Shoulder and elbow joint

Question 1

Describe ligaments of the shoulder

Answer 1

Corico-acromion ligament very strong

Corocoid humeral strong Corocoid to greater tubercle strong
Transverse humeral short
Gleno humeral ligaments
3 bands

Question 2

Describe the shoulder joint

Answer 2

Most mobile joint
Poor stability
Ball and socket joint: shallow glenoid made slightly deep by the labrum
Capsule is a mix of tight and loose anteriorly, posteriorly and superiorly right to prevent sag
Inferiorly loose to allow rom

Question 3

Describe shoulder Bursae

Answer 3

Sub acromion large +++

Sub scapular opens into joint activity

Question 4

Describe blood supply and nervous supply

Answer 4

Circumflex artery

Subscapular and supra scapula nerve axilary nerve

Question 5

Which muscle are involved in abduction and which initiate

Answer 5

Sipraspinous initiates until 40* abduction
Deltoid the. Takes over

This is due to fibres of deltoid being below the joint line while the arm is testing and will addict at that time once at 40 above or in line so bulk of be fibres can act to abduct the arm this is affective to 90*

To abduct further three things need to happen. Seratus anterior, trapezius need to be recruited and infra spinatus need to external rotate so the tubercles are not in the way

Question 6

Describe Innervation of serratus anterior by long thoracic nerve

Answer 6

C5 first two slips
C6 3&4
C7 supplies 567 allowing isolated activity of c7 allowing lateral rotation of the scapula

Question 7

What Attaches to the coracoid process of the scapular

Answer 7

Short head of biceps
Pec Major
Coracobrachialis
Coracohumeral, acromial and clavicular ligaments

Question 8

What attaches to the bicipital groove and what passes through it

Answer 8

Long head of biceps passes thorugh
lat lip insertion for pec major
med lip insertion for terres major
Floor insertion for lat dosi

Question 9

Describe the ligaments of the elbow joint

Answer 9

Radial colateral – originates from the radial epicondyle inserting into the anular ligament

Annular ligament of the radius encircles and holds the head of radius in the radial notch forming the proximal radioulnar joint. Attaches to the ulna anterior and posterior to its radial notch

Ulnar colateral– medial epicondyle into the coranoid process of the ulnar and olecranon – consists of three bands

1) anterior cord like strongest
2) posterior cord fan like weakest
3) oblique

Quadrate ligament

• from lower margin of radial notch of ulnar to neck of radius
• prevents herniation of synovial memrbane between anterior and posterior free edges of the annular ligament

Question 10

Describe carrying angle of the elbow

Answer 10

Describes the way the forearm angles away from the body when something is carried. The obliquity of the ulna and thus the carrying angle is more pronounced in women due to their large pelvis

Question 11

What is the axis of rotation for pronation and supination

Answer 11

During pronation and supination the head of the radius rotates within the collar formed by the annular ligament
The axis for these movements passes proximally through the centre of the head of the radius and distally though the site of attachment of the apex of the articular disc to the head (styloid) of the ulna

Head of radius rotates within the annular notch around the radial notch of the ulna
Distally the end of the radius rotates around the head of the ulna

Question 12

Describe the AC joint

Answer 12

synovial joint,
incomplete fibrocartilage disc in upper part of joint

Capsule: invest the articular surfaces like a sleeve

Ligaments

• acromioclvaivular ligament
• corcacoclavicular ligment two parts
• –conoid part
• –trapezoid part

Question 13

Describe the calvipectoral fascia

Answer 13

Strong fascial sheet between clavicle and pec minor
laterally attached to coronoid process
medialy blends with external intercostal membranes
superiorly attached to subclavian groove

Pierced by 
IN 
-cephalic vein 
-lymphatics from infraclaviular LN to axillary LN 
OUT
-lateral pectoral nerve 
-thoracoacromial artery

Question 14

Describe the wrist joint

Answer 14

Condylar type of synovial joint
The ulnar does not participate in the wrist joint. Distal ends of the radius and the articuklar disc of the distal radioulnar joint articulatre with the prximal row of carpal bones except for the pisifomr.

Ligaments

• palmar radiocarpal ligament from the radius to the two rows of carpals.
• Dorsal radiocarpl ligament
• ulnar collateral
• radial collateral

Movements

• flexion, extension
• adduction, abduction
• circumduction