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Bones > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

What is the pectoral girdle?

A

Clavicle and scapula

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2
Q

What is the clavicle?

A

Collarbone
Extending between sternum and acromium
Long bone

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3
Q

Function of clavicle

A

Attaches upper limb to trunk
Protects underlying neurovascular structures supplying the upper limb
Transmits force from upper limb to axial skeleton

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4
Q

Articulations of clavicle

What kind of joints do they form?

A

Sternoclavicular joint
Acromioclavicular joint

Both are fibrocartilaginous joints

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6
Q

Bony landmarks of scapula

A

Sternal end - large facet for sternoclavicular joint
Shaft - acts as point of origin and attachment for muscles
Acromial end - small facet for acromioclavicular joint, attachment point for conoid tubercle and trapezoid line

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7
Q

What is the scapula?

Articulations of the scapula

A

Shoulder blade

Glenohumeral joint (hyaline cartilage) 
Acromioclavicular joint - connects upper limb to trunk
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8
Q

What are the different surfaces of the scapula? Bony landmarks of each surface

A

Costal(anterior), lateral, posterior

Costal - a concave depression called subscapular fossa on its surface, coracoid process on superolateral surface (hook like projection) lying underneath clavicle

Lateral - glenoid fossa which articulates with humerus to form glenohumeral joint, supraglenoid tubercle immediately superior to glenoid fossa, infraglenoid tubercle inferior to glenoid fossa

Posterior - spine which runs transversely across scapula, infraspinous fossa below spine, supraspinus fossa above spine, acromion which is a projection of spine that arches over glenohuneral joint articulating with clavicle

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9
Q 
Scapula fracture:
Common? 
Cause? 
What does it indicate? 
Intervention?
A

Relatively uncommon, cause by high speed road collisions, crushing injuries, sports injuries
Indication of severe chest trauma
Doesn’t need much intervention as tone of surrounding muscles holds pieces in place for healing

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10
Q

What is the humerus?

A

Long bone of the upper arm

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11
Q

Role of humerus

A

Attachment site for many muscles and ligaments

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12
Q

Anatomical features of the proximal humerus

A

Head - connected to greater and lesser tubercles by anatomical neck

Greater tubercle - lateral, attachment site for supraspinatus, infraspinatus and teres minor

Lesser tubercle - medial, attachment site for subscapularis

Tubercles separated by intertubercular sulcus

Surgical neck runs from tubercles to shaft

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13
Q

Anatomical features of shaft of humerus

A

Deltoid tuberosity - lateral, where deltoid muscle attaches

Radial groove - runs diagonally down posterior surface of humerus parallel to deltoid tuberosity, radial nerve and profunda brachii artery lie here
Attachment site for coracobrachialis, deltoid, brachialis, brachioradialis anteriorly and medial and lateral heads of triceps posteriorly

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14
Q

Anatomical features of distal humerus

A

Medial and lateral Supraepicondylar ridges - formed by lateral and medial borders of humerus

Lateral and medial epicondyles - distal to supraepicondylar ridges, ulnar nerve passes into forearm along posterior side of medial epicondyle

Trochlea - medial, extends posteriorly
Capitulum - lateral, articulates with radius

3 depressions - anterior: coronoid, radial and posteriorly olecranon fossa

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15
Q

Fractures of humerus

A

Surgical neck fracture - direct blow to area or falling on outstretched hand, risk of damage to axillary nerve and posterior circumflex artery

Mid-Shaft fracture - could damage radial nerve and profunda brachii artery (lie in radial groove). Radial nerve damage = wrist drop (unopposed flexion), sensory loss on posterior surface of hand and proximal ends of lateral 3 and half fingers posteriorly

Distal humeral fracture - supracondylar fracture and epicondyle fractures are common. Supracondylar fracture caused by falling on a flexed elbow, spans between two epicondyles
Direct damage could cause interference to brachial artery = ischaemia = uncontrolled flexion go hand
Medial epicondyle frActure could damage ulnar nerve = ulnar claw, loss of sensation over medial 1.5 fingers of hand on both dorsal and palmar surface

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16
Q

Articulations of humerus

A

Glenohumeral joint

Elbow joint - trochlea and capitulum articulate with ulna and radius respectively

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17
Q

Why is the glenohumeral joint susceptible to dislocation?

A

Humerus disproportionately larger than glenoid fossa = poor fit = unstable

18
Q

What is the elbow joint?

A

Joint connecting the proximal arm to the forearm
2 articulations:
Trochlear notch of ulna to trochlear of ulna
Head of radius to capitulum of humerus

19
Q

What is the ulna?

A

Medial bone of forearm

20
Q

Role of ulna and radius

A

Ulnar - stabilising bone

Radius - pivots to produce movement

21
Q

Different parts of ulna and it’s anatomical features

A

Proximal, shaft, distal

Proximal
Articulations: trochlear notch + trochlea = elbow joint, radial notch and head of radius = proximal radioulnar joint
Bony landmarks: olecranon - forms part of trochlear notch, coronoid process - ridge of bone projecting outward anteriorly, forms part of trochlear notch, trochlear notch = olecranon + coronoid process, radial notch laterally, ulna tuberosity = immediately distal of coronoid process

Shaft
Anterior surface - muscle attachment
Posterior - muscle attachment
Medial

Anterior border
Interosseous - attachment site for interosseous membrane; spans distance between 2 forearms
Posterior - palpable along entire length

Posterior
Much smaller in diameter than proximal end
Distal projection = ulnar styloid processes
Head articulates with ulnar notch of radius forming distal radioulnar joint

22
Q

Different types of ulna fractures and their causes

A

Shaft fracture - normal muscle tone pulls ulna posteriorly, Occurs as a result of ulna being hit by an object

Olecranon process fracture - less common, caused by patient falling on flexed elbow

Ulna and radius attached by interosseous membrane and so force of trauma to one bone can be transmitted to the other by this membrane. Both bone fractures are common:
Monteggia’s - caused by force from behind ulna, proximal shaft fractured, head of radius dislocates anteriorly at elbow
Galeazzi’s - fracture to distal radius with ulna head dislocating at the distal radio-ulnar joint

23
Q

What is the radius?

A

The lateral bone of the forearm

24
Q

Anatomical features of proximal radius

A

Head - disk shaped, thicker medially, articulates with capitulum of humerus forming elbow joint, articulates with radial notch forming proximal radioulnar joint
Neck - narrow area between head and tuberosity
Radial tuberosity - attachment site of biceps brachii

25
Q

Anatomical features of shaft of radius

A

Expands in diameter as it moves distally

Roughening at Middle of lateral surface for attachment of probator teres muscle

26
Q

Anatomical features for distal radius

A

Lateral side projects forming radial styloid process
Ulnar notch medially articulating with ulna head forming distal radioulnar joint

2 facets on distal surface for articulation with scaphoid and lunate carpal bones making up wrist joint

27
Q

Fractures of radius

A

Colles’ - most common, cause = FOOSH causing fracture to distal radius, structures distal to fracture displaced posteriorly (wrist and hand) forming dinner fork deformity

Fractures of radial head - cause FOOSH, radial head forced in capitulum of humerus causing it to fracture

Smiths - cause falling onto back of hand, distal fragment placed anteriorly

Monteggia’s fracture
Galleazzi’s fracture

28
Q

What is the wrist joint?

A

Aka radiocarpal joint

Synovial joint, marking transition of forearm to hand

29
Q

Articulating surfaces of radiocarpal joint

A

Distally - proximal row of carpal bones (not pisiform)

Proximally - distal end of radius and fibrocartilaginous ligament called articular disk (not ulnar)

30
Q

Injuries to wrist joint

A

Scaphoid fracture - if FOOSH, scaphoid takes most of force. Can disrupt blood supply to proximal portion - emergency as failure to revascularise the scaphoid = avascular necrosis + future arthritis
Main clinical sign = tenderness in anatomical snuffbox

Anterior dislocation of lunate - caused by falling on a dorsiflexed wrist, lunate forced anteriorly and compressed carpal tunnel causing carpal tunnel syndrome

Colles fracture - most common

31
Q

Function of bones of hand

A

Provide support and flexibility to the soft tissues

32
Q

What are bones of hands categorised into?

A

Carpals - most proximal, 8 irregularly shaped bones

Metacarpals - 5, each related to a digit

Phalanges - most distal, bones of finger

33
Q

Names of carpals

A 
Proximal Row: (lateral to medial) 
Scaphoid
Lunate
Triquetrum
Pisiform - sesamoid bone formed within tendon of flexor Carpi ulnaris
Distal Row: (lateral to medial) 
Trapezium
Trapezoid
Capitate
Hamate - projection on palmar surface called hook of hamate
34
Q

Names of metacarpals

A 
Metacarpal I - thumb 
Metacarpal II - index finger
Metacarpal III - middle finger
iV - ring finger
V - little finger
35
Q

Structure of metacarpals

A

Base, shaft, head

36
Q

Structure of phalanges

A

Thumb - proximal and distal phalanx

Rest of digits have proximal, middle and distal phalanges

37
Q

Joints in hand

A

Metacarpophalangeal joints

Interphalangeal

Carpometacarpal

38
Q

Fracture of metacarpals

A

Boxers - fracture of 5th metacarpal neck, caused by clenched fist striking hard object, distal part of fracture displaced posteriorly = shorter affected finger

Bennett’s - fracture of 1st metacarpal base, extending into carpometacarpal joint, caused by hyperabduction of thumb

Bones (4 decks)

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