TEC1 - Semester 2: Upper Extremity Flashcards
Name the upper extremity joints.
shoulder girdle, elbow, proximal & distal radioulnar, wrist, hand, fingers
Which joints belong to the shoulder girdle?
SCJ, ACJ, GHJ
Describe the SCJ.
- synovial diarthrotic
- biaxial saddle joint
- between proximal clavicle and clavicular notch at manubrium and sup. surface of first costal cartilage
Name the intrinsic and extrensic ligaments of the SCJ.
intrinsic: interclavicular, anterior & posterior sternoclavicular
extrinsic: costoclavicular
Describe the SCJ movements in the planes.
sagittal: anterior & posterior rotation
frontal: elevation, depression
transverse: protraction & retraction
What does humeral abduction require?
clavicular elevation and rotation
What is reciprocal movement?
movement at the same time but in opposite direction
Where does reciprocal movement occur in the clavicle?
at the distal and proximal ends
Describe the ACJ.
- synovial, diarthrosis
- plane/gliding
- between distal clavicle and facet in acromion process
What are the ligaments and discs of the ACJ?
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
functions of the ACJ?
- gives scapula additional ROM
- allows scapula to change shape of thorax as humerus moves
- transmission of forces from UE to clavicle
What happens to scapula in ACJ movements?
- abduction/flexion: scapula rotates sup.
- adduction/extension: scapula rotates inf.
- protraction: internal rotation
- retraction: external rotation
- elevation: anterior tiliting
- depression: posterior tilting
Describe the GHJ.
- synovial, diarthrosis
- ball & socket
- multiaxial
- between humeral head and glenoid cavity
What are the intrinsic and extrinsic ligaments of the GHJ?
intrinsic: glenohumeral (sup, middle, inf.), transverse humeral, coracohumeral
extrinsic: coracoacromial
What are their functions?
- Superior: prevents inf. translation
- middle: limits ext. rotation
- inferior: limits ext/int rotation
- transverse humeral: prevents displacement of bicep tendon
- coracohumeral: limits inf. translation & ext. rotation
- coracoacromial: protection
in which ration do movements of scapula and humerus occur?
2:1 (2x GHJ: 1x Scapulothoracal) -> scapulothoracic rhythm
Describe the elbow joint.
- synovial, diarthrosis
- hinge, ellipsoid, pivot
- uniaxial
What are the three articulations?
- humeroulnar (modified hinge)
- humeroradial (gliding plane)
- proximal radioulnar (pivot)
What are the ligaments of the elbow?
- medial/ulnar collateral
- lateral/radial collateral
- annular ligament
Functions of the ligaments?
- reinforcement of capsule
- stabilize joint in opposing varus and valgus movements
Describe the humeroulnar joint.
- 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
Describe the humeroradial joint.
role in stability of elbow through pronation and supination
Describe the proximal radioulnar joint.
- axis for pronation and supination from center of radial head to ulna styloid
What is cubitus varus and valgus?
varus: arm carrying angle of less than 5 degrees
valgus: arm carrying angle of more than 15 degrees
Symptoms of tennis elbow?
- pain radiating from outside of elbow into forearm and wrist
- difficulty shaking hands and gripping objects
- difficulty turning doorknobs
- difficulty holding cups
Symptoms of Golfer’s elbow?
- pain and tenderness on inside
- stiffness
- weakness
- numbness or tingling
Describe the distal radioulnar joint.
- between head of ulna and ulnar notch of radius
- synovial uniaxial pivot joint
- assists in supination and pronation
Ligaments of the joint?
- ant. radioulnar ligament: from anterior margin of ulnar notch of radius to front of head of ulna
- post. radioulnar ligaments
What is their function?
stabilize the joint
What are the wrist and hand joints?
- radiocarpal (synovial condyloid)
- intercarpal (synovial-plane gliding)
- carpal-metacarpal (synovial-plane gliding)
- trapezium-metacarpal (synovial saddle)
- metacarpal-phalangeal (synovial condyloid)
- interphalangeal (synovial hinge)
Describe the radiocarpal joint.
- between distal end of radius and scaphoid, lunate and triquetrum
- radioulnar disc between ulna and carpals
- NO ART. BETWEEN ULNA AND CARPALS!!
Extrinsic ligaments of the wrist?
- palmar radiocarpal
- palmar ulnocarpal
- dorsal radiocarpal
- radial collateral
- ulnar collateral
What do they do?
bridge carpal bones to radius and ulna
What is their function?
- stabilize the wrist joint
- limit flexion and extension
- limit radial and ulnar deviation
What are the intrinsic muscles of the wrist?
- palmar intercarpal
- dorsal intercarpal
What do they do?
bridge between carpal bones
What is their function?
- stabilize the carpals
- provide stabilization between hand and forearm
What are the most important intrinsic ligaments?
Scapholunate interosseous and Lunotriquetral interosseous ligament
What is flexor retinaculum?
the transverse carpal ligament
What does it do?
- arches over carpus, holding flexor tendons and median nerve in place
- creates carpal tunnel
- attaches to pisiform & hamate (medially) and the scaphoid & trapezius (laterally)
What is the extensor retinaculum?
the dorsal carpal ligament
What does it do?
- holds extensor tendons in place
- attaches to lateral margin of radius and medially to triquetrum & pisiformis
Describe flexion and extension in the wrist.
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
Describe ulnar and radial deviation?
- at radiocarpal and midcarpal joints around axis through capitate
- ulnar deviation: includes extension of prox. carpals
- radial deviation: includes flexion of prox. carpals
What is grip strength a measure of?
muscular strength, maximum force generated by forearm and hand muscles
Describe the intercarpal joints.
- between proximal carpals and distal ones
- plane gliding joints
Describe the carpo-metacarpal joint 1/trapeziometacarpal joint.
- saddle joint
- trapezium + 1st metacarpal
- rotary component
Describe the carpometacarpal joint 2&3.
- between distal row of carpals and proximal end of metacarpals
- plane gliding
- provide more stability than mobility
Describe carpometacarpal joints 4&5.
- structurally: biaxial saddle; functionally: uniaxial hinge
- allow flexion/extension and adduction/abduction
Describe the metacarpal phalangeal joints.
- synovial condyloid
- flexion, extension, passive rotation
Describe the interphalangeal joints.
- synovial hinge
- flexion, extension, passive rotation
What are the ligaments of the hand?
- collateral
- deep transverse metacarpal
- palmar
- cruciate
- annular
