Lecture 22 - Upper Limb 1

Question 0

What gives rise to the ability to oppose the thumb?

Answer 0

The thumb is rotated 90 degrees with respect to the other fingers

Question 1

What is the basic mammalian form of the bones inthe upper limb?

Answer 1

Limb girdle connected to the axial skeleton
One proximal bone
Two distal bone
Pentadactyl hand
- Thumb rotated 90 degrees

Question 2

What is interesting about upper limb development?

Answer 2

It rotates, giving rise to the anatomical position
Big toe is medial
Thumb is lateral

Question 3

What does the clavicle do?

Answer 3

Connects to the axial skeleton and the upper limb

Question 4

What are the names of the two ends of the clavicle?

What are the cakes of the joints?

Answer 4

Acromial
Sacral

Acromial-clavicle
Sternal-clavicle

Question 5

What is the role of the scapula?

Answer 5

Muscle attachments the shoulder joint

Question 6

In what does the head of the humerus sit?

Answer 6

Glenoid fossa

Question 7

Where does the clavicle normally fracture?

What happens after there is a fracture?

Answer 7

At the weakest point: biggest bend

At the Lateral 1/3

The lateral end and limb drops down

Question 8

Describe the structure of the humerus and the pertinent features

Answer 8

Head
Tuberosities (greater, lesser, deltoid)
Neck (surgical and anatomical)
Epichondyles (medial and lateral)

Question 9

What are tuberosities?

Answer 9

This is where muscle attaches to the bone

Question 10

What is the difference between the anatomical and the surgical neck?

Answer 10

Surgical neck: much more frequently fractured

Anatomical: epiphyseal plate

Question 11

What are the bones of the forearm?

How are they linked?

Answer 11

Ulna: medial
Radius: lateral

They are linked by the interosseus membrane

Question 12

Where are the ulna and the radius each articulated?

Answer 12

Ulna: elbow

Radius: wrist

Question 13

Describe rotation of the ulna and radius

What is the rotation called?

Answer 13

Ulna remains attaches at the elbow hinge joint to the humerus

The radius rotates around the ulna

Supernation and pronation

Question 14

Describe the bones of the wrist

Answer 14

There are two rows (proximal and distal), each with four bones

Question 15

What are the bones in the proximal row of the wrist?

Answer 15

Pisiform, triquetrum, lunate, scaphoid

Question 16

What are the bones in the distal row of the wrist?

Answer 16

Trapezium, trapezoid, capitate, hamate

Question 17

Where are common sites of fracture in the humerus?

Answer 17

Surgical neck
Mid shaft
Suprachondylar

Question 18

What are common fractures of bones in the forearm?

What causes them

Answer 18

Colles fracture: fracture of the distal radius
Normally caused by falling on an outstretched arm

Parry fracture: shaft of the ulna

Question 19

What can fracture of the scaphoid lead to?

Answer 19

Necrosis of the proximal end of the scaphoid –> blood comes to the distal end first

Question 20

What are the features of stable joints?

Answer 20

Congruent
Limited range of movement
Tight capsule and strong ligaments

Question 21

What are features of mobile joints?

Answer 21

Low stability
Low congruence
Susceptible to subluxation and dislocation
Rely on fixators and labra for stability

Question 22

What are the joints of the upper limb?

Answer 22

Acromioclavicular
Sternlclavicular

Glenohumeral

Elbow

Wrist

Question 23

What are some features of the glenohumeral joint?

Answer 23

Very instable due to the large range of movement

Coracoclavicular ligaments are the main stabilisers and prevent upwards rotation of the clavicle

Weak capsule

Question 24

What are the features of the sternoclavicular joint?

Answer 24

Very strong capsule

Costoclavicular ligament

Question 25

What is the name of the socket in which the head of the humerus sits?

Answer 25

Glenoid fossa

Question 26

What is the name of the labrum in the glenohumeral joint?

Answer 26

Glenoid labrum

Question 27

Which muscles and ligaments stabilise the glenohumeral joint?

Answer 27

Coraco-acromial
Head of biceps
Rotator cuff

Question 28

What do the rotator cuff muscle do?

Answer 28

Pull the head of the humerus towards the glenoid

Fuse with the capsule

Question 29

What are the names of the rotator cuff muscles?

Answer 29

• Supraspinatus
• Infraspinatus
• Subscapularis

Question 30

What is the name of the bursa in the glenohumoral joint?

Where exactly is it?

Answer 30

It is called the subacromial bursa

It is located under the acromion process of the scapula

Question 31

Shoulder abductioncan bring about …

Answer 31

Irritation of the sub acromial bursa

Question 32

When is the shoulder most commonly dislocated?

In which direction is the shoulder normally dislocated?

What are some other features?

Answer 32

Most susceptible when abducted and externally rotated

Dislocated anterior and inferior

Joint capsule tears and shoulder appears less broad

Question 33

Which ligaments stabilise the hinge joint of the elbow?

Where do they attach?

Answer 33

The collateral ligaments that attach to the epichondyles and runs down the sides of the limb

Question 34

What is the other joint present in the forearm?

What sort of movement does this joint allow?

Answer 34

Radio-ulnar joint

Supination and pronation

Question 35

Which bones are connected in the wrist?

Answer 35

Distal radius joins with the scaphoid and lunate

Question 36

What sort of joints are present in the phalanges?

How are here joints stabilised?

Answer 36

Hinge joints

They are stabilised by collateral ligaments