Unit 2 Flashcards
1
Q
Glenohumeral joint
A
Lax, most loose one arm is by the side. Capsule tightens with 90° abduction and 90° external rotation.
2
Q
Acromioclavicular joint
A
Stabilize clavicle, 3° of freedom, made up of three ligaments. Acromioclavicular, coracoacromial, and Coracoclavicular (2)
3
Q
Sternoclavicular joint
A
- Only bony attachment of the arm to the body
- resists, posterior rotation of the clavicle,
- 3° of freedom for elevation/depression, protraction/retraction, posterior/anterior rotation.
- Three ligaments: anterior and posterior sternoclavicular ligaments, costoclavicular, interclavicular.
4
Q
Scapulothoracic joint
A
Functional joint, upward rotation, between the ribs and anterior scapula
5
Q
Synovial joint
A
Bones meet cartilage, has articular cartilage, synovial membrane
6
Q
Functional joint
A
No joint cavity, held by soft tissues
7
Q
Glenoid labrum
A
O, ring of fibrocartilage, with glenoid that deepens pocket. Connects to the long head of the bicep, pear-shaped with the tip of the pair facing anteriorly. Use his clock analogy.
8
Q
Bursa
A
Synovial membrane protrude through fibrous membrane to form bursa between two tendons
9
Q
Anterior and posterior sternoclavicular ligament
A
Resists, excessive anterior and posterior motion of clavicle
10
Q
Costoclavicular ligament
A
Assist with clavicular, elevation, and superior glide
11
Q
Interclavicular ligament
A
Assists with Depression, in downward glide of sternum and clavicle
12
Q
Acromioclavicular ligament
A
Stabilizes AC joint
13
Q
Coracoacromial ligament
A
Roof of subacromial space
14
Q
Coracoclavicular ligament
A
Guides clavicular rotation.
Made up of trapezoid and conoid.
Trapezoid: guides clavicle during rotation
Conoid: piano key, triangular shaped, prevents vertical displacement
15
Q
Scapulohumeral rhythm
A
ST: upward rotation
GH: externally rotate for greater tubercle to clear acromion
Clavicle: elevates and rotates backwards
- Initial phase: 30° of abduction with no ST motion only humerus
- Mid phase: 30 to 120°, GH & SC move 1:1. First 30° of ST movement needs clavicular elevation, second 30° of ST movement needs 50° of clavicular posterior rotation.
- Last phase: 120 to 180°. GH 2-3:1 ST.
16
Q
Suprascapular nerve entrapment
A
Flows through suprascapular notch under Transversus ligament (suprascapular artery does not). Leads to weakness and atrophy to supraspinatus and infraspinatus, in the order.
Can lead to hypertrophy or athletic.
17
Q
Subacromial space entrapment
A
Under acromion, possible entrapment site for suprascapular nerve
18
Q
Scalene block
A
Ultrasound, scalene and brachial plexus to give anesthesia to upper extremity during surgery
19
Q
Thoracic outlet syndrome
A
Not common, presents as upper extremity signs and symptoms
1. Between anterior and posterior scalene
2. Underneath pec minor
3. Between clavicle, and first rib.
4. Upper extremity and hyper abduction.
5. Cervical rib.
20
Q
Radial tunnel syndrome
A
Radial nerve entrapment, supinator entrapment
21
Q
Cubital tunnel syndrome
A
Numbness of fourth and fifth digits due to pressure on ulnar nerve in cubital tunnel, requires ulnar nerve reassignment
22
Q
Acromion types
A
Flat, curved, hooked: can cause damage to muscle, or entrapment, shaved during rotator cuff surgery
23
Q
Order of rotator cuff tear
A
Sits
24
Q
Supraspinatus tendon tear types
A
- Articular side tear: underside of tendon
- Bursal side tear: top side of tendon.
- Full thickness, tear.
25
Slap injury
Superior labrum, peel back injury of the long head of the bicep tendon due to excessive external rotation. 12 to 1 o’clock.
26
Shoulder instability
Most mobile joint, can be born, loose or torn loose. Bilateral if congenital. Unilateral is injury.
27
Acromioclavicular dislocation
Can occur with or without rupture of the Coracoclavicular ligament
28
Clavicular fracture
Usually in children, Central 1/3 region
29
Shoulder dislocation
Anterior dislocation, most common, axillary nerve can get injured.
Bankhart injury: front of capsule stretches, or tears.
30
Quadrangular space
Side: Lateral margin of long head of tricep
Bottom: superior margin of teres major,
Top: inferior margin of teres minor, Side: surgical neck of humerus
Contents: axillary nerve, posterior circumflex humoral artery, and vein
31
Triangular space
Superior.
Side: medial margin of long head of tricep
Top: superior margin of teres major
Bottom: inferior margin of teres minor
Contents: circumflex scapular artery, and vein
32
Triangular interval
Inferior.
Top: inferior margin of teres major
Side: shaft of humerus
Side: lateral margin of long head of tricep
Contents: deep Brachii artery and radial nerve
33
Proximal bicep tendon rupture
Long head of bicep. Popeye sign, can still use a short head of bicep, typical an older population.
34
Carrying angle
Normal: 10 to 15°
Cubital Valgus: greater than 15°
Cubital Varus: less than 5°
35
Annular ligament
Ligament that wraps around radius by attaching to both sides of the ulna. Contains articular cartilage. Resists excessive radial movement at the head.
36
Collateral ligaments
Supportive on sides, reinforce AB and adduction.
Radio collateral ligament, and ulnar collateral ligament
37
Tommy John surgery
Torn UCL, found in athletes (pitching javelin and water polo), replaced with an autograph from palmaris longus
38
Monteggia
Proximal Ulna fracture with dislocated radial head
39
Galeazzi
Distal radial fracture with dislocated distal radioulnar joint
40
Humeroulnar joint
Main joint of flexion and extension. Trochlear groove, elbow proper.
Hourglass
41
Humeroradial joint
Capitulum and radial head. Flexion and extension.
42
Proximal radioulnar joint
Radial head and radial notch of ulna. Supination and pronation.
43
Cubital fossa
Lateral border: brachioradialis
Medial border: pronator teres
Floor: brachialis and supinator
Roof: line between lateral and medial epicondyle’s
Contents: TAN
Biceps brachii tendon
Brachial artery
Median nerve
44
Interosseous membrane
Hold radius and ulna together, transfer forces from radius to ulna
45
Distal radioulnar joint
Rounded head of ulna articulates with ulnar notch. Articular disc.
46
Quadrate ligament
Radial notch of ulna to neck of radius, inside annular ligament
47
Oblique cord
Below notch of ulna to radial tuberosity. Limits distal motion of the radius or pulled elbow.
48
Triangular, fibrocartilage complex (TFCC)
Triangular disc that binds ends of radius and ulna at the distal radioulnar joint, connects, anterior and posterior radioulnar ligaments
49
Volar
Ventral surface of antebrachium
50
Listers tubercle
Small and rounded on distal radius, pulley of extensor pollicis longus tendon
51
Radiocarpal joint
Flexion and extension of wrist, radial and ulnar deviation
52
Midcarpal joint
Flexion and extension, radial and ulnar deviation, circumduction with radiocarpal joint
53
Carpometacarpal joint’s
Gliding joint
Thumb: basilar joint, AB, and adduction of thumb (site of osteoarthritis)
54
Metacarpophalangeal joint (MCP)
Knuckle, flexion and extension, abduction and adduction
55
Interphalangeal joints (IP)
Between phalanges, flexion and extension
56
Extrinsic muscles
Originate, proximal to the wrist with greater force
57
Intrinsic muscles
Only in the hand, precise movements
58
Extrinsic, extensor muscles: superficial
5
Extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi
59
Extrinsic, extensor muscles: deep
2
Extensor indicis, supinator
60
Extrinsic, extensor muscles: outcropping of the deep
3
Abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus
61
Tennis elbow
Lateral epicondylitis: inflammation
Lateral epicondylosis: Degeneration
Inflammation of lateral epicondyle. Extensor carpi radialis longus, and brevis.
62
Anatomical snuffbox
Thumb.
Extensor pollicis longus, extensor pollicis brevis, abductor pollicis, longus
63
Extensor compartments
1. Apple peanut butter.
Abductor pollicis longus, and extensor pollicis brevis
2. Tennis elbow. Extensor carpi radialis longus, and brevis.
3. Listers tubercle. Extensor pollicis longus
4. Extensor digitorum and extensor indicis.
5. Tea with the queen. Extensor digiti minimi
6. Extensor carpi ulnaris
64
De Quervain’s tenosynovitis
Texting thumb, inflammation in trauma of the first dorsal tendons. Apple peanut butter. Common with new mothers.
65
Tenodesis
Fingers flex with wrist extension, when wrist extension is lost. C6
66
Smith’s fracture
Fall on flexion, Distel radius fracture, volar displacement of the radius
67
Colles Fracture
Fall on extension, distal, radius fracture, dorsal displacement of radius
68
Scaphoid fracture
Fall on outstretched hand injury, can compress radial artery
69
Hand arches
Proximal transverse arch, distal transverse arch, longitudinal arch
70
Movements of the thumb
Abduction, adduction, extension, flexion, opposition, reposition
71
Extrinsic, flexor muscles: superficial
4
Pronator teres, Flexor carpi radialis, flexor carpi ulnaris, palmaris longus
72
Extrinsic, flexor muscles: intermediate
1
Flexor digitorum superficialis
73
Extrinsic, flexor muscles: deep
3
Flexor digitorum profunda, flexor pollicis longus, pronator quadratus
74
Trigger finger
Stenosing tenosynovitis. Inflammation of A1 pulley leads to locking of finger, typically fourth.
75
Mallet finger deformity
DIP flexed position, issues with active range of motion, ruptured, long-term damage, can lead to avulsion: pulls off bone when torn
76
Boxers fracture
Fracture of neck of metacarpal usually fifth
77
Game keepers thumb
Ski thumb, ruptures ulnar collateral ligament of thumb
78
Dupuytren’s contracture
Abnormal thickening of Palmer after neurosis, contraction of fourth and fifth fingers
79
Intrinsic hand muscles
10
Thenar muscles, hypothenar muscles, adductor pollicis, short muscles
80
Palmer aponeurosis
facia over palm, lubricates tendons
81
Thenar muscles
3
Flexor pollicis brevis, abductor pollicis brevis, opponens pollicis
82
Hypothenar muscles
3
Flexor digiti minimi, abductor digiti minimi, opponents, digiti minimi
83
Adductor compartment
Adductor pollicis
84
Short muscles
Palmar interossei, dorsal interossei, lumbricals
85
Elbow flexion
4
Biceps brachii, coracobrachialis, brachialis, brachioradialis
86
Elbow extension
2
Triceps brachii, Anconeus
87
Wrist flexion
4
Flexor carpi radialis, palmaris longus, flexor carpi ulnaris, flexor digitorum profundus
88
Wrist extension
4
Extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor indicis
89
Forearm supination
3
Biceps brachii, brachioradialis, supinator
90
Forearm pronation
4
Brachioradialis, Anconeus, pronator teres, pronator quadratus
91
Radial deviation
3
Flexor carpi radialis, extensor carpi radialis longus, extensor carpi radialis brevis
92
Ulnar deviation
2
Flexor carpi ulnaris, extensor carpi ulnaris
93
Finger flexion
8
Flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus, flexor pollicis brevis, flexor digit minimi, palmar interossei, dorsal interossei, lumbricals
94
Finger extension
6
Extensor digitorum, extensor digiti minimi, extensor indices, Palmar interossei, dorsal interossei, lumbricals
95
Thumb abduction
2
Abductor pollicis longus, abductor pollicis brevis
96
Thumb adduction
Adductor pollicis
97
Thumb extension
3
Abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus
98
Thumb flexion
2
Flexor pollicis brevis, Flexor pollicis longus
99
Thumb opposition
3
Flexor pollicis brevis, abductor pollicis brevis, opponens pollicis
100
Median nerve
Superficial layer of anterior forearm (except FCU) , intermediate layer of anterior forearm, Deep layer of flexors (AIN), thenar muscles (recurrent branch), lumbricals (digital Branch)
101
Median nerve brachial plexus
Parents structure: lateral and medial chords
All levels of brachial plexus
102
Radial nerve muscles
Brachialis, triceps brachii, Anconeus, brachioradialis, superficial layer of posterior forearm, outcropping of the deep layer of posterior forearm (PIN),
103
Ulnar nerve muscles
Medial part of fDP (regular), FCU
hypothenar muscles, adductor pollicis, Palmsr interossei, dorsal interossei, 4th and 5th lumbricals (deep branch)
104
Carpal tunnel syndrome
Entrapment of median nerve. Contents: FDP, FDS, FPL, median nerve.
Sensory issues with digits one through three and atrophy of thenar muscles
105
Ape hand
Median nerve palsy, relaxed position. Thumb rests in adductor pollicis is ulnar nerve.
106
Hand of benediction
Ape hand becomes this when active range of motion. HyperExtension of digits one through three, thumb adduction, only last two fingers flex
107
Wrist drop
Radial nerve palsy, wrist or fingers cannot extend
108
Claw hand
Ulnar nerve palsy. MCP joints are hyperextended, and IP are flexed, loss of intrinsic muscles, lose ability to extend and last two fingers (lateral 2 have lumbrical median nerve)
109
Donor activated, focused rehab approach (DARFA)
Strengthen new neural pathways to increase function of re-innervated atrophied muscles after nerve transfer
110
Extensor hood
Extends IP joints, counterbalances, flexor forces.
Sagittal band: prevents bow strings, transverse fibers
Central tendon: extends, PIP, extensor digitorum becomes central tendon
Lateral band: extends DIP
Oblique retinacular ligament: coordinates, PIP and DIP movements. Extension of PIP causes GIP extension, flexion of the IP causes PIP flexion
111
Terminal tendon
Extends DIP joint
112
Swan neck deformity
Damage to terminal tendon causes DIPs to be flexed and PIP hyperextends
113
Boutonniere deformity
Damage to Central tendon causes PIP to stay flexed while DIPs hyperextended
114
Pulley system
FDS and FDP pass-through, prevents bowstringing, five annular, five oblique. A2 and A4 are most important.
115
Guyon’s canal
Ulnar, nerve and ulnar artery compression, between pisiform and hook of hamate, similar to carpal tunnel
116
Superior trunk injury
Neck injury to brachial plexus, waders tip, no, C6 or C5
117
Inferior trunk injury
Arm injury from upper extremity being pulled superiorly, klumpke palsy
118
Intrinsic plus
Sock puppet, MCP flex and IP extend
119
Intrinsic minus
MCP hyperextends, IP flexion, clawed fingers
120
Hook grasp pattern
Simultaneous, PIP and DIP flexion and mcp extension, carrying a bucket
121
Composite grasp patterns
Maximum flexion of all digits
122
Three jaw chuck pinch pattern
Three fingers, no motion in ASL
123
Lateral pinch pattern
Car key
