In the first six weeks of the course, we begin with an introduction to the parts of the upper limb and a discussion of the anatomic position, including the three-dimensional planes in which body movements are performed. Next, we cover the osteology of the upper limb by describing the bones of the extremity, how they articulate at synovial joints, and the movements that are possible at these joints. We explore the blood supply and innervation to the upper limb. We then discuss the major muscles that act at each joint, pointing out what muscles allow us to shrug our shoulders, row a boat, make a fist, and rotate our hand forwards or backwards.

In the final three weeks of the course, we investigate nerve injuries that occur in the upper limb and their clinical effects. We also explore common pathologies that appear in the extremity, such as rheumatoid arthritis, osteoarthritis, gout, and Dupuytren’s contracture. We finish with a description of the embryologic development of the upper limb and common causes of limb malformations and deformations.

Please note that some lectures in this course contain graphic medical images, including illustrations of the human body, and photographs of birth defects and other medical conditions. Discretion is advised.

Unit 1: Normal Anatomy of the Upper Limb (Weeks 1-6)
Week 1 – The Language of Anatomy

1. Overview
2. Anatomic Terminology and Limb Regions
3. Osteology and Skeletal Anatomy; Muscle Action
4. Origins and Insertions; Planes of Motion

Week 2 – Innervation and Blood Supply of the Upper Limb

1. The Nervous System: Overview
2. The Brachial Plexus: Motor Innervation
3. The Brachial Plexus: Sensory Innervation; Blood Supply to the Upper Limb

Week 3 – The Scapula

1. Elevation and Depression
2. Protraction, Retraction, Medial Rotation, and Lateral Rotation

Week 4 – The Glenohumeral Joint

1. Structure of the Joint; Flexion and Extension
2. Abduction, Adduction, and the Rotator Cuff

Week 5 – The Elbow and Wrist

1. Elbow: Flexion, Extension, Supination, and Pronation
2. Wrist: Structure of the Joint; Flexion and Extension

Week 6 – The Hand

1. Bony Structure, the Carpal Tunnel, and Extrinsic Muscles of the Hand
2. Intrinsic Muscles of the Hand
3. Extrinsic and Intrinsic Muscles of the Thumb

Unit 2: Pathology of the Upper Limb (Weeks 7-9)
Week 7 – Nerve Injuries

1. Nerve Injuries 1: Brachial Plexopathies
2. Nerve Injuries 2: The Arm and Forearm
3. Nerve Injuries 3: The Hand

Week 8 – Rheumatology

1. Rheumatoid Arthritis
2. Osteoarthritis
3. Septic Arthritis and Gout

Week 9 – Connective Tissue Disease and Embryology

1. Connective Tissue Diseases: Dupuytren’s Contracture, De Quervain Tenosynovitis, and Trigger Finger
2. Embryology 1: Intrinsic Causes of Limb Malformation
3. Embryology 2: Extrinsic Causes of Limb Deformation

No background knowledge is required, but given the rapid pace of the course, a motivated interest in anatomy is recommended. Introductory courses in anatomy or physiology, while not required, may also be useful.

Although the class is designed to be self-contained, students who want to to expand their knowledge beyond what we cover in this one region of the body can find a much more extensive coverage of anatomy in USMLE Road Map Gross Anatomy, by James White ,published by McGraw-Hill; or Clinically Oriented Anatomy, 5th ed., by Keith Moore and Arthur Dalley, published by Lippincott Williams & Wilkins.

Get 20% off when purchasing these Elsevier titles used in “Going Out on a Limb: The Anatomy of the Upper Limb.” Enter Promotional Code = 07594  at checkout at www.us.elsevierhealth.com:

Iannotti, JP and Parker, RD.  The Netter Collection of Medical Illustrations: Musculoskeletal System –Part 1: Upper Limb, 2e. © 2013 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

Drake, R, Vogl, W, Mitchell, AWM.  Gray’s Anatomy for Students, 2e. © 2010 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

Netter, FH.  Atlas of Human Anatomy, 5e. © 2010 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

Moore, KL, Persaud, TVN, Torchia, MG.  The Developing Human, 9e. © 2010 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

Miller-Keane, O’Toole MT. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, 7e. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

The class consists of lecture videos, which are between 15 and 20 minutes in length. Each video contains 8-12 integrated quiz questions per video. There are also 15-question end-of-lecture quizzes, most of which include a “practical” which requires you to identify structures in images.

Will I get a Statement of Accomplishment after completing this class?
Yes. Students who successfully complete the class will receive a Statement of Accomplishment.What resources will I need for this class?
No specific resources are needed for this class; all material is self-contained in the course. Access to an anatomy atlas, such as Atlas of Human Anatomy, 5th ed., by Frank H. Netter, published by Saunders, an imprint of Elsevier, Inc., may be helpful for visualization.What is the coolest thing I’ll learn if I take this class?
Next time a friend or family member — or a player on your favorite sports team — has an upper limb injury, you’ll know what’s going on!What future learning opportunities does this class prepare me for?
This class can be supplemented with additional coursework in regional anatomy and physiology.

For more information on Penn’s Open Learning initiative, please go to:
http://provost.upenn.edu/initiatives/openlearning