Upper Extremity Arthrology Flashcards
Sternoclavicular joint type
Sellar synovial joint
Ligaments of sternoclavicular joint
Costoclavicular ligament- from sternal end of clavicle to first rib
Anterior/posterior sternoclavicular ligaments
Interclavicular ligament- clavicle to clavicle
Acromioclavicular joint type
Planar synovial joint
Ligaments of acromioclavicular joint
Acromioclavicular ligament
Coracoclavicular ligament- two bands
–Trapezoid ligament- horizontal band of CC ligament
–Conoid ligament- vertical band of CC ligament, medial to trapezoid ligament
Shoulder separation
Refers to separation of the AC joint, can separate with or without rupture of coracoclavicular ligament
Glenohumeral joint type
Spheroidal synovial joint
Subscapular bursa
Part of glenohumeral joint, between subscapularis tendon and scapular neck
Communicates with synovial membrane
Subacromial bursa
Part of glenohumeral joint, between deltoid muscle, supraspinatus tendon and articular capsule
Does not communicate with synovial membrane
Ligaments of the glenohumeral joint
Glenohumeral ligament- from supraglenoid tubercle to anatomical humeral neck
Coracohumeral ligament- from base of coracoid process to anterior edge of greater tubercle of humerus
Transverse humeral ligament- spans intertubercular groove b/w greater/lesser tubercles of humerus, encapsulates long head of biceps brachii
Coracoacromial arch- prevents superior displacement of humerus from glenoid cavity
–Coracoacromial ligament
Dislocation of the glenohumeral joint
Usually occurs anteriorly or inferiorly due to the presence of the coracoacromial arch
Elbow joint type
Ginglymus synovial joint
Humeroulnar joint ligaments
Ulnar collateral ligament- from medial humeral epicondyle to coronoid process, consists of 3 bands
- Anterior band- strongest
- Posterior band- weakest
- Oblique band
Humeroradial joint ligaments
Radial collateral ligament from lateral humeral epicondyle to blend with annular ligament of radial head
Elbow dislocation
Can occur posteriorly, usually involves tear in ulnar collateral ligament
Subtendinous olecranon bursa and bicipitoradial bursa
Two of the more common elbow bursae to become inflamed
Subcutaneous olecranon bursitis
Sometimes called students elbow, dart throwers elbow and miners elbow
Results from excessive friction b/w the skin and the olecranon
Proximal radioulnar joint type
Trochoid synovial joint- primary site of supination/pronation
Sacciform recess
Small pocket of synovial membrane protruding out from under annular ligament
Annular ligament description and nursemaids/pulling elbow
From coronoid process of the ulna around the radial head to insert back on the ulna, holding radial head in radial notch
-Nursemaids elbow/pulled elbow is when the radial head is dislocated out of the annular ligament, typically from pulling on arm of child
Middle radioulnar joint type
Syndesmosis
Radiocarpal (wrist) joint type
Condylar synovial joint
Ligaments of the radiocarpal joint
Palmar radiocarpal- 2 bands- from radius to lunate and radius to capitate
Dorsal radiocarpal- radius to triquetrum
Palmar ulnocarpal- two bands- from ulna to lunate and ulna to triquetrum
Dorsal ulnocarpal- from ulna to triquetrum
Radial collateral of wrist- from radial styloid process to scaphoid
Ulnar collateral of wrist- from ulnar styloid to triquetrum
Intercarpal joints type
Planar synovial joints
Ligaments of intercarpal joints
Anterior/posterior intercarpal ligaments
Interosseous intercarpal ligaments
Pisohamate ligament- b/w pisiform and hook of hamate
Midcarpal joint type
Sellar synovial
1st Carpometacarpal joint type and ligaments
Sellar synovial
Palmar/dorsal carpometacarpal ligaments
2-5 carpometacarpal joint type and ligaments
Planar synovial
Palmar/dorsal carpometacarpal ligaments
Pisometacarpal ligament- 5th metacarpal association
Radiate carpal ligament- from capitate to bases of metacarpal bones
Intermetacarpal joint type and ligaments
4 Planar synovial joints
Dorsal/palmar intermetacarpal ligaments
Interosseous intermetacarpal ligament
Metacarpophalangeal joint type
Condylar synovial
Ligaments of the metacarpophalangeal joint
Palmar- attachment point for part of collateral ligament, provides groove for flexor tendons with digital sheeth
Medial collateral- inserts onto palmar ligament
Lateral collateral- inserts onto palmar ligament
Deep transverse metacarpal- joins palmar ligaments of the medial four metacarpophalangeal joints
Bull riders thumb
Sprain of the lateral collateral ligament and possible avulsion of the lateral part of the proximal phalanx of the thumb
Skiers thumb or game keepers thumb
Laxity or rupture of both collateral ligaments of the first metacarpophalangeal joints results in hyperabduction of the joint
Interphalangeal joints description
Ginglymus synovial joints
All contain palmar ligament, medial and lateral collateral ligaments- same description as those in the metacarpophalangeal joints
Mallet finger or baseball finger
Sudden hyperflexion of the distal interphalangeal joint can avulse the attachment of the long extensor tendon with that tendon away from the distal phalanx
Pectoral fascia invests what, is continuous with what
Pectoralis major
Continuous with deltoid fascia superiorly, axillary fascia laterally and abdominal deep fascia inferiorly
Axillary fascia
Floor of axilla
Continuous medially with pectoral fascia, inferiorly with clavipectoral fascia
Clavipectoral fascia invests
Invests subclavius and pectoralis minor
Suspensory ligament of axilla
Deltoid fascia covers what, continuous with what
Covers deltoid muscle
Continuous with pectoral fascia anteriorly and infraspinous fascia posteriorly
Brachial fascia continuous with what
Continuous superiorly with pectoral, deltoid, infraspinous and axillary fascia
Inferiorly with antebrachial fascia
Medial intermuscular septum
Separates the brachium into anterior and posterior compartments in conjunction with the lateral intermuscular septum
Antebrachial fascia
Divides antebrachium into anterior and posterior compartments
Continues superiorly with brachial fascia
Extensor retinaculum
Thickening of antebrachial fascia, holds extensor tendons in place
Synovial/ganglion cysts
Irritation of the synovial sheaths can cause accumulation of mucopolysaccharide fluid that can form a painless lump
Palmar carpal ligament continuous with
Extensor retinaculum
Flexor retinaculum
Transverse carpal ligament
From scaphoid/trapezium to hook of hamate and pisiform
Forms carpal tunnel
Palmar aponeurosis features
Superficial transverse metacarpal ligament- base of PA
Retinacula cutis- restricts palmar skin movement
Medial fibrous septum- separates hypothenar from central compartment
Lateral fibrous septum- separates thenar from central compartment
Dupuytren contracture
Disease resulting in the shortening, thickening and fibrosis of the palmar aponeurosis and palmar fascia, which results in a partial flexion of the 4th and 5th digits
Fibrous digital sheaths
Enclose the synovial sheaths of the long flexor tendons in the hand
Central compartment
Contains flexor tendons, lumbrical muscles, superficial palmar arterial arch, digital vessels and nerves
Adductor compartment
Contains adductor pollicus
