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Clinical Anatomy 2 > elbow, wrist, hand > Flashcards

elbow, wrist, hand Flashcards

1
Q

in the frontal plane, how much valgus is there?

A

6 degrees

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2
Q

in the sagittal plane, how much anterior rotation is there?

A

30 degrees

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3
Q

what kind of joint is the humeroulnar

A

hinge

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4
Q

how is the humeroulnar joint formed

A
  • concave trochlear notch of ulna

- convex trcohlea of humerus

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5
Q

how does the humeroulnar joint glide

A

in the same direction

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6
Q

what is the carrying angle of males and females

A

M: 11-14
F: 13-16

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7
Q

how is the humeroradial joint formed

A
  • convex capitulum of humerus

- concave head of radius

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8
Q

how does the humeroradial joint glide

A

in the same direction for flexion and extension

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9
Q

which motions does the humeroradial joint do

A
  • flex/ext

- rotation of radius

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10
Q

which motions does the humeroulnar joint do

A

flex ext

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11
Q

what is the elbow capsule

A
  • thin, but strong
  • does not respond well to injury or immobilization
  • forms thick scar tissue resulting in flexion contractures
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12
Q

describe the ulnar (medial) collateral ligament

A
  • triangular shaped
  • medial epicondyle to coronoid process and olencarnon
  • 3 components: anterior, posterior, transverse/oblique
  • provides stability against valgus stress
  • important role between 20-130 degrees of motion
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13
Q

describe the anterior band of the ulnar (medial) collateral ligament

A
  • strongest and stiffest elbow collateral lig
  • becomes taught in terminal extension
  • stabilizes elbow against valgus stress between 20-120 degrees
  • secondary restraint at end range flexion beyond 120
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14
Q

describe the posterior band of the ulnar (medial) collateral lig

A
  • weakest band
  • taught beyond 55 of elbow flexion
  • secondary restraint to valgus stress at lesser degrees of flexion
  • an equal co-restraint with anterior band at terminal flexion (especially in overhead athlete in counteracting valgus stresses)
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15
Q

describe the transverse/oblique band of the ulnar (medial) collateral lig

A
  • originates and inserts on ulna
  • little role in elbow stablity
  • deepends socket for trochlea
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16
Q

describe ulnar collateral lig injury

A
  • most commonly anterior band ruptured
  • varied repair and reconstruction techniques
  • autograft of palmaris longus
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17
Q

describe the radial (lateral) collateral lig

A
  • fan shaped
  • lateral epicondyle and blends with annular lig
  • consistent tension throughout arc of flexion
  • restraint against varus load at elbow
  • also primary restraint again posterolateral instability
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18
Q

what is posterolateral instability

A
  • of the radial head
  • if you distrupt radial/lateral collateral ligament then the radial head can sublux out of annular ligament in a postlat direction
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19
Q

describe the annular ligament

A
  • provides 80% of the articular surface of humeral radial joint
  • stabilizes radial head
  • maintains relationship of radial head with ulna
  • forms prox radioulnar joint
  • permits pronation/sup
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20
Q

desribe osteokinematics of pronation

A
  • radial head convex
  • radial notch on ulna concave
  • roll and glide of convex radius on concave ulna
  • radial head rolls and glides in OPPOSITE direction

-radial head rolls ant and glides post

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21
Q

desribe osteokinematics of supination

A
  • roll and glide of convex radius and concave ulna
  • radial head rolls and glides in OPPOSITE direction

-radial head rolls post and glides ant

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22
Q

what kind of joint configuration is the distal radioulnar joint

A

ovoid

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23
Q

how is the distal radioulnar joint formed

A
  • head of ulna convex
  • ulnar notch on radius concave

-radius moving on ulna:
convex= roll and glide in same direction

24
Q

what are the functions in conjunction with PRUJ

A

pron/sup

  • occur simultaenously at both prox and distal radioulnar joints
  • also requires rotation of radius at humeroradial joint in annular lig
25
Q

what is the distal radioulnar joint articulation

A
  • head of ulna
  • TFCC
  • ulnar notch radius
26
Q

what is the radiocarpal/ulnocarpal joint articulation

A
  • radius
  • TFCC
  • prox row carpals (not pisiform)
27
Q

what is the midcarpal joint articulation

A

-prox and distal row

28
Q

what is the TFCC

A

triangular fibrocartilage complex

29
Q

what are the components of the TFCC

A
  • biconcave fibrocartilage disc
  • palmar ulnocarpal lig
  • ulnar collateral lig
  • dosral and volar radioulnar ligs sometimes
30
Q

what is the function fo the TFCC

A
  • major stabilizer DRUJ
  • binds distal radius and ulna
  • provides dual articular surface
  • separates radioulnar from radiocarpal joint
  • cushion- ulnar sided force transmission
31
Q

how do TFCC injuries happen

A

variable

  • FOOSH
  • extension wtih ulnar compression
  • forced radial or ulnar deviation
  • strong distratcion force
32
Q

what is the axis of rot for flex/ext

A

coronal axis between lunate and capitate

33
Q

what is the axis of rot for rad/ulnar dev

A

sagittal between lunate and capitate

34
Q

what is the axis fo rot for circumduction

A

polyaxial

35
Q

in the midcarpal joint, what is the ulnar compartment

A

capitate and hamate

convex

36
Q

in the midcarpal joint, what is the radial compartment

A

trapezium and trapezoid

  • concave in dorsal/volar direction
  • convex in radial/ulnar direction
37
Q

which motion does the midcarpal joint prefer

A

extension

38
Q

describe the ring system

A
  • bones within each row tethered together by interosseuous ligs
  • ring is only complete by addition of midcarpal ligs
  • as long as ligaments in tact, carpal bones move together as a unit
39
Q

describe the joint configuration at the radiocarpal/ulnocarpal joints

A
  • flex/ext prox row rolls and glides opposite
  • radial/ulnar dev prox row rolls and glides opposite
  • RD: scaphoid/lunate flex (rocks)
  • UD: prox row extend (twists)

-RD and UD limited in extremes of wrist flex and ext due to lig constraints

40
Q

how many metacarpal bones

A

5

41
Q

how many phalange bones

A

14

42
Q

what kind of joint is the 1st carpometacarpal

A

sellar

43
Q

describe the joint configuration of the distal surface of the trapezium

A

convex: radial/ulnar
concave: dosral/volar

44
Q

describe the joint configuration of the prox surface of the 1st MC

A

concave: radial/ulnar for radial abd/adduction
concex: dorsal/volar for palmar abd/add

45
Q

how many degrees of freedom in the thumb

A

3

46
Q

talk about radial ab/ad in the thumb

A

MC rolls nad glides in SAME direction

47
Q

talk about palmar ab/ad in the thumb

A

MC rolls and glides in OPP direction

48
Q

what kind of joint is the thumb

A

condyloid

49
Q

describe the joint configuration of carpometacarpal joint 2 and 3

A

difficulty to classify as interlocking articular surfaces prevent movement- stability

50
Q

describe the joint configuration of carpometacarpal joint 4 and 5

A
  • distal surface of hamate: slightly concave

- prox surface of 4 and 5 metacarpals: slightly convex

51
Q

what do the degrees of freedom allow for

A

cupping of the hand by slight flexion and IR of metacarples

52
Q

what is the function of the 2-5 fingers volar plates

A

ext: increases contact surface w MC head
flex: glides prox and prevents tendon pinching

53
Q

talk about the joint configuration of metacarpophalangeal joints 2-5

A

ovoid
distal surface of metacarpals: biconvex
prox surface of phalanges: concave

54
Q

describe flex/ext of phalanx

A

rolls and glides in SAME direction

55
Q

describe ab/ad of phalanc

A

rolls nad glides in SAME direction

56
Q

describe the joint configuation of interphalangeal joints 1-5 and thumb MP joint

A

true synovial hinge joints

  • distal surface of prox phalanx: convex
  • prox surface of distal phalanx: concave

Clinical Anatomy 2 (11 decks)

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