Joints of the Upper Limb

Question 1

What is the general purpose of the clavicle?

Answer 1

the sternoclavicular joint acts as a strut to hold the upper limb away from the chest to afford maximum degree of movement

Question 2

What are the 3 articulations of the sternoclavicular joint?

Answer 2

Sternal end of clavicle
clavicular notch of manubrium
first costal cartilage

Question 3

What divides the sternoclavicular joint into 2 synovial cavities?

Answer 3

Interarticular disc (fibrocartilage)

Question 4

What are the ligaments of the sternoclavicular joint? What is the main support?***

Answer 4

Anterior and posterior sternoclavicular ligaments

Costoclavicular ligament***

Question 5

In which compartment of the sternoclavicular joint does forward and backward movement of the clavicle take place in? What about elevation and depression?

Answer 5

Medial compartment = forward and backward

Lateral compartment = elevation and depression

Question 6

What does the costoclavicular ligament firmly hold together?

Answer 6

Firms hols the medial end of clavicle to the first costal cartilage and first rib

Question 7

What does the acromioclavicular joint articulate with?

Answer 7

Articulates with:
acromion process of scapula
acromial extremity of clavicle

Question 8

What is the main support ligament of the acromioclavicular joint?

Answer 8

Coracoclavicular ligament

Question 9

What does the coracoclavicular ligament connect?

Answer 9

Connects the coracoid process of scapula to undersurface of clavicle

Question 10

What is the coracoclavicular ligament responsible for?

Answer 10

Suspending the weight of scapula and upper limb from the clavicle

Question 11

What happens in an acromioclavicular dislocation?

Answer 11

Acromion process is thrust beneath lateral end of clavicle
clavicle is elevated
Shoulder falls away from clavicle because of weight of upper limb

Question 12

What does the shoulder joint (glenohumeral joint) articulate with?

Answer 12

Articulates with the head of the humerus and the glenoid cavity of the scapula

Question 13

What deepens the glenoid cavity?

Answer 13

A rim of fibrocartilage called the glenoid labrum

Question 14

What are the 2 apertures in the articular capsule of the glenohumeral joint?

Answer 14

1. Between the tubercles of the humerus (for passage of tendon of long head of biceps)
2. Opening for subscapular bursa (continuation of synovial cavity of the joint)

Question 15

What are the 4 ligaments of the shoulder joint?

Answer 15

1. Glenohumeral ligaments (strength capsule anteriorly)
2. Transverse humeral ligament (hold down the synovial sheath and tendon of long head of biceps)
3. Coracohumeral ligament (strengthens capsule superiorly)
4. Coracoacromial ligament (connects coracoid process to acromion process)

Question 16

What makes up the coracoacromial arch? What is its purpose?

Answer 16

coracoid process – coracoacromial ligament – acromion process
Prevents superior displacement of head of humerus

Question 17

What are the 4 rotator cuff tendons?

Answer 17

Rotator cuff tendons are the principal support of shoulder joint
1. Supraspinatous tendon (superior support)
2. Infraspinatous tendon (posterior support)
3. Teres minor tendon (posterior support)
4 Subscapularis tendon (anterior support)

Question 18

What is the only anatomical direction that the capsule is not supported by from the rotator cuff tendons?

Answer 18

Inferiorly:

rotator cuff tendons do not support the capsule of this joint inferiorly

Question 19

Definition of bursae of shoulder joint.

Answer 19

Synovial sacs located where tendons rub against bone, ligaments, other tendons, or skin, so as to prevent friction

Question 20

What are the 2 principal bursae of the shoulder joint?

Answer 20

Subscapular bursa (between tendon of subscapularis muscle and scapula)
Subacromial bursa (between deltoid muscle and supraspinatous tendon)

Question 21

Which of the 2 principal bursae communicate with the capsule of the shoulder joint, and which doesn’t?

Answer 21

Subscapular bursa communicates with the capsule of shoulder joint
Subacromial bursa does not communicate with capsule of shoulder joint

Question 22

What muscles control flexion of the shoulder joint?

Answer 22

Anterior deltoid
Pectoralis major
Biceps brachii
Coacobrachialis

Question 23

What muscles control extension of the shoulder joint?

Answer 23

posterior deltoid
latissimus dorsi
teres major

Question 24

What muscles control abduction of the shoulder joint?

Answer 24

supraspinatus

middle deltoid

Question 25

What muscles control adduction of the shoulder joint?

Answer 25

pectoralis major
latissimus dorsi
teres major
teres minor

Question 26

What muscles control the lateral rotation of the shoulder joint?

Answer 26

infraspinatus
teres minor
posterior deltoid

Question 27

What muscles control the medial rotation of the shoulder joint?

Answer 27

subscapularis
latissimus dorsi
teres major
anterior deltoid
pectoralis major

Question 28

What is the weak part of the capsule of the shoulder joint, why, and what happens when there is displacement here? What nerve is at risk of being damaged?

Answer 28

Weak part of the capsule of shoulder joint is the inferior part
No rotator cuff tendons inferiorly
Leads to anterior-inferior dislocation
May damage the axillary nerve

Question 29

What results in a posterior dislocation?

Answer 29

Subglenoid displacement of the humeral head into the quadrangular space
could cause damage to axillary nerve with paralysis of deltoid muscle and loss of skin sensation over lower half of deltoid

Question 30

What happens if there is swelling of the supraspinatous muscle or excessive fluid within the subacromial bursae?

Answer 30

May cause impingement when arm is abducted
Causes degeneration of the tendon (supraspinatous tendinopathy)
Extreme pain during abduction

Question 31

What is the most common issue with the shoulder joint in the elderly?

Answer 31

Rupture of the supraspinatous tendon

Question 32

What does the elbow joint articulate with?

Answer 32

2 articulations:

• between the trochlea and trochlear notch of ulna
• between the capitulum and the head of radius

Question 33

What are the principal planes of movement of the elbow joint?

Answer 33

Only 1 principal plane of movement:

Flexion and extension

Question 34

What are the 2 supporting ligaments of the elbow joint?

Answer 34

Radial collateral (lateral epicondyle to anular ligament of radius)
Ulnar collateral (medial epicondyle to coronoid and olecranon process of ulna)

Question 35

What are the articulations of the proximal radioulnar joint?

Answer 35

2 articulations:

• between head of radius and radial notch of ulna
• at the synovial pivot joint which allows for supination and pronation

Question 36

What is the supporting ligament of the proximal radioulnar joint, and what is it attached to?

Answer 36

The annular ligament
Attached to the margins of the radial notch
Not directly attached to radius

Question 37

What happens with a ‘pulled elbow’?

Answer 37

Radial head moves distally partially out of annular ligament

Question 38

What are the articulations of the distal radioulnar joint?

Answer 38

Articulates with:

• between the head of ulna and the ulnar notch of the radius
• synovial pivot joint which allows for supination and pronation

Question 39

What separates the ulna from the wrist joint?**

Answer 39

The articular disc of the distal radioulnar joint

**Ulna does NOT contribute to the wrist joint

Question 40

What makes up the wrist joint?

Answer 40

Made up of the distal radius and articular disc (scaphoid, lunate, and triquetral carpal bones)

Question 41

What type of joint is the wrist joint?

Answer 41

An ellipsoid type of wrist joint

Question 42

What are the movements of the wrist joint? Which is greater?

Answer 42

Flexion (~80 degrees) > Extension (~45 degrees)
Adduction > Abduction
Circumduction

Question 43

What inhibits abduction of the wrist joint?

Answer 43

radial styloid process

Therefore, adduction exceeds abduction