Limb bones and joints Flashcards
What are the five different types of bone based on shape?
Flat bones: scapula, cranial vault.
Long bones: bones of the limb.
Short bones: carpals and tarsals.
Irregular bones: vertebrae or facial bones
Sesamoid bones: contain inside tendons, patella
What are the three sections of a long bone?
Diaphysis - shaft
Epiphysis - ends of bone
Epiphysial plate - hyaline cartilage where growth occurs, new bone called metaphysis
What bones does the pectoral girdle consist of?
Clavicle
Scapula
Proximal humerus
What is the only bony attachment between the upper limb and trunk?
Clavicle
What is the shape of the clavicle?
S-shaped contour
What are the two ends of the clavicle and what is their overall shape?
The lateral / acromial end is flat.
The medial / sternal end is more quadrangular in shape.
What is the facet at the acromial end of the clavicle for?
Acromial facet there for articulation with facet on acromion of scapula
What is the facet at the sternal end of the clavicle for?
Large facet for articulation with the manubrium of sternum and first costal cartilage
What are the three angles, three borders and two surfaces of the scapula?
Lateral, superior and inferior angles
Superior lateral and medial borders
Costal and posterior surface
What angle does the glenoid fossa mark on the scapula?
Lateral angle
What is the acromion?
Anterolateral projection of scapula that articulates with the clavicle.
What is the coracoid process?
Hook-like structure, anterolaterally, inferior to the lateral clavicle
What does the spine of the scapula divide the posterior scapula into?
Supraspinous fossa
Infraspinous fossa
What bones does the upper limb consist of?
Humerus Radius Ulna Metacarpals Phalanges
What marks the proximal end of the humerus?
Head which fits into the glenoid fossa ( ball and socket joint).
What is the anatomical neck of the humerus?
The anatomical neck which is very short and formed from an narrow constriction distal to the head.
What is the surgical neck of the humerus?
The surgical neck describes the narrow part just below the anatomical neck
Why is the surgical neck clinically relevant?
Axillary nerve, posterior circumflex, humeral artery lie posterior to the surgical neck. As this is a common fracture sight, it can be dangerous.
What are the two prominence on the proximal humerus, what key muscles attach here?
The greater and lesser tubercles (rotator cuff muscle attachment sites)
Where do the greater and lesser tubercles lie in relation to eachother?
Greater lies laterally and the lesser lies anteriorly.
Distally, what happens to the humeral shaft?
Flattens
What prominence does the distal humerus have?
Two condyles, two epicondyles and three fossae.
What are the humeral condyles called and what do they articulate with?
Capitulum - articulates the radius
Trochlea - articulates the ulna.
Where do the two epicondyles lie, which one is more prominent?
Epicondyles lie adjacent to the condyles.
The medical epicondyle is a large bony protrusion and the lateral epicondyle is much less pronounced.
Where are the humeral fossae in relation to the condyles?
Superior
What are the three fossae on the distal humerus?
Radial fossa
Coronoid fossa
Olecrannon fossa
Where does the radial fossa lie, what does it receive in flexion?
Superior to the capitulum
Receives the anterior border of the head of the radius
Where does the coronoid fossa lie, what does it receive in flexion?
Superior to the trochlea, adjacent to radial fossa
Receives coronoid process of the ulna
Where does the olecrannon fossa lie, what does it receive in flexion?
Superior to trochlea on posterior surface of distal humerus
Receives olecrannon process
What joint does the radial head form with the humerus?
Pivot
What lies just distal to the radial head?
Radial tuberosity
What prominence does the proximal head of the ulna have?
Olecrannon and coronoid processes
Where does the biceps brachii tendon attach distally?
Radial tuberosity
Where does the triceps brachii insert distally?
Superior surface of olecrannon
What is the trochlear notch formed by, what does it articulate with?
Formed by olecrannon and coronoid process
Trochlea
What is the attachement site for brachialis?
Tuberosity of ulna
What processes lie at the distal end of the ulna and radius?
Styloid processes
What are the 8 carpal bones?
Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capaitate, Hamate
What do the metacarpals articulate with?
Carpals and proximal phalanges
What digit only has two phalanges, what is it missing?
Thumb (first digit) no medial phalanges
What forms the pelvis?
Two innonimate hip bones and the sacrum
What are the three elements of the hip bone?
Ilium, pubis and ischium
During development do the 3 parts of the hip bone ossify together?
No
Where do all 3 parts of the hip bone connect?
The acetabulum
When do the 3 hip bones fuse at the acetabulum?
At puberty
What is the most superior margin of the ilium called?
Iliac crest
What is the peak of the iliac crest called?
Anterior superior iliac spine (hipbones) ASIS.
What joins the sacrum and the hip bones?
Sacroiliac joint
What are the two prominences of the ischium called?
Ischial tuberosities
What does the head of the femur articulate with?
Acetabulum
Where does the ligament of the femur head attach?
Fovea
Roughly what angle does the neck of femur project from shaft at?
125 degrees superomedially
What are the two prominence of the proximal femur?
Greater and lesser trochanter
What are the bones of the lower limb?
Femur Tibia Tibula Patella Tarsals Metatarsals Phalanges.
What is the deep groove posterior to the greater trochanter an what attaches here?
Trochanteric fossa
Obturator externus muscle
What attaches to the greater trochanter?
Gluteus medius and minimus
What attaches to the lesser trochanter?
Attachment iliacus and psoas
What posterior bump runs down the femur?
Linear aspera
What attaches to the linear aspera?
Adductors
What attaches the gluteus maximus?
Gluteal tuberosity
What type of bone is the patella?
Sesamoid
What articulates with the tibial plateau?
Femoral condyles (medial and lateral)
Does the tibia and fibular articulate at the knee joint?
No, only the tibia
What tibial facets articulate with the femur
Lateral and medial condyles
Which femur condyle is larger, why?
Medial condyle is larger than the lateral (outer) condyle due to more weight bearing caused by the centre of mass being medial to the knee.
Where do quadricep femoris muscles attach?
Tibial tuberosity
What is the patellar ligament?
Continuation of quadriceps femoris tendon below patella
Do tibia and fibular rotate?
No
Where is the fibular in relation to the tibia?
Laterally
At the distal end of the tibia and fibular what prominence is there?
Fibular - lateral malleolus
Tibia - medial malleolus
What holds the tibia and fibular together?
Interosseous membrane
Where does the proximal fibular articulate?
Inferior lateral condyle of tibia
What tarsal articulates with the malleoli?
Talus
What are the 7 tarsals?
Talus, calcaneus, navicular, cuboid and cuneiforms (medial intermediate and lateral)
What do metatarsals articulate with?
Tarsals and distal phalanges
How many phalanges do the toes have?
3, except big toe which has 2
What is a joint?
Where two bones meet
What are the three types of joint?
Fibrous
Cartilaginous
Synovial
What holds bones together at a fibrous joint?
Bones are bound together by collagen-rich fibrous dense connective tissue.
What are fibrous joints between bones of the skull called?
Sutures
What are fibrous joints between long bones called?
Syndesmoses
What are examples of syndesmoses?
Inferior (anterior) tibiofibular joint
Interosseous membrane between the radius and ulna of the forearm.
How much movement do fibrous joints provide?
Very small amounts
What holds bones together in cartilaginous joints?
Cartilage (fibro-cartilage or hyaline cartilage)
What are the two types of cartilaginous joint?
Primary cartilaginous joints - These bones are connected by hyaline cartilage.
Secondary cartilaginous joints - fibrocartilaginous and hyaline joints
What is an example of primary cartilaginous joints?
Growth plates between ossification centers in long bones at epiphyseal (growth) plates, which ossify when long bone extension is complete.
What is an example of secondary cartilaginous joints?
Manubriosternal joint (between the manubrium - upper sternum and the sternum and intervertebral discs.
What are the characteristic features/ structure of synovial joints?
presence of a joint cavity which contains a small volume of synovial fluid. Smooth, articular hyaline cartilage covers the bone ends. The joint is enclosed in a sleeve-like fibrous capsule (joint capsule) lined with
What are the characteristic features/ structure of synovial joints?
Ppresence of a joint cavity which contains a small volume of synovial fluid.
Smooth, articular hyaline cartilage covers the bone ends.
The joint is enclosed in a sleeve-like fibrous capsule (joint capsule) lined with synovium
Where does the synovial fluid come from in a synovial joint?
Specialised synovial membrane (synovium) composed of secretory cells secretes synovial fluid to lubricate the joint.
Why do synovial joints need associated ligaments?
Ligaments crossing the joint prevent excessive movement.
What are the three most common synovial joint types and three more less common?
Most common: hinge, ellipsoid and ball and socket
Less common: plane, pivot and saddle
What is the name of the joint where the acromial end of the clavicle articulates with the scapula?
Acromioclavicular
What is the name of the joint where the sternal end of the clavicle articulates with the axial skeleton?
Sternoclavicular joints
What type of the joint is the glenohumeral joint?
Ball and socket
What movements does the glenohumeral joint allow?
Allows flexion-extension, abduction-adduction, circumduction and rotation.
What acts to deepen the glenoid fossa?
Fibrocartilaginous rim surrounding the fossa called the glenoid labrum
What aspect of the joint do the glenohumeral ligaments strengthen?
Anterior aspect
Where does the coracoacromial ligament lie and what does it prevent/support?
Coracoacromial ligament passes between the acromion and coracoid
Forms part of a fibrosseous arch superior to the head of the humerus, helping to prevent superior dislocation of the humeral head
Where does the coracohumeral ligament lie?
Between the coracoid process and the greater tubercle
What does the coracoclavicular ligament do?
Maintains clavicle position
What does the transverse humeral ligament run between, what does it do?
Runs between the two tubercles, holding the head of biceps in position here
What are the four rotator cuff muscles?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
What are the main roles of rotator cuff?
Stabilising the glenohumeral joint - musculotenindous cuff
Movement at glenohumeral joint
Where do the rotator cuff muscles attach?
The Infraspinatus, supraspinatus and teres minor all insert into the greater tuberosity of the humeral head, but the subscapularis inserts into the lesser tuberosity.
What type of joint is the elbow joint?
Synovial hinge joint
What movements does the elbow joint permit?
Flexion and extension
What are the two sub-joints of the elbow, what are the articulations?
Surfaces of the trochlea and capitulum of the humerus articulate with the trochlear notch of the ulna and head of the radius at the humeroulnar and humeroradial joints respectively
Does the elbow joint capsule attach directly to the radius?
No
Where does the elbow joint capsule attach instead of the radius, what does this allow?
Anular ligament
Freedom of movement between the radius and ulnar
What ligaments strengthen the elbow joint?
Co-lateral ligaments
At what position is the elbow joint at max stability?
Forearm flexed to 90 degrees in a position of mid-pronation –supination.
What joint is between the radius and ulnar at the distal end ?
Distal radio-ulna joint
What type of joints are the proximal and distal radio-ulnar joints?
Pivot
What movement does rotation of the radius at the radioulnar joints produce?
Pronation/supination
What holds the proximal radius in place?
Annular ligament
What type of joint is the radio-carpal?
Synovial ellipsoid joint
What three carpals articulate at the radiocarpal joint?
Scaphoid, lunate and triquetrum.
What movements does the radiocarpal joint permit?
Flexion-extension as well as abduction and adduction
What ligaments support the radiocarpal joint?
Radial and ulnar collateral carpal ligaments.
What are midcarpal joints and what do they permit?
Midcarpal joints are found between the proximal and distal rows of the carpal bones.
Permit flexion-extension and some degree of abduction and adduction.
What is the first carpometacarpal joint between, what type of joint is it ?
First metacarpal bone and the trapezium
Synovial saddle joint which allows for specialised movements.
What is opposition?
Complex interaction of flexion, abduction, rotation and adduction due to the saddle shape of the first carpometacarpal joint
What type of joint is at the articulation of distal carpals and metacarpal (2-5th digits)?
Plane, synovial joints
What type of joint is metacarpophalageal (2-5th digits), what movements are permitted?
Synovial ellipsoid
Flexion-extension and abduction-adduction
Why type of joint are interphalangeal, what movements and what supports them?
Synovial hinge joints
Allow flexion-extension.
Stabilised by collateral ligaments.
What type of joint is the hip joint?
Synovial ball and socket joint
What movements does the hip joint permit?
Flexion-extension, abduction-adduction, circumduction and medial and lateral rotation.
What deepens the acetabulum?
Acetabular labrum
What are the three main ligaments that stabilise the hip joint?
Iliofemoral
Ischiofemoral
Pubofemoral
Where does the iliofemoral ligament lie?
Anteriorly between the ilium and the region between the greater and lesser trochanters of the femur (the intertrochanteric line)
Where does the pubofemoral ligament lie?
Between the pubis and the intertrochanteric line,
Where does the ischiofemoral ligament lie?
Spirals between the ischium and the greater trochanter
When are the ligaments of the hip tight and when are they relaxed?
Relaxed with flexion and tight on extension
Why is it beneficial to have tight ligaments at the hip when standing?
Takes the action out of the muscles so standing can be a passive process.
What type of joint is the knee joint?
Modified synovial hinge joint
What movements does the knee joint produce?
Flexion-extension and a small amount of medial and lateral rotation
When and when only can the knee joint have a small amount of lateral rotation?
When the joint is flexed
What are the menisci made of and what is their role?
Fibrocartilage
Increase the joint congruency, assist in weight bearing and act as shock absorbers.
What type of knee injuries can tear the medial meniscus?
Rotational
Where does the lateral co-lateral ligament of the knee insert into?
Fibula
What ligament attaches to the medial meniscus?
Medial co-lateral ligament
Is the lateral meniscus attached to the lateral collateral ligament?
No
How is the lateral collateral ligament separated from the fibrous capsule?
By the tendon of the popliteus muscle.
Which surface of the patella is covered in hyaline cartilage, what joint does it make?
Posterior surface
Patellofemoral joint
When the knee is extended how does it ‘lock’?
The medial femoral condyle medially rotates on tibia, this tightens ligaments
How does the knee ‘un-lock’?
‘unlocked’ by the popliteus muscle, which laterally rotates the femur on the tibia at initiation of flexion.
What are the two cruciate ligaments
ACL
PCL
Where does the ACL lie?
Anterior cruciate ligament (ACL) arises from the anterior part of the intercondylar area of the tibia and attaches to the lateral condyle of the femur.
Where does the PCL lie?
The posterior cruciate ligament (PCL) attaches from the posterior part of the intercondylar region of the tibia to the medial condyle of the femur.
What does the ACL prevent?
Over extension of the knee
What is the joint between the leg bones and tarsals?
Synovial hinge talocrural joint
What does the talocrural joint allow?
Plantarflexion and dorsiflexion
What joints permit inversion and eversion of the foot?
Joints between the tarsals
What ligaments strengthen the ankle joints?
Collateral
What type of joint is the elbow?
Compound hinge synovial joint
What does the radial collateral ligament insert into?
Annular ligament
How many parts is the ulnar collateral ligament made up of?
Three parts
What part of the elbow does the ulnar collateral ligament stabilise?
Medial aspect of the joint
Where do the quadriceps originate?
Rectus femoris originates from the anterior inferior iliac spine
Vastus lateralis originates from the shaft and greater trochanter of the femur
Vastus intermedius originates from the shaft of the femur
Vastus medialis originates from the medial shaft of the femur
Where does the sartorious originate?
ASIS
What side is the fibula on?
Lateral
What sort of joint is the sacro iliac?
syndesmosis
What joints are between bones of the skull?
Fibrous
What sort of joint is the manubriosternal joint?
Secondary cartilaginous
What joint to joint capsules surround?
Synovial
Is the capsule particularly lax on the inferior aspect of the shoulder joint?
Yes
What defines a compoud joint?
They are a type of synovial joint, containing more than two articulating bones.
The elbow joint and radiocarpal joints are examples.
The radius articulates with
both the radial notch of the ulna and the capitulum humerus
Coracoid, coronoid, capitulum?
Coracoid - (process) scapula (C in it - near clavicle)
Coronoid - elbow (process on ulna that articulates with coronoid fossa in humerus)
Capitulum - elbow (condyle articulates with head of radius)
Tubercle, tuberosity, trochlea, trochanter?
Greater and lesser tubercle/tuberosity (rotator cuff attachments)
Tuberosity also used for bone prominence
Trochlea - elbow (condyle that receives coronoid and olecrannon processes of ulna)
Trochanter - process on proximal femur (greater glute med /min, lesser psoas and iliacus)
How do lateral and medial menisci contact?
By an anterior transverse ligament
Does the medial meniscus contact the medial collateral ligament?
Yes
Compare the shapes of the medial meniscus with lateral meniscus?
It is a C shaped disc, in contrast to the more rounded lateral meniscus.
Do extensors of the knee pass posterior to the joint?
No
What tarsal does the fibular articulate with?
Talus
Does the tibia articulate with the patella?
No
What tarsal does the tibia articulate with?
Talus
What movements does the talus and tibial joint allow?
Plantar and dorsi flexion
What joint is the talocalcaneous joint? What does it allow?
Synovial allows eversion and inversion
Bones of ankle/foot?
Talus, calcaneous, navicular, cuboid, medial, intermediate and lateral cuneiforms
Metatarsals
Phalanges (same as hand)
Arches of foot
Medial and lateral longitudial arch and transverse arch (coronal plane)
Apex of foot arches
Talus
Ligaments which support arches
Plantar ligaments and spring ligaments
Spring ligament action and location
Calcaneous to the navicular prevent medial arch from collapsing
Plantar ligament action and location
Calcaneus to cuboid stabilise lateral longitudinal arch
Ankle joint
Compound hinge synovial
Most ankle injuries occur during
Plantarflexion
Ankle lateral collateral ligament
Three segments
Ankle medial collateral ligament (deltoid ligament)
Deltoid very thick
Oblique popliteal ligament
Lateral femoral epicondyle to medial condyle of tibia - limits rotation
ACL tear
Tibia comes out in front of the femur
Bursae around knee
Suprapatellar, prepatellar, deep infrapatellar, superficial infrapatellar
Suprapatellar bursa location
Between femur and quadriceps tendon
Prepatellar bursa location
Between skin and anterior patella
Superficial infrapatellar location
Between skin and tibial tuberosity
Deep infrapatellar location
Between patellar ligament and anterior tibia
