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Anatomy Unit I > GA 9 - Joints of the Upper Extremity > Flashcards

GA 9 - Joints of the Upper Extremity Flashcards

1
Q

Describe the the sternoclavicular (SC) joint.

A

the only bony articulation between the upper extremity

and the axial skeleton.

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2
Q

Describe the structure of the sternoclavicular joint.

A

a. Saddle-shaped synovial joint between the medial

clavicle, manubrium, and the first costal cartilage.

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3
Q

Describe the articular disc of the sternoclavicular joint.

A

The SC joint has a fibrocartilaginous articular disc,
which subdivides the synovial cavity.
1) Disc attaches inferiorly to the first costal
cartilage and superiorly to the medial clavicle. It
also attaches to the anterior and posterior fibrous
joint capsule.
2) Resists superomedial dislocation of the clavicle.
3) Provides additional mobility.

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4
Q

What is an intrinsic ligament?

A

1) Thickenings of anterior, posterior, and superior
joint capsule.
2) Resist lateral dislocation

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5
Q

Give an example of an intrinsic ligament.

A

Sternoclavicular Ligament

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6
Q

Give an example of an extrinsic ligament.

A

Costoclavicular ligament

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7
Q

Describe the costoclavicular ligament.

A

Costoclavicular ligament (extrinsic): most
important ligament of SC joint.
1) Attaches the inferomedial clavicle to the first
costal cartilage and rib.
2) This extrinsic ligament resists superior
dislocation of the joint.

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8
Q

What is the interclavicular ligament?

A

spans superior manubrium; resists lateral

dislocation.

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9
Q

In most cases, the clavicle will fracture before what ligaments rupture?

A

The ligaments of the sternoclavicular joint - particularly costoclavicular ligament.

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10
Q

Describe the movement of the SC joint.

A

a. Anteroposterior axis: elevation/depression of pectoral girdle.
b. Vertical axis: protraction/retraction of pectoral girdle.
c. Circumduction: rotary motion combining above movements.

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11
Q

Describe the structure of the Acromioclavicular (AC) joint.

A

Plane-type synovial joint between the lateral clavicle and acromion process of
the scapula.
b. Incomplete, wedge-shaped articular disc.

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12
Q

What ligaments are in the acromioclavicular joint?

A

Acromioclavicular ligament, coracoclavicular ligament (conoid ligament and trapezoid ligament).

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13
Q

What is the acromioclavicular ligament?

A

intrinsic: thickening of superior joint capsule

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14
Q

Describe the Coracoclaviucular ligament.

A

(extrinsic): principal support of AC joint.
1) From inferolateral clavicle to the coracoid
process.
2) Two portions
a) Conoid ligament
b) Trapezoid ligament
3) Suspends the scapula from the clavicle and
supports the weight of upper limb.

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15
Q

What is the Trapezoid ligament?

A

the lateral portion of the coracoclavicular ligament, horizonally
oriented portion extending from the
body of the coracoid process.

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16
Q

what is the conoid ligament?

A

The medial portion of the coracoclavicular ligament, vertically oriented portion extending from the root of the coracoid process

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17
Q

What type of joint is the Acromioclavicular joint?

A

A multiaxial joint with limited range of motion.

Gliding movements enable superior/inferior rotation of the scapula.

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18
Q

What is a AC dislocation?

A

shoulder separation - common athletic injury. AC dislocations can involve rupture of the acromioclavicular and
coracoclavicular ligaments and inferomedial dislocation of the acromion.

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19
Q

Describe the glenohumeral joint.

A

Ball-and-socket synovial joint between the glenoid

fossa of the scapula and the head of the humerus

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20
Q

What is the glenoid labrum?

A

fibrocartilaginous ring encircling the
glenoid fossa; improves fit by deepening (slightly) the
fossa.

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21
Q

Describe the joint capsule of the Glenohumeral joint.

A

1) Attaches to margins of glenoid fossa and
anatomical neck of the humerus.
2) Thin and loose except at extremes of range of
motion.
3) Pierced by biceps brachii tendon.

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22
Q

What are the ligaments of the glenohumeral joint?

A

Superior, middle and inferior: intrinsic ligaments that reinforce the anterior capsule.

a. Coracohumeral ligament
b. coracoacromial ligament
c. Transverse humeral ligament

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23
Q

What is the Coracohumeral ligament?

A

1) From the coracoid process to the greater tubercle of the humerus.
2) Free anterior margin but fused with the capsule posteriorly.
3) Reinforces the superior capsule and resists inferior dislocation

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24
Q

What is the coracoacromial ligament?

A

1) Bridges the coracoid process and acromion to form the coracoacromial
arch.
2) Prevents superior dislocation of the humerus.

25
Q

What is the Transverse humeral ligament?

A

bridges intertubercular groove of humerus,

creating a canal for the tendon of the long head of biceps brachii m.

26
Q

What are bursae?

A

fibrous sacs lined with synovial
membrane and filled with synovial fluid. Bursae are located
in and around joints and reduce friction between moving
elements

27
Q

What is the subscapular bursa?

A

1) Between the tendon of subscapularis m. and the
neck of the scapula.
2) Communicates with the synovial cavity of the
glenohumeral joint.

28
Q

What is the subacromial (subdeltoid) bursa?

A

1) Superior to the supraspinatus tendon.
2) Does not normally communicate with glenohumeral
joint cavity.
3) Reduces friction from overlying coracoacromial
arch and deltoid m.

29
Q

What is adhesive capsulitis or “frozen shoulder”?

A

Inflammation of the rotator cuff tendons can result in abnormal
thickening of the capsule and reduced range of motion

30
Q

What is calcific tendonitis?

A

Calcific deposits in rotator cuff tendons are a common

cause of shoulder pain.

31
Q

What are some functional considerations for the glenohumeral joint?

A

a. The glenohumeral joint is multiaxial and is the most mobile joint of the body.
b. Joint integrity is dependent upon the rotator cuff muscles.
1) Tendons fuse with and reinforce the fibrous joint capsule.
2) Tonic muscle contraction maintains contact between humeral head and
glenoid fossa.

32
Q

When does an anterior dislocation occur?

A

when a posteriorly directed force is applied to the

abducted, extended arm, usually rupturing the anterior joint capsule.

33
Q

What is subluxation and inferior dislocation?

A

Subluxation - partial displacement of the humeral head inferiorly
Inferior dislocation - total displacement of the humeral head inferiorly

34
Q

Describe the elbow joint.

A
  1. A hinge-type synovial joint formed by two separate articulations: humeroulnar and humeroradial
  2. The fibrous joint capsule is loose and relatively thin anteriorly and posteriorly. It is strengthened medially and laterally by intrinsic ligaments: Ulnar (medial) collateral ligament and Radial (lateral) collateral ligament
35
Q

Describe the humeroulnar articulation of the elbow joint.

A

1) Between trochlea of humerus and trochlear notch of ulna.

2) Allows flexion/extension and a minor amount of abduction/adduction

36
Q

Describe the humeroradial articulation of the elbow joint.

A

1) Between capitulum of humerus and head of radius.

2) Allows flexion/extension and rotation (see below).

37
Q

Describe the Ulnar (medial) collateral ligament.

A

1) Strong, triangular intrinsic ligament.
2) Extends from the medial epicondyle of the humerus to the coronoid and
olecranon processes of the ulna.

38
Q

Describe the Radial (lateral) collateral ligament.

A

1) Fan-shaped intrinsic ligament.
2) Extends from the lateral epicondyle of the humerus to blend distally with the
annular ligament of the proximal radioulnar joint

39
Q

What is the second most common major joint dislocation?

A

Posterior dislocation - It is typically caused by a fall onto the extended forearm and is
accompanied by rupture of the posterior capsule

40
Q

What are the radioulnar joints?

A
  1. proximal radioulnar joint
  2. middle (intermediate) radioulnar joint
  3. Distal radioulnar joint
41
Q

Describe the proximal radioulnar joint.

A

a. A pivot-type synovial joint between the head of the radius and the radial notch
of the ulna. Its cavity is continuous with that of the elbow joint.
b. Annular ligament
1) Holds the radial head in contact with the radial notch of the ulna.
2) Forms an osseotendinous ring within which the radial head rotates.

42
Q

What is subluxation of the radial head?

A

AKA. nursemaid’s elbow, inferior dislocation of the radial head occurs frequently in small children. This injury is often caused by lifting of pulling a child by the forearm.

43
Q

Describe the middle (intermediate) radioulnar joint.

A

a. Mobile radioulnar syndesmosis.

b. Formed by interosseous membrane uniting radial and ulnar shafts.

44
Q

Describe the distal radioulnar joint.

A

a. A pivot-type synovial joint between the ulnar head and the ulnar notch of the
distal radius.
b. Articular disc (triangular ligament)

45
Q

What is the articular disc (triangular ligament)?

A

1) A triangular, fibrocartilaginous disc attaching the styloid process of the ulna
to the medial edge of the ulnar notch of the radius.
2) Separates the synovial cavity of the distal radioulnar joint from that of the
radiocarpal joint
3) Forms a pivot for the distal radius during pronation/supination.

46
Q

What are the movements of the radioulnar joints?

A

a. allow pronation/supination of the forearm which occurs around an oblique axis extending from the center of the radial head through the distal radioulnar articulation
b. during pronation, the distal end of the radius rotates anteriorly and medially around the stationary ulnar head
c. in the prone position, the distal radius lies anteromedial to the ulnar head and the radial shaft crosses the ulnar shaft anteriorly.

47
Q

Describe the wrist (radiocarpal) joint.

A

a. A condyloid synovial joint between the distal radius
and triangular ligament and the scaphoid, lunate and triquetral.
b. The fibrous joint capsule extends from the distal radius and ulna to the proximal row of carpal bones.

48
Q

What is the purpose of the triangular ligament of the radiocarpal joint?

A

The triangular ligament prevents the ulnar head
from articulating with the proximal carpals. Force may be transmitted to the ulna via the articular disc when the wrist is fully adducted.

49
Q

What are the intrinsic ligaments of the radiocarpal joint?

A

a. Palmar and dorsal radiocarpal ligaments
b. Radial collateral ligament
c. Ulnar collateral ligament

50
Q

What are the palmar and dorsal radiocarpal ligaments?

A

1) Thickenings of the anterior and posterior fibrous capsule.
2) Limit extension and flexion, respectively, of the wrist.

51
Q

What is the radial collateral ligament of the wrist?

A

radial styloid process to scaphoid.

52
Q

What is the ulnar collateral ligament of the wrist?

A

ulnar styloid process to triquetrum and pisiform.

53
Q

Which axes do the radiocarpal joint rotate on and what do they do?

A

Transverse axis: extension/flexion

1) Greater range of motion in flexion.
2) Extension is limited by muscular tension and the structure of the distal radius.

Anteroposterior axis: abduction/adduction (radial/ulnar deviation)

1) Greater range of motion in adduction.
2) Abduction is limited by the radial styloid process.

Circumdution: rotary motion combining above movements

54
Q

What are the joints of the hand?

A

Carpometacarpal (CM) and intermetacarpal joints, metacarophalangeal (MP) joints, Interphalangeal (IP) joints.

55
Q

What is the 1st caropmetacarpal joint?

A

a. A saddle-shaped synovial joint between the trapezium and the base of the metacarpal I.
b. highly mobile with a separate joint capsule.
c. contributes significantly to movements of the thumb

56
Q

Where are the carpometacarpal and intermetacarpal joints and what reinforces them?

A
  1. Formed between the distal row of carpals and the bases of the metacarpal bones.
  2. Digits II–V: carpometacarpal and intermetacarpal joints share a common joint space and fibrous capsule reinforced by carpometacarpal and intermetacarpal
    ligaments.
57
Q

What are the carpometacarpal joints II-V?

A

1) Plane-type synovial joints allowing limited flexion/extension.
2) The CM joint of Digit V permits limited rotation associated with opposition.

58
Q

What are the intermetacarpal joints?

A

plane-type synovial joints between adjacent metacarpal bases

Anatomy Unit I (8 decks)

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