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Anatomy > Joints of the Upper Limb: Shoulder and Elbow > Flashcards

Joints of the Upper Limb: Shoulder and Elbow Flashcards

1
Q

classification of joints (4)

A

solid
-fibrous
-cartilagenous
synovial

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2
Q

fibrous (3)

A

sutures
syndesmoses
gomphoses

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3
Q

cartilaginous (2)

A

synchondroses

symphyses

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4
Q

synovial (4)

A

joint capsule
hyaline cartilage
some have articular disc
typically very mobile

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5
Q

joint capsule (2)

A

inner synovial membrane

outer fibrous capsule

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6
Q

most joints are — joints

A

synovial

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7
Q

Synarthrosis =

A

no movement

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8
Q

Amphiarthrosis =

A

little movement

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9
Q

Diarthrosis =

A

a lot of movement

i.e. most synovial joints

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10
Q

movements at synovial joints (4)

A

nonaxial
uniaxial
biaxial
multiaxial

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11
Q

nonaxial =

A

no axis of moment (gliding)

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12
Q

uniaxial =

A

single axis of movement (hinge)

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13
Q

biaxial =

A

2 axes of movement

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14
Q

multiaxial =

A

> 2 axes of movement

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15
Q

what does the double saddle joint refer to

A

sternoclavicular

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16
Q

another term for “saddle joint” is “—

joint”

A

sellar

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17
Q

the pectoral girdle (shoulder girdle) includes (2)

A

the scapula and clavicle only

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18
Q

sternoclavicular joint (3)

A

• synovial joint
• double saddle (also called
“shallow saddle”)*
• 2 separate synovial cavities

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19
Q

The only “true” boney articulation between upper limb & thorax

A

Sternoclavicular Joint

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20
Q

sternoclavicular joint is a — joint

A

multiaxial

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21
Q

function of the sternoclavicular joint (3)

A

elevation/depression (clavicle and disc)
protraction/retraction (clavicle and sternum)
rotation (both)

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22
Q

dislocation of the sternoclavicular joint rarely occur because

A

this is such a strong joint

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23
Q

Direction of force transmission through the clavicle also prevents —

A

fracture

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24
Q

Forces are usually transmitted along the length of

A

the clavicle, such that the clavicle may fracture, but dislocation of the SC joint typically does
not occur

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25
Q

Most SC dislocations are the result of —- in individuals >— years of age

A

fractures through the epiphyseal plate at the sternal end of the clavicle
25

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26
Q

A 41-year-old, right-handed male farmer was struck in the chest by a charging bull
that forced him to the ground and trampled on him. He presented with complaints
of pain localized to the right sternoclavicular area, intermittent right upper
extremity paresthesias, and occasional subjective feelings of shortness of breath.
He denied hand, wrist or elbow weakness and had no difficulty swallowing. On
clinical examination he had a “stooped” posture with protraction of his right
scapula. There was bruising over the right sternoclavicular joint, with obvious local
deformity. The range of motion of his right arm was markedly limited secondary to
pain. What does the 3 dimensional CT scan below suggest is the cause of his
physical distress?

A

Right sternoclavicular dislocation

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27
Q

Ankylosis of the Sternoclavicular Joint results in (3)

A

Stiffening, fixation, or fusion of the SC joint.

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28
Q

Ankylosis of the Sternoclavicular Joint is associated with — conditions

A

arthritic

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29
Q

with Ankylosis of the Sternoclavicular Joint, — mobility is limited

A

shoulder

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30
Q

SAPHO syndrome

A

an inflammatory disorder that may include synovitis,

acne, pustulosis, hyperostosis, and osteitis

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31
Q

A 35 year-old woman crashes her bicycle into a tree when she rides off a rocky
ledge while participating in a mountain bike race. She landed on her left arm and
sustained a fractured olecranon. In addition, she complained of pain when trying
to move her left shoulder and there was a rather prominent lump with swelling
and edema over the superior aspect of her left shoulder. What additional injury
has she likely sustained?

A

Right shoulder separation

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32
Q

Acromioclavicular Joint (2)

A
  • synovial joint

* plane joint

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33
Q

supporting or accessory ligaments of the acromiclavicular joint

A

coracoclavicular ligaments

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34
Q

Acromiocclavicular ligament

has 2 parts:

A

•superior acromioclavicular
ligament
• inferior acromioclavicular
ligament

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35
Q

coracoclavicular ligaments (2)

A
  • conoid ligament

* trapezoid ligament

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36
Q

Grade 1 separated shoulder:

A

acromioclavicular ligament

sprain

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37
Q

Grade 2 separated shoulder:

A

acromioclavicular ligament

tear

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38
Q

Grade 3 separated shoulder:

A

both acromioclavicular and
coracoclavicular ligaments
are torn

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39
Q

A 35 year old woman robs a local grocery store and flees on foot, pursued
by the store owner. Before law enforcement arrives and catches up to
them, the store owner manages to subdue the woman. The store owner
grabs the woman by both of her arms and pulls them behind her, such that
her arms are extended behind her back and laterally rotated. She winces
in pain as her left shoulder becomes dislocated. Which of the following
nerves has likely been injured?

A

Axillary

40
Q

Synovial Capsule of Glenohumeral Joint is —, but very —

A

weak

mobile

41
Q

Synovial Capsule of Glenohumeral Joint is reinforced by tendons of the

A

rotator cuff muscles

42
Q

Synovial Capsule of Glenohumeral Joint: long tendon of — — pierces the
capsule and attaches to

A

biceps brachii

supraglenoid tubercle of scapula and glenoid labrum

43
Q

capsular ligaments of glenohmeral joint (2)

A

glenohumeral ligaments

coracohumeral

44
Q

glenohumeral ligaments (3)

A

superior
middle
inferior

45
Q

Bursa

A 
“pillows” of 
synovial fluid between 
muscle and joint capsule 
and/or bone and joint 
capsule
46
Q

bursas (4)

A
  1. subscapular bursa
  2. subacromial bursa
    (subdeltoid bursa)
  3. subcoracoid bursa
  4. synovial sheath
    (long biceps tendon)
47
Q

Rotator Cuff Muscles tendons reinforce and strengthen

A

glenohumeral joint

48
Q

Injury to the rotator cuff muscles can

affect

A

glenohumeral joint stability

49
Q

Dislocation of the Glenohumeral Joint: freely —, but relatively — joint

A

movile

unstable

50
Q

glenohumeral joint is commonly —-

A

dislocated

51
Q

Most dislocations occur in the — direction (but are described as —)

A

downward (inferior)

anterior

52
Q

The — structures and the rotator

cuff tend to prevent upward dislocation

A

coracoacromial

53
Q

— dislocations are more rare

A

Posterior

54
Q

Anterior dislocations occur most often in

A

young adults, especially athletes

55
Q

Hyperextension with — rotation

A

lateral

56
Q

Humeral head is forced in an —

direction

A

infero-anterior

57
Q

Fibrous layer of joint capsule and glenoid

labrum may —

A

tear

58
Q

Anterior disclocation from a hard low to the humerus while fully abducted (2)

A

• Tilts humeral head inferiorly and pushes it
through the weaker part of the joint capsule
• Joint capsule may tear and such that the
humeral head is positioned inferior to the
glenoid cavity and anterior to the infraglenoid
tubercle.

59
Q

Chronic inflammation in the glenohumeral joint can lead to fibrosis between the
(3)

A

joint capsule, rotator cuff muscles and synovial bursa

60
Q

Adhesive Capsulitis of the Glenohumeral Joint is also called

A

“frozen shouldeR:

61
Q

Adhesive Capsulitis of the Glenohumeral Joint is seen in individuals age

A

40-60

62
Q

Adhesive Capsulitis of the Glenohumeral Joint: — affected; compensatory scapular movements

A

Abduction

63
Q

Acromioclavicular joint may become —

A

strained

64
Q

May be initiated by (4)

A

glenohumeral dislocation, supraspinatus tendinitis, bicipital
tendinitis and/or rotator cuff tears

65
Q

The elbow joint consists of 3 separate articulations:

A
  1. humeroulnar articulation
  2. humeroradial articulation
  3. proximal radioulnar articulation
66
Q

Biceps
Brachialis &
Brachialis

A

= Flexors

67
Q

Several ligaments around the elbow joint reinforce these articulations
HUMEROULNAR/HUMERORADIAL ARTICULATIONS: (2)

A
  1. medial (ulnar) collateral ligaments

2. lateral (radial) collateral ligaments

68
Q

A 4 year-old girl presents in the ED with a painful right arm. She refuses
to move her arm and holds it close to her body. There is no evident
swelling or bruising. Her parents report that earlier that day they had been
visiting a local city festival. At one point while crossing a busy street, the
girl started forward into a crosswalk and the mother quickly grabbed the
girl by the right hand and pulled her back, fearing that a car was coming.
What is the likely diagnosis?

A

Subluxation of the radial head

69
Q

Subluxation and Dislocation of Radial Head is also known as

A

“nursemaids elbow”

70
Q

Subluxation and Dislocation of Radial Head: — age children tend to be vulnerable

A

preschool

71
Q

Subluxation and Dislocation of Radial Head happens in preschool age children by

A

children suddenly lifted by their upper limb in a. jerking motion

72
Q

Subluxation and Dislocation of Radial Head:

A 
Distal attachment of 
annular ligament 
becomes torn and radial 
head becomes 
dislocated
73
Q

Lateral Epicondylitis is also known as

A

“tennis elbow”

74
Q

Lateral Epicondylitis

A

tendons of forearm extensors become inflammed and/or torn at their lateral epicondylar
attachment (in particular the tendon of extensor carpi radialis brevis)

75
Q

Lateral Epicondylitis occurs due to

A

repetitive motion injury

76
Q

“Colles” fracture

A

complete transverse fracture of the distal 2cm of the radius

77
Q

Radius Fractures is common in

A

adults >50

78
Q

Radius Fractures: distal fragment is displaced —

A

dorsally

79
Q

Radius Fractures results from forced extension of

A

hand on outstretched limb while breaking fall

80
Q

radius fractures are so known as — — deformity

A

“dinner fork”

81
Q

Carpals (wrist): - bones

A

8

82
Q

Metacarpals (hand) - bones

A

5

83
Q 
Phalanges (fingers)
• - bones
• - digits
• each has - segments
• but thumb has only -
A

14
5
3
2

84
Q

Flexion: 40% occurs at — joint, 60% occurs at — joint

A

radiocarpal

midcarpal

85
Q

Extension: 33% occurs at — joint, 67% occurs at — joint

A

midcarpal

radiocarpal

86
Q

Radial Deviation =

A

Abduction (15-25o)

87
Q

Ulnar Deviation =

A

Adduction (30-45o)

88
Q

Abduction & Adduction mainly occurs at — joints

A

midcarpal

89
Q

collateral ligaments (3)

A
  • radial
  • ulnar
  • phalangeal
90
Q

transverse carpal ligament

A

Reinforces
carpals and forms
roof of carpal
tunnel

91
Q

metacarpal ligaments

A

Bind metacarpal

bones together

92
Q

carpometacarpal ligaments

A

Bind carpals to

metacarpals

93
Q

palmar ligaments

A 
Bind 
metacarpals to 
proximal 
phalangeal 
segments
94
Q

intermetacarpal ligaments

A

Bind metacarpal

bones together

95
Q

Some of the ligaments of the hand and wrist
contribute to the formation
of

A

spaces within the wrist &
hand, through which tendons,
nerves, and arteries must pass

Anatomy (29 decks)

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