Unit Two Articulations Of UE Flashcards
What are the joints of the pectoral girdle
Sternoclavicular, acromioclavicular, and glenohumeral joint
Major role of joints of pectoral girdle
Positioning the distal upper extremity to perform manipulations
What is the law of hilton
Joints are innervated by the nerves supplying the muscles that move the joint
The sternoclavicular joint is what type of synovial joint
Saddle type
The articular disc in the sternoclavicular joint has how many compartments
Two
The articular disc in the sternoclavicular joint is held in place by
Anterior and posterior sternoclavicular ligaments
Articular disc in sternoclavicular joint acts as what
Shock absorber
The interclavicular ligament runs between what
The two clavicles
Function of interclavicular ligament
Strengthens the joint capsule superiorly and connects the clavicles
Sternal head of clavicle articulates with what
Manubrium and 1st costal cartilage
What surrounds the sternoclavicular joint
Fibrous capsule lined with synovial membrane
What reinforces the fibrous capsule of the sternoclavicular joint
Anterior and posterior ligaments
Function of costoclavicular ligaments
Anchor the proximal clavicle inferiorly to the 1st rib costal cartilage
Sternoclavicular joint can abduct how many degrees
60
The sternoclavicular joint can move in the A-P range of how many degrees
30
What innervates the sternoclavicular joint
Supraclavicular nerves and nerve to subclavius
What is the type of synovial joint of the acromioclavicular joint
Plane type
The articular surfaces of the acromioclavicular joint are separated by
Incomplete articular disc
What strengthens the superior margin of the acromioclavicular joint capsule
Fibers of trapezius muscle
What in the acromioclavicular joint strengthens the superior joint capsule and connects bony ends
Acromioclavicular ligament
The coracoclavicular ligament runs from
Coracoid process to clavicle
What are the two parts of the coracoclavicular ligament
Conoid and trapezoid ligaments
Function of coracoclavicular ligament
Prevents the acromion from being driven beneath the clavicle and serves to suspend upper extremity from the clavicle
What provides the most strength to the acromioclavicular joint
Extrinsic ligaments
Do the extrinsic ligaments attach to the acromioclavicular joint
No
Function of the coracoacromial ligaments
Anchor the acromion to the coracoid process
What are the ligaments of the acromioclavicular joint
Acromioclavicular, coracoclavicular, extrinsic and coracoacromial ligaments
Acromioclavicular joint is innervated by
Lateral cutaneous branch of the Supraclavicular nerve, the axillary and lateral pectoral nerve
What is the type of synovial joint of glenohumeral joint
Ball and socket type
What is the most mobile and unstable joint in the body
Glenohumeral joint
The glenoid cavity is deepened by what
Fibrocartilaginous glenoid labrum
The joint surfaces of the glenohumeral joint are lined by
Hyaline cartilage
1/3rd of the humerus head is accommodated by what
Glenoid fossa
What ligaments are associated with the glenohumeral joint
Glenohumeral, coracohumeral, transverse humeral, coracoacromial ligament
What ligament is 3 bands, strengthens anterior joint of glenohumeral joint
Glenohumeral ligament
What ligament runs across the top of the glenohumeral joint
Coracohumeral ligament
What ligament covers the interbercular groove of the glenohumeral joint
Transverse humeral ligament
What ligament is from coracoid to acromial process of the glenohumeral joint
Coracoacromial ligament
What helps maintain the head in proper position of the glenohumeral joint
Intrinsic tone of the of the rotator cuff muscles
A loose fibrous capsule attaches to what on the glenohumeral joint
Medial margin of the glenoid cavity and laterally to the anatomical neck of the humerus
The glenohumeral joint has what lining the capsule
Synovial membrane
The synovial membrane of the glenohumeral joint forms a sheath for what
The long head of the biceps
What bursa in the glenohumeral joint communicates with the synovial joint
Subscapular bursa
The glenohumeral ligament is formed by
Folds of fibrous bands radiating from the labrum inferiorly and laterally
What ligament in the glenohumeral joint serves to strengthen the anterior capsule
Glenohumeral ligament
Where can you see the glenohumeral ligament
Internal inspection of the capsule
What ligament in the glenohumeral joint strengthens the capsule superiorly
Coracohumeral ligament
The coracohumeral ligament runs from
Base of the coracoid process to the anterior aspect of the greater tubercle
The transverse humeral ligament runs from
The greater to lesser tubercle
What ligament creates a canal for the long head of the biceps
Transverse humeral ligament
The coracoacromial ligament attaches what to what
Acromion to the coracoid process
What forms the coracoacromial arch
The acromion-coracoacromial ligament coracoid process
Function of coracoacromial arch
Prevents superior displacement of the humerus
The coracoacromial arch is so strong what happens before this structure fails
Humerus or clavicle will fracture
What joint in UE has more ROM that any other joint
Glenohumeral joint
Why does glenohumeral joint have more ROM
Lax joint capsule and a large head in a shallow cavity
What increases the range of abduction in the glenohumeral joint
Lateral rotation by releasing the greater tubercle from contact with the coracoacromial arch
What scapulohumeral muscles act on the humerus
Deltoid, teres major, latissimus dorsi and rotator cuff muscles (SITS)
What innervates the glenohumeral joint
Suprascapular, lateral pectoral, axillary, lower subscapular and thoracodorsal nerves
Bursae are located where
Tendons rub on bones, ligaments or other tendons, or where the skin moves over a bony prominence
Where is the subacromial bursa
Sits between the acromion, coracoacromial ligament, deltoid muscle, supraspinatus tendon and the joint capsule of glenohumeral joint
Subacromial bursa facilitates what
Supraspinatus tendon movement
What are the two bursae of the glenohumeral joint
Subacromial and subscapular bursa
Where is the subscapular bursa located
Between the subscapularis tendon and the neck of the scapula
Function of subscapular bursa
Protects the tendon where it passes inferiorly to the base of the coracoid process and the scapular neck
Dislocation of the sternoclavicular joint occurs how often
Rarely
What causes an AC joint rupture
Direct injury or transmitted forces
AC joint rupture is what
Shoulder separation
The AC joint is weak compared to
The extrinsic coracoclavicular ligaments
What happens with the AC joint and coracoclavicular ligament are disrupted
Pectoral girdle is released from the axial skeleton
AC joint injuries are described at what grades
Grade 1 mild, grade 2 moderate, grade 3 severe
What is Grade 1 in AC joint injury
Minor injuries to the fibers of the AC joint, radiographs are normal
Grade 2 of AC joint injury
Disruption of the acromioclavicular (intrinsic) ligaments with posterior displacement of the distal part of the clavicle that manifests on AP radiograph as AC joint widening
What does Grade 2 AC joint injury look like
Minimal elevation of the distal clavicle relative to the acromion but the coracoclavicular distance remains normal
Grade 3 of AC joint injury
Disruption of both the acromioclavicular (intrinsic) ligaments and the coracoclavicular (extrinsic) ligaments
What does grade 3 AC joint injury
Elevation of the distal clavicle and widening of the coracoclavicular space, the space between the coracoid and the undersurface of the clavicle
What in the rotator cuff is particularly prone to injury
Supraspinatus tendon
What produces inflammation of the cuff muscles
Impingement of the humeral head on the coracoacromial arch
Why is upward dislocation rare in the UE
Coracoacromial arch and rotator cuff
How does an anterior dislocation of humerus occur
Pressure is applied to the fully abducted humerus using the acromion as a fulcrum
What is the most common dislocation of the UE
Humerus dislocated inferiorly
What occurs during a humerus dislocation inferiorly
Joint capsule is least supported, usually the head of the dislocated humerus rests anterior to the infraglenoid tubercle
Inferior dislocations are frequently associated with what
Avulsion fractures of the greater tubercle (insertion site of Supra, infra and teres minor)
What is adhesive capsulitis
Fibrosis and adhesions
What occurs during frozen shoulder
Fibrosis and adhesions between the glenohumeral joint capsule, rotator cuff tendons, subacromial bursa and deltoid
The elbow joint is what type of joint
Hinge
Where are the articulations in the elbow joint
Humerus, radius and ulna
Trochlea articulates with what
Trochlear notch on ulna
Capitulum articulates with what
Radial head of radius
The fibrous joint capsule surrounds the elbow joint and attaches to
Humerus at the margins of the ends of the articular surfaces
The synovial membrane of the elbow joint is continuous with what
Proximal radio-ulnar joint
What strengthens the capsule of the elbow joint
Medial and lateral ligaments
Lateral collateral ligament AKA
Radial collateral ligament
Shape of lateral collateral ligament
Triangular band
The lateral collateral ligament runs from
Lateral epicondyle of humerus to blend with the annular ligament of the radius
Function of annular ligament
Hold the radial head in the radial notch of ulna, allowing for pronation and supination
Medial collateral ligament AKA
Ulnar collateral ligament
The medial collateral ligament extends from
Medial epicondyle to the conoid process and olecranon of the ulna
What are the three parts of the medial collateral ligament
Anterior cord, posterior cord, oblique band
What is the strongest cord of the medial collateral ligament
Anterior cord
What is the fan shaped and weakest cord of the medial collateral ligament
Posterior cord
What is tommy John surgery
Replacement of the anterior cord of the medial collateral ligament
In tommy john surgery what replaces the anterior cord
Cadaver tendon or palmaris longus
Replacement of the anterior cord of medial collateral Iigament results in
Greater valgus stress tolerance and less joint laxity
How is anterior cord replaced in tommy john surgery
Submuscular placement of ligament/tendon woven in figure 8 pattern through tunnels in the ulna and humerus
The promixal radioulnar joint is what type of joint
Pivot joint
What holds the radial head in place
Annular ligament of the radius
What is continuous with the elbow joint
Joint capsule and synovial membrane
How is the annular ligament attached to the elbow joint
Ulna anterior and posterior to the radial notch forming a collar around the radial head and has a distal extension to form the sacciform recess
The sacciform recess in the proximal radioulnar joint allows for
Unimpaired rotation
The quadrate ligament in the proximal radioulnar joint is where
Extends from the inferior border of the annular ligament below the radial notch to the neck of the radius
What are the ligaments in the proximal radioulnar joint
Annular ligament and quadrate ligament
Main flexors of elbow
Biceps, brachialis and brachioradialis
Main extensors of elbow
Triceps
What is the degree that the elbow is fully extended
170
Carrying angle of elbow for male
10 to 15 degree
Carrying angle of elbow for females
Greater than 15 degrees
Blood supply of elbow
Periarticular anastomotic network
Innervation of elbow
Musculocutaneous, radial and ulnar nerves
The carrying angle percents the arm to do what
Be swung without contacting the hips
What are the three olecranon bursae
Intratendinous olecranon, subtendinous olecranon, subcutaneous olecranon bursa
Location of intratendinous olecranon bursa
Present in triceps tendon
Location of subtendinous olecranon bursa
Present in triceps tendon
Location of subcutaneous olecranon bursa
Subcutaneous tissue over the olecranon
Bicipital bursa does what
Separates the biceps tendon from the anterior aspect of the radial tuberosity
How to subluxate the radial head of child
Lift UE with arm pronates
What happens to annular ligament in subluxation of the radial head
Disrupted and trapped between the radial head and capitulum
How to fix the subluxation of the radial head
Slow supination with the elbow extended under mild distraction
What is the main radioulnar ligament
Interosseous membrane
The distal radioulnar joint is what type of joint
Pivot, radius moves around the fixed distal end of ulna
What binds the ends of the radius and ulna of the distal radioulnar joint
Fibrocartilaginous articular disc
How does the fibrocartilaginous disc in the distal radioulnar joint attach
Attach to medial edge of ulnar notch and apex of the disc is attached to the lateral side of the base of the ulnar styloid process
The disc in the distal radioulnar joint separates what
Cavity of distal radioulnar joint from cavity of wrist joint
Ligaments of the distal radioulnar joint
Anterior and posterior ligaments from radius to ulna
Nerve and vascular supply of distal radioulnar joint
Anterior and posterior interosseous arteries and nerves
