B6-010 Joints and Imaging Flashcards
only attachment of upper limb to axial skeleton
sternoclavicular joint
movement of this physiologic joint aids in elevation of the upper extremity
scapulothoracic joint
for upper limb elevation, there is 120 degrees of […] abduction, and an additional 25 degrees at the […] to complete abduction
glenohumoral
sternoclacvicular
what muscles attach to the coracoid process? [3]
short head of the biceps brachii
coracobrachialis
pectoralis minor
ligaments of the sternoclavivular joint [4]
anterior sternoclavicular
posterior sternoclavicular
interclavicular
costoclavicular
what ligament prevents excessive elevation of the clavicle?
costoclavicular
what nerves may cause pain in the arcomioclavicular joint? [3]
axillary
lateral pectoral
supraclavicular
what is the movement of the acromioclavicular joint?
rotation
fibrocartilage disc encircling glenoid fossa
glenoid labrum
the superior, middle, and inferior glenohumeral ligaments can only be viewed
internally
what ligament helps prevent superior shoulder dislocations?
coracoacromial
the tendon of the [….] passes between the greater and lesser tubercles
long head of biceps
the [….] ligament crosses between the greater and lesser tubercles, keeping the long head of the biceps between them
transverse humeral
where does the tendon of the long head of biceps attach?
supraglenoid tubercle
some fibers also attach to labrum
occurs when great force is applied to the biceps
or in athletes with repetitive abduction and external rotation (pitchers)
SLAP tear of glenoid labrum
common tears seen at the labrum with SLAP injury [2]
superior anterior
superior posterior
if this bursa becomes inflamed, it causes tenderness at the point of the shoulder and individual will not want to move limb
subacromial
what two boney structures provide lateral humeral-radial articulation?
capitulum of humerus
head of radius
what two boney structures provide medial humeral-ulnar articulation?
trochlea of humerus
trochlear notch of ulna
joint formed by radial head and radial notch of ulna
proximal radial ulnar joint
what joints allows for supination and pronation of the elbow?
proximal/distal radial-ulnar joint
fossa on posterior aspect of humerus
olecranon
fossa on anterior aspect of humerus
coronoid
the […] is where the biceps attaches distally
radial tuberoscity
at what point do we get the movements of pronation and supination?
point of radial tuberoscity
pain at the elbow joint is provided by what nerves? [3]
musculocutaneous
radial
ulnar
attaches humerus to radius
radial collateral ligament
attaches humerus to ulna
ulnar collateral ligament
what ligament is repaired in Tommy-Johns surgery?
ulnar collateral
ligament that goes around the head of the radius
annular ligament
what ligament keeps the radial head in the notch of the radius during pronation and supination?
annular ligament
how to reduce radial head subluxation
thumb on head of radius, flex/supinate until it pops back in
determine the age of the patient in each xray
A. 2
B. 5
C. 5-6
D. 12
**bones will not fuse until puberty
the distal radio- ulnar joint allows for what movement?
supination and pronation
the radius articulates with what carpal bones to form the radio-carpal joint? [3]
scaphoid
lunate
triquetrum
an articular disc lies between the distal ulna and the
triquetrum
does the ulna participate in the radio-carpal joint?
no
what allows the thumb its movement pattern?
saddle joint of CMC
the scapulothoracic is an example of a […] joint
physiologic
what ligament prevents excessive elevation of the clavicle?
costoclavicular
what ligaments reinforce the sternoclavicular joint?
anterior and posterior sternoclavicular
what ligament strengthens the AC joint superiorly?
acromioclavicular
what ligaments anchor the clavicle in the AC joint?
coracoclaviculars
hilton’s law
any muscle that acts on the joint will send articular nerve branches to supply the joint
nerves that supply the sternoclavicular joint [2]
supraclavicular
subclavius
nerves that supply the glenohumeral joint [3]
axillary
suprascapular
lateral pectoral
nerves that supply the elbow joint [3]
musculocutaneous
ulnar
radial
forceful eccentric traction on the […] can tear the glenoid labrum
biceps brachii
muscles responsible for flexion of the arm [4]
pectoralis major
anterior head of deltoid
coracobrachialis
biceps brachii
responsible for extension, adduction, and medial rotation of the arm
latissimus dorsi
responsible for extension and lateral rotation of the arm
posterior deltoid
responsible for adduction and medial rotation of the arm
teres major
what joints produce the movements of pronation and supination?
proximal and distal radio-ulnar joints
formed by articulation of the radial head with the radial notch of the ulna
proximal radio-ulnar joint
formed by head of ulna and ulnar notch of radius
distal radio-ulnar joint
formed by head of humerus with glenoid cavity
glenohumeral joint
formed by articulation of trochlea of humerus and trochlear notch of ulna
humeral-ulnar joint
permits flexion and extension of the elbow
humeral-ulnar joint
what bones form the radiocarpal joint?
radius, scaphoid, lunate, triquetrum
what joint permits flexion, extension abduction and adduction of the hand?
radiocarpal
the saddle joint of the thumb is formed between the […] and [..]
trapezium and 1st metacarpal
allows for flexion, extension, abduction, adduction, and circumduction of the thumb
CMC of thumb
connects the radius and ulna and forms a syndesmosis joint
interosseus membrane
forms the anterior boundary of carpal tunnel
flexor retinaculum
transmits forces from the upper limb to the axial skeleton
clavicle
what muscles attach to the corocoid process [3]
coracobrachialis
short head of biceps
pec minor
.
separation of AC joint
what structures are in danger of being damaged by this? [2]
acromioclavicular ligament
coracoclavicular ligament
what is your diagnosis?
clavicle fracture
what accounts for the presentation of bone?
sternocleidomastoid is pulling up the proximal piece
the AC joint and gravity is pulling down the distal part
what structures could be damaged by this injury? [3]
-traction on the lower trunk of the brachial plexus due to proximity to first rib
-subclavian artery
-subclavian vein
what is the diagnosis?
glenohumoral dislocation
what structures are in danger of being damaged? [5]
axillary nerve
posterior circumflex a
glenoid labrum
long head of biceps
glenohumoral ligaments
-abduction of the arm is painful
-palpation of deltoid produces exquisite pain
-intermuscular inflammation over the head of humerus
subacromial bursitis
most commonly torn rotator cuff muscle
suprasinatus
lies in the intertubercular groove of the humerus
long head of biceps brachii
what movements happen at radiocapitellar joint and ulnotrochlear joint?
flexion/extension
what movement happens at the proximal radioulnar joint?
supination/pronation
[…] of the humerus articulates with the head of the radius
capitellum
trochlea of the humerus articulates with the […] of the ulna
coronoid process
what muscle attaches to the olecranon?
tricep
what muscle attaches to the radial tuberoscity and what movement does it provide?
biceps -provides supination
what is the location of cubital tunnel?
medial epicondyle
flexor carpi ulnaris
what nerve passes though the cubital tunnel?
ulnar
what does the patient complain of in cubital tunnel syndrome?
abnormal sensation in 4-5 digits both dorsal and ventral
hypothenar atrophy
weakness in intrinsic muscles of hand
what muscles attach to the medial epicondyle?
common flexor tendons
what muscles attach to the lateral epicondyle?
common extensor tendons
**except extensor carpi radialis and brachioradialis
chronic inflammation in the medial epicondyle would result in
medial epicondylitis (pitchers elbow)
chronic inflammation in the lateral epicondyle would result in
lateral epicondylitis (tennis elbow)
where do extensor carpi radialis and brachioradialis attach?
suprachondylar ridge
identify the carpal bones
what is in the encircled space?
articular disc
what bones create the radiocarpal joint?
radius
scaphoid
lunate
triquetrum
what carpal bone is next to the thumb?
trapezium
what is the diagnosis?
Colles fracture (dorsal distal radius fracture)
what is a Smith fracture?
ventrally displaced distal radius fracture
How can you tell quickly if median nerve is intact?
“OK” sign
how can you tell quickly is ulnar nerve is intact?
ab and adduct finger
how can you quickly tell if radial nerve is intact?
sensation to back of hand
wrist extension intact
what are sesamoid bones?
bones that form in tendons and help mechanics and prevent rubbing
why is a scaphoid fracture problematic?
receives retrograde blood supply from the radial a., potential for necrosis and nonunion
if the lunate bone dislocates, it can compress […] nerve
median
whats a boxer’s fracture?
fracture of 5th metacarpal head
a boxer’s fracture is commonly caused by a
hit with a closed fist
what type of fracture involves compression and the posterior displacement of the distal radius?
Colles
borders of the anatomical snuffbox
laterally: extensor pollicis brevis, abductor pollicis longus
medial: extensor pollicis longus
the floor of the anatomical snuffbox is crossed by the […] artery
radial
long head of the biceps brachii tendonitis presents as pain in the […] shoulder
anterior
pain from 50-120 degrees of abduction of arm during both passive and active motion is indicative of
subacromial bursitis
“painful arch snydrome”
thickening of the extensor pollicis brevis and longus tendons due to inflammation
De Quervain tendinopathy
pain on radial side of wrist and thumb while holding objects, and with ulnar deviation
De Quervain tendinopathy
avulsion of the extensor digitorum tendon
mallet finger
progressive fibrosis of the palmar fascia
Dupuytrens
disparity in fibrous flexor sheath
trigger finger
identify A-D
a. deltoid
b. acromion
c. supraspinatus
d. subscapularis
binds the end of the ulna and radius together distally
articular disc
the major supporting structure of the distal radio-ulnar joint
articular disc
separates the cavity of the distal radio-ulnar joint from the cavity of the wrist
articular disc
partial subluxation of the proximal radioulnar joint
nursemaids elbow (radial head subluxation)
fracture commonly seen in golfer’s due to the positioning of the proximal aspect of the golf club in their grip
fractured hamate
largest carpal bone
capitate
what carpal bone articulates with the third metacarpal?
capitate
carpal between scaphoid and triquetrum
lunate
most commonly dislocated carpal bone
lunate
pea-shaped sesamoid bone that lies on the palmar aspect of the triquetrum
pisiform
most commonly fractured carpal bone
scaphoid
injury seen after an individual improperly punches a solid object with a clenched fist
fracture of the fifth metacarpal
“boxers fracture”
the […] nerve passes between the heads of pronator teres
median
the […] nerve enters the supinator and continues as […] which can be entrapped by the supinator
deep branch of radial
posterior interosseus
deep and superficial branches of […] pass through Guyon’s
ulnar nerve
the musculocutaneous nerve passes through […] and can become entrapped there
coracobrachialis
what two tendons form the anatomical snuffbox?
extensor pollicis brevis
extensor pollicis longus