Upper Limb Flashcards
What does the appendicular skeleton include?
Upper limb
- Pectoral Girdle (Clavicle (collarbone) + scapula (shoulder blade))
- Bones of the arms/hands
Lower limb
- Pelvic Girdle (Pelvis: Ilium, Ischium, Pubis)
- Bones of the legs/feet
What does the upper limb include?
- Shoulder (Axilla, scapula & pectoral/breast regions)
- Arm (shoulder – elbow/cubitis)
- Forearm (elbow – wrist)
- Hand (wrist, hand & digits)
The upper limb is a ________ limb which means it is specialised for grip & grasping objects.
Weight bearing not important and so bones are ______ and less ______.
The upper limb & pectoral girdle are ______ attached to the body, making it highly ______ but with poor _______.
The upper limb is a PREHENSILE limb which means it is specialised for grip & grasping objects.
Weight bearing not important and so bones are LIGHTER and less ROBUST
The upper limb & pectoral girdle are LOOSELY attached to the body, making it highly MOBILE but with poor STABILITY.
What movements occur at the shoulder?
- flexion/extension
- abduction/adduction
- internal/external rotation
What movements occur at the elbow?
- flexion/extension
* pronation/supination
What movements occur at the wrist?
- flexion/extension
* abduction/adduction
The pectoral girdle is made up of the Scapula and Clavicle. There are 2 main joints: the sternoclavicular joint and acromioclavicular joint. Describe each.
Sternoclavicular joint • the only upper limb joint that directly articulates with the trunk • manubrium & medial clavicle • ball and socket joint • Strengthened by ligaments
Acromioclavicular joint
• lateral clavicle & acromion of scapula
• Gliding synovial joint
Describe the clavicle
The clavicle, or collar bone, is the first bone to ossify in the foetus. It is highly visible/palpable.
The manubrium of the sternum joins to the acromion of †he scapula.
It has slight sigmoid curves, which is space for vessels/nerves that go into the axilla.
The clavicle acts as strut so limb swings clear of trunk
There are strong ligaments of Sternoclavicular joint, and so the clavicle is rarely dislocated but often fractured.
Describe the scapula
The scapula is a large flat triangular bone. It overlaps ribs 2-7 on posterior. The scapula is mostly held in place by muscles.
Spine = sharp ridge on posterior surface
Acromion process = lateral, high point of shoulder, articulates with clavicle & shoulder muscles
Coracoid process = lateral & anterior, muscles attach
Glenoid cavity – Lateral, inferior to acromion, articulates with humerus
What does the humerus articulate with at the elbow and shoulder?
At Shoulder: Head articulates with glenoid cavity
At Elbow: Articulates with 2 forearm bones Laterally - radius at humerus, Medially - ulna at humerus
The shoulder joint is called the Glenohumeral joint. It is made up of the head of the humerus + glenoid cavity. It is a ______, multiaxial ball & socket joint with extensive free range of movement- more than any other joint. This is because the _____ head is 4 times too big for _____. Because of this it also has poor _______- it is the most frequently dislocated joint. It has a thin loose capsule which adds some stability. It has 4 _______ which provide more stability by ______ the capsule, and most stability comes from _______.
The shoulder joint is called the GLENOHUMERAL joint. It is made up of the head of the humerus + glenoid cavity. It is a SYNOVIAL, multiaxial ball & socket joint with extensive free range of movement- more than any other joint. This is because the HUMERUS head is 4 times too big for FOSSA. Because of this it also has poor STABILITY- it is the most frequently dislocated joint. It has a thin loose capsule which adds some stability. It has 4 LIGAMENTS which provide more stability by THICKENING the capsule, and most stability comes from MUSCLES.
How do the 2 sets of muscles attaching the humerus to scapula each effect the shoulder?
- Attach close to shoulder: Smaller mechanical effect on shoulder, stabilise joint
- Attach further away: Considerable mechanical effect on shoulder, Wide range movements at shoulder joint due to instability
Describe shoulder dislocation
Most frequently dislocated joint e.g. fall on outstretched hand: arm abducted, humeral head pushes against weakest part of capsule (inferior and anterior), tears ligaments and articular capsules
Describe rotator cuff injuries
Common injury during repetitive use limb above the horizontal – e.g. swimming, throwing, racket sports, frozen shoulder - Irritation and inflammation of tendons, shoulder stiffness
Describe axillary nerve damage
May be injured with dislocations with head of humerus, causes paralysis of deltoid and loss of sensation in small area of skin over deltoid
Describe the ulna
Medial (at the side of your pinky finger!)
Longer than radius
Proximal = receives trochlea of humerus; forms elbow
Distal - head – articulates with radius & wrist
Describe the radius
Lateral (at the side of your thumb!)
Proximal - Head – articulates with humerus & ulna (elbow)
Distal – broad, articulates with ulna & carpals
Describe the elbow
The elbow is a hinge joint.
It is made up of the ulna, radius & humerus, and allows flexion/extension
The elbow is a compound joint of 3 joints:
-Humeroulnar joint
-Humeroradial joint
-Proximal radioulnar joint
Describe the humeroulnar joint
Humeroulnar joint is made up of the trochlea of humerus and trochlear notch ulna. It is medial, and responsioble for allowing flexion/extension. It has no pronation/ supination and the bony processes limit range of motion
Describe the humeroradial joint
Humeroradial joint is made up of the capitulum humerus and radius head. It is lateral and responsible for supination/pronation- the radius rotates in pronation.
Describe tennis elbow (cause, symptoms, diagnoses, and treatment, etc)
Tennis elbow is lateral epicondylitis.
The cause is repetitive use of the forearm extensor muscles & tendons
Symptoms are that the lateral epicondyle becomes swollen & sore
To diagnose, when the elbow is fully extended, the patient feels tenderness over the origin of the extensor carpi radialis brevis muscle from the lateral epicondyle.
Also pain with passive wristflexionand resistive wristextension.
Treatment is rest, anti-inflammatories, cold press and physiotherpay. As a last resort surgery to remove part of damage tendon.
“Golfer’s elbow” is medial epicondylitis.
What is the cubital fossa?
- concavity under anterior crease of elbow
- bound by muscles on either side
- brachial artery enters base of fossa - leaves as radial & ulnar arteries
- median nerve runs straight through it
- radial nerve can be seen laterally
Describe the radioulnar jointd
Superior / Proximal Radioulnar
- Pivot joint radius head & ulna
- Rotates during pronation/supination
- Radial Annular ligament = strong band, encircles head of radius, keeps radius in contact with ulna
Inferior / Distal Radioulnar
- Pivot joint between ulna head & radius
- Held together by articular disc and interosseous membrane
Describe pronation and supination
Movements occurring between forearm bones at radioulnar joints, radius rotates over ulna, head of radius rotates on humerus. This occurs below and independent of shoulder & elbow joint
Supination is more powerful than pronation. Actual range of movement = 140 – 150˚
What does subluxation mean?
partial dislocation
How does incomplete dislocation of head of radius often occur?
This occurs if jerked while forearm pronated and tears the anular ligament, causing the radial head to moves distally out
What are the 27 bones of the hand’s 3 main groups? How many of each?
Carpals = 8 Metacarpals = 5 Phalanges = 14
Hand movements can be non-prehensile or prehensile. Describe each.
Non-prehensile movements= Pushing, Hitting – with flat hand etc.
Prehensile movements = Grasp and grip, This is the fundamental movement of hand and is dependent on positioning of fingers (digits 2-5) and thumb
