Upper Extremity Flashcards
What is articulations?
joints or arthroses
hold bones together but offers some degree of movement
What are joint classifications?
Functionally and structurally
What are the functional classifications?
Synarthrosis - immovable
Amphiarthrosis - slightly moveable
Diarthrosis - freely moveable
Structural classification
fibrous joints
cartilaginous joints
sinovial joints
fibrous joint
no sinovial cavity
bones held together by dense connective tissue (rich in collagen)
strongest joints in body
cartilaginous joint
no synovial cavity
bones held together by cartilage
synovial joint
have a synovial cavity or joint cavity
bones held together by dense connective tissue
often have accessory ligaments
what are the 4 types if fibrous joints?
syndesmosis
suture
gomphosis
interosseous membrane
Syndesmosis
slightly moveable joint (amphiarthrosis)
- distal tibia and fibula
suture
immovable in adults (synarthrosis)
only in skull
gomphosis
immovable joint in healthy gums (synarthrosis)
periodontal ligaments hold roots of teeth in position
interosseous membrane
sheets of dense connective tissue (diarthrosis)
found between tibia and fibula AND radius and ulna
What are the 2 cartilaginous joints?
symphysis
syndochondrosis
symphysis
joints contain a fibrocartiliginous disc - slightly movable (amphiarthrosis)
designed for strength and shock absorbency
- pubic symphysis, intervertebral joints (discs)
synchondrosis
immovable joint (synarthrosis)
epiphyseal plate (temporary)
articulation between the first rib and sternum
Articular capsule
surrounds all synovial joints and joins the bones together
outer layer - fibrous capsule - connects the capsule to the periosteum of the bone
inner layer - synovial membrane - produces synovial fluid
synovial fluid
viscous, clear fluid (similar to an uncooked eggwhite)
consists of hylauronic acid and fluid filtered from blood plasma
What are the functions of synovial fluid?
lubricates joint and reduces friction
absorbs shock
supplies oxygen and nutrients to chondrocytes within articular cartilage
removes wastes and CO2 from chondrocytes
removes debris from joint (normal wear and tear)
what new the synovial joint accessories
ligaments
menisci - knee
labrum - shoulder and hip joints - deepens the joint socket
What are the 2 kinds of ligaments in the knee?
extracapsular and intracapsular
what are the extra capsular ligaments of the knee?
MCL and LCL
What are the MCL attachment sites?
proximal condyle of the tibia to the medial condyle of the femur
What are the LCL attachment sites?
lateral epicondyle of femur to fibular head
what are incapsulate ligaments
ACL and PCL
- within the capsule but excluded from the synovial cavity (covered by folds of synovial membrane)
Why are the ACL and PCL cruciate ligaments
because they form an X
What are the ACL attachment sites?
Anterior tibial spines to mid lateral femoral condyle
prevents the femur from sliding posteriorly to the tibia
What are PCL attachment sites?
posterior tibial spines to mid medial femoral condyle
prevents the tibia from sliding posteriorly to the femur when the knee is flexed
What is bursae?
strategically placed to reduce friction in some joints
fluid filled sacs cushion movement between:
- skin and bones
- tendons and bones
-muscles and bones
-ligaments and bones
What Is old maidās knee?
fluid filled intrapatellar bursae
What are the 6 classifications of synovial joints
- gliding plane
- hinge
- pivot
- condyloid (ellipsoid)
- saddle
- ball and socket
gliding plane joints
articulating surfaces are flat or slightly curved
- inter carpal bones, inter tarsal bones, SC joints, AC joints, sternocostal joints (2-7), costovertebral joints
Hinge joints
convex surface of one bone fits into the concave art of another
permit flexion and extension only
- knee, space between humerus and radius and ulna, ankle, interphalangeal joints
pivot joints
rounded or pointed surface on one bone articulates with a ring formed by bone and ligament - allows pronation and supination
allows rotation only
Atlanta-axial joint, radioulnar joints (both proximal and distal)
Condyloid (ellipsoid) joints
convex projection of one bone fits into oval-shaped depression in another
permits flexion-extension and abduction-adduction (ulnar/radial deviation)
radoiocarpal joints, MCPs (2-5)
saddle joint
one bone is saddle-shaped, the other sits in the saddle
permits flexion-extension and abduction-adduction
1st CMC joint
ball and socket joint
head of one bone fits into a cup-like depression in the other
shoulder, hip, talonavicular joints
Shoulder joint
glenohumeral joint
ball and socket
greatest degree of movement of any joint
dislocation is common
labrum helps to stabilize as well as 4 bursae
Rotator cuff muscles
provide greatest amount of stability to shoulder
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
AC joint
between acromion and clavicle
Ligaments: acromioclavicular, coracoacromial, coracoclavicular
bottom of clavicle and acromion should line up if no AC separation
Elbow joint
hinge joint
- head of radius articulates with capitulum of humerus
- trochlear notch of ulna articulates with trochlea of humerus
pivot joint
- radial head articulates with radial notch of ulna
Elbow joint ligaments
Ulnar collateral ligament (Tommy John surgery)
- medial epicondyle to coronoid process and olecranon
Radial collateral ligament
- lateral epicondyle to annular ligament and radial notch of ulna
Annular ligament
- strong band that encircles radial head
- holds radial head to radial notch
elbow ligament indetification
slide 50
Hip joint
less mobile compared to shoulder
extremely stable
- very strong articular capsule
- accessory ligaments: ileofemoral, pubofemoral, ischiofemoral, ligament of head of femur, transverse ligament of acetabulum
- surrounding muscles
- deep socket (acetabulum)
- labrum
knee joint
tibiofemoral OR femorotibial
largest and most complex in the body
3 joints within synovial cavity
- lateral tibiofemoral
- medial tibiofemoral
- patellofemoral
What is the menisci
help compensate for the irregular shapes of the femur and tibia
medial meniscus - C-shaped
Lateral meniscus - nearly circular
Ankle joint
hinge joint
dorsiflexion and plantar flexion
medial ligaments - deltoid - more stable
lateral ligaments - anterior talofibular ligament, calcanea fibular ligament, posterior talofibular ligament
Vertebral discs
cartilaginous joints (symphysis)
designed for weight bearing
annulus fibrosus
nucleus pulposus
Hand
5 metacarpals, Metocarpophalangeal joint, proximal phalanx, proximal interphalangeal joint, middle phalanx, distal interphalangeal joint, and distal phalanx
Thumb
also referred to as pollex, has CMC joint, metacarpal, MCP joint, Proximal phalanx, interphalangeal joint and distal phalanx
Wrist
carpal bones
proximal row (lateral to medial) - scaphoid, lunate, triquetrum, pisiform
distal row (lateral to medial) - trapezium, trapezoid, capitate and hamate
Scaphoid
- most commonly fractured carpal bone FOOSH
- below anatomical snuff box
- distal part of scaphoid is more anterior
- blood flow to the proximal part of the scaphoid is retrograde
- AVN is more common with proximal fractures
Carpal Tunnel
anterior surface of the wrist is concave (carpal sulcus)
passageway created between the carpal sulcus and flexor retinaculum
median nerve and flexor tendons pass through this area
joints of the hand
IP - hinge
MCP - condyloid
CMC - thumb (saddle) 2-5 gliding
Intercarpal - gliding
Radiocarpal - condyloid
What is the radoiocarpal joint?
radius articulates with the scaphoid and lunate
palmer, radial, colar tilt of about 11 degrees
How do you open radiocarpal joint for x-ray?
angle CR 11 degrees cephalad
bones of the forearm
radius on lateral side
ulna on medial side
What is the most distal part of the forearm?
radial styloid process
What is the most proximal part of the forearm?
olecranon process
What are the characteristics of the radius?
narrower at proximal end
wider at distal end
What are the parts of the proximal end of the radius?
radial head
radial neck
radial tuberosity
- distal to neck on anteromedial surface
- attachment for biceps muscle
What are the parts of the distal end of the radius?
radial styloid process
ulnar notch
- named after the bone it articulates with not the bone it is on
What are the parts of the proximal end of the ulna?
trochlear notch - articulates with the trochlea of humerus
- olecranon process
- coronoid process
radial notch
ulnar tuberosity
What are the parts of the distal end of the ulna?
head of ulna
ulnar styloid process
- posterior surface of ulnar head
What re the joints connecting the radius and ulna?
proximal radioulnar joint
interosseous membrane
distal radioulnar joint (DRUJ)
pronation and supination is possible because of the proximal and distal radioulnar joints
What is the proximal radioulnar joint?
radial head articulates with radial notch of the proximal ulna
What kind of joint is the interosseous membrane?
fibrous joint
amphiarthrosis
What is the distal radioulnar joint?
also known as DRUJ
ulnar head articulates with the ulnar notch of the distal radius
What are the physical symptom differences in a clenched fist?
Drug tears hurt scapholunate tears do not
What are the parts of the proximal end of the humerus?
humeral head
anatomical neck
greater tuberosity
lesser tuberosity
inter tubercular (bicipital) groove
surgical neck
What are the parts of the distal end of the humerus?
trochlea
coronoid fossa
olecranon fossa
medial epicondyle
capitulum
radial fossa
lateral epicondyle
What does the radial head articulate with?
radius and the radial notch of the proximal ulna when in acute flexion
What is the elbow joint?
it is a hinge joint
- capitulum and radial head
- trochlea and trochlear notch
What are the fat pads of the elbow?
anterior fat pad - tear drop shape
posterior fat pad
supinator fat pad
What does seeing the posterior fat pad in a radiograph mean?
seeing displacement of the anterior fat pad and seeing the posterior fat pad on a lateral image are good indicators of a fracture
What are the parts of the shoulder (pectoral) girdle?
clavicle
scapula
- function is to connect the upper extremity to the trunk
what are the parts of the clavicle?
āSā shaped (for strength)
coronoid tubercle
oblique plane
- medial end is inferior and anterior to lateral end
What are the calivicular joints?
sternal end articulates with inferior half of manubrium (SC joint)
acromial end articulates with the acromion of scapula (AC joints)
- inferior part of the clavicle aligns with inferior part of acromion
What is the scapulae?
between 2nd and 7th ribs
45 to 60 degrees in relati9on to anatomic position
What are the scapulae borders?
superior
medial (vertebral)
lateral (axillary)
what are the angles of the scapula?
superior
inferior
lateral
- thickest part
- ends at the glenoid cavity
What are the anterior parts of the scapula?
also known the costal surface
subscapular fossa - slightly concave
coracoid process
What are the posterior parts of the scapula?
also known as the dorsal surface
spine runs diagonally and ends at the acromion (flattened process)
supraspinous fossa
infraspinous fossa
