Upper Extremity: Ligaments Flashcards

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0
Q

Quadrate Ligament

A

Description:

  • thickened band
  • thin, square-shaped
  • short but pliable to allow for pronation/supination
  • cover synovial membrane below annular ligament

Attachments:

  • extends from the inferior border of the annular ligament
  • runs from the radial notch of the ulna to the neck of the radius

Functions:
-helps to stabilize the proximal radioulnar joint

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1
Q

Annular Ligament

A

Description:

  • strong ligament that encircles the head of the radius
  • retains contact of the radial head with the radial notch of the ulna
  • deep surface is lines with the synovial membrane

Attachments:

  • ulna (anterior and posterior to the radial notch)
  • surrounds articulating surfaces and forms a collar around the head of the radius

Functions:
-anchors and stabilizes the proximal radioulnar joint

Relevant Structures:

  • RCL of the elbow blends in
  • upper border blends with anterior and posterior joint capsules
  • superficial fibres of the anterior capsule (come from medial epicondyle of the humerus)
  • inferior anterior joint capsule (with coronoid process)
  • inferior aspect of the posterior joint capsule
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2
Q

RCL of the Elbow

A

Description:

  • short and narrow fibrous band (less distinct than ulnar)
  • fan-shaped

Attachments:

  • extends from the lateral epicondyle of the humerus
  • blends distally with the lateral aspect of the annular ligament
  • also blends with the tendon of the supinator

Functions:

  • stabilizes the lateral side of the elbow
  • prevents lateral translation
  • stabilizes the elbow during flexing
  • limits varus stress

Relevant Structures:
-deep (transverse) fibres of the anterior joint capsule (run from UCL)

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3
Q

UCL of the Elbow

A

Description:

  • thick and triangular shaped; strong
  • has 3 bands (anterior,posterior and transverse)

Attachments:
Anterior Band:
-cord-like and strongest
-attached superiorly by its apex on the anterior surface of the medial epicondyle
-attached inferiority by the medial margin of the anterior surface of the coronoid process

Posterior Band:

  • fan-shaped and weakest
  • apex attaches superior to the inferior posterior aspect of the medial epicondyle
  • attached inferiority to the medial margin of the olecranon process

Transverse Band:
-forms a bridge between the olecranon process and coronoid process

Functions:

  • stabilizes the medial side of the elbow joint
  • prevents values stress
  • limits medial translation
  • stabilizes elbow during flexion

Relevant Structures:
-deep (transverse) fibres of the anterior joint capsule (run from RCL)

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4
Q

Oblique Cord

A

Description:

  • syndesmotic ligamentous band
  • fibers run inferior and lateral

Attachments:

  • lateral surface of the base of the coronoid process
  • proximal shaft of the anterior radius, just distal to the tuberosity

Functions:

  • limits movement of the radius by stabilizing the head of the radius during pronation/supination
  • limits shearing of the ulna and radius
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5
Q

Volar Radioulnar Ligament

A

Description:

  • narrow band
  • fibre direction: oblique and medial

Attachments:

  • anterior aspect of the ulnar notch
  • anterior aspect of the head of the ulna

Functions:
-limits anterior shear if the radius (allows slight pivot/rotation)

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6
Q

Dorsal Radioulnar Ligament

A

Description:

  • narrow band
  • Fibre direction: oblique and medial

Attachments:

  • posterior aspect of the ulnar notch
  • posterior aspect of the head of the ulna

Functions:
-limits posterior shear if the radius on the ulna (allows slight pivot/rotation)

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7
Q

Arcuate Ligament

A

Description:
Continuous with interosseous membrane

Attachments:

  • articular margins if the ulna (anterior surface)
  • extends laterally and inserts on the distal aspect just superior to the ulnar notch on the radius

Functions:

  • supports the joint superiorly
  • stabilizes radius in pronation/supination
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8
Q

Palmar Radiocarpal Ligament

A

Description:

  • broad, membranous band
  • 3 bands: radioscapholunate, radiocapitate, radiotriquetral
  • thickening of joint capsule

Attachments:

  • anterior margin of distal radius to its styloid process to the anterior aspect of the distal ulna
  • fibers descend inferiorly and medially to attach to the anterior surfaces of the scaphoid, lunate, capitate and triquetral

Functions:
-limits extension of the radiocarpal joint

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9
Q

Palmar Ulnocarpal Ligament

A

Description:

Attachments:

  • anterior margin if the TFCC and the base if the styloid process of the ulna
  • inserts on the anterior surfaces if the triquetrum and lunate

Functions:
-limits extension of the radiocarpal joint

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10
Q

Posterior Radiocarpal Ligament

A

Description:

  • broad, ligamentous sheet
  • some fibers blend with disc
  • no band differentiation

Attachments:

  • distal end of the radius, fibers run inferiomedially
  • insert onto the scaphoid, lunate and triquetrum

Function:
-limits flexion of the radiocarpal joint

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11
Q

UCL of the Wrist

A

Description:

  • short, ligamentous band
  • superficial
  • vertical fibre direction

Attachments:
-styloid process of the ulna toward triquetrum and pisiform

Functions:

  • stabilizes medial aspect of the radiocarpal joint
  • limits radial deviation
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12
Q

RCL of the Wrist

A

Description:

  • weak, thin ligament
  • vertical fibre direction

Attachments:

  • tip of the radial styloid process
  • lateral aspect of the scaphoid and trapezium

Functions:

  • stabilizes the lateral aspect of the radiocarpal joint
  • limits ulnar deviation
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13
Q

Proximal Interosseous Intercarpal Ligament

A

Description:
-2 bands between carpals in the proximal row

Attachments:

  • scaphoid to lunate
  • lunate to triquetrum

Functions:
-limits anterior and posterior shearing

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14
Q

Distal Intercarpal Interosseous Ligament

A

Description:

  • between the carpals of the distal row
  • dorsal aspect

Attachments:

  • trapeziotrapezoid
  • trapeziocapitate
  • capitohamate
  • triquetrohamate

Functions:
-limits posterior shearing on one another

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15
Q

Palmar Intercarpal Ligament

A

Description:
-lies deep to the palmar radiocarpal ligament

Attachments:
-transverse band to attach the scaphoid, lunate and triquetrum (one band)

Functions:
-resists anterior shearing of the carpals in the proximal row

16
Q

Dorsal Intercarpal Ligament

A

Description:

  • more superficial (same depth as the dorsal radiocarpal ligament)
  • 2 bands

Attachments:

  • dorsal surface of scaphoid to dorsal surface of triquetrum (attaches to lunate)
  • dorsal surface of triquetrum to dorsal surface of the trapezoid

Functions:

  • strengthens joint posteriorly
  • limits posterior shearing
17
Q

Pisohamate Ligament

A

Description:
-continuous with flexor carpi ulnaris tendon

Attachments:
-anterior aspect of the pisiform to the anterior aspect of the hook of hamate

Functions:

  • forms the tunnel of Guyon with pisometscarpal ligament (ulnar nerve passes through) - protects nerve
  • reinforces pisotriquetal joint
18
Q

Pisometacarpal Ligament

A

Description:
-continuous with flexor carpi ulnaris tendon

Attachments:
-anterior aspect of the pisiform to the anterior aspect of the base of the 5th metacarpal

Functions:

  • forms the tunnel of Guyon with pisometscarpal ligament (ulnar nerve passes through) - protects nerve
  • reinforces pisotriquetal joint
19
Q

Dorsal Carpometacarpal Ligaments

A

Description:
-stronger and more distinct than palmar side

Attachments:

  • distal aspect of the carpals to the dorsal aspect of the base of the metacarpals
  • 2nd metacarpal - 2 bands (trapezium and trapezoid)
  • 3rd metacarpal - 3 bands (trapezoid, capitate and smaller band from hamate)
  • 4th metacarpal - 2 bands (capitate and hamate)
  • 5th metacarpal - 1 band (hamate)

Functions:
-resists posterior shearing

20
Q

Palmar Carpometacarpal Ligaments

A

Attachments:

  • distal aspect of the carpals to the palmar aspect of the base of the metacarpals
  • 2nd metacarpal - 1 band (trapezium)
  • 3rd metacarpal - 3 bands (trapezoid, capitate concave surface of hamate)
  • 4th metacarpal - 1 band (concave surface of hamate)
  • 5th metacarpal - 2 bands (hook of hamate and pisiform - pisometacarpal)

Functions:
-resists anterior shearing

21
Q

Palmar Metacarpal Ligaments

A

Description:
-transverse fibers

Attachments:

  • sits at the base of adjacent metacarpals
  • 2/3, 3/4, 4/5

Functions:
-limits anterior shearing

22
Q

Dorsal Metacarpal Ligaments

A

Description:
-transverse fibers

Attachments:

  • sits at the base of adjacent metacarpals
  • 2/3, 3/4, 4/5

Functions:
-limits posteriorshearing

23
Q

Palmar Plate

A

Description:

  • accessory volar ligaments
  • thick ligaments that attach loosely

Attachments:
-thickening of joint capsule between collateral ligaments

Functions:
-helps to limit extension of the MCP

24
Q

Deep Transverse Metacarpal Ligaments

A

Description:
-3 short bands

Attachments:

  • head of the metacarpals
  • palmar plate

Functions:
-resist anterior or posterior shearing of metacarpal heads 2-5

25
Q

Collateral Ligaments of the MCP Joint

A

Description:
-strong, rounded cords

Attachments:
-posterior tubercle of the head of the metacarpal bone and to the base of the proximal phalanx

Functions:
-resist valgus/varus forces

26
Q

Extensor Retinaculum

A

Description:

  • lies in the extensor crease
  • strong band

Attachments:

  • styloid process of the radius
  • styloid process of the ulna, triquetrum and pisiform

Functions:
-lined with synovial fluid (sheaths) to protect extensor tendons

27
Q

Flexor Retinaculum

A

Description:

  • strong, square-shaped
  • forms the carpal tunnel
  • also known as transverse carpal ligament
  • continuous with palmar fascia (palmaris longus blends in)

Attachments:

  • lateral: scaphoid tubercle and trapezium tubercles
  • deep part attaches to body of the trapezium (forms an aperture for the flexor carpi radialis)
  • medial: pisiform and hook of hamate

Relevant Structures:

  • flexor digitorum superficialis (superficial - 3,4 and 2,5
  • flexor digitorum profundus (deep)
  • median nerve
28
Q

Dorsal Ulnocarpal Ligament

A

Description:

  • short ligamentous band
  • blends with distal border of the UCL

Attachments:
-head of e ulna to the posterior aspect of the triquetrum

Functions:
-limits flexion of the radiocarpal joint

29
Q

Interosseous Membrane:

A

Description:

  • continuous with the arcuate ligament
  • fibre direction: lateral to medial toward ulna
  • superior aperture
  • inferior aperture in distal 1/3 for anterior interosseous artery

Attachments:

  • medial border of the radius, starts
  • lateral border of the ulna
  • starts inferior to the radial tuberosity at oblique cord

Functions:

  • serves as an attachment for muscles of the antebrachium
  • holds the radius and ulna together, prevents shearing
30
Q

Articular Disc (TFCC)

A

Description:

  • triangular in shape
  • base: attaches to medial edge of the ulnar notch
  • apex: attaches to the lateral aspect of the styloid process of the ulna
  • articulates with carpals

Functions:
-helps maintain congruency of the radiocarpal joint

Attachments:
-palmar ulnocarpal ligament

31
Q

Ulnocarpal Ligament

A

Description:

  • deep band of the ulnar collateral ligament
  • ulnotriquetral
  • ulnolunate

Functions:
-limits radial deviation and extension of the radiocarpal joint

32
Q

Interosseous Ligaments

A

Description:

-thickenings if joint capsule between 2/3, 3/4, 4/5

33
Q

Interphalangeal Collateral Ligaments

A

Description:
-hinge joint - flexion/extension

Attachments:

  • convex head of the roximal phalanx
  • base of distal phalanx

Functions:
-resists valgus/varus forces