Upper Extremity Arthrology

Question 1

Sternoclavicular joint type

Answer 1

Sellar synovial joint

Question 2

Ligaments of sternoclavicular joint

Answer 2

Costoclavicular ligament- from sternal end of clavicle to first rib
Anterior/posterior sternoclavicular ligaments
Interclavicular ligament- clavicle to clavicle

Question 3

Acromioclavicular joint type

Answer 3

Planar synovial joint

Question 4

Ligaments of acromioclavicular joint

Answer 4

Acromioclavicular ligament
Coracoclavicular ligament- two bands
–Trapezoid ligament- horizontal band of CC ligament
–Conoid ligament- vertical band of CC ligament, medial to trapezoid ligament

Question 5

Shoulder separation

Answer 5

Refers to separation of the AC joint, can separate with or without rupture of coracoclavicular ligament

Question 6

Glenohumeral joint type

Answer 6

Spheroidal synovial joint

Question 7

Subscapular bursa

Answer 7

Part of glenohumeral joint, between subscapularis tendon and scapular neck
Communicates with synovial membrane

Question 8

Subacromial bursa

Answer 8

Part of glenohumeral joint, between deltoid muscle, supraspinatus tendon and articular capsule
Does not communicate with synovial membrane

Question 9

Ligaments of the glenohumeral joint

Answer 9

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

Question 10

Dislocation of the glenohumeral joint

Answer 10

Usually occurs anteriorly or inferiorly due to the presence of the coracoacromial arch

Question 11

Elbow joint type

Answer 11

Ginglymus synovial joint

Question 12

Humeroulnar joint ligaments

Answer 12

Ulnar collateral ligament- from medial humeral epicondyle to coronoid process, consists of 3 bands

• Anterior band- strongest
• Posterior band- weakest
• Oblique band

Question 13

Humeroradial joint ligaments

Answer 13

Radial collateral ligament from lateral humeral epicondyle to blend with annular ligament of radial head

Question 14

Elbow dislocation

Answer 14

Can occur posteriorly, usually involves tear in ulnar collateral ligament

Question 15

Subtendinous olecranon bursa and bicipitoradial bursa

Answer 15

Two of the more common elbow bursae to become inflamed

Question 16

Subcutaneous olecranon bursitis

Answer 16

Sometimes called students elbow, dart throwers elbow and miners elbow
Results from excessive friction b/w the skin and the olecranon

Question 17

Proximal radioulnar joint type

Answer 17

Trochoid synovial joint- primary site of supination/pronation

Question 18

Sacciform recess

Answer 18

Small pocket of synovial membrane protruding out from under annular ligament

Question 19

Annular ligament description and nursemaids/pulling elbow

Answer 19

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

Question 20

Middle radioulnar joint type

Answer 20

Syndesmosis

Question 21

Radiocarpal (wrist) joint type

Answer 21

Condylar synovial joint

Question 22

Ligaments of the radiocarpal joint

Answer 22

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

Question 23

Intercarpal joints type

Answer 23

Planar synovial joints

Question 24

Ligaments of intercarpal joints

Answer 24

Anterior/posterior intercarpal ligaments
Interosseous intercarpal ligaments
Pisohamate ligament- b/w pisiform and hook of hamate

Question 25

Midcarpal joint type

Answer 25

Sellar synovial

Question 26

1st Carpometacarpal joint type and ligaments

Answer 26

Sellar synovial | Palmar/dorsal carpometacarpal ligaments

Question 27

2-5 carpometacarpal joint type and ligaments

Answer 27

Planar synovial Palmar/dorsal carpometacarpal ligaments Pisometacarpal ligament- 5th metacarpal association Radiate carpal ligament- from capitate to bases of metacarpal bones

Question 28

Intermetacarpal joint type and ligaments

Answer 28

4 Planar synovial joints Dorsal/palmar intermetacarpal ligaments Interosseous intermetacarpal ligament

Question 29

Metacarpophalangeal joint type

Answer 29

Condylar synovial

Question 30

Ligaments of the metacarpophalangeal joint

Answer 30

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

Question 31

Bull riders thumb

Answer 31

Sprain of the lateral collateral ligament and possible avulsion of the lateral part of the proximal phalanx of the thumb

Question 32

Skiers thumb or game keepers thumb

Answer 32

Laxity or rupture of both collateral ligaments of the first metacarpophalangeal joints results in hyperabduction of the joint

Question 33

Interphalangeal joints description

Answer 33

Ginglymus synovial joints All contain palmar ligament, medial and lateral collateral ligaments- same description as those in the metacarpophalangeal joints

Question 34

Mallet finger or baseball finger

Answer 34

Sudden hyperflexion of the distal interphalangeal joint can avulse the attachment of the long extensor tendon with that tendon away from the distal phalanx

Question 35

Pectoral fascia invests what, is continuous with what

Answer 35

Pectoralis major | Continuous with deltoid fascia superiorly, axillary fascia laterally and abdominal deep fascia inferiorly

Question 36

Axillary fascia

Answer 36

Floor of axilla | Continuous medially with pectoral fascia, inferiorly with clavipectoral fascia

Question 37

Clavipectoral fascia invests

Answer 37

Invests subclavius and pectoralis minor | Suspensory ligament of axilla

Question 38

Deltoid fascia covers what, continuous with what

Answer 38

Covers deltoid muscle | Continuous with pectoral fascia anteriorly and infraspinous fascia posteriorly

Question 39

Brachial fascia continuous with what

Answer 39

Continuous superiorly with pectoral, deltoid, infraspinous and axillary fascia Inferiorly with antebrachial fascia

Question 40

Medial intermuscular septum

Answer 40

Separates the brachium into anterior and posterior compartments in conjunction with the lateral intermuscular septum

Question 41

Antebrachial fascia

Answer 41

Divides antebrachium into anterior and posterior compartments Continues superiorly with brachial fascia

Question 42

Extensor retinaculum

Answer 42

Thickening of antebrachial fascia, holds extensor tendons in place

Question 43

Synovial/ganglion cysts

Answer 43

Irritation of the synovial sheaths can cause accumulation of mucopolysaccharide fluid that can form a painless lump

Question 44

Palmar carpal ligament continuous with

Answer 44

Extensor retinaculum

Question 45

Flexor retinaculum

Answer 45

Transverse carpal ligament From scaphoid/trapezium to hook of hamate and pisiform Forms carpal tunnel

Question 46

Palmar aponeurosis features

Answer 46

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

Question 47

Dupuytren contracture

Answer 47

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

Question 48

Fibrous digital sheaths

Answer 48

Enclose the synovial sheaths of the long flexor tendons in the hand

Question 49

Central compartment

Answer 49

Contains flexor tendons, lumbrical muscles, superficial palmar arterial arch, digital vessels and nerves

Question 50

Adductor compartment

Answer 50

Contains adductor pollicus