Chapter 6- Upper Limb Flashcards
Upper limb is connected to the trunk by the shoulder girdle consisting of the ______ and the _____ that articulates with the axial skeleton at the sternoclavicular join.
- Scapula
- Clavicle
Upper limb include following regions:
- shoulder girdle
- upper arm (brachial)
- the elbow (cubital)
- forearm (ante brachial)
- wrist (carpal)
- hand
Bones of the upper limb include:
- Scapula
- clavicle
- humerus
- radius
- ulna
- carpal bones
- five metacarpal bones
- five proximal, distal and intermediate phalanges
Scapula is located on the back of the ____ and has two surfaces called _____ and ______. Spine of scapula divides into 2 parts, the _____ and ______.
- shoulder
- anterior (sub scapular fossa) and posterior surface
- supraspinous and infraspinous
Spine of scapula bears and expansion laterally called _____, which articulates with clavicle.
Acromion process
Three borders of scapula:
Three angles of scapula:
- Medial, lateral, and superior borders
- superior, inferior and lateral angles
Which site of articulation with head of humerus, located at lateral angle of scapula _______
Glenoid cavity
______ is above the Glenoid cavity and extends anterolaterally. Gives origin to or is an insertion site for 3 muscles: short head of biceps brachii, coracobrachialis muscle, and pectoralis minor.
Coracoid process
_____ is bridged at its top by the superior transverse scapular ligament. And beside base of the coracoid process on superior border of scapula.
Supra scapular notch
What runs through the supra scapular notch?
-suprascapular nerve and vessels
S-shaped bone with a superior and inferior surface, it had an anterior and posterior border as well.
Clavicle
Clavicle bone is convex anteriorly for its medial _____, and concave anteriorly for its lateral____. It has two ends, the _____ end and the ______ end, which are covered by _____ and form articular facets to articular with the sternum at the _____ end with the acromion at the _____ end.
- 2/3
- 1/3
- sternal
- acromial
- hyaline cartilage
- sternal end
- acromial end
(Clavicle region) Synovial joint that is supported by several surrounding ligaments, it’s a ball and socket type joint.
Sternoclavicular joint
(Clavical region) Joint that is a plane type joint that permits sliding/gliding movements w
Acromioclavicular joint
Ossification of the clavicle occurs in the ______ tissue, similar to that of the skull bones during _______. Two ends have _____ ossification, which appears in the second decade of life and ossified centers fuse to each other after that.
- connective
- fetal development
- endochondral ossification
Normal female. Ask to push during baby delivery and push too hard and break clavicle. This is called ____
Cleidocranial dysostosis
Long bone compromised of a shaft and two ends: proximal and distal ends.
Humerus
_____ end, Head of the humerus, articulates with _____ cavity of scapula in the shoulder joint. And distal end articulates with _____ and ___ in elbow joint. The _____ is cylindrical is upper section and triangular in lower section. Three surfaces can be distinguished on humerus and 3 borders.
- proximal
- gleniod
- radius and ulna
- shaft
Proximal end: Head of the ______ is semi-ball like structure with a smooth, articular surface covered by hyaline cartilage. Fits in the ____ cavity of the scapula and forms the shoulder joint. Inferior to the head lies the circumference, and where the articular surface ends and joins the shaft is known as the ______ neck of the humerus, followed by greater and lesser ______. Surgical neck is found _____ to the tubercles. ____ groove lies between the greater and lesser tubercles, through which tendon of the long head biceps brachii muscles passes. _____ tuberosity can be seen on the lateral aspect of the middle shaft, and the _____ groove lies on posterior surface in middle of the shaft humerus.
- humerus
- gleniod
- anatomical
- tubercles
- intertubercular (bicipital)
- deltoid
- radial
What passes through the spiral groove?
Radial nerve and deep brachial vessels
Distal end: there are two sharp edges (ridge), medial and lateral _____ edges, which continue distally to the medial and lateral non articular ____ of the humerus. Medial condyle is larger and bears the ______ groove posteriorly. Condyles of humerus are ____. The capitulum articulates with the head of the _____ and the trochlea articulates with the _____ at the trochlear notch. Anteriorly, ______ is found above the capitulum and the coronoid fossa above the trochlea. On posterior aspect of distal humerus the bigger size ____ fossa can be seen.
- suprachondylar
- epicondyles
- ulnar
- articular
- radius
- ulna
- radial fossa
- olecranon
Medial epicondyle is larger and bears the ulnar groove posteriorly, through which the ______ nerve passes beneath the skin.
Ulnar
Elbow flexed or extended? These fossae accommodate space for the edge of the circumference of the head of the radius and the coronoid process of the ulna.
Elbow flexed
Elbow flexed or extended? The olecranon process of the ulna fits in the latter fossa.
Elbow extended
Is a ball and socket type synovial joint between the head of the humerus (ball) and the gleniod cavity (socket), which is expanded by an articular lip at its border.
Shoulder joint
The long head of the biceps brachii muscle originates from the supraglenoid tubercle, passing through the joint into the ______.
Bicipital groove
The rotator cuff muscles help strengthen the _____ joint.
Shoulder
Capsule of the shoulder joint is supported by several ligaments: ____ and ______
- coracohumeral ligaments
- glenohumeral ligaments
______ ligament restricts the movement found in the shoulder joint and a few bursae are associated
Coracoacromial ligament
Movements of the shoulder joint are:
Abduction, addiction, anteversion (flexion), retroversion (extension), lateral and medial rotation and circumduction of the arm.
In humerus, the ulnecranon deep fossa allow for _____.
Elbow bend
Fractures of surgical neck in humerus leads to damage of ______ nerve. It’s affect the _____, which helps in abduction of the arm.
- Auxiliary
- deltoid
Fractures of the middle of the shaft, may cause injury to the ______ nerve. This leads to _____.
- Radial
- wrist drop
Fracture of the distal end of humerus leads to injury of _____ nerve. This leads to not being able to do _____
- medial
- flexion of fingers
Fracture of medial epicondyle leads to injury to _____ nerve.
Ulna
Traumatic separation of the _____ epiphysis under 18-29 years. Also in younger children since the capsule is _____
- proximal
- stronger
Long bone that’s found laterally in forearm and consists of a body and 2 ends
Radius
Proximal end of the radius consists of the _____ and _____. Inferior to the neck, ______ is found.
- head
- neck
- radial tuberosity
The triangular-like body of the radius had 3 surfaces:
3 borders:
- anterior
- lateral
- posterior
- anterior
- posterior
- medial (interosseous) border
Distal end of the radius is expanded and has a _____ tip inferiorly called the ______ located laterally. The ulnar notch is located ____for articulation with the head of the ulna, carpal articulation surface is located _____ for articulation with proximal row carpal bones. Several grooves for the passage of _____of various extensor muscles are found on the posterior aspect of the _____
- sharp
- styloid process
- medially
- distally
- tendons
- distal radius
The other forearm and is located medially in anatomical position. Consist of a body and two ends
Ulna
Proximal end of the ulna consist of a large hooklike cavity, ______ which articulates with trochlea of distal ______. Sharp bony point, ____ is found anteriorly on lower edge of the trochlear notch. ______ is a Lateral expansion of the articular surface close to the trochlear notch, for articulation with the circumference of the head of the radius. Rough part of the proximal end of ulna posteriorly is called the_____ process. Site of attachment of brachialis muscles is called the_____ tuberosity, which is inferior to the coronoid process on the anterior view, just inferior to the proximal end of the ulna.
- trochlear notch
- humerus
- coronoid process
- radial notch
- olecranon process
- ulnar
Ulna-triangular like body has 3 surfaces:
3 borders:
In the upper part of the body lateral to ulnar tuberosity and inferior to the radial notch the ______ is seen
- anterior, medial, and posterior
- anterior, posterior, and medial (interosseous)
- supinator crest
Distal end of the ulna bears the head, equipped with an articular circumference for articulation with the_____ of the distal radius. The _____is not in direct contact to the carpal bones, rather it is the ____ that has such connection. Therefore, wrist joint is often called _____ joint. A small, sharp, bony distal expansion of the lower end of ulna called _____ of ulna can be seen behind the ulnar head.
- ulnar
- ulna
- radius
- radio carpal
- styloid process
Colles fracture
Fracture of the distal end of the radius, posterior displacement. Falling on hands with extended arm (falling on ice). May be accompanied by Avulsion (fracture) of ulnar styloid process. Posteriorly X-ray, looks like dinner fork. May have injury to median and ulnar nerves
All muscles posterior aspect of arm/forearm affect the ____ nerve. Leads to _____.
- Radial
- wrist drop
Falling on the hand with the arm extended. During a slip and fall, as one foot slide out in front, person goes down slightly sideways and lands on the heel of the extended hand
Colles fracture
In X-ray, giving a dinner fork shape to the forearm is ______deformity
Silver fork
Synovial joint. Capsule compromises 3 joints, the humeroulnar, humeroradial, and proximal radio ulnar joints (compound joint). Supported by several ligaments, including the 2 collateral ligaments-medial/ulnar and lateral/radial-restricts the movements.
Elbow joint
Movements of the elbow joint include:
Flexion. Extension of elbow. As well as supination, pronation of forearm. Latter movements assisted by middle and distal radio carpal joints. Proximal radio ulnar articulation is a pivot joint, and head of radius is supported by the surrounding annular ligament.
Joints between the radius and ulna include the middle _____ joint, which is the interosseous membrane and is a continuous joint. And _____ joint, which is synovial and pivot type joint. _____ and _____ of the forearm are possible on these joints.
- radio ulnar
- distal radio carpal
- pronation and supination
An ulnar (medial) collateral ligament injury In a sprain may lead to abnormal ____of the forearm.
Abduction
A radial (lateral) collateral ligament injury in a spray may lead to abnormal ____ of the forearm
Adduction
These bones are located near the wrist joint and are arranged in two rows, each row with 4 bones.
Carpal bones
Carpals bones are firmly articulated together to form a unit, called _______, which concave on the palmar side
Carpal groove
The carpal groove is covered by the ______, forming the carpal tunnel, through which several muscles and the median nerve pass
Flexor retinaculum
Lying from a lateral to a medial direction in an anatomical position, the proximal row of carpal bones includes the ______, which has a prominent ______ of scaphoid at its palmar (anterior) surface. It articulated with the ____ 1superiorly and with the neighboring carpal bones inferiorly and medially.
- scaphoid
- tubercle
- radius
The first carpal bone in the distal row is the ______. This bone has a tubercle on its anterior aspect, and medial to the tubercle is a groove through which the tendon of the _______ muscle passes. The second bone in the distal row ______, the third is ______ (largest bone in the second row), and the most medial bone is the _____, which bears a ______, on its anterior surface.
- trapezium
- flexor carpi radialis muscle
- trapezoid
- capitate
- hamate
- hamulus
Upper extremity fractures are among the most ____fractures of the skeletal system
Common
Carpal bone fractures account for ____ of hand fractures, and of the carpal elements, the bones in the proximal row are the most frequently fractured. The most commonly fracture carpal bone is the _____, representing ____ of fractures in the carpal group and ____ of all hand fractures. Triquetral fractures are the second most common, accounting for ____ of wrist injuries. The incidence of isolated fractures of any remaining carpal bones is comparatively low.
- 18%
- scaphoid
- 70%
- 10%
- 14%
Carpal injury is typically a result of ____ or _____ trauma. In general, mechanisms that cause carpal fractures are injuries of moderately _____. If diagnosis is not established early or if a displaced fracture is not recognized, _____ may result.
- direct, indirect
- high energy
- disability
Two rows of the carpal bones produce the ______, which is concave anteriorly.
Carpal groove
Flexor retinaculum consists of two different fibrous structures with different histology characteristics, which are present in the ____ aspect of the _____. More superficial layer is in continuity with _____ and could be considered its reinforcement , deeper one is composed of strong lamina, with histological features similar to those of a ligament.
- volar
- wrist
- ante brachial fascia
Flexor retinaculum inserts to _____ points that are palpable in the anterior aspect of the wrist. These points are the tubercle of the ____, the _____, the tubercle of the ____, and the hook of the _____.
- 4 bony
- scaphoid
- pisiform
- trapezium
- hamate
Flexor retinaculum that covers the carpal groove forms the ____, through which the tendons of some flexor muscles of the wrist and hand pass, along with the ____ nerve.
- carpal tunnel
- median
A very painful condition of the anterior region of the wrist joint, caused by compression of the median nerve in the carpal tunnel. The most common cause of carpal tunnel syndrome is repetitive movement of the wrist, such as typing. This compression may also be due to a variety of conditions, such as hypothyroidism, rheumatoid arthritis, pregnancy, and amyloidosis. Also known as ______ syndrome
- Carpal tunnel syndrome
- compartment
Courses of surgical and non surgical treatments are recommended to help relieve ______. Early surgery is an option, either with clinic evidence of _____ denervation or when the patient so elects. Local steroid injection or splinting is suggested before surfer. Also oral steroids. Surgical treatment of carpal tunnel syndrome by compete division of the _____ is recommended
- carpal tunnel syndrome
- median nerve
- flexor retinaculum
_____ is the most dislocated carpal bone. Most commonly dislocated and disturbs _____ nerve (anterior displacement).
- lunate
- median
Is an ellipsoid type synovial joint whose joint surfaces are created proximally by the radius and articular discs (located between distal end of the ulna and the proximal row of carpal bones), and distally by the proximal row of carpal bones
Wrist (radio carpal) joint
Movements of wrist joint:
- abduction (radial deviation)
- adduction (ulnar deviation)
- flexion and dorsiflexion
- circumduction
These ligaments support and reinforce the wrist joint:
- ulnar and radial collateral ligament
- palmar and dorsal radio carpal ligament
- palmarulnocarpal ligament
There are 5 metacarpal bones in the head, first is the thumb and fifth is on the side of the little finger. Each metacarpal bone has a ____; a ____ which is toward the phalanges and a ____, which features articular surfaces to articular with the carpal bones.
- body
- head
- base
A saddle joint, includes abduction, adduction, opposition, reposition, and circumduction of the thumb.
1st carpometacarpal
This joint is a S shaped. There’s a little movement between the bones of the first row, but almost no movement at all between the second row, and between these joints and the metacarpal bones, first carpometacarpal joint
Carpal bones
