UE joints - Shoulder And Elbow Flashcards
T/F: all joints of the upper extremity are synovial and diarthrotic
True
Which upper limb joint has the following characteristics:
Synovial; plane
Diarthrotic; gliding and rotation of scapula on clavicle
Acromioclavicular joint
[articulating bones are the acromion process of scapula and the clavicle]
Which upper limb joint has the following characteristics:
Synovial; ball-and-socket
Diarthrotic; multi-axial: flexion, extension, abduction, adduction, circumduction, rotation of humerus/arm
Glenohumeral joint
[articulating bones are the scapula and humerus]
Which upper limb joint has the following characteristics:
Synovial; hinge
Diarthrotic; uniaxial: flexion, extension of forearm
Elbow
[articulating bones are the ulna+radius and humerus]
Which upper limb joint has the following characteristics:
Synovial; pivot
Diarthrotic; uniaxial: rotation of radius around long axis of forearm to allow pronation and supination
Proximal radioulnar joint
[articulating bones are radius and ulna]
Which upper limb joint has the following characteristics:
Synovial; pivot; contains articular disc
Diarthrotic; uniaxial: rotation (convex head of ulna rotates in the ulnar notch of radius)
Distal radioulnar joint
Which upper limb joint has the following characteristics:
Synovial; shallow saddle with articular disc
Diarthrotic; multiaxial
Sternoclavicular joint
[articulating bones are sternum and clavicle]
What is another term for saddle joint?
Sellar joint
The sternoclavicular joint is classified as a shallow saddle joint, but may also be referred to as a ___________ ____________ because of the interarticular disc
Double saddle (or double gliding)
The pectoral girdle is made up of only 2 bones - what are they?
Scapula
Clavicle
What are the 2 joints of the pectoral girdle?
Sternoclavicular joint
Acromioclavicular joint
What is the only TRUE bony articulation between the upper limb and thorax?
Sternoclavicular joint
Which joint of the upper extremity has 2 separate synovial cavities?
Sternoclavicular joint
What are the 3 types of movements that take place at the multi-axial sternoclavicular joint?
Elevation/depression
Protraction/retraction
Rotation
Is dislocation of the sternoclavicular joint common? Why or why not?
No, it rarely occus because the SC joint is very strong; would need a strong longitudinal compressive force in order to dislocate it
You are more likely to have a fracture if this type of force is applied
Although SC dislocations are rare, what is the most common cause?
Fractures through the epiphyseal plate at the sternal end of the clavicle in individuals less than 25 years old
What is the Sprengel Deformity?
Rare congenital anomaly resulting in high placement of scapula
What happens to the musculature surrounding the scapula with the Sprengel deformity? What does this lead to?
Regional muscle hypoplasia or atrophy
Leads to disfigurement and limitation of shoulder movement
What causes a winged scapula deformity?
Muscles of the scapula are weak or paralyzed - may result from brachial plexus injury or post-infection
What nerve of the brachial plexus is commonly associated with the winged scapula deformity?
Long thoracic n.
Winged scapula deformity is characterized by medial border of scapula protruding like wings - what are the clinical implications of this deformity and what are the treatments (i.e., what muscle needs to be strengthened?)
Patient will have limited ability to stabilize the scapula
Treatment includes strengthening muscles - particularly serratus anterior m.
What ligaments are associated with the acromioclavicular joint?
Superior and inferior acromioclavicular ligaments
Accessory ligaments = coracoclavicular ligaments
What are the 3 components of the coracoacromial arch?
Acromion
Coracoacromial ligament
Coracoid process
Dislocation at which upper extremity joint is characterized as a shoulder separation?
Acriomioclavicular dislocation
What are the 3 grades of a shoulder separation aka acromioclavicular dislocation?
Grade 1: acromioclavicular ligament sprain
Grade 2: acromioclavicular ligament tear
Grade 3: both acromioclavicular and coracoclavicular ligaments are torn
What fibrocartilaginous structure functions to slightly deepen the glenoid cavity?
Glenoid labrum
What is the most commonly dislocated upper extremity joint?
Glenohumeral joint
The glenohumeral joint is commonly dislocated. Most dislocations occur in the ____________ direction, but are described as ___________.
Inferior; anterior
What structures tend to prevent upward dislocation of the glenohumeral joint?
Coracoacromial arch structures (acromion, coracoacromial ligament, coracoid process)
Rotator cuff muscles
Anterior dislocations of the glenohumeral joint occur most often in young adults due to what motion?
Hyperextension with lateral rotation
[humeral head is forced in an infero-anterior direction; fibrous layer of joint capsule and glenoid labrum may tear]
How does anterior dislocation of the glenohumeral joint occur from a hard blow to the humerus while fully abducted?
Humeral head is tilted inferiorly and pushed through weaker part of joint capsule
Joint capsule may tear such that humeral head is positioned inferior to glenoid cavity and anterior to infraglenoid tubercle
What deformity of the upper extremity is characterized by the humeral head resting against the antero-inferior part of the glenoid, chipping the humeral head?
Hill-Sach’s Deformity
Hill Sach’s Deformity is characterized by the humeral head resting against the antero-inferior part of the glenoid, chipping the humeral head.
What type of injury causes this?
Posterolateral humeral head compression fracture - usually secondary to recurrent anterior shoulder dislocations
What condition results from chronic inflammation in the glenohumeral joint, leading to fibrosis between the joint capsule, rotator cuff muscles, and synovial bursa?
Adhesive capsulitis of glenohumeral joint
What is the common term used to describe adhesive capsulitis of the glenohumeral joint?
Frozen shoulder
What motion is primarily affected by adhesive capsulitis of the glenohumeral joint (frozen shoulder)
Abduction; compensatory scapular movements
What injuries might initiate adhesive capsulitis of the glenohumeral joint (frozen shoulder)?
Glenohumeral dislocation
Supraspinatus tendonitis
Bicipital tendonitis
Rotator cuff tears
What are the 2 types of glenoid labrum injury and which one is more common?
Superior labrum anteroposterior (SLAP) injury
Inferior labrum anteroposterior (ILAP) injury
SLAP is more common
The long biceps head tendon attaches to the labrum as well as the superior glenoid tubercle. How might a superior labrum anteroposterior (SLAP) injury occur?
Tear of labrum due to sudden contraction of biceps or forceful subluxation of humerus
What 3 articulations make up the elbow (cubital) joint?
Humeroulnar articulation
Humeroradial articulation
Proximal radioulnar articulation
What ligaments are associated with the elbow?
Humeroulnar and humeroradial ligaments (lateral/radial collateral and medial/ulnar collateral ligaments)
Proximal radioulnar (annular) ligament
What injury, commonly known as nursemaid’s elbow, is caused by sudden lifting motion of the upper limb in a jerking motion (common in children)?
Subluxation/dislocation of radial head
During subluxation/dislocation of radial head, the distal attachment of the _________ ligament becomes torn
Annular
If a sail sign is present on the x-ray of an elbow, what does it mean?
What causes the sail sign?
Elbow joint effusion
Could indicate radial head fracture; fluid pushes up anterior condylar fat pad and posterior olecranon fat pad
What elbow ligament is commonly injured in baseball pitchers?
Ulnar collateral ligament
A torn ulnar collateral ligament can be repaired with full restoration of function by grafting tendon from what muscle?
Palmaris longus m.
What is the term for a complete transverse fracture of the distal 2 cm of the radius?
Colle’s fracture
Colle’s fracture, or complete transverse fracture of the distal 2 cm of the radius, is associated with _______ displacement of the distal fragment.
It results from forced ________ of the hand on an outstretched limb while breaking a fall. The bone fragment often takes shape of a silver fork on x-rays.
Dorsal
Extension
