UE arthrology LOs Flashcards

1
Q

sternoclavicular joint

A
  • sellar joint with articular disc
  • superior –> inferior
    • convex clavicle
    • concave manubrium
  • anterior –> posterior
    • concave clavicle
    • convex manubrium
  • motions
    • protraction: anterior glide of concave clavicle
    • retraction: posterior glide
    • elevation: superior roll and inferior glide of convex clavicle
    • depression: inferior roll and superior glide
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2
Q

acromioclavicular joint

A
  • plane/gliding motion
  • acromion and clavicle: flat?
  • motions
    • protraction and retraction: A-P glide
    • abduction and adduction: acromion rotattion on clavicle
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3
Q

glenohumeral joint

A
  • like golf ball on tee, ball in socket
    • convex humeral head
    • concave glenoid fossa
  • motions:
    • convex on concave – roll and glide opposite (most off the time)
    • ER: roll posterior, glide anterior
    • IR: roll anterior, glide posterior
    • flexion: roll superior, glide inferior
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4
Q

scapulothoracic joint

A
  • pseudo joint – muscular between scapula and joint
    • no direct ligamentous attachments
  • motions:
    • abduction/protraction: lateral and anterior
    • adduction/retraction: medial and posterior
    • “rotations:” upward/downward, IR/ER, anterior/posterior tilt
    • depression
    • elevation
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5
Q

labrum

A
  • produces concavity of glenoid fossa
    • deepens socket 50-75%
      • glenoid is shallow socket: faces lateral/anterior/superior, changes with scapular position
      • glenoid fossa is 1/4 side of humeral head, pear shaped
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6
Q

joint capsule

A
  • anterior and posterior capsula tissue continues on neck of humerus
    • anterior and inferior cpasule thicker than posterior
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7
Q

ligament complex

A
  • anterior GH ligaments
    • superior GHL, middle GHL
  • inferior GHL: pliable redundant ligament complex
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8
Q

muscles/dynamic stabilizes

A
  • reotator cuff: pull head of humerus into glenoid fossa
    • supraspinatus, subscapularis, infraspinatus, teres minor, long head of biceps
    • RC <> capsule <> ligaments
      • tendons intimate with capsule – interdigitate
      • encapsulates humeral head
      • tendon”itis”/inflammation rarely isolated to 1 tendon
      • muscles/tendons do not function in isolation
  • deltoid: largely stabilizing, regardless of humeral position
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9
Q

sternoclavicular dislocation

A
  • very rare: occurs with direct trauma or blow to clavicle or FOOSH/arm
    • much more common to fracture clavicle
  • can be anterior or posterior
    • posterior type holds higher risk of injury to other structures
      • auto/allograft
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10
Q

acromioclavicular sprain/separation

A
  • fall on tip of shoulder/acromion
  • progressive disruption of ligaments
    • AC ligament
    • trapezoid
    • conoid
  • then by displacement
  • 1-3 generally managed non-surgically
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11
Q

glenohumeral subacromial “impingement”

A
  • RTC of LHB repeatedly compressed with bursa
  • potential causes
    • RTC dysfunction
    • scapular position
    • acromion shape
    • GH mobility deficit or hypermobility
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12
Q

elbow joint

A
  • modified hinge joint
  • humeroulnar and proximal radioulnar and humeroradial
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13
Q

humeroulnar joint

A
  • hinge: roll and glide same – ulnar on humerus
    • concave ulnar (trochlear notch)
    • convex humerus (trochlea)
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14
Q

proximal radioulnar joint

A
  • ovoid joint: opposite roll and glide
    • convex radial head
    • concave ulna (radial notch)
  • motions:
    • pronation: radial head rolls anterior, glide posterior
    • supination: radial head rolls posterior, glide anterior
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15
Q

humeroradial joint

A
  • hinge joint: roll and glide same directions for flexion and extension
    • convex humerus capitulum
    • concave head of radius
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16
Q

distal radioulnar joint

A
  • ovoid joint: roll and glide same
    • convex head of ulnar
    • concave radius (ulnar notch)
17
Q

radiocarpal/ulnocarpal joints

A
  • ovoid: convex on concave, roll and glide opposite
    • convex arm bone on concave
18
Q

midcarpal joint

A
  • proximal surface of distal row
  • convex ulnar compartment
    • capitate and hamate
  • radial compartment
    • RD/UD: convex radial compartment
      • trapezium and trapezoid
    • flexion/extension: concave radial compartment
      • dorsal/volar
19
Q

first carpometacarpal joint

A
  • sellar joint: R&G opposite palmar abd/add, R&G same radial abd/add
  • distal trapezium
    • convex radial/ulnar
    • concave dorsal/volar
  • proximal surface of 1st MC
    • convex dorsal/volar – palmar abd/add
    • concave radial/ulnar – radial abd/add
20
Q

thumb metacarpophalangeal

A
  • condyloid
  • capsule, volar plate, and collateral ligaments
  • sesamoids
21
Q

interphalangeal joints (IP 1-5, thumb MP)

A
  • true synovial hinge: roll and glide same for flexion and extension
    • convex distal proximal phalanx
    • concave proximal of distal phalanx
  • PIP and DIP 2-5
    • convex proximal, pull shaped
    • bi-concave distal
22
Q

carpometacarpal joints 2&3 vs 4&5

A
  • 2&3: interlocking articular surfaces prevent motion
  • 4&5: opposite roll and glide
    • slightly convex proximal MC surfaces
    • slightly concave distsal surface hamate
23
Q

metacarpophalangeal 2-5

A
  • ovoid: roll and glide same
    • biconcave distal surface of metacarpals
    • concave proximal surface of phalanges
24
Q

elbow capsule

A
  • thin but strong
  • does not respond well to injury or immobilization
    • forms thick scar tissue resulting in flexion contractions
25
Q

triangular fibrocartilage complex (TFCC)

A
  • components
    • biconcave fibrocartilage disc
    • palmar ulnocarpal ligament
    • ulnar collateral ligament
    • sometimes dorsal and volar radioulnar ligaments
  • functionals
    • major stabilizer DRUJ – binds distal radius and ulna
    • provides dual articular surface
    • separates RU from RC joint
    • cushion ulnar sided forces transmission
26
Q

ulnar collateral ligament injury

A
  • anterior band most commonly ruptured
  • varied repair and reconstruction techniques
27
Q

TFCC injury

A
  • mechanism
    • FOOSH
    • extension with ulnar compression
    • forced radial or ulnar deviation
    • strong distraction force
  • structures involved dictate symptoms
    • disc injury from compression and sheer
    • ligamentous attachment injury from distraction force or extreme radial deviation