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Ortho BMSc > Mechanics: Unit 4 Upper limb + spine (online) > Flashcards

Mechanics: Unit 4 Upper limb + spine (online) Flashcards

1
Q

what are the 5 parts of the upper limb?

A 
shoulder girdle
arm
forearm
wrist
hand
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2
Q

What are the 3 synovial joints of the shoulder? what is the other articulation

A

glenohumeral
acromioclavicular
sternoclavicular

other is scapulothoracic (bone-muscle-bone)

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3
Q

What type of joint is the glenohumeral joint and what forms it?

A

synovial ball and socket formed from the humeral head and the glenoid fossa of the scapula

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4
Q

Is the glenohumeral joint stable? which structures help stability?

A

no the shallow glenoid fossa gives increased ROM but decreased stability so we need the glenoid labrum, joint capsule and rotator cuff muscles to stabilise

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5
Q

What movement do the rotator cuff muscles prevent? how?

A

anterior and posterior displacement of glenohumeral joint by pushing on the humeral head
inferior displacement

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6
Q

Which ligaments prevent upward movement of the scapula?

A

coracoclavicular ligaments

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7
Q

What structures prevent movement at the acromioclavicular joint?

A

thorax and mucle attachments

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8
Q

What is the only joint that connects the shoulder girdle to the trunk?

A

sternoclavicular

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9
Q

How does the clavicle elevate at the sternoclavicular joint?

A

elevates between 0-90 degrees: 4 degrees for every 10 degrees of arm elevation
past this minimal

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10
Q

What structure is the axis for rotation of the clavicle during elevation and depression?

A

costoclavicular ligaments

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11
Q

Why is the scapulothoracic articulation not a joint in the truest sense?

A

there is no direct ligamentous or bony attachment it is bone-muscle-bone

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12
Q

What two muscles form the scapulothoracic articulation?

A

serratus anterior

subscapularis

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13
Q

Where does serratus anterior originate and insert?

A

ribs 1-8/9

on scapula along vertebral border

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14
Q

Where does subscapularis originate and insert?

A

subscapular fossa

lesser tubercle of the humerus

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15
Q

What movement does serratus anterior do?

A

strong abductor in pushing/pulling

prevents scapula winging

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16
Q

What movement does subscapulris do?

A

medially rotates humerus

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17
Q

What are the 4 rotator cuff muscles?

A

subscapularis
infraspinatus
supraspinatus
teres minor

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18
Q

What are the main movements of the shoulder referred to?

A

shoulder elevation and depression

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19
Q

What is shoulder elevation called in the

a) sagittal plane?
b) frontal/coronal plane?

A

a) forward flexion

b) abduction

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20
Q

What is shoulder depression called in the

a) sagittal plane?
b) frontal/coronal plane?

A

a) backward extension

b) adduction

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21
Q

What are internal/external rotation of the shoulder?

A

rotation about the longitudinal axis of the humerus

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22
Q

What are horizontal flexion and extension?

A

with arms abducted parallel to the ground
flexion = move arm across body
extension = move arm behind body

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23
Q

What is the ROM of the shoulder for

a) backward extension?
b) abduction?
c) adduction
d) internal and external rotation?
e) horizontal flexion?
f) horizontal extension?

A

a) 60
b) 180
c) 75
d) 90 each
e) 135
f) 45

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24
Q

Which articulation of the shoulder is most prone to dislocation?

A

anterior dislocation of glenohumeral joint

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25
Q

When does anterior dislocation of glenohumeral joint occur?

A

heavy blow applied to abducted, horizontally extended arm

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26
Q

When the arm is in a position of abduction and horizontal extension what type of lever system are the shoulder and arm acting as?

A

1st class lever system

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27
Q

With the arm fully extended is the effort force working at a mechanical advantage or disadvantage at the acromion? What does this mean the resistance force must be?

A

MA
so a small effort force can cause dislocation
resistance force must be much larger (eg 10x)

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28
Q

What are the 3 articulations of the elbow joint?

A

humeroradial
humeroulnar
proximal radioulnar

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29
Q

What does the radial head articulate with on the humerus?

A

capitellum

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30
Q

What does the ulnar head articulate with on the humerus?

A

trochlea

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31
Q

Which articulations of the elbow allow

a) flexion/extension?
b) pronation/supination?

A

a) humeroradial and humeroulnar

b) proximal radioulnar

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32
Q

Where does the axis of rotation for flexion/extension of the elbow pass through?

A

trochlea

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33
Q

What is the ROM of flexion/extension of the elbow?

A

140 of flexion

0 of extension

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34
Q

What does the radial head rotate in during pronation/ supination of the elbow?

A

radial notch of the ulna

35
Q

What structure binds the radius and ulna together at the proximal radioulnar joint?

A

annular ligament

36
Q

What is the ROM of pronation/supination at the elbow ?

A

70 pronation

80 supination

37
Q

How many degrees of flexion, pronation and supination at the elbow are required for daily activites at the elbow?

A

100 of flexion from 30-100 degrees

100 of pro/sup from 50 degrees

38
Q

Which structure resistes A/P and P/A forces at the elbow?

A

olecranon

39
Q

Which structures resist lateral and medial forces at the elbow?

A

collateral ligaments

40
Q

Which collateral ligament of the elbow prevents

a) abduction?
b) adduction?

A

a) ulnar/medial

b) lateral

41
Q

Which collateral ligament of the elbow is worse at its job? which structure helps it?

A

lateral

anconeus muscle

42
Q

Why is the elbow joint subject to such high forces?

A

moment arm of muscles are much smaller than the moment arms of external forces so the muscle force must be very large

43
Q

What is the radiocarpal joint between?

A

lunate and scaphoid and distal radius

44
Q

What type of joint is the radiocarpal joint?

A

condyloid

45
Q

What movements occur at the radiocalpar joint?

A

flexion-extension
abduction-adduction
circumduction

46
Q

How do the triquetrum and ulna articulate?

A

via triangular intra-articular disc in ulnocarpal space

47
Q

Which wrist joint allows for flexion more than extension?

A

midcarpal

48
Q

Which wrist joint allows for extension more than flexion?

A

radiocarpal

49
Q

How much ROM at the wrist for

a) flexion?
b) extension?
c) abduction?
d) adduction?

A

a) 80
b) 70
c) 15
d) 35

50
Q

What is the most functional position for an immobilised wrist joint?

A

fixed extension of 15 degrees

51
Q

What bones are in the hand?

A

5 metacarpals and 14 phalanges

52
Q

What type of joint are the carpometacarpals?

A

saddle

53
Q

Why is the 1st CMC joint so important? what bones does it lie between?

A

most freely moving to allow opposition of thumb

trapezium and 1st metacarpal

54
Q

Where are the intermetacarpal joints?

A

in the joint capsules of the CMC, formed by articulations between proximal ends of adjacent metacarpals

55
Q

What type of joint are the metacarpophalangeal joints?

A

condyloid

56
Q

What movements does a
a) hinge joint
b) saddle joint
allow?

A

a) flexion/extension

b) flexion/extension, abduction/adduction

57
Q

What type of joint are the interphalangeal joints?

A

hinge

58
Q

How does the maximum amount of flexion at the metacarpo- phalangeal joint vary from finger to finger?

A

generally decreases from the fifth to the second joint. At the fifth joint (little finger) it is around 95 to 100 degrees and at the second joint (index finger) it is about 70 degrees.

59
Q

What is metacarpophalangeal extension dependent on?

A

ligamentous laxity

60
Q

Is flexion greater at the proximal or distal interphalangeal joints?

A

proximal

61
Q

What is extension of the interphalangeal joint beyond neutral called?

A

hyperextension

62
Q

Do the MCP joints allow more flexion in the thumb or the fingers?

A

fingers 90

thumb can be 30-90

63
Q

What movements does the CMC of the thumb allow?

A

flexion
extension
abduction
rotation

64
Q

How does movement of the wrist affect hand movement?

A

muscles that move the digits are found in the forearm but their tendons cross the wrist and as it moves it alters their functional length

65
Q

Name the five regions of the spine.

A 
cervical
thoracic
lumbar
sacral
coccygeal
66
Q

How many vertebrae are found in the

a) cervical region?
b) thoracic region?
c) lumbar region?

A

a) 7
b) 12
c) 5

67
Q

What is the spine made up of?

A

24 unfused vertebrae
sacrum (5 fused)
coccyx (4 fused)

68
Q

What is the function of the intervertebral discs ?

A

bear and distribute load

restrain excessive motion

69
Q

What forms the inner nucleus pulposus?

A

hydrophilic gel in a collagen matrix

70
Q

What forms the annulus fibrosus? why is this helpful?

A

tough collagen form concentric layers of lamellae

alternating orientations help to resist bending and torsion loads

71
Q

Describe C1

A

no body
ring within which an oval fossa articulates with axis
rotates about dens

72
Q

Describe C2

A

superior articular process, the dens, joins to form a synovial joint with the oval fossa

73
Q

What is each thoracic vertebrae attached to?

A

a pair of ribs

  • head of rib to vertebral body
  • tubercle of rib to transverse process
74
Q

Why are the lumbar spine’s vertebral bodies bigger?

A

they are subjected to higher loads

75
Q

What links the spine to the pelvic girdle?

A

sacrum

76
Q

Which spinal region has

a) the most mobility?
b) the least mobility?

A

a) cervical

b) thoracic

77
Q

What part of the spine is there no lateral bending?

A

occipital bone and C1

C1 and C2

78
Q

How does rotation change along the spine?

A

greatest C1 and C2 then decreases down the spine

79
Q

As the moment arm of the upper body weight increases does the loading on the spine increase or decrease?

A

increases

80
Q

Is the load on the lumbar spine more when standing or sitting?

A

sitting

81
Q

Give the carpal bones in order from right to left if looking anteriorly at the right hand

A

scaphoid
lunate
triquetrum
pisiform

(new row)
traezium
trapezoid
capitate
hamate
82
Q

Where is the pisiform positioned? what significance does it have?

A

anteriorly to triquetrum (can be palpated)

it is the point of insertion of the flexor carpi ulnaris muscle and increases the lever arm

83
Q

What does flexor carpi ulnaris do?

A

flexes and adducts the wrist

Ortho BMSc (14 decks)

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