Elbow & Hand Joints

Question 1

What makes up the elbow joint?

Answer 1

3 bony articulations in a single joint capsule:
1. Humeroulnar: Tochlear + tochelar notch (ulna)
2. Humeroradial: Fovea (radius) + Capitulum
3. Proximal Radio-ulnar: Head of radius + radial notch (ulna)

Question 2

What type of joint is the humeroulnar & humeroradial?

Answer 2

“elbow joint”
-synovial hinge joint: flexion & extension

Question 3

What type of joint is the proximal radio-ulnar joint?

Answer 3

synovial pivot joint = rotation

Question 4

Fibro-osseous ring?
Annular ligament?

Answer 4

Both on the proximal radial-ulnar joint:

FR: articular cartilage covering the radial notch of the ulna

AL: Strong fibrous band lined by cartilage continuous with radial notch lining

Question 5

Elbow joint ligaments (4)?

Answer 5

1. Medial/ulnar collateral ligament
2. Lateral/radial collateral ligament
3. Anterior ligament
4. Oblique anterior ligament

Question 6

Function of medial/ulnar & lateral/radial collateral ligaments?

Answer 6

-keep articular surfaces in opposition
-keep trochlear notch fitted (prevent sideways movement)

Question 7

Function of anterior and oblique anterior ligaments?

Answer 7

-strengthen capsule anteriorly

Question 8

Where is the axis of motion?

Answer 8

Slightly distal to the epicondyles

Question 9

What is the carrying angle?

Answer 9

• 5-19 degrees (about 0-6 degree more pronouced in women due to hips)
• arms deviate laterally
  -permits arm to be swung without contacting hips

Question 10

Cubitus varus vs cubital valgus?

Answer 10

VARUS: Deformity where extended forearm deviates toward sideline

VALGUS: deformity where elbow is turned in

Question 11

Elbow flexion degrees & muscles (3)?

Answer 11

Passive (145), Active (160)

1. Biceps
2. Brachialis
3. Bachioradialis

Question 12

Elbow extension degrees & muscles (2)?

Answer 12

extension (0), hyperextension (5-10)
-women & children greater laxity

1. Triceps
2. Anconeus

Question 13

Inferior/distal radio-ulnar joint AS & type?

Answer 13

AS: ulnar head + ulnar notch (radius)
TYPE: synovial pivot joint
MOVEMENT: rotation

Question 14

Function of articular disc @ inferior/distal radio-ulnar joint?

Answer 14

Aritcular disc: binds radius & ulnar together while separating distal radioulnar joint & ulnar from radiocarpal joint

Question 15

Ligaments at distal radio-ulnar joint (2)?

Answer 15

1. Palmer/ anterior radio-ulnar ligament
2. Dorsal/ posterior radio-ulnar ligament
   support joint anteriorly and posteriorly

Question 16

Middle radio-ulnar joint type?

Answer 16

amphiarthrosis, syndesmosis joint

interosseous membrane: ligamentous connection between the bodies of ulna + radius

Question 17

Rotators of radius - supinators (2)?

Answer 17

Supination (90):
1. Biceps
2. supinator

Question 18

Rotators of radius-protonators (2)?

Answer 18

Pronation (90):
1.Pronator teres
2. Protonator quadraturs

Question 19

What are the 3 components of the wrist complex?

Answer 19

1. Radio-carpal joints
2. Mid-carpal joints
3. Intercarpal joints

Question 20

Radio-carpal joint AS, type & movement?

Answer 20

AS: radius + proximal row of carpal bones (except pisiform)
TYPE: Condyloid/ellipsoid
MOVEMENTS: flexion/extension, abd/add

Question 21

Mid-carpal joint AS, type & movement?

Answer 21

AS: distal & proximal rows of carpal bones (except pisiform)
TYPE: Synovial planar
MOVEMENT: slide & glide

Question 22

Intercarpal joints AS, Type & Movement?

Answer 22

AS: small group between carpal bones
TYPE: synovial planar
MOVEMENT: Slide & glide

Question 23

Ligaments at the wrist complex (4)and where do the first 2 extend to?

Answer 23

1. Collateral Ligaments:
   lateral: styloid process (radius) - scaphoid bone
   medial: styloid process (ulna) - pisiform & triquetrum
2. Anterior/Posterior Ligaments:
   Radiocarpal
   Radioulnar

Question 24

Degrees of radial & ulnar deviation & which ligaments are stretched/pinched?

Answer 24

Radial deviation/ abd (15):
- RCL pinched, UCL stretched

Ulnar deviation/add (30):
-UCL pinches, RCL stretched

Question 25

Degrees of wrist flexion & extension & which ligaments are stretched/pinched?

Answer 25

Wrist flexion (85):
Anterior pinched, posterior stretched

Wrist extension (85):
Posterior pinched & anterior stretched

Question 26

Carpometacarpal joint AS, type, movement?

Answer 26

1ST JOINT
AS: thumb & trapezium
Type: Modified saddle joint
MOVEMENT:
flex/ext
abd/add
opposition
rotation possible (thick loose joint capsule)

2nd - 5th articulate in a irregular matter

Question 27

Metacarpophalangeal joint type and movements with degrees?

Answer 27

synovial condyloid/ellipsoidal - 2DOF
Flexion (90)
hyperextension (0-45)
abduction (20)
adduction (20)
***abd/add with finger flexion = 0 as collateral ligaments are taught at 90 degrees.

Question 28

Ligaments at MCP joints (2)?

Answer 28

1. Medial & lateral collateral ligaments: head of metacarpals to base of phalanges
2. Palmer plates: Support ventrally

Question 29

Interphalangeal joints type & movements with degrees?

Answer 29

Hinge joints - 1DOF:
-PIP flexion: (120)
-DIP flexion: (90)

-PIP hyperextension: (0)
-DIP hyperextension: (5-10)