondary movement (i.e. ulnar or radial deviation). To produce pure flexion or extension at the wrist, these muscle therefore must act in pairs to cancel out each other's secondary action. On the other hand, finger movements without the corresponding wrist movements require the wrist muscles to cancel out the contribution from the extrinsic hand muscles at the wrist.
In addition, the central group of intrinsic hand muscles give important contributions to human dexterity. The palmar and dorsal interossei adduct and abduct at the MCP joints and are important in pinching. The lumbricals, attached to the tendons of the flexor digitorum profundus (FDP) and extensor digitorum communis (FDC), flex the MCP joints while extending the IP joints and allow a smooth transfer of forces between these two muscles while extending and flexing the fingers.
The muscles of the upper limb are innervated segmentally proximal to distal so that the proximal muscles are innervated by higher segments (C5–C6) and the distal muscles are innervated by lower segments (C8–T1).
Motor innervation of upper limb by the five terminal nerves of the brachial plexus:
Other animals
Evolutionary variation
thumb|left|Upper/front limbs of (top) [[salamander, sea turtle, crocodile, bird, (bottom) bat, whale, mole, and human]]
The skeletons of all mammals are based on a common pentadactyl ("five-fingered") template but optimised for different functions. While many mammals can perform other tasks using their forelimbs, their primary use in most terrestrial mammals is one of three main modes of locomotion: unguligrade (hoof walkers), digitigrade (toe walkers), and plantigrade (sole walkers). Generally, the forelimbs are optimised for speed and stamina, but in some mammals some of the locomotion optimisation have been sacrificed for other functions, such as digging and grasping.
In primates, the upper limbs provide a wide range of movement which increases manual dexterity. The limbs of chimpanzees, compared to those of humans, reveal their different lifestyle. The chimpanzee primarily uses two modes of locomotion: knuckle-walking, a style of quadrupedalism in which the body weight is supported on the knuckles (or more properly on the middle phalanges of the fingers), and brachiation (swinging from branch to branch), a style of bipedalism in which flexed fingers are used to grasp branches above the head. To meet the requirements of these styles of locomotion, the chimpanzee's finger phalanges are longer and have more robust insertion areas for the flexor tendons while the metacarpals have transverse ridges to limit dorsiflexion (stretching the fingers towards the back of the hand). The thumb is small enough to facilitate brachiation while maintaining some of the dexterity offered by an opposable thumb. In contrast, virtually all locomotion functionality has been lost in humans while predominant brachiators, such as the gibbons, have very reduced thumbs and inflexible wrists.