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GROSS ANATOMY > Joints And Ligaments Of The Upper Limb > Flashcards

Joints And Ligaments Of The Upper Limb Flashcards

1
Q

These are the 4 Joints that make up the shoulder:

A

A. Glenohumeral joint
B. Acromioclavicular joint
C. Sternoclavicular joint
D. Scapulothoracic joint

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2
Q

It is the 💡main shoulder joint

It is formed where the ball of the humerus fits into a
shallow socket on the scapula called 💡GLENOID

💡Ball-and-socket joint in which 💡stability is sacrificed to obtain greater freedom of movement

💡Head of humerus (1/3 of a sphere) articulates with 💡shallow glenoid fossa of the scapula

Articular capsule is thin and loose

Muscle tendons contribute to joint stability

A

GLENOHUMERAL JOINT

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3
Q

Stability of the glenohumeral joint is maintained by:

A

o Thin,loose 💡joint capsule
o 💡Four ligaments coracohumeral, and 💡three glenohumeral
o 💡Tendon of the long head of biceps, which travels thru the intertubercular groove and secures the humerus to the glenoid cavity
o 💡Rotator cuff (four tendons) encircles the shoulder joint and blends with the articular capsule

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4
Q

GLENOHUMERAL RANGE OF MOTIONS

A

§ The shoulder can abduct, adduct, rotate, be raised in front of and behind the torso and move through a full 360 in the sagittal plane.

§ This tremendous range of motion also makes the shoulder extremely unstable, far more prone to dislocation and injury than other joints.

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5
Q

ACTION

Shoulder Flexion

Shoulder Extension

Shoulder Abduction

Shoulder Adduction

Shoulder Lateral Rotation

Shoulder Medial Rotation

A

GLENOHUMERAL RANGE OF MOTIONS

0-90°

0-50

0-180°

180-0°

0-90°

0-90°

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6
Q

ANTERIOR DISLOCATION OF GLENOHUMERAL JOINT

MECHANISM OF INJURY

A

Vulnerable position: level with the shoulder and bent back (like throwing a ball)

When the arm dislocates it falls forward and downward.

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7
Q

Types of dislocation (glenohumeral joint)

A

Subcoracoid
Subclavicular
Subglenoid
Intrathoracic

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8
Q

Treatments for glenohumeral dislocation:

A

Hippocratic maneuver
Stimson maneuver
Tractio/counter traction
Sling and swathe

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9
Q

Patient supine on table.
Examiner places 💡sole of the foot against px’s axillary fold for countertraction, grasps px’s wrist with both hands and applies steady longitudinal traction.

A

Hippocratic maneuver

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10
Q

Px prone on the table with affected limb 💡hanging freely over edge: 💡10-15lb weight suspended from wrist. Gradual traction overcomes muscle spasm and in most cases achieves reduction in 20-25 mins.

A

Stimson Maneuver

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11
Q

Clavicle meets the acromion

Joint at the top of the shoulder

Joint between the acromion and the clavicle

A

ACROMIOCLAVICULAR JOINT

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12
Q

FUNCTIONS OF ACROMIOCLAVICULAR JOINT

A

Allows the ability to raise the arm above the head

Functions as a 💡pivot point acting like a strut to help with movement of the scapula resulting in greater degree of arm rotation

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13
Q

THREE LIGAMENT THAT STABILIZED THE ACROMIOCLAVICULAR JOINT:

A

Acromioclavicular ligament–attaches the clavicle to the acromion of the scapula

Coracoacromial ligament – runs from the coracoid process to the acromion

Coracoclavicular ligament – attaches the clavicle to the coracoid process
• Made up of 2 ligaments:
1. Conoid
2. Trapezoid

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14
Q

TREATMENT FOR ACROMIOCLAVICULAR JOINT SEPARATION

A

Taping and sling

Surgical repair

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15
Q

It supports the connection of the 💡arms and shoulders to the main skeleton on the front of the chest

💡Synovial double-plane joint composed of two portions separated by an articular disc

Formed by the:
o Sternal end of the clavicle
o Clavicular notch of the manubrium sterni
o Cartilage of the first rib visible from the outside as the Suprasternal Notch

💡Only joint linking the bones of the arm & shoulder to the main part of the skeleton

A

STERNOCLAVICULAR JOINT

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16
Q

These are the 4 ligaments that hold the sternoclavicular joint:

A

Intra-articular disc ligament

Costoclavicular ligament

Interclavicular ligament

Capsular ligament

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17
Q

It is a ligament of the sternoclavicular joint that attaches to the 💡first rib and divides the joint into two separate spaces. It is 💡very thick and fibrous

A

Intra-articular disc ligament

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18
Q

It is a ligament of the sternoclavicular joint that is 💡short and strong. It attaches 💡underneath the clavicle to the first rib just below. It helps 💡steady the SC joint during certain motions

A

Costoclavicular ligament

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19
Q

It is a ligament of the sternoclavicular joint that supports the 💡end of both clavicle bones near the SC joint. It passes over the 💡top of the sternum, connecting one clavicle to the other.

A

Interclavicular ligament

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20
Q

It is a ligament of the sternoclavicular joint that 💡reinforces the capsule that surrounds the SC joint. It keeps the 💡sternum end of the clavicle from 💡pointing up as the other end of the clavicle drops down.

A

Capsular ligament

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21
Q

STERNOCLAVICULAR JOINT RANGE OF MOTION

A

§ Clavicle elevation/ depression
§ Clavicle protraction/ depression
§ Clavicle posterior rotation

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22
Q

💡Not a true joint, instead a 💡sliding joint between medial border of scapula and ribs 2-7

Function: 💡allow scapular motion against the rib cage

Resting position is angled anteriorly at 💡30° and an upward tilt of 3°

A

SCAPULOTHORACIC JOINT

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23
Q

SCAPULOTHORACIC JOINT RANGE OF MOTION

A

During shoulder abduction glenohumeral motion to scapulothoracic motion is 💡1:2 (ST does 60°, GH does 120°)

Position fixed primarily by scapular muscle attachment

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24
Q

Moving the superior border of the scapula and acromion in an 💡upward direction

A

ELEVATION

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25
Q

Moving the superior border of the scapula and acromion in a 💡downward direction

A

DEPRESSION

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26
Q

Glenoid fossa facing upwards with inferior angle of scapula 💡sliding laterally & anteriorly

A

UPWARD ROTATION

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27
Q

Glenoid fossa facing downwards with inferior angle of scapula 💡sliding medially and posteriorly

A

DOWNWARD ROTATION

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28
Q

Moving the scapula 💡away from the midline

A

PROTRACTION

29
Q

Moving the scapula 💡toward midline

A

RETRACTION

30
Q

Type: Synovial hinge joint
Location: 2-3 cm inferior to epicondyles of humerus

A

ELBOW JOINTS

31
Q

Surfaces of elbow joints are covered

A

Hyaline cartilage

32
Q

ARTICULATIONS of elbow joints

A

Humero-ulnar joint (hinge joint)

Humeroradial (bone and socket joint)

33
Q

Articulation of an elbow joint between the
💡trochlea and 💡capitulum of the humerus and
💡trochlear notch of the ulna

A

Humero-ulnar joint (hinge joint)

34
Q

Articulation of an elbow joint between the 💡capitulum

and 💡upper concavesurface of the radial head

A

Humeroradial (bone and socket joint)

35
Q

LIGAMENTS THAT PROVIDE STABILITY IN ELBOW JOINT

A

RADIAL (LATERAL) COLLATERAL
LIGAMENT

ULNAR (MEDIAL) COLLATERAL
LIGAMENT

36
Q

They provide stability 💡anteriorly and 💡posteriorly to the elbow joint

A

Tendons of biceps and triceps brachii

37
Q

ELBOW STABILITY
Triangular in shape

Extends from 💡lateral epicondyle of humerus
and blends distally with 💡anular ligament
(head of radius)

💡Important lateral stabilize

💡Oppose varsus (medial) stresses

A

RADIAL (LATERAL) COLLATERAL

LIGAMENT

38
Q

Also triangular

Broad fibrous band that runs from the
💡epicondyle to 💡coronoid and 💡olecranon of ulna

Provides 💡protection against Valgus (lateral)
processes of ulna.

A

ULNAR (MEDIAL) COLLATERAL

LIGAMENT

39
Q

ELBOW RANGE OF MOTION

A

FLEXION: 0-150 degrees
EXTENSION: 150-10 degrees
PRONATION (inward) 0-90 degrees
SUPINATION (outward) 0-90 degrees

40
Q

ELBOW RANGE OF MOTION

FLEXION: 0-150 degrees

A

􀂃 Joint: 💡humero-ulnar

􀂃 Muscles: 💡brachialis & biceps brachii (chief
flexors), brachioradialis, and pronator teres
muscles

􀂃 limited by the anterior surfaces of the forearm
and arm coming into contact

41
Q

ELBOW RANGE OF MOTION

EXTENSION: 150-10 degrees

A

􀂃 Joint: 💡Humeroradial

􀂃 Muscles: 💡triceps brachii (chief extensor) and
anconeus muscles

􀂃 checked by the tension of the anterior
ligament and the brachialis muscle.

􀂃 Carrying angle: angle where Long axis of
FOREARM lies to the long axis of ARM
(disappears when fully flexed)
o Male: 170 degrees
o Female: 167 degrees
42
Q

ELBOW RANGE OF MOTION

SUPINATION (outward) 0-90 degrees

A

􀂃 💡Proximal radio-ulnar joint (in conjugation with
associated movements of distal radio-ulnar
joint)

􀂃 The 💡radius is the one that rotates

􀂃 Supination: 💡supinator (absent resistance)
and 💡biceps brachii (w/ resistance)

􀂃 Pronation: 💡pronator quadratus (primarily) and
💡pronator teres (secondarily)

43
Q

􀂃 💡Condyloid synovial joint between:
o distal end of the radius
o articular disc overlying the distal end of the ulna
o scaphoid, lunate, and triquetrum

􀂃 Complex of eight carpal bones

􀂃 💡Ulna does not participate as a bone rather there is
an 💡articulate disc lying between ulna and lunate

􀂃 Articulating with the forearm via the wrist joint and
distally with the five metacarpals.

A

WRIST JOINTS

44
Q

It is formed by
the 💡articular surfaces of the carpals which then
corresponds to the 💡concave surface of the radius
and articular disc.

A

Carpal arch (convex oval shape)

45
Q

The 💡fibrous layer of the joint capsule is

strengthened by strong

A

Dorsal
Palmar
radiocarpal ligaments.

46
Q

TWO IMPORTANT LIGAMENTS HOLDING
THE WRIST JOINTS IN PLACE:

They connect the forearm to the wrist, one on
each side of the wrist

A

ULNAR COLLATERAL LIGAMENT

RADIAL COLLATERAL LIGAMENT

47
Q

􀂃 💡Cord shaped

􀂃 Crosses the 💡ulnar edge of the wrist starting from
the 💡ulnar styloid process where the ulna meets
the wrist joint to the triquetrum

􀂃 2 parts of UCL
􀂃 Connects to the 💡pisiform and to the 💡transverse carpal ligament (a thick band of tissue that
crosses in front of the wrist) and the other goes to 💡triquetrum

􀂃 Adds support to a 💡small disc of cartilage where the ulna meets the wrist called 💡The triangular
fibro cartilage complex (TFCC)

A

ULNAR COLLATERAL LIGAMENT

48
Q

It is a small disc of cartilage where the ulna meets the wrist

A

The triangular

fibro cartilage complex (TFCC)

49
Q

􀂃 strengthens joint capsule 💡laterally

􀂃 attached to the 💡radial styloid process and
💡scaphoid

􀂃 on the 💡thumb side of the wrist

􀂃 starts on the 💡outer edge of the radius at the 💡radial styloid

􀂃 connects to the side of the 💡scaphoid

􀂃 Prevents the wrist from 💡bending too far to the side (away from the thumb)

A

RADIAL COLLATERAL LIGAMENT

50
Q

WRIST JOINT ROM

A 
􀂃 Wrist flexion 0-90
􀂃 Wrist extension 0-70
􀂃 Wrist abduction 0-25
􀂃 Wrist adduction 0-65
􀂃 Circumduction of the hand consists of
successive flexion, adduction, extension,
and abduction.
51
Q

CARPAL JOINTS

A

The synovial joints between the carpal bones share a common articular cavity

52
Q

The joint capsule of the carpal joints is reinforced by

numerous ligaments.

A

o Intrinsic Ligaments: intra-articular intrinsic ligaments connect adjacent carpal bones

o Proximal Row
  􀁸 scapholunate ligament
  􀁸 lunotriqueral ligament
o Distal Row
  􀁸 trapeziotrapezoid ligament
  􀁸 trapeziocapitate ligament
  􀁸 capitohamate ligament
o Palmar midcarpal
  􀁸 scaphotrapeziotrapezoid
  􀁸 scaphocapitate
  􀁸 triquetralcapitate
53
Q

Although movement at the carpal joints
(intercarpal joints) is 💡limited, they do
contribute to the 💡positioning of the hand in abduction, auction, flexion, and particularly,
extension.

A

True

54
Q

There are 💡five carpometacarpal joints
between the metacarpals and the related
distal row of carpal bones.

A

True

55
Q

Movements at this carpometacarpal joint are:

A

flexion,
extension, abduction, adduction, rotation, and
circumduction.

56
Q

The carpometacarpal joints between 💡metacarpals
II to V and the 💡carpal bones are much less mobile
than the carpometacarpal joint of the 💡thumb,
allowing only limited 💡gliding movements.

A

True

57
Q

Movement of the joints increases medially so

💡metacarpal V slides to the greatest degree.

A

True

58
Q

It is the main 💡knuckle joints formed by the
connections of the phalanges to the
metacarpals.

It work like a hinge when you bend and
straighten your fingers and thumb.

A

METACARPOPHALANGEAL JOINTS

59
Q

METACARPOPHALANGEAL JOINTS

STABILITY:

A

COLLATERAL LIGAMENTS**

VOLAR PLATE

60
Q

A part of the joint capsule that attaches only
to the 💡proximal phalanx, allowing
💡hyperextension.

The 💡SITE OF INSERTION for the 💡INTERMETACARPAL LIGAMENTS.

A

VOLAR PLATE

61
Q

These ligaments 💡restrict the separation of the metacarpal heads.

A

INTERMETACARPAL LIGAMENTS.

62
Q

MCP JOINT RANGE OF MOTION:

A

􀂃 MCP: Abduction 0-25
􀂃 MCP: Adduction 20-0
􀂃 MCP: Flexion 0-90
􀂃 MCP: Extension 0-30

63
Q

􀂃 It 💡separates the three phalanges in each finger.

􀂃 These are the 💡hinge type of synovial joint that permit:
o 💡FLEXION EXTENSION only

o The heads of the phalanges articulate with the bases of more distally located
phalanges in the IP joints.

A

INTERPHALANGEAL JOINTS

64
Q

It is the closest to the MCP joint.

A

PROXIMAL IP POINT or PIP POINT

65
Q

It is the joint near the end of the finger.

A

DISTAL IP POINT OR DIP POINT

66
Q

INTERPHALANGEAL JOINTS STABILITY:

A

COLLATERAL LIGAMENTS**

VOLAR PLATE

67
Q

􀂃 It is the 💡strongest ligament in the PIP joint.

􀂃 It connects the Proximal phalanx to the Middle phalanx on the palm side of the joint.

􀂃 Tightens as the joint is straightened

􀂃 Keeps the joint from hyperextending

A

VOLAR PLATE

68
Q

ICP JOINTS RANGE OF MOTION:

A

INTERPHALANGEAL PROXIMAL (PIP)
Joints of Fingers:
􀂃 Flexion: 0-120
􀂃 Extension: 120-0

INTERPHALANGEAL DISTAL (DIP) Joints
of Fingers:
o Flexion: 0-80
o Extension: 80-0

GROSS ANATOMY (8 decks)

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