Joints Upper Extremities/ Brachial Plexus

Question 1

Differentiate the functional classifications of joints and their moveability

Answer 1

Synarthrosis - Immovable

Amphiarhtrosis - Slightly moveable

Diarthrosis - Freelymoveable

Question 2

What are bursae?

Answer 2

Flattened sacs lined with synovial membrane and containing synovial fluid

Question 3

What are tendon sheaths?

Answer 3

Elongated bursae wrapped around a tendon to reduce friction

Question 4

What are menisci?

Answer 4

Edges of fibrocartilage which subdivide synovial cavities

Question 5

What are the 6 types of synovial joints?

Answer 5

1. BAll and Socket
2. Hinge
3. Saddle
4. Ellipsoidal
5. Pivot
6. Gliding

Question 6

What are the attachments and actions of the deltoid?

Answer 6

Lateral 1/3 clavicle, acromion, spine of scapula —> Deltoid tuberosity

Abduction, extension, lateral rotation of humerus

Question 7

What are the attachments and actions of the Supraspinatus?

Answer 7

Supraspinous Fossa —> Superior facet of greater tubercle

Lateral rotation and assists abduction

Question 8

What are the attachments and actions of the Infraspinatus?

Answer 8

Infrspinous fossa —> Middle facet of greater tubercle

Lateral rotation; helps keep head of humerus in during abduction

Question 9

What are the attachments and actions of the Teres Minor?

Answer 9

Lateral border of scapula —> Inferior facet of greater tubercle

Lateral rotation and Adduction

Question 10

What are the attachments and actions of the Teres Major?

Answer 10

Inferior angle of scapula —> Medial lip off inter tubercular groove

Adduction and medial rotation

Question 11

What are the attachments and actions of the Infraspinatus?

Answer 11

Subscapularis Fossa —> Lesser Tubercle

Medial rotation

Question 12

What innervates the deltoid?

Answer 12

Axillary nerve

Question 13

What innervates supraspinatus?

Answer 13

Suprascapular nerve (C4-6)

Question 14

What innervates Infraspinatus?

Answer 14

Suprascapular Nerve (C4-6)

Question 15

What innervates Teres Minor?

Answer 15

Axillary Nerve

Question 16

What innervates Teres major?

Answer 16

Lower Subscapular nerve (C5-6)

Question 17

What innervates subscapularis?

Answer 17

Lower and upper subscapular nerves

Question 18

What are the 4 types of anterior dislocations? Which is most common, and which is least common?

Answer 18

• Subcoracoid
• Subglenoid
• Subclavicular
• Infrathoracic

Question 19

What are the male and female carrying angles?

Answer 19

Male: 10-15

Female: 15

Question 20

What are the bursae of the elbow joint?

Answer 20

• Subcutaneous bursa do medial epicondyle
• Olecranon bursae: Subtendinous, Intratendinus, subcutaneous
• Bursa of anconeus
• Subcutaneous bursa on lateral Epicondyle
• Bursa at origin of extensor carpi Radialis brevis

Question 21

What is nurse aids elbow?

Answer 21

Incomplete dislocation of head of radius; Common in children 1-3

Question 22

What is Erb-Duchene Paralysis?

Answer 22

• Excessive Separation of neck/shoulder from sports
• Stretching of infants neck during delivery
• Upper Brachial plexus injury

Question 23

What is Waiter’s Tip position?

Answer 23

Extremity which hangs in medial rotation with the wrist in flexion due to upper brachial plexus injury

Question 24

What is the most common middle brachial plexus injury?

Answer 24

• Intrascalene anesthesia of brachial plexus
• Spinal nerve C7
• Affects Adduction, Abduction, extension, and lateral rotation

Question 25

What is Djerine-Klumpke paralysis?

Answer 25

- Violent upward displacement of arm (ex shoulder dislocation) - Affects C8/T1 - Intrinsic Claw Hand - Inability to adducts due to involvement of medial pectoral nerve

Question 26

What is crutch palsy?

Answer 26

- Radial nerve affected - Results in impaired abd/add as well as wrist drop - impaired thumb movement

Question 27

Describe damage to the axillary nerve

Answer 27

- Usually from fracture of the surgical neck of humerus - Affects deltoid and teres minor - loss of abduction and impaired lateral rotation

Question 28

Describe damage to musculocutaneous nerve

Answer 28

- Flexion at forearm and shoulder is lost | - Sensory is lost to lateral forearm

Question 29

Describe injury to the Median nerve at different locations.

Answer 29

At Axilla: No branches in arm; flexion at hand, digits, pronation of arm is lost; All Thenar muscles except adductor is affected Laceration of wrist: Only Thenar muscles affected Above elbow: Muscles of thumb except adduction

Question 30

Describe Ulnar Nerve damage and locations

Answer 30

Medial Epicondyle: - Adduction of hand, - interossei/lumbricals, - hand/digit flexion, - adduction of thumb - sensory loss to medial 1 1/2 digits * ** Claw Hand Section at wrist: - Hypothenar parlayed. - More severe clawing; Ring flexor tendons intact - Adduction of thumb - Movement of little finger lost