TEC1 - Semester 2: Upper Extremity

Question 1

Name the upper extremity joints.

Answer 1

shoulder girdle, elbow, proximal & distal radioulnar, wrist, hand, fingers

Question 2

Which joints belong to the shoulder girdle?

Answer 2

SCJ, ACJ, GHJ

Question 3

Describe the SCJ.

Answer 3

• synovial diarthrotic
• biaxial saddle joint
• between proximal clavicle and clavicular notch at manubrium and sup. surface of first costal cartilage

Question 4

Name the intrinsic and extrensic ligaments of the SCJ.

Answer 4

intrinsic: interclavicular, anterior & posterior sternoclavicular
extrinsic: costoclavicular

Question 5

Describe the SCJ movements in the planes.

Answer 5

sagittal: anterior & posterior rotation
frontal: elevation, depression
transverse: protraction & retraction

Question 6

What does humeral abduction require?

Answer 6

clavicular elevation and rotation

Question 7

What is reciprocal movement?

Answer 7

movement at the same time but in opposite direction

Question 8

Where does reciprocal movement occur in the clavicle?

Answer 8

at the distal and proximal ends

Question 8

Describe the ACJ.

Answer 8

• synovial, diarthrosis
• plane/gliding
• between distal clavicle and facet in acromion process

Question 9

What are the ligaments and discs of the ACJ?

Answer 9

intrinsic: AC -> prevents post. dislocation, limits scapular rotation
extrinsic: coracoclavicular -> prevents sup. dislocation, limits scap. rot.
disc: projects into joint from superior part of capsule

Question 10

functions of the ACJ?

Answer 10

• gives scapula additional ROM
• allows scapula to change shape of thorax as humerus moves
• transmission of forces from UE to clavicle

Question 11

What happens to scapula in ACJ movements?

Answer 11

• abduction/flexion: scapula rotates sup.
• adduction/extension: scapula rotates inf.
• protraction: internal rotation
• retraction: external rotation
• elevation: anterior tiliting
• depression: posterior tilting

Question 12

Describe the GHJ.

Answer 12

• synovial, diarthrosis
• ball & socket
• multiaxial
• between humeral head and glenoid cavity

Question 13

What are the intrinsic and extrinsic ligaments of the GHJ?

Answer 13

intrinsic: glenohumeral (sup, middle, inf.), transverse humeral, coracohumeral
extrinsic: coracoacromial

Question 14

What are their functions?

Answer 14

1. Superior: prevents inf. translation
2. middle: limits ext. rotation
3. inferior: limits ext/int rotation
4. transverse humeral: prevents displacement of bicep tendon
5. coracohumeral: limits inf. translation & ext. rotation
6. coracoacromial: protection

Question 15

in which ration do movements of scapula and humerus occur?

Answer 15

2:1 (2x GHJ: 1x Scapulothoracal) -> scapulothoracic rhythm

Question 16

Describe the elbow joint.

Answer 16

• synovial, diarthrosis
• hinge, ellipsoid, pivot
• uniaxial

Question 17

What are the three articulations?

Answer 17

1. humeroulnar (modified hinge)
2. humeroradial (gliding plane)
3. proximal radioulnar (pivot)

Question 18

What are the ligaments of the elbow?

Answer 18

1. medial/ulnar collateral
2. lateral/radial collateral
3. annular ligament

Question 19

Functions of the ligaments?

Answer 19

• reinforcement of capsule
• stabilize joint in opposing varus and valgus movements

Question 20

Describe the humeroulnar joint.

Answer 20

• axis of rotation for flexion/extension runs through capitulum and trochlea
• 145 degrees of active motion
• active flexion limited by tissue approximation
• active extension limited by boney approximation

Question 21

Describe the humeroradial joint.

Answer 21

role in stability of elbow through pronation and supination

Question 22

Describe the proximal radioulnar joint.

Answer 22

• axis for pronation and supination from center of radial head to ulna styloid

Question 23

What is cubitus varus and valgus?

Answer 23

varus: arm carrying angle of less than 5 degrees
valgus: arm carrying angle of more than 15 degrees

Question 24

Symptoms of tennis elbow?

Answer 24

- pain radiating from outside of elbow into forearm and wrist - difficulty shaking hands and gripping objects - difficulty turning doorknobs - difficulty holding cups

Question 25

Symptoms of Golfer's elbow?

Answer 25

- pain and tenderness on inside - stiffness - weakness - numbness or tingling

Question 26

Describe the distal radioulnar joint.

Answer 26

- between head of ulna and ulnar notch of radius - synovial uniaxial pivot joint - assists in supination and pronation

Question 27

Ligaments of the joint?

Answer 27

- ant. radioulnar ligament: from anterior margin of ulnar notch of radius to front of head of ulna - post. radioulnar ligaments

Question 28

What is their function?

Answer 28

stabilize the joint

Question 29

What are the wrist and hand joints?

Answer 29

1. radiocarpal (synovial condyloid) 2. intercarpal (synovial-plane gliding) 3. carpal-metacarpal (synovial-plane gliding) 4. trapezium-metacarpal (synovial saddle) 5. metacarpal-phalangeal (synovial condyloid) 6. interphalangeal (synovial hinge)

Question 30

Describe the radiocarpal joint.

Answer 30

- between distal end of radius and scaphoid, lunate and triquetrum - radioulnar disc between ulna and carpals - NO ART. BETWEEN ULNA AND CARPALS!!

Question 31

Extrinsic ligaments of the wrist?

Answer 31

1. palmar radiocarpal 2. palmar ulnocarpal 3. dorsal radiocarpal 4. radial collateral 5. ulnar collateral

Question 32

What do they do?

Answer 32

bridge carpal bones to radius and ulna

Question 33

What is their function?

Answer 33

- stabilize the wrist joint - limit flexion and extension - limit radial and ulnar deviation

Question 34

What are the intrinsic muscles of the wrist?

Answer 34

1. palmar intercarpal 2. dorsal intercarpal

Question 35

What do they do?

Answer 35

bridge between carpal bones

Question 36

What is their function?

Answer 36

- stabilize the carpals - provide stabilization between hand and forearm

Question 37

What are the most important intrinsic ligaments?

Answer 37

Scapholunate interosseous and Lunotriquetral interosseous ligament

Question 38

What is flexor retinaculum?

Answer 38

the transverse carpal ligament

Question 39

What does it do?

Answer 39

- arches over carpus, holding flexor tendons and median nerve in place - creates carpal tunnel - attaches to pisiform & hamate (medially) and the scaphoid & trapezius (laterally)

Question 40

What is the extensor retinaculum?

Answer 40

the dorsal carpal ligament

Question 41

What does it do?

Answer 41

- holds extensor tendons in place - attaches to lateral margin of radius and medially to triquetrum & pisiformis

Question 42

Describe flexion and extension in the wrist.

Answer 42

flexion: initiated in intercarpal joint extension: initiated at mid-carpal, most occurs in radio-carpal both: occur at radiocarpal and midcarpal joints around axis through capitate

Question 43

Describe ulnar and radial deviation?

Answer 43

- at radiocarpal and midcarpal joints around axis through capitate - ulnar deviation: includes extension of prox. carpals - radial deviation: includes flexion of prox. carpals

Question 44

What is grip strength a measure of?

Answer 44

muscular strength, maximum force generated by forearm and hand muscles

Question 45

Describe the intercarpal joints.

Answer 45

- between proximal carpals and distal ones - plane gliding joints

Question 46

Describe the carpo-metacarpal joint 1/trapeziometacarpal joint.

Answer 46

- saddle joint - trapezium + 1st metacarpal - rotary component

Question 47

Describe the carpometacarpal joint 2&3.

Answer 47

- between distal row of carpals and proximal end of metacarpals - plane gliding - provide more stability than mobility

Question 48

Describe carpometacarpal joints 4&5.

Answer 48

- structurally: biaxial saddle; functionally: uniaxial hinge - allow flexion/extension and adduction/abduction

Question 49

Describe the metacarpal phalangeal joints.

Answer 49

- synovial condyloid - flexion, extension, passive rotation

Question 50

Describe the interphalangeal joints.

Answer 50

- synovial hinge - flexion, extension, passive rotation

Question 51

What are the ligaments of the hand?

Answer 51

1. collateral 2. deep transverse metacarpal 3. palmar 4. cruciate 5. annular