Bones And Joints Of The Upper Extremity Flashcards
Radiohumeral articulating surfaces
Capitulum of the humerus, head of radius
AKA
Concave surface of radial head and capitulum of humerus
Ulnohumeral articulating surfaces
Trochlear notch of ulna and trochlea of humerus
Radiohumeral and ulnohumeral classification
Uniaxial, hinge, synovial joint
Radiohumeral and ulnohumeral movements permitted
Flexion/extension: Roughly sagittal plane, medial lateral axis.
ROM: ~140-150 degree flexion. 0-10 degree extension.
Radiohumeral and ulnohumeral ligaments
Capsule
Medial/ulnar collateral
Lateral/radial collateral
Radiohumeral and ulnohumeral capsule
Weak anteriorly and posteriorly
Encloses the radiohumeral, ulnohumeral, and proximal radioulnar joints
Flexion limited by soft tissue approximation between ulna and biceps brachii
Design works well: elbow extension is limited (by bony contact between olecranon process of ulna and olecranon fossa of humerus)
Strengthen medially and laterally by collateral ligaments
Radiohumeral and ulnohumeral medial/ulnar collateral ligament
Triangular shaped (anterior, posterior, oblique bands)
Attaches medial humeral epicondyle to coronoid and olecranon processes
Limit/restricts: valgus force
Radiohumeral and ulnohumeral lateral/radial collateral ligament
Fan shaped
Attaches lateral humeral epicondyle to annular ligament of proximal radioulnar joint
Limit/restricts: varus force
Proximal radioulnar joint articulating surfaces
1/5 head of radius and radial notch of ulna
Proximal radioulnar joint classification
Uniaxial, pivot, synovial joint
Proximal radioulnar joint movements permitted
Supination/pronation: No plane, mechanical axis of radius
ROM: ~90 degree supination, 60 degree pronation
Proximal radioulnar joint ligaments
Capsule
Annular ligament
Oblique cord
Olecranon bursae
Anterior and posterior fat pads
Proximal radioulnar joint capsule
Continuous with capsule of radio- and ulno-humeral joints
Proximal radioulnar joint annular ligament
Encircles the radial head and ensures correct radial alignment with respect to the humerus and ulna
Forms 4/5 of the articulating surface
Limit/restricts: lateral and inferior motion of radius
Proximal radioulnar joint oblique cord
Orientation inferolateral from the anterior aspect of the ulna to anterior radius
Limits/restricts: supination and inferior radial displacement
What joint does this describe:
Distal trapezium with base of 1st metacarpal. Biaxial saddle synovial joint
1st CMC joint
Proximal radioulnar joint anterior and posterior fat pads of the elbow
Intracapsular fat between the synovial membrane and capsule
Offer some cushion and protection to the joint
Middle/intermediate radioulnar joint articulating surfaces
Interosseous boarders of radius and ulna
Middle/intermediate radioulnar joint classification
Fibrous, syndesmosis, amphiarthrodial joint
Middle/intermediate radioulnar joint motion
Supination/pronation
Middle/intermediate radioulnar joint ligaments
Interosseous membrane
Middle/intermediate radioulnar joint interosseous membrane
Attaches superior lateral to inferior medial between border of radius and ulna
Limits/restricts: supination and pronation; fibre direction of the membrane help to transfer force from distal radius to ulna to humerus with FOOSH
Distal radioulnar joint articulating surfaces
Head of ulna
Ulnar notch of radius
Distal radioulnar joint classification
Uniaxial, pivot, synovial joint
Distal radioulnar joint movements permitted
Supination/pronation
Distal radioulnar joint ligaments
Capsule
Anterior (palmer/volar) and posterior (dorsal) radioulnar ligament
Trifolar/ triradiate cartilage/ disc
Distal radioulnar joint capsule
Encloses the joint, but is deficient superiorly
The synovial membrane extends superiorly to accommodate twisting of capsule with radial motion in pronation
Distal radioulnar joint anterior (palmar/volar) and posterior (dorsal) radioulnar ligament
Transverse orientation between distal radius and distal surface of ulna
Limit/restrict: Anterior fibres limit supination, posterior fibres limit pronation
Distal radioulnar joint trifolar/triradiate cartilage/ disc
Attaches between ulnar notch of radius and ulnar styloid
Separates the distal radial joint from the wrist joint (radiocarpal joint)
Limits/restricts: cushions impact between carpals and radius and ulna
Radiocarpal joint articulating surfaces
Distal radius and trifolar cartilage (concave)
Proximal row of carpals: Scaphoid, lunate (and triquetrum in extreme ulnar deviation) (convex)
Radiocarpal joint classification
Biaxial, condyloid, synovial joint
Radiocarpal joint movements permitted
Flexion/extension; sagittal plane, medial lateral axis (ROM: ~85 degree flexion, 75 degree extension)
Radial-ulnar deviation; frontal plane, anterior posterior axis (ROM: ~ 20 degree radial deviation, 40 degree ulnar)
Radiocarpal joint ligaments
Capsule
Anterior (palmar) radiocarpal ligament
Posterior (dorsal) radiocarpal ligament
Ulnocarpal ligament (anterior and posterior)
Medial/ulnar collateral
Lateral/radial collateral
Radiocarpal joint capsule
Attaches distal radius and ulna to proximal carpals
Loose
Many folds
Separate from capsule from the distal radioulnar joint
Radiocarpal joint anterior (palmar) radiocarpal ligament
Long and short radioulnate, radioscaphoid, and radiotriquetral bands
Limit/restrict: wrist extension, causes hand to follow radius in supination
Attaches distal radius to carpals anteriorly
Radiocarpal joint posterior (dorsal) radiocarpal ligament
Attaches distal radius and radial styloid to triquetrum and lunate
Limit/restrict: wrist flexion, causes the hand to follow radius in pronation
Radiocarpal joint anterior (palmar) ulnocarpal ligament
3 bands: ulnotriquetral, ulnocapitate and ulnoluntae
Limits: extension and controls carpal motion
Radiocarpal joint medial/ulnar collateral
Attaches between ulnar styloid and triquetrum
Limits/restricts: radial deviation, strengthen capsule
Radiocarpal joint lateral/radial collateral
Attaches between radial styloid, scaphoid, trapezium, and 1st metacarpal
Limit/restrict: ulnar deviation, strengthens capsule
Intercarpal/midcarpal joint articulating surfaces
Proximal row of carpals: scaphoid, lunate, triquetrum (concave)
Distal row of carpals: trapezium, trapezoid, capitate, hamate (convex)
Intercarpal/ midcarpal joint classification
Nonaxial, plane, synovial joint
Intercarpal/ midcarpal joint movements permitted
Gliding
Intercarpal motion arguments that at the wrist
Motion at the midcarpal joint occurs primarily with wrist flexion/extension and ulnar-radial deviation
Intercarpal/ midcarpal joint ligaments
Capsule
Anterior (palmar) radiocarpal ligament
Posterior (dorsal) radiocarpal ligament
Media/ulnar collateral
Lateral/radial collateral
Interosseous ligaments
Intercarpal/ midcarpal joint capsule
Helps to unite the carpals
Intercarpal/ midcarpal joint anterior (palmar) radiocarpal ligament
Long and short radioulnate, radioscphoid, and radiotriquetral bands
Limits/restricts: wrist extension, causes the hand to follow radius in supination
Intercarpal/ midcarpal joint posterior (dorsal) radiocarpal ligament
Attaches distal radius and radial styloid to triquetrum and lunate
Limit/restrict: wrist flexion, causes the hand to follow radius in pronation
Intercarpal/ midcarpal joint medial/ ulnar collateral
Proximal insertion at the ulnar styloid
Attches between ulnar styloid and triquetrum
Limits/ restricts: Radial deviation, strengthens capsule
Intercarpal/ midcarpal joint lateral/ radial collateral
Proximal insertion at the radial styloid
Attaches between radial styloid, scaphoid, trapezium, and 1st metacarpal
Limits/restrict: ulnar deviation, strengthen capsule
Intercarpal/ midcarpal joint interosseous ligaments
Attached between adjacent carpal bones within the same row
NOT between rows!
Limit/restrict: joint distraction
1st Carpometacarpal (CMC) joint articulating surfaces
Base of 1st metacarpal
Distal trapezium
1st CMC joint classification
Biaxial, saddle, synovial joint
1st CMC joint movements permitted
Flexion/ extension: frontal plane, anterior-posterior axis
Abduction/ abduction: sagittal plane, medial-lateral axis
Opposition (combination, motion of abduction, flexion, and abduction)
1st CMC joint ligaments
Capsule
Lateral collateral
Anterior and posterior CMC ligaments
Interosseous CMC ligaments
1st CMC joint capsule
Loose to allow free motion
Separate from 2nd-5th CMC joints
1st CMC joint lateral collateral
Attaches lateral trapezium to radial side of base of 1st MC
Limits/restrict: Adduction
1st CMC joint anterior and posterior CMC ligaments
Attach anterior and posterior surfaces of adjacent bones
Limit/restrict: hyperflexion and extension
1st CMC joint interosseous CMC joint
Attached between adjacent bones
Limit/restrict: joint distraction
2nd-5th CMC joint are articulating surfaces
Base of 2nd MC with trapezoid
Base of 3rd MC with capitate
Base of 4th MC with capitate and hamate
Base of 5th MC with hamate
2nd-5th carpometacarpal joint classification
2nd-4th CMC: nonaxial, plane synovial joint. Allows flexion/ extension
5th CMC: biaxial, saddle, synovial joint. Allows flexion/ extension and adduction/ abduction
2nd-5th carpometacarpal joint movements permitted
Gliding with flexion/extension, and radial-ulnar deviation
ROM available at the CMC joints increases towards the ulnar side with the 2nd and 3rd joints being a stable point around which others move
2nd-5th carpometacarpal joint ligaments
Capsule
Anterior and posterior CMC ligaments
Interosseous CMC ligament
2nd-5th carpometacarpal joint capsule
Continuous capsule between 2-5
2nd-5th carpometacarpal joint anterior and posterior CMC ligaments
Attach anterior and posterior surfaces of adjacent bones
Limits/restricts: hyperflexion and extension
2nd-5th carpometacarpal joint interosseous CMC ligament
Attached between adjacent bones
Limit/restrict: joint distraction
Intermetacarpal joint articulating surfaces
Surfaces of adjacent basis of metacarpals 2-5
Intermetacarpal joint classification
Nonaxial, plane, synovial joint
Intermetacarpal joint movements permitted
Gliding with movement of the CMC joints
Mettacarpophalangeal (MCP) joint articulating surfaces
Head of metacarpal (convex)
Base of proximal phalanx (concave)
Mettacarpophalangeal (MCP) joint classification
Biaxial, condyloid, synovial joint
Mettacarpophalangeal (MCP) joint movements permitted
Flexion/extension: sagittal plane, medial-lateral axis
Adduction/ abduction: frontal plane, anterior-posterior axis
Reference point is the 3rd digit
Mettacarpophalangeal (MCP) joint ligaments
Capsule
Deep transverse metacarpal ligament
Lateral/radial and medial/ulnar collaterals
Volar fibrocartilangeous plate/ palmar ligament
Mettacarpophalangeal (MCP) joint capsule
Each joint has its own capsule
Mettacarpophalangeal (MCP) joint deep transverse metacarpal ligament
On the anterior surface of 2nd-5th MC’s
Limits/restrict: separation of MC heads
Mettacarpophalangeal (MCP) joint lateral/radial and medial/ulnar collaterals
Fuse with the anterior capsule
Holds volar plate on joint
Limits/restrict: lateral stresses
Mettacarpophalangeal (MCP) joint volar fibrocartilagenous plate/ palmar ligament
Thick, dense plate located anterior to the joint
Blends with deep transverse MC ligament proximally
Limits/restrict: hyperextension, prevents impingement of the flexor tendons in the joint, reinforces capsule
Proximal and distal interphalangeal (PIP, DIP) joint articulating surfaces
Head of proximal phalanx (convex)
Base of distal phalanx (concave)
Proximal and distal interphalangeal (PIP, DIP) joint classification
Uniaxial, hinge, synovial joint
Proximal and distal interphalangeal (PIP, DIP) joint movements permitted
Flexion/extension: sagittal plane, medial-lateral axis
ROM increases ulnarly and the PIPs vs DIPs
Proximal and distal interphalangeal (PIP, DIP) joint ligaments
Capsule
Lateral/radial and medial/ulnar collaterals
Volar fibrocartilagenous plate/ palmar ligament
Proximal and distal interphalangeal (PIP, DIP) joint capsule
Each IP joint has its own capsule
Proximal and distal interphalangeal (PIP, DIP) joint lateral/radial collateral ligaments
Limits varus strain
Proximal and distal interphalangeal (PIP, DIP) joint medial/ ulnar collateral ligaments
Limits valgus strain
Proximal and distal interphalangeal (PIP, DIP) joint volar fibrocartilagenous plate
Limits extension
Prevents impingement of flexor tendons
Radiocarpal joint posterior (dorsal) ulnocarpal ligament
Attaches distal ulna and trifolar cartilage to triquetrum and lunate posteriorly
Limits: flexion and controls carpal motion