Bones and Joints of the Upper limb Flashcards
What movement is restricted as the glenohumeral capsule tightens with age?
Abduction
What two structures on the humerus articulate with the radius and ulnar?
Capitulum
Trochlea
Which rotator cuff muscle lie posteriorly to the joint?
Teres minor
Infraspinatus
Which joints are contained in the elbow complex capsule
Elbow joint
Proximal radioulnar joint
What are the attachments of the lateral collateral ligament?
Humerus
Annular ligament
Why are children more likely to get student’s elbow?
The annular ligament is weaker in children
Describe two features of hyaline/articular cartilage
Avascular
Aneural
What are the names of the two collateral ligaments of the elbow complex?
Medical collateral ligament
Lateral collateral ligament
What do the collateral ligaments attach to?
The epicondyles
What can happen if the rotator cuff muscles are weak?
The humerus slide upwards with the movement of the deltoid
What commonly happens the subacromial bursa in certain sports?
Bursitis
What aspect/side of the ulnar is the coronoid process on?
Anterior
What happens to hyaline cartilage with age?
It breaks down and is replaced by bone
What is the scapulo-thoracic joint?
A pseudo-joint between the scapulae and chest wall
What do all hinge joint have?
Collateral ligaments
Why is the a fold in the glenohumeral capsule?
Increase range of motion
Which rotator cuff muscle lie anterior to the joint?
Subscapularis
What does the synovial membrane do?
Lines all non-articular surfaces within the capsule
What is located in the olecranon fossa?
Olecranon bursae - fat pads to facilitate movement
Which radioulnar joint has a triangular fibrocartilage complex (disc)?
The distal one
What are bursae?
Sacks of synovial fluid
What is the purpose of having an attachment between the LCL and annular ligament?
Allows pronation and supination of forearm
What makes the acromioclavicular joint vunerable to dislocation?
It is in the sagittal plane
How can you test if the axillary nerve has been damaged in a dislocation?
Prick the skin innervated by that nerve
What joins the shaft of the ulnar and radius?
Interosseous membrane
What is a labrum?
Fibrous socket that increases the depth of a joint
Which side of the humerus does the head of the radius articulate?
Lateral
What is cubitus vulgus?
Abnormal abduction of forearm when in extension
How does the clavicle afffect the glenohumeral joint?
Increase the range of motion
What is the name of the feature of the ulnar that forms the point of the elbow?
Olecranon
What does the coracoclavicular joint connect?
Coronoid tubercle of the clavicle to the coronoid process of the scapulae
What does congruent mean in terms of joints?
There is a relatively high amount of surface articulating
When does subluxation of the sternoclavicular joint occur?
Rarely, mainly associated with trauma
Describe two features of the glenohumeral joint
Incongruenous - large head of humerus into shallow gleno fossa
Loose capsule on the medial surface - enables movement
What are the names of the joints of the clavicle?
Stenoclavicular joint
Acromioclavicular joint
What is the function of fat pad within a joint?
Spread synovial fluid
What stabilises the acromioclavicular joint?
Coracoclavicular ligament
What can attach to a labrum?
Muscle
What type of dislocation is associated with a fracture of the coronoid process?
Posterior
In what position is the elbow joint most secure?
Full extension
What is the difference between an epiphysis and fracture on a x-ray?
Fracture are jagged, epiphyses are straight
What muscle attaches to the gleno-labrum?
Long head of the bicep
Describe a grade 3 acromioclavicular subluxation
The acromioclavicular ligament and coracoclavicular ligament are both ruptured
What are the 5 layers of the glenohumeral joint
Bone
Labrum
Capsule
Tendons
Coraco-acromial ligaments
What stabilises fibrous capsules?
Intrinsic/extrinsic ligaments
Muscles
Where does the capsule of the glenohumeral joint attach to the humerus
Anatomical neck above
Surgical neck below
What are the implications of the tight connection between bones made by the interosseous membrane?
A force that breaks one bone can be transferred to break the other
The two RU joints function as together
What rotator cuff muscles lies superiorly to the joint
Supraspinatus
Which rotator cuff muscles lie inferiorly to the joint?
None
What are the key features of the sternoclavicular joint?
Strong fibrouscapsule and intra-articular disc
Very stable
Costoclavicular joint for stability
What can cubitus vulgus result in?
Friction of the ulnar nerve
Which collateral ligament of the of the elbow joint is stronger?
The medial
Where the rotator muscle originate and insert?
Originate - Scapulae
Insert - Glenohumeral capsule
What is the most common direction of shoulder dislocation? Why?
Inferio-anterior
No inferior rotator cuff muscle
What are the potential complications with bursae?
Infection can spread through them
What is an avulsion injury?
An injury where there is tear off of a limb
What is an epiphyses?
The end of a long bone that articulates at a joint
What is the function of disc/menisci within joints?
Absorb shock
Fill out any irregularities
What are the 4 muscles of the rotator cuff?
Teres minor
Infraspinatus
Supraspinatus
Subscapularis
What is the function of collateral ligaments?
Prevent abduction and adduction
What occurs in students elbow?
Radial head is pulled out of the annular ligament
What 2 structures protect the head of the humerus?
Subacromial bursa
Subacromial ligament
Where do fat pads lie within joints?
Intra-articular but extrasynovial
Where are three common sites for fracture of the humerus?
Surgical neck
Mid-shaft
Supracondylar
Where are factures of the clavicle most common?
Between the lateral 1/3 and medial 2/3s - the point of greatest curvature therefore weakness
Name the carpal bones, from lateral to medial
Scaphoid
Lunate
Triquetral
Pisiform
Trapezium
Trapezoid
Capitate
Hamate
What is a sesamoid bone?
A bone located in a tendon
What type of bone are metacarpals?
Long bone
What do sesamoid bones do?
Create a tunnel
Reduce friction
What forms the floor and proximal wall of the anatomical snuff box?
Floor: scaphoid
Wall: Styloid process radius
What do retinaculum do?
Hold down tendons, in and around joint usually
Which nerve is affected in carpal tunnel syndrome?
Median nerve
Where are the sesamoid bones of in the hand?
Pisiform - carpal
Thumb x2
Index finger (aka second finger)
Which tendon is the pisiform bone inside?
Flexor carpi ulnaris
Which carpals bones have tubercles?
Scaphoid
Trapezium
Which carpal bone is the largest?
Capitate
Which carpals make up the radialcarpal joint?
Scaphoid
Lunate
Which is the first carpal to ossify?
Capitate
In what direction do the carpal bone sequentially ossify?
Anti-clockwise
What type of joint is the radiocarpal joint?
Synovial, Ellipsoid
What makes up the wrist complex?
Radiocarpal joint
Intercarpal joint
What movements happen at the wrist complex?
Flexion/Extension
Radial/Ulnar deviation
Which movement is greatest at the wrist, flexion or extension?
Flexion
Which movement is greatest at the wrist, ulnar or radial deviation?
Ulnar
Which intercarpal joint is the most important?
Scaphoid and lunate with the capitate
How do the movements at intercarpals differ from the radiocarpal?
Opposite
Greater flexion
Greater radial deviation
What direction do the intercarpal ligaments generally run?
From the radius to across to the carpals
What is the primarily purpose of the intercarpal ligaments?
Preventing the carpals from sliding proxi-medially
Which side of the palm has more ligaments, the palmar or dorsal?
Palmar
Where do the tendons of the forearm muscles generally attach?
Metacarpals
Where is the radius most commonly fractured?
Distal end
Which carpal is most commonly fractured?
Scaphoid
Which carpal is most commonly subluxed?
Lunate
What does FOOSH stand for?
Fall on out stretched hand
What commonly results from a fall on out stretched hand?
Fracture of distal radius causing dinner fork structure
What can happen to scaphoid blood supply after a fracture?
Blood supply to the proximal end is removed - avascular necrosis
What type of joint in the thumb carpometacarpal?
Saddle
What movements happen at the metacarpophalangeal joints?
Extension/Flexion
Add/Abd
What extra movement does the thumb joint allow?
Opposition
What is a condyloid joint?
Oval shape into ellipsoid cavity
What is the volar plate?
Fibrocartilaginous joint that increases the articular surface of the metacarpophalangeal and interphalangeal
What occurs in a Swan neck deformity?
A phalanx bone breaks through the ventral volar plate
What occurs in a Boutonniere deformity?
Phalanx breaks through a dorsal volar plate
