Musculoskeletal Anatomy - Upper Limb Flashcards
name the 6 types of synovial joints, with an example of each
hinge - elbow joint ball and socket - hip joint plane - lamina in vertebrae ellipsoid - atlas vs skull pivot - ulna/radius saddle - thumb
name three examples of fibrous cartilage
periodontal ligaments
flat bones of skull
membrane between ulna and radius
what are primary and secondary cartilage joint called, and name an example of each
primary - synchondrosis: articular cartilage in long bones
secondary - symphysis: pubic symphysis
what is the difference between primary and secondary cartilage joints?
primary: only hyaline cartilage
secondary: hyaline + fibrocartilage
name the difference in chondrocyte shape and secretions in the superficial and transitional layers of articular cartilage
superficial layer: flat chondrocytes, secrete glycoproteins (lubricin)
transitional layer: round chondrocytes, secrete proteoglycans (aggegan)
how is nutrition delivered to cartilage and waste removed?
via synovial fluid
which cells produce synovial fluid?
Type B synoviocytes
what is the main function of type A synoviocytes?
remove waste
what is the main function of type B synoviocytes?
produce synovial fluid
what is synovial fluid composed of?
- fluid from plasma
- glycoproteins
- hyaluronic acid
name four functions of synovial fluid
- friction reduction
- waste removal
- nutrition to cartilage
- cushioning
- lubrication
what changes in characteristics of synovial fluid cause joint damage with age?
- increased viscosity
- decreased water content
what are bursae and where are they found?
they are fluid filled cushions found next to joint areas at high risk of friction against ligaments or bone
what encourages synovial fluid to reach the cartilage?
lack of an epithelial lining on the synovial membrane
what are the terminal branches of the brachial plexus?
- muscolocutaneous nerve
- axillary nerve
- radial nerve
- median nerve
- ulnar nerve
what are the root values of the brachial plexus?
C5-T1
what are the 6 branches of the lumbar plexus?
- ilioinguinal nerve
- iliohypogastric nerve
- genitofemoral nerve
- femoral nerve
- obturator nerve
- lateral femoral cutaneous nerve
what are the root values of the lumbar plexus?
L1-L5
what are the main branches of the sacral plexus?
- superior gluteal nerve
- inferior gluteal nerve
- sciatic nerve
what are the root values of the sacral plexus?
L4-S4
what two nerves make up the sciatic nerve?
common peroneal nerve
tibial nerve
what nerves supply the lateral, anterior and posterior aspects of the leg?
lateral - superficial peroneal nerve
anterior - deep peroneal nerve
posterior - tibial nerve
what nerve supply the anterior, medial and posterior aspects of the thigh?
anterior - femoral nerve
medial - obturator nerve
posterior - sciatic nerve
what nerve supplies the posterior aspect of the arm?
radial nerve
what are the LOAF muscles, and what nerve are they supplied by?
- lateral two lumbricals
- opponens pollicis
- abductor pollicis brevis
- flexor pollicis brevis
all supplied by median nerve
which arteries contribute the most to the superficial and deep palmar arch respectively?
superficial palmar arch - ulnar artery
deep palmar arch - radial artery
on a specimen, where does the ulnar nerve lie in relation to the ulnar artery?
ulnary nerve lies medial to the ulnary artery
in the antecubital fossa, where does the median nerve lie in relation to the brachial artery?
median nerve lies medial to the brachial artery
what are the three main flexors of the elbow joint?
- brachioradialis
- brachialis
- biceps brachii
what are the three main pronators of the forearm?
- biceps brachii
- pronator teres
- pronator quadratus
what are the two main extensors of the elbow joint?
- triceps brachii
- anconeus
what is the main supinator of the forearm?
- supinator muscle
which muscle receives radial nerve supply despite not being in the posterior compartment?
brachioradialis
what are the root values of the ulnar nerve?
C8-T1
what are the root values of the median nerve?
C5-T1
what are the root values of the musculocutaneous nerve?
C5-C7
what are the root values of the radial nerve?
C5-T1
what is the function of the palmar and dorsal interosseous muscles respectively?
palmar interosseous - adduction of fingers
dorsal interosseous - abduction of fingers
what is the function of the lumbricals?
flexion at MCP joints and extension at proximal and distal IP joints
what are the superficial flexor muscles of the forearm, and what nerve innervates them?
- pronator teres
- flexor carpi radialis
- palmaris longus
- flexor carpi ulnaris
innervated by median nerve except for flexor carpi ulnaris, which is innervated by the ulnar nerve
what structures pass through the carpal tunnel?
- median nerve
- flexor digitorum profundus tendons
- flexor digitorum superficialis tendons
- flexor pollicis longus tendon
what type of joint is found at the proximal and distal radio-ulnar joints?
synovial pivot joints
what type of joint is found at the carpal bones?
synovial condylar joints
what type of joint is found at the thumb?
synovial saddle joint
which two carpal bones articulate with the radius in the wrist?
- scaphoid
- lunate
name the 8 carpal bones
- scaphoid
- lunate
- pisiform
- triquetrum
- hamate
- capitate
- trapezoid
- trapezium
name the ligaments that support the elbow joint medially and laterally
medial collateral ligament
lateral collageral ligament
what is the annular ligament?
a circular ligament that surrounds the head of the radius and attaches it to the ulna
name the borders of the anatomical snuffbox in the hand
- extensor pollicis longus
- abductor pollicis longus/extensor pollicis brevis
name the thenar eminence muscles and their innervation
- abductor pollicis brevis
- flexor pollicis brevis
- opponens pollicis
innervated by median nerve
name the hypothenar eminence muscles and their innervation
- abductor digiti minimi
- flexor digiti minimi
- opponens digiti minimi
innervated by ulnar nerve
is the ulnar nerve found in the antecubital fossa?
no
which finger flexor only flexes the fingers at the proximal IP joints?
flexor digitorum superficialis
which finger flexor flexes fingers at the proximal and distal IP joint?
flexor digitorum profundus
the lumbrical muscles arise from the tendons of which muscle?
flexor digitorum profundus
damage to which nerve causes carpal tunnel syndrome?
damage to median nerve
damage to which brachial plexus trunk causes Klumpke’s palsy? specify the nerve roots involved
damage to lower trunk (C8-T1)
damage to which brachial plexus trunk causes Erb’s palsy? specify the nerve roots involved
damage to upper trunk (C5-C6)
what is the action of the extensor carpi radialis longus and brevis on the wrist joint?
abduction of wrist
extension of wrist
what is another term for wrist adduction and abduction?
wrist adduction - ulnar deviation
wrist abduction - radial deviation
what is the name of the branch of the radial nerve that innervates the extensor muscles of the forearm?
posteriour interosseous nerve
which artery passes underneath the anatomical snuff box?
radial artery
what are the extensor expansions in the fingers, and what muscles attach to them?
bands of connective tissue that arise from the extensor digitorum tendon forming a triangular hood
palmar/dorsal interossei, lumbricals and extensor digitorum/indicis attach to the extensor expansions
if an xray of a long bone shows an epiphyseal plate, what does that tell you about the patient undergoing the xray?
it’s a young person who is still growing
inability to move fingers means damage to which nerve?
ulnar nerve
what are the SITS muscles? name them
they are the rotator cuff muscles
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
which three muscles attach to the coracoid process in the scapula?
- coracobrachialis
- short head of biceps brachii
- pectoralis minor
which teres muscle is part of the rotator cuff?
teres minor
does the thumb have a proximal interphalangeal joint?
no
which carpal bones can be felt in the anatomical snuffbox?
scaphoid
trapezium
why is the scaphoid at risk of avascular necrosis in proximal scaphoid fractures?
because scaphoid receives retrograde blood supply
which flexor muscle of the forearm is used as landmark to guide wrist surgery?
flexor carpi radialis
what is the clinical significance of the palmaris longus?
it is used for tendon transfers/grafts
how many tendons act on the proximal interphalangeal joints? name them
two - flexor digitorum superficialis and profundus
how many tendons act on the distal interphalangeal joints? name them
one - flexor digitorum profundus
what test is used to examine the blood supply of the hand? what does it involve?
Allen’s test
compress ulnar and radial artery, then decompress ulnar artery
which rotator cuff muscles attach to the greater tuberosity of the humerus?
supraspinatus
infraspinatus
teres minor
which rotator cuff muscle attaches to the lesse tuberosity of the humerus?
subscapularis
what are the important functions of the clavicle?
stabilise shoulder
protect neurovascular structures underneath
attachment for muscles
what are the three main ligaments in the glenohumeral joint which stabilise the joint?
superior glenohumeral ligament
middle glenohumeral ligament
inferior glenohumeral ligament
what’s the tear called in which the glenohumeral labrum detaches from the glenoid fossa? name the commonest cause of this
Bankart lesion
often as a result of an anterior shoulder dislocation
what is the nerve supply of the serratus anterior?
long thoracic nerve (nerve of Bell)
what is the action of the serratus anterior?
protraction of the scapula
what nerve is often damaged as a result of a shoulder dislocation?
axillary nerve
name which muscles are involved in abduction of the arm (specify degrees of abduction)
supraspinatus - initiation of abduction to 15 degrees
deltois - abduction from 15 to 90 degrees
trapezius and serratus anterior - abduction from 90 to full elevation
if the supraspinatus muscle is damaged, what will the patient struggle to do?
they will struggle to initiate abduction of their arm
what are the rotator cuff muscles, and what are their movements
teres minor - external rotation, extension
infraspinatus - external rotation, extension
supraspinatus - abduction
subscapularis - internal rotation
what is the innervation of the rotator cuff muscles?
supraspinatus - suprascapular nerve
infraspinatus - suprascapular nerve
teres minor - axillary nerve
supscapularis - subscapular nerves (inf and sup)
what are the four main joints in the shoulder?
- sternoclavicular joint
- acromioclavicular joint
- glenohumeral joint
- physiological (scapulothoracic) joint
