UE Arthrology Flashcards
What are the joints that comprise the shoulder girdle?
What are their classifications?
- sternoclavicular joint: sellar synovial joint (saddle joint), between the clavicular notch of the manubrium and sternal facet on sternal end of the clavicle
- acromioclavicular joint: planar synovial joint, between the acromial facet on the acromial end of the clavicle and the facet on the acromion of the scapula
- glenohumeral joint: spheroidal synovial joint, between the glenoid cavity of the scapular head, which is deepened and supported by the glenoid labrum and the head of the humerus
What are the components of the sternoclavicular joint?
- articular capsule (surrounds the joint): fibrous capsule and synovial membrane
- articular disc
- costoclavicular L.: from sternal end of clavicle to 1st rib
- anterior sternoclavicular L.: thickened fibrous capsule on anterior aspect
- interclavicular L.: from sternal end of clavicle to contralateral clavicle
What are the components of the acromioclavicular joint?
- articular capsule (sleeve like, surrounds the joint): fibrous capsule and synovial membrane
- articular disc
- acromioclavicular L.: from acromion to clavicle
- coracoclavicular L. (two bands uniting the coracoid process and the clavicle): trapezoid L. (nearly horizontal band from trapezoid line to coracoid process, lateral to conoid L.) and conoid L. (vertical, inverted triangular band from conoid tubercle to coracoid process, medial to trapezoid L.)
What are the components of the glenohumeral joint?
- glenoid labrum
- articular capsule (loose, surrounds the joint): fibrous capsule (open in two places to allow passage of the long head of biceps T. and communication w/ the subscapular bursa) and the synovial membrane (lines the fibrous capsule, communicates w/ the subscapular bursa, forms a sheath around the long head of the biceps brachii T. in the intertubercular groove)
- glenohumeral L.: from glenoid labrum and supraglenoid tubercle to the anatomical humeral neck blending w/ the fibrous capsule
- coracohumeral L.: from the base of the coracoid process to the anterior edge of the greater tubercle of the humerus
- transverse humeral L.: broad band from the greater humeral tubercle to lesser humeral tubercle spanning the intertubercular groove; encapsulates the long head of the biceps brachii T.
- coracoacromial arch (osseoligamentous arch preventing superior displacement of the humerus from the glenoid cavity): coracoacromial L. (from coracoid process to acromion)
What bursae are present in the glenohumeral joint?
- subscapular bursa: between the subscapularis T. and the scapular neck, communicates w/ the synovial membrane of the glenohumeral joint
- subacromial bursa: between the deltoid M., supraspinatus T., and the articular capsule; does not usually communicate w/ the synovial membrane
The _____________ joint is susceptible to injury and separation, often referred to as “shoulder separation,” and is capable of separating with or w/o rupture of the coracoclavicular L.
acromioclavicular joint
The _____________ joint is susceptible to dislocation due to its mobility and relative instability. Due to the presence of the coracoacromial arch, dislocation of this joint most commonly occurs anterioly or inferiorly
glenohumeral joint
What type of joint is the elbow?
What is the capsule type?
What are the names of the subjoints?
What articulations are involved?
- ginglymus synovial joint
- articular capsule: fibrous capsule and synovial membrane (continuous distally w/ the synovial membrane of the proximal radioulnar joint)
- humeroulnar joint and humeroradial joint
- articulations between the humeral condyle, the trochlear notch of the ulna, and the head of the radius
- joint within the elbow
- trochlear notch of ulna wraps around humeral trochlea
- ulnar collateral L. of the elbow (from the medial humeral epicondyle to the coronoid process of the ulna and olecranon, consists of three bands): anterior band (cord shaped, strongest), posterior band (fan shaped, weakest), and oblique band (deepends socket for humeral trochlea)
humeroulnar joint
- joint within the elbow
- humeral capitulum articulates w/ the fovea of the radial head
- radial collateral L. of the elbow: fan shaped, from the lateral humeral epicondyle to blend w/ the annular L. of the radial head
humeroradial joint
What are the bursae present in the elbow joint?
- olecranon bursae: subtendinous (between triceps brachii T. and olecranon), intratendinous (inside the triceps brachii T.), and subcutaneous (in the subcutaneous connective tissue over the olecranon)
- subcutaneous bursa of the medial humeral epicondyle
- subcutaneous bursa of the lateral humeral epicondyle
- bursa of the anconeus: between the lateral humeral epicondyle and anconeus M.
- bursa at origin of extensor carpi radialis brevis: between the lateral humeral epicondyle and the extensor carpi radialis brevis M.
- bicipitoradial bursa: between the biceps brachii T. and the radial tuberosity
- injury of the elbow in response to force transmitted along the long axis of forearm
- usually involves a tear in the ulnar collateral L.
posterior elbow dislocation
What are the two more common elbow bursae to become inflammed?
- subcutaneous olecranon bursa and bicipitoradial bursa
- subcutaneous is sometimes called “student’s elbow”, “dart thrower’s elbow”, and “miner’s elbow”
- results from excessive friction between the skin and the olecranon
What are the 3 subjoints or articulations within the radioulnar joint?
- proximal radioulnar joint: trochoid synovial joint, primary site of supination and pronation
- middle radioulnar joint: syndesmosis
- distal radioulnar joint: trochoid synovial joint, L shaped joint between the head of the ulna and the ulnar notch of the radius laterally and the articular disc inferiorly
What are the components of the proximal radioulnar joint?
(trochoid synovial joint, primary site of supination/pronation)
- articular capsule (continues w/ the articular capsule of the elbow joint): fibrous capsule and synovial membrane (continues w/ the synovial membrane of elbow joint, lines the underside of the annular L., continues distally as the sacciform recess*)
- annular L.: from coronoid process of the ulna around the radial head to insert back on the ulna, holds the radial head in the radial notch
*sacciform recess: small pocket of synovial membrane protruding out from under the annular L.
What are the components of the middle radioulnar joint?
(syndesmosis)
- oblique cord: between the coronoid process of the ulna and radial body
- interosseous membrane: between length of ulna and radius, divides the forearm into anterior and posterior compartments, serves as muscular attachments, does not limit pronation/supination
What are the components of the distal radioulnar joint?
(trochoid synovial joint, L shaped between the head of the ulna and the ulnar notch of the radius laterally and the articular disc inferiorly)
- articular capsule (surrounds the joint): fibrous capsule (deficient superiorly), synovial membrane (lines the fibrous capsule, extends proximally out from under the fibrous capsule as sacciform recess* of the distal radioulnar joint), and articular disc
*sacciform recess: small pocket of synovial membrane protruding out from under the fibrous capsule
The ______ head is capable of being dislocated out of the annular L. to varying degrees. This injury typically occurs from pulling on the arm of a child, sometimes called “nursemaid’s elbow” or “pulled elbow”
radial
- wrist joint: condylar synovial joint, between the distal end of the radius, plus the articular disc of the distal radioulnar joint and the scaphoid, lunate, and triquetrum bones
- articular capsule (surrounds the joint): fibrous capsule (from radius and ulna to proximal row of carpal bones), synovial membrane (lines the fibrous capsule, folds), and articular disc
radiocarpal joint
What are the ligaments of the radiocarpal joint?
- palmar radiocarpal L. (two bands: one from the radius across to the scaphoid, and to the lunate, the other is from the radius to the capitate)
- dorsal radiocarpal L. (oblique band from the radius across the lunate to the triquetrum)
- palmar ulnocarpal L. (two bands: one from the ulnar head to the lunate, the other from the ulnar head to the triquetrum)
- dorsal ulnocarpal L. (from the ulnar head to the triquetrum)
- radial collateral L. of the wrist (from radial styloid process to scaphoid)
- ulnar collateral L. of the wrist (from ulnar styloid process to triquetrum, via the pisiform)
What are the components of the intercarpal joints?
(planar synovial joints: scapholuntae, lunotriquetrum, pisotriquetrum, pisohamate, trapeziotrapezoid, capitiohamate, trapeziocapitate)
- articular capsule (continuous, common joint space between all intercarpal and carpometacarpal joints except the 1st carpometacarpal joint): fibrous capsule (surrounds joint) and synovial membrane (lines the fibrous capsule)
- posterior intercarpal L. (between carpal bones posteriorly)
- anterior intercarpal L. (between carpal bones anteriorly)
- interosseous intercarpal L. (in the joint space between carpal bones)
- pisiform joint (articulation of the pisiform with the anterior surface of the triquetrum): pisohamate (between the pisiform and the hook of the hamate)
What are the components of midcarpal joint?
(sellar synovial joint, between proximal and distal rows of carpal bones)
- articular capsule (continuous w/ the capsule of the intercarpal and carpometacarpal joints, surrounding a common joint cavity, strengthened anteriorly and posteriorly by the anterior and posterior intercarpal L., strengthened medially and laterally by the radial and ulnar collateral L. of the wrist), fibrous capsule (surrounds the joint), and synovial membrane (lines the fibrous capsule)
What are the components of the 1st carpometacarpal joint?
(sellar synovial joint, from trapezium to 1st metacarpal)
- articular capsule (separate from the common joint capsule and space of the medial four carpometacarpal joints): fibrous capsule (surrounds joint) and synovial membrane (lines fibrous capsule)
- palmar carpometacarpal L.
- dorsal carpometacarpal L.
What are the components of the 2nd-5th carpometacarpal joints?
(planar synovial joint, from distal carpal row to 2nd-5th metacarpals)
- articular capsule (common joint capsule and space for the medial four carpometacarpal joints): fibrous capsule (surrounds joint) and synovial membrane (lines fibrous capsule)
- palmar carpometacarpal L.
- dorsal carpometacarpal L.
- pisometacarpal L. (a/w 5th metacarpal, in junction w/ pisohamate L., are the continuation of the flexor carpi ulnaris T.)
- radiate carpal L. (from the capitate to the bases of metacarpals)
What are the components of the intermetacarpal joints?
(4, planar synovial joints)
- articular capsule (between the bases of the 1st and 2nd metacarpal bones, separate from the medial three joints that share a joint capsule and cavity w/ the medial four carpometacarpal joints): fibrous capsule and synovial membrane
- dorsal intermetacarpal L.
- palmar intermetacarpal L.
- interosseous intermetacarpal L. (inside the joint space between bases of metacarpal bones)
What are the components of the metacarpophalangeal joints?
(5, condylar synovial joints)
- articular capsule (separate for each metacarpophalangeal joint): fibrous capsule and synovial membrane
- palmar L. (or plate L.; thickened anterior aspect of the articular capsule, attachment point for the fan shaped part of the collateral L., blends w/ the digital sheath providing a longitudinal groove for the flexor tendons to glide and stay over the center of the joint)
- medial collateral L. (medial side of the joint, possesses a cord shaped part running proximal to distal and a fan shaped part traveling anteriorly to insert onto the palmar L.)
- lateral collateral L. (lateral side of the joint, possesses a cord shaped part running proximal to distal and a fan shaped part traveling anteriorly to insert onto the palmar L.)
- deep transverse metacarpal L. (transverse fibers joining the palmar L. of the medial four metacarpophalangeal joints)
Sprain of the ______ _______ ligament, and even avulsion of the lateral part of the proximal phalanx of the thumb is an injury common to individuals who ride a mechanical bull, and is therefore known as “bull rider’s thumb”
lateral collateral L.
Laxity or rupture of both _______ _________ of the 1st ______________ joints results in a hyperabduction of that joint and is referred to as “skier’s thumb” or “game keeper’s thumb”
- collateral ligaments
- 1st metacarpophalangeal joints
What are the components of the 1st interphalangeal joint?
(ginglymus synovial joint)
- articular capsule: fibrous capsule and synovial membrane
- palmar L. (or plate L., thickened anterior aspect of the articular capsule, attachment point for the fan shaped part of the collateral L., blends w/ the digital sheath providing a longitudinal groove for the flexor tendons to glide and stay over the center of the joint)
- medial collateral L. (medial side of the joint, possesses a cord shaped part running proximal to distal and a fan shaped part traveling anteriorly to insert onto the palmar L.)
- lateral collateral L. (lateral side of the joint, possesses a cord shaped part running proximal to distal and a fan shaped part traveling anteriorly to insert on the palmar L.)
What are the components of the proximal interphalangeal joints?
(4, ginglymus synovial joint, union between 2nd-5th proximal and intermediate phalanges)
- articular capsule (separate for each joint): fibrous capsule and synovial membrane
- palmar L. (or plate L.)
- medial collateral L.
- lateral collateral L.
*descriptions of Ls. are the same as the 1st interphalangeal joint*
What are the components of the distal interphalangeal joints?
(4, ginglymus synovial joint, union between 2nd-5th intermediate and distal phalanges)
- articular capsule (separate for each joint): fibrous capsule and synovial membrane
- palmar L. (or plate L.)
- medial collateral L.
- lateral collateral L.
*descriptions of Ls. are the same as the 1st interphalangeal joint*
Sudden hyperflexion of the _____ ____________ joint can avulse the attachment of the long extensor tendon w/ that tendon away from the distal phalanx, this is known as “mallet finger” or “baseball finger”
distal interphalangeal joint
What fascia is present in the shoulder and axilla?
- pectoral fascia (invests the pectoralis major M., continuous superiorly w/ deltoid fascia, laterally w/ axillary fascia, and inferiorly w/ abdominal deep fascia
- axillary fascia (floor of the axilla, continuous medially w/ pectoral fascia and inferiorly w/ clavipectoral fascia)
- clavipectoral fascia (deep to pectoral fascia and pectoralis M., extends inferiorly from the clavicle to invest the subclavius and pectoralis minor M. before blending w/ axillary fascia): costocoracoid membrane (clavipectoral fascia between the subclavius M. and pectoralis minor M.) and suspensory L. of the axilla (clavipectoral fascia between pectoralis minor M. and axillary fascia, forms axillary fossa
- deltoid fasica (covers the deltoid M., continuous anteriorly w/ pectoral fascia and posteriorly w/ infraspinous fascia
- supraspinous fascia (extremely dense fascia overlying the supraspinatus M.)
- infraspinous fascia (extremely dense fascia overlying the infraspinatus M.)
What fascia is present in the brachium?
- brachial fascia (continuous superiorly w/ the pectoral, deltoid, infraspinous, and axillary fascia, continuous inferiorly w/ antebrachial fascia, covers the musculature of the brachium)
- medial intermuscular septum (extends from the deep surface of brachial fascia to the humerus, distally to the medial supraepicondylar ridge, in conjunction w/ the lateral intermuscular septum, separates the brachium into an anterior (flexor) and posterior (extensor) compartment
- lateral intermuscular septum (extends from the deep surface of brachial fascia to the humerus, distally to the lateral supraepicondylar ridge)
What fascia is present in the antebrachium?
- antebrachial fascia (continuous superiorly w/ brachial fascia, utilizes the interosseous membrane to divide the antebrachium into an anterior (flexor) and posterior (extensor) compartment
- interosseous membrane
- extensor retinaculum and synovial tendon sheaths
- palmar carpal L. (corresponding anterior transverse focal thickening of antebrachial fascia, continuous w/ the extensor retinaculum
- flexor retinaculum and common flexor sheath
Describe the extensor and flexor retinaculums of the UE and associated structures:
- extensor retinaculum (transverse focal thickening of antebrachial fascia, holds the extensor tendons in position): synovial tendon sheaths (6 synovial tendon sheaths surround the long extensor tendons of the forearm as they pass under the extensor retinaculum to reduce friction)
- flexor retinaculum (transverse carpal L., deep and distal to the palmar carpal L., fibrous band extending from the tubercles of the scaphoid and trapezium across the carpal arch to the hook of the hamate and pisiform, forming the carpal tunnel): common flexor sheath (1 large synovial sheath surrounding the long tendons of the flexor digitorum superficialis and profundus M. to reduce friction under the flexor retinaculum)
What fascia is present in the hand?
- palmar fascia (continuous proximally w/ antebrachial fascia)
- palmar aponeurosis (thickened central region of palmar fascia, continuous proximally w/ the palmaris longus T.): superficial transverse metacarpal L. (base of the palmar aponeurosis), retinacula cutis (numerous small ligaments that extend from the palmar aponeurosis to the skin, restricting palmar skin movement), medial fibrous septum (extends dorsally to the 5th metacarpal, separates the hypothenar compartment from the central compartment), and lateral fibrous septum (extends dorsally to the 3rd metacarpal, separates the thenar compartment from the central compartment)
- dorsal fascia (deep to subcutaneous fat on the dorsum of the hand)
- fibrous digital sheaths (distal extensions from the palmar aponeurosis, fibrous tubes that enclose the synovial sheaths of the long flexor tendons, arranged into altering annular and cruciform segments): digital synovial sheaths (synovial sheaths for the individual digits that surround the long tendons of the flexor digitorum superficialis and profundus M., held firmly in place by the fibrous digital sheaths
- irritation of the synovial sheaths can cause an accumulation of mucopolysaccharide fluid that can form an usually painless lump known as a synovial, or ________ ______
- infections of the synovial sheath can cause swelling in very specific and characteristic configurations that follow the shapes of these sheaths
ganglion cyst
- a disease resulting the shortening, thickening, and fibrosis of the palmar aponeurosis and plamar fascia
- results in partial flexion of the 4th and 5th digits
Dupuytren contracture
