 لیکن یہ اہم سے سمجھتے ہیں کہ ذات کی حکمرت کی حکمرت کی بات ہوتی ہے یہ جو برائك کے حکمرت میں بیٹ پر مرار کے جو میں ہی نظام ہیں ہی نمی بھی بیٹنے کی نظام ہے لنبا تنبے مجھا پہلے ہے۔ اس آچھاتا ہوتے ہیں، سپرککلینار تیو بکل ہے۔ جو سبہ پر کسٹ کرسکتے ہیں اور پر شیطigner کہتے ہیں۔ اور پر سلک resolوشات کی طور پر کسٹ کرسکتے ہیں، جب یہ اوپر پہلے کی تقرر ہے، کہ برڈ بھوڈ ہے اور سلة کی تر خالح دانیا۔ بہت CN کی طرح ہوتے ہیں۔ جو پیلی ہوتے ہیں، جمعت ہوگا، bothering باک کوککل۔ پھر پتھاتیں کھون جانتے ہیں ، انہیں ہماری دوستہ ہوتے ہیں انہوں کا اتنا یہاں کہاں کبیٹل فاظہ اس کے بارے میں رادیئر کو단یل یہاں کرتے ہیں yet میں بھی اتنی لیکن ہماری بھی بہتے ہیں پر ایک عشان ہے اور یہ عشان مرد کبیٹل ہماری اپرانڈیبریکیل پیشیہ سی پر بہت ہو پہلے خط بہت ہوتا ہے ناہ سپلائی کے بارے میں ہیں سے پر ایک مسکیلوڈینس نروب ہاٹا سکتا ہوں گے ابھی کلٹ دہنی سکتا ہوں بکتے ہیں بکتے ہیں ہم قطارانی ہے یہاں ہمید لُ singular ہمید بکتے ہیں ہمید بہت بہت پہلے کے لیسے اسی مشاہر ہے اسی مشاہر ہے اسی مشاہر ہے اسی مشاہر ہے اور اسی طرح پہلےWhen the arm is supinated. So these are the two main actions of the biceps. With the arm fully pronated , the biceps does not act as a flexor. It acts only as a powerful supinator like for example when turning a screwdriver. The next muscle that we can see here, on the medial side of the arm, this muscle, this is the core什 break-out. This also arises from the core quiet process as the term implies chordacus and it gets inserted مریخ عوز داتے ہیں یہ ، آپpی کو ایک ایک ایک ایچنی ہے جو کسolutely جو لوگ ہے, ایک ایک شوڈر جو لوگ کے لئے یہ علاوہ دکتے ہیں اور ساری بھی منم'mا ہے اسی جس ہے جو آپpی بیکی علیس نے doپ جانچ ہے آپقریب rest ہمیشان ہمیشان ہمیشان ہمیشان مہار ہےتھائہ ہمیشان ہمیشان ہمیشان پر یہ بیکی علیس مہار ہے ہمیشان یہ ہے جاتی ہے ، آپpی سی جانچ ہے اور اور ہماری پر پر انظرِس راحت ہے جو آنس آنٹے سے انتظر ہوتی ہے اور یہ پر آنکہ ہے اور یہ بی ان کے سامنے کے سامنے پر انتظر کا مطلب ہے اماری شباریہ جو کمائن کے سامنے کو کمائن کی اجازی ہے کمائن کو دار ہوتی ہے اور اسی ہومنی کی سامیہ اجازی ہے ایسیومیٹریک کنتریکشن، ایسیوترونیک، کنتریک، ایسیوترونیک، ایکسنٹریک، all forms of contraction of the elbow are achieved by the brachialis. کمیٹر the nerve supply of these three muscles. The nerve supply is the musculocutaneous nerve and we can see the musculocutaneous nerve here. It arises from the lateral cord of the brachial plexus. This is the lateral cord of the brachial plexus and it is arising. It enters the coraco brachialis muscle and in that respect this is referred to as the landmark muscle because it indicates a position where the musculocutaneous nerve is entering the arm. It supplies the coraco brachialis and then we can see the main nerve emerges. It gives branches to the biceps brachialis. It is giving multiple branches and then it continues and it supplies the brachialis. We can see that also and then again the main nerve continues and it emerges between the biceps and the brachialis and we can see the main nerve emerging here and here it becomes subcutaneous and it becomes the cutaneous nerve. That's the reason why this is called the musculocutaneous nerve. The place where it becomes subcutaneous it is accompanied by the cephalic way and we can see that here. And as a cutaneous nerve it supplies the entrolateral aspect of the forearm till the base of the tongue. So this is the full course of the musculocutaneous nerve and its supply. In this we can see that there is a communication between the musculocutaneous nerve and the medial nerve. This is well documented and we can see that communication here though of course it is not present in all cases. Now let's mention a few points of functional and practical and clinical significance pertaining to the muscle and the nerve. Ingenuity of the musculocutaneous nerve is not very common because it is located on the medial side and it is rather deep. However it can rarely get injured in which case the flexors of the elbow will get paralyzed. In the rare event that such a thing happens the procure radialis can partially compensate as a flexor of the elbow. Here in this patient we can see in this cadaver that there is an echemosis here. I told you that the cephalic vein is very close to the cubital fossa in this region and it is also very close to the musculocutaneous nerve. This is a very common site of venipuncture and therefore in this it looks like as if they have tried to do venipuncture. So that brings me to another important clinical correlation pertaining to the musculocutaneous nerve. When we do multiple attempts at venipuncture and we produce extravasation of blood like in this case or echemosis. It can produce irritation of this musculocutaneous nerve at the place where it becomes subcutaneous and it's very close to the cephalic vein. And then the patient can complain of numbness, dingney or parasthesia on the skin on the lateral aspect of the atrolateral aspect of the forearm till the base of the thumb. So that is another clinical point pertaining to the musculocutaneous which is the nerve supply of the biceps brachialis and the coracobrachialis. The biceps is referred to as a three joint muscle because it crosses the shoulder joint, it crosses the elbow joint and it also acts on the superior radio wall in our joint. In ten percent of the population, there can be a third head of the biceps. The long head of the biceps can undergo degenerative tear especially in old age. In which case when the patient has to flex his elbow because this tendon has told the muscle bunches up like this and it forms a hollow on the top. That is referred to as the pop eye sign and the pop eye deformity. This is a clinical image of a patient seen by the author with rupture of the long head of the biceps producing the pop eye deformity. Now let's come a little further down some implications of the bicepital aponeurosis. The bicepital aponeurosis as I mentioned it forms the roof of the cubital fossa and it merges with the antipirical fascia. By so do we, it serves several purposes. First, it protects the structures in the cubital fossa. Most importantly, it protects the median nerve and the brachial artery. Secondly, because it is inserted onto the anticubital fascia, it partially pulls the biceps tendon and reduces the pressure of the biceps tendon on the radio tuberosity. پرشن and the friction of the biceps tendon on the radio tuberosity is reduced by the bicepital aponeurosis. At the place where the biceps tendon gets inserted onto the radio tuberosity, there is a bursa and that is called the biceps bursa. The biceps is a powerful flexor only when the arm is supinated so therefore that is used as a test of the biceps. With the arm fully supinated, we ask the patient to flex the elbow against resistance and then we feel for the biceps. In contrast, the brachialis is a flexor of the elbow in all positions of the forearm, pronated supinated any position. So therefore, in order to test the brachialis, we ask the patient to semi pronate the arm and then flex it against resistance and that way we neutralize the action of the biceps and then we get tested for the brachialis. The coracobrachialis muscle from the humerus is referred to as a landmark muscle. It acts as a landmark for two structures. One, as I mentioned a little earlier, it indicates the location where the musculocritinus nerve enters the arm. That is in one respect. The other respect why it is called the landmark muscle is because it indicates the place where the humerus receives its nutrient artery from the brachial artery and we can see the nutrient artery here. So therefore, both the musculocritinus and the nutrient artery are indicated by the coracobrachialis. One not very common clinical correlation pertain to the coracobrachialis is it can rarely be a site of entrapment of either the brachial artery or the median nerve but that is not very common. So therefore, it can act as a cause of an entrapment syndrome. These are all the points which I wanted to mention about the muscles of the arm. Thank you very much for watching. If you have any questions or comments, please put them in the comment section below. Have a nice day. Dr. Sanjay Sanyal signing out.