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Extremities Lecture > Unit Two Articulations Of UE > Flashcards

Unit Two Articulations Of UE Flashcards

1
Q

What are the joints of the pectoral girdle

A

Sternoclavicular, acromioclavicular, and glenohumeral joint

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2
Q

Major role of joints of pectoral girdle

A

Positioning the distal upper extremity to perform manipulations

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3
Q

What is the law of hilton

A

Joints are innervated by the nerves supplying the muscles that move the joint

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4
Q

The sternoclavicular joint is what type of synovial joint

A

Saddle type

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5
Q

The articular disc in the sternoclavicular joint has how many compartments

A

Two

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6
Q

The articular disc in the sternoclavicular joint is held in place by

A

Anterior and posterior sternoclavicular ligaments

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7
Q

Articular disc in sternoclavicular joint acts as what

A

Shock absorber

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8
Q

The interclavicular ligament runs between what

A

The two clavicles

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9
Q

Function of interclavicular ligament

A

Strengthens the joint capsule superiorly and connects the clavicles

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10
Q

Sternal head of clavicle articulates with what

A

Manubrium and 1st costal cartilage

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11
Q

What surrounds the sternoclavicular joint

A

Fibrous capsule lined with synovial membrane

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12
Q

What reinforces the fibrous capsule of the sternoclavicular joint

A

Anterior and posterior ligaments

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13
Q

Function of costoclavicular ligaments

A

Anchor the proximal clavicle inferiorly to the 1st rib costal cartilage

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14
Q

Sternoclavicular joint can abduct how many degrees

A

60

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15
Q

The sternoclavicular joint can move in the A-P range of how many degrees

A

30

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16
Q

What innervates the sternoclavicular joint

A

Supraclavicular nerves and nerve to subclavius

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17
Q

What is the type of synovial joint of the acromioclavicular joint

A

Plane type

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18
Q

The articular surfaces of the acromioclavicular joint are separated by

A

Incomplete articular disc

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19
Q

What strengthens the superior margin of the acromioclavicular joint capsule

A

Fibers of trapezius muscle

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20
Q

What in the acromioclavicular joint strengthens the superior joint capsule and connects bony ends

A

Acromioclavicular ligament

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21
Q

The coracoclavicular ligament runs from

A

Coracoid process to clavicle

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22
Q

What are the two parts of the coracoclavicular ligament

A

Conoid and trapezoid ligaments

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23
Q

Function of coracoclavicular ligament

A

Prevents the acromion from being driven beneath the clavicle and serves to suspend upper extremity from the clavicle

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24
Q

What provides the most strength to the acromioclavicular joint

A

Extrinsic ligaments

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25
Q

Do the extrinsic ligaments attach to the acromioclavicular joint

A

No

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26
Q

Function of the coracoacromial ligaments

A

Anchor the acromion to the coracoid process

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27
Q

What are the ligaments of the acromioclavicular joint

A

Acromioclavicular, coracoclavicular, extrinsic and coracoacromial ligaments

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28
Q

Acromioclavicular joint is innervated by

A

Lateral cutaneous branch of the Supraclavicular nerve, the axillary and lateral pectoral nerve

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29
Q

What is the type of synovial joint of glenohumeral joint

A

Ball and socket type

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30
Q

What is the most mobile and unstable joint in the body

A

Glenohumeral joint

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31
Q

The glenoid cavity is deepened by what

A

Fibrocartilaginous glenoid labrum

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32
Q

The joint surfaces of the glenohumeral joint are lined by

A

Hyaline cartilage

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33
Q

1/3rd of the humerus head is accommodated by what

A

Glenoid fossa

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34
Q

What ligaments are associated with the glenohumeral joint

A

Glenohumeral, coracohumeral, transverse humeral, coracoacromial ligament

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35
Q

What ligament is 3 bands, strengthens anterior joint of glenohumeral joint

A

Glenohumeral ligament

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36
Q

What ligament runs across the top of the glenohumeral joint

A

Coracohumeral ligament

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37
Q

What ligament covers the interbercular groove of the glenohumeral joint

A

Transverse humeral ligament

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38
Q

What ligament is from coracoid to acromial process of the glenohumeral joint

A

Coracoacromial ligament

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39
Q

What helps maintain the head in proper position of the glenohumeral joint

A

Intrinsic tone of the of the rotator cuff muscles

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40
Q

A loose fibrous capsule attaches to what on the glenohumeral joint

A

Medial margin of the glenoid cavity and laterally to the anatomical neck of the humerus

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41
Q

The glenohumeral joint has what lining the capsule

A

Synovial membrane

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42
Q

The synovial membrane of the glenohumeral joint forms a sheath for what

A

The long head of the biceps

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43
Q

What bursa in the glenohumeral joint communicates with the synovial joint

A

Subscapular bursa

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44
Q

The glenohumeral ligament is formed by

A

Folds of fibrous bands radiating from the labrum inferiorly and laterally

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45
Q

What ligament in the glenohumeral joint serves to strengthen the anterior capsule

A

Glenohumeral ligament

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46
Q

Where can you see the glenohumeral ligament

A

Internal inspection of the capsule

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47
Q

What ligament in the glenohumeral joint strengthens the capsule superiorly

A

Coracohumeral ligament

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48
Q

The coracohumeral ligament runs from

A

Base of the coracoid process to the anterior aspect of the greater tubercle

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49
Q

The transverse humeral ligament runs from

A

The greater to lesser tubercle

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50
Q

What ligament creates a canal for the long head of the biceps

A

Transverse humeral ligament

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51
Q

The coracoacromial ligament attaches what to what

A

Acromion to the coracoid process

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52
Q

What forms the coracoacromial arch

A

The acromion-coracoacromial ligament coracoid process

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53
Q

Function of coracoacromial arch

A

Prevents superior displacement of the humerus

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54
Q

The coracoacromial arch is so strong what happens before this structure fails

A

Humerus or clavicle will fracture

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55
Q

What joint in UE has more ROM that any other joint

A

Glenohumeral joint

56
Q

Why does glenohumeral joint have more ROM

A

Lax joint capsule and a large head in a shallow cavity

57
Q

What increases the range of abduction in the glenohumeral joint

A

Lateral rotation by releasing the greater tubercle from contact with the coracoacromial arch

58
Q

What scapulohumeral muscles act on the humerus

A

Deltoid, teres major, latissimus dorsi and rotator cuff muscles (SITS)

59
Q

What innervates the glenohumeral joint

A

Suprascapular, lateral pectoral, axillary, lower subscapular and thoracodorsal nerves

60
Q

Bursae are located where

A

Tendons rub on bones, ligaments or other tendons, or where the skin moves over a bony prominence

61
Q

Where is the subacromial bursa

A

Sits between the acromion, coracoacromial ligament, deltoid muscle, supraspinatus tendon and the joint capsule of glenohumeral joint

62
Q

Subacromial bursa facilitates what

A

Supraspinatus tendon movement

63
Q

What are the two bursae of the glenohumeral joint

A

Subacromial and subscapular bursa

64
Q

Where is the subscapular bursa located

A

Between the subscapularis tendon and the neck of the scapula

65
Q

Function of subscapular bursa

A

Protects the tendon where it passes inferiorly to the base of the coracoid process and the scapular neck

66
Q

Dislocation of the sternoclavicular joint occurs how often

A

Rarely

67
Q

What causes an AC joint rupture

A

Direct injury or transmitted forces

68
Q

AC joint rupture is what

A

Shoulder separation

69
Q

The AC joint is weak compared to

A

The extrinsic coracoclavicular ligaments

70
Q

What happens with the AC joint and coracoclavicular ligament are disrupted

A

Pectoral girdle is released from the axial skeleton

71
Q

AC joint injuries are described at what grades

A

Grade 1 mild, grade 2 moderate, grade 3 severe

72
Q

What is Grade 1 in AC joint injury

A

Minor injuries to the fibers of the AC joint, radiographs are normal

73
Q

Grade 2 of AC joint injury

A

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

74
Q

What does Grade 2 AC joint injury look like

A

Minimal elevation of the distal clavicle relative to the acromion but the coracoclavicular distance remains normal

75
Q

Grade 3 of AC joint injury

A

Disruption of both the acromioclavicular (intrinsic) ligaments and the coracoclavicular (extrinsic) ligaments

76
Q

What does grade 3 AC joint injury

A

Elevation of the distal clavicle and widening of the coracoclavicular space, the space between the coracoid and the undersurface of the clavicle

77
Q

What in the rotator cuff is particularly prone to injury

A

Supraspinatus tendon

78
Q

What produces inflammation of the cuff muscles

A

Impingement of the humeral head on the coracoacromial arch

79
Q

Why is upward dislocation rare in the UE

A

Coracoacromial arch and rotator cuff

80
Q

How does an anterior dislocation of humerus occur

A

Pressure is applied to the fully abducted humerus using the acromion as a fulcrum

81
Q

What is the most common dislocation of the UE

A

Humerus dislocated inferiorly

82
Q

What occurs during a humerus dislocation inferiorly

A

Joint capsule is least supported, usually the head of the dislocated humerus rests anterior to the infraglenoid tubercle

83
Q

Inferior dislocations are frequently associated with what

A

Avulsion fractures of the greater tubercle (insertion site of Supra, infra and teres minor)

84
Q

What is adhesive capsulitis

A

Fibrosis and adhesions

85
Q

What occurs during frozen shoulder

A

Fibrosis and adhesions between the glenohumeral joint capsule, rotator cuff tendons, subacromial bursa and deltoid

86
Q

The elbow joint is what type of joint

A

Hinge

87
Q

Where are the articulations in the elbow joint

A

Humerus, radius and ulna

88
Q

Trochlea articulates with what

A

Trochlear notch on ulna

89
Q

Capitulum articulates with what

A

Radial head of radius

90
Q

The fibrous joint capsule surrounds the elbow joint and attaches to

A

Humerus at the margins of the ends of the articular surfaces

91
Q

The synovial membrane of the elbow joint is continuous with what

A

Proximal radio-ulnar joint

92
Q

What strengthens the capsule of the elbow joint

A

Medial and lateral ligaments

93
Q

Lateral collateral ligament AKA

A

Radial collateral ligament

94
Q

Shape of lateral collateral ligament

A

Triangular band

95
Q

The lateral collateral ligament runs from

A

Lateral epicondyle of humerus to blend with the annular ligament of the radius

96
Q

Function of annular ligament

A

Hold the radial head in the radial notch of ulna, allowing for pronation and supination

97
Q

Medial collateral ligament AKA

A

Ulnar collateral ligament

98
Q

The medial collateral ligament extends from

A

Medial epicondyle to the conoid process and olecranon of the ulna

99
Q

What are the three parts of the medial collateral ligament

A

Anterior cord, posterior cord, oblique band

100
Q

What is the strongest cord of the medial collateral ligament

A

Anterior cord

101
Q

What is the fan shaped and weakest cord of the medial collateral ligament

A

Posterior cord

102
Q

What is tommy John surgery

A

Replacement of the anterior cord of the medial collateral ligament

103
Q

In tommy john surgery what replaces the anterior cord

A

Cadaver tendon or palmaris longus

104
Q

Replacement of the anterior cord of medial collateral Iigament results in

A

Greater valgus stress tolerance and less joint laxity

105
Q

How is anterior cord replaced in tommy john surgery

A

Submuscular placement of ligament/tendon woven in figure 8 pattern through tunnels in the ulna and humerus

106
Q

The promixal radioulnar joint is what type of joint

A

Pivot joint

107
Q

What holds the radial head in place

A

Annular ligament of the radius

108
Q

What is continuous with the elbow joint

A

Joint capsule and synovial membrane

109
Q

How is the annular ligament attached to the elbow joint

A

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

110
Q

The sacciform recess in the proximal radioulnar joint allows for

A

Unimpaired rotation

111
Q

The quadrate ligament in the proximal radioulnar joint is where

A

Extends from the inferior border of the annular ligament below the radial notch to the neck of the radius

112
Q

What are the ligaments in the proximal radioulnar joint

A

Annular ligament and quadrate ligament

113
Q

Main flexors of elbow

A

Biceps, brachialis and brachioradialis

114
Q

Main extensors of elbow

A

Triceps

115
Q

What is the degree that the elbow is fully extended

A

170

116
Q

Carrying angle of elbow for male

A

10 to 15 degree

117
Q

Carrying angle of elbow for females

A

Greater than 15 degrees

118
Q

Blood supply of elbow

A

Periarticular anastomotic network

119
Q

Innervation of elbow

A

Musculocutaneous, radial and ulnar nerves

120
Q

The carrying angle percents the arm to do what

A

Be swung without contacting the hips

121
Q

What are the three olecranon bursae

A

Intratendinous olecranon, subtendinous olecranon, subcutaneous olecranon bursa

122
Q

Location of intratendinous olecranon bursa

A

Present in triceps tendon

123
Q

Location of subtendinous olecranon bursa

A

Present in triceps tendon

124
Q

Location of subcutaneous olecranon bursa

A

Subcutaneous tissue over the olecranon

125
Q

Bicipital bursa does what

A

Separates the biceps tendon from the anterior aspect of the radial tuberosity

126
Q

How to subluxate the radial head of child

A

Lift UE with arm pronates

127
Q

What happens to annular ligament in subluxation of the radial head

A

Disrupted and trapped between the radial head and capitulum

128
Q

How to fix the subluxation of the radial head

A

Slow supination with the elbow extended under mild distraction

129
Q

What is the main radioulnar ligament

A

Interosseous membrane

130
Q

The distal radioulnar joint is what type of joint

A

Pivot, radius moves around the fixed distal end of ulna

131
Q

What binds the ends of the radius and ulna of the distal radioulnar joint

A

Fibrocartilaginous articular disc

132
Q

How does the fibrocartilaginous disc in the distal radioulnar joint attach

A

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

133
Q

The disc in the distal radioulnar joint separates what

A

Cavity of distal radioulnar joint from cavity of wrist joint

134
Q

Ligaments of the distal radioulnar joint

A

Anterior and posterior ligaments from radius to ulna

135
Q

Nerve and vascular supply of distal radioulnar joint

A

Anterior and posterior interosseous arteries and nerves

Extremities Lecture (15 decks)

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