Upper Limb

Question 1

What are the bones that make up the shoulder girdle?

Answer 1

Clavicle and scapula

Question 2

Describe the clavicle: type of bone, key landmarks, articulation (makes what joint), function, muscle and ligament attachment

Answer 2

• Long bone, lateral end: flat, broad, sternal end: round, small
• Acromial facet on lateral end articulates with acromion of the scapula forming the acromioclavicular joint.
• Sternal facet on the sternal end articulates with clavicular notch of the manubrium of sternum forming the sternoclavicular joint. (attach to axial skeleton)
• Pushes upper limb out to the side enabling great range of motion.
• Roughening on inferior surface of lateral end provides attachment for coracoclavicular ligament.
• Roughening on inferior surface of sternal end provides attachment for costoclavicular ligament.

Question 3

Describe the scapula: type of bone, key landmarks, articulation (makes what joint), function, muscle and ligament attachment

Answer 3

• Flat bone
• Clavicular facet on medial border of acromion articulates with acromial end of clavicle forming the acromioclavicular joint.
• Glenoid fossa on lateral end of scapula articulates with head of humerus forming the glenohumeral joint (shoulder joint).
• Stabilise bones involved in shoulder movement.
• Fossae (depressions) for muscle attachment.

Question 4

Describe sternoclavicular joint: type of joint, movements allowed, ligaments attached

Answer 4

• saddle type synovial joint
• Elevation, depression, protraction, retraction and rotation of the shoulders.
• Sternoclavicular ligaments (anterior and posterior)
• Costoclavicular ligament (very strong, main stabilising force of the joint, resisting elevation of the pectoral girdle)
• Strong capsule

Question 5

Describe acromioclavicular joint: type of joint, movements allowed, ligaments attached

Answer 5

• plane synovial joint
• all movements are passive, axial rotation to a degree
• Acromioclavicular ligament (covers joint capsule, reinforcing superior aspect)
• Conoid and trapezoid ligament making the coracoclavicular ligament (help stabilise joint- very strong)
• Weak capsule

Question 6

Which shoulder girdle joint is commonly injured?

Answer 6

• Acromioclavicular joint

- Fall on outstretched hand

Question 7

What are common sites of injury of the humerus?

Answer 7

• Surgical neck of humerus, midshaft and supracondylar

Question 8

Which muscle attaches to lesser tuberosity of humerus?

Answer 8

• subscapularis muscle

Question 9

Which muscles attaches to greater tuberosity of humerus?

Answer 9

• supraspinatus muscle, infraspinatus muscle, teres minor

Question 10

Which muscle attaches to scapula and runs through the bicipital groove of the humerus?

Answer 10

• Long head of biceps brachii

Question 11

Which muscle attaches to coracoid process of scapula?

Answer 11

• Short head of biceps brachii

Question 12

Which muscles attaches to lateral epicondyle of humerus?

Answer 12

• extensor carpi ulnaris, extensor digitorum, extensor carpi radialis brevis, extensor digiti minimi

Question 13

Which muscles attaches to medial epicondyle of humerus?

Answer 13

• flexor carpi radialis, flexor digitorum superficialis, flexor carpi ulnaris

Question 14

What does the capitulum of the humerus articulate with?

Answer 14

• head of radius

Question 15

What does the trochlea of the humerus articulate with?

Answer 15

• the trochlear notch of the ulna

Question 16

What type of joint is the glenohumeral joint? What supports this unstable joint?

Answer 16

• Synovial ball and socket joint

- Supported by glenoid labrum, coracoaromial ligament, rotator cuff muscles, long head of biceps

Question 17

What are the rotator cuff muscles of the shoulder?

Answer 17

• Supraspinatus, infraspinatus, teres minor, subscapularis

Question 18

What is the physiological joint of the shoulder? (not true joint)

Answer 18

• scapulo-thoracic joint

Question 19

Where is the clavicle most commonly fractured and why?

Answer 19

• The junction between the two curvatures because the coracoclavicular ligament is quite strong here and so the clavicle will fracture before the ligament is broken.

Question 20

What position of shoulder joint dislocation is most common?

Answer 20

• Anterior shoulder joint dislocation

- Occurs when force is applied to abducted and externally rotated arm

Question 21

What type of bone is the humerus, ulna and radius?

Answer 21

• Long bones

Question 22

What links the ulna and the radius?

Answer 22

• Interosseous membrane

Question 23

Which muscles attaches to the olecranon process of the ulna?

Answer 23

• triceps muscles (long head, lateral head and medial head of triceps brachii)

Question 24

Which muscles attaches to the radial tuberosity of the radius?

Answer 24

• biceps muscles (long head and short head of bicpes brachii

Question 25

Where is the proximal radioulnar joint?

Answer 25

- Between head of radius and radial notch of ulna

Question 26

What two joint are at the elbow? What type of joints are they?

Answer 26

- elbow joint (hinge type synovial joint) | - proximal radioulnar joint (pivot type synovial joint)

Question 27

Where is the distal radioulnar joint?

Answer 27

- Between the head of ulna and ulnar notch on the distal radius

Question 28

What types of bones are in the wrist and hand? Example?

Answer 28

- Short bones (the 8 carpals) - Long bones (the metacarpals and phalanges) - Sesamoid bones (pisiform bone)

Question 29

What type of joint is the wrist joint (radiocarpal joint)? Where is this joint?

Answer 29

- Condyloid type synovial joint | - Between the distal radius and the carpal bones (scaphoid and lunate)

Question 30

What type of joints are found in the hand?

Answer 30

- Thumb: saddle type synovial joint | - The rest of the carpometacarpal joints are plane type synovial joints

Question 31

What type of joints are found in the fingers?

Answer 31

- metacarpophalangeal joints are condyloid joints | - interphalangeal joints are hinge type joints

Question 32

Which carpal is most commonly fractured?

Answer 32

- Scaphoid bone

Question 33

What are the superficial/extrinsic muscles of the back? (not true back muscles)

Answer 33

- Trapezius, latissimus dorsi, levator scapulae, rhomboid minor, rhomboid major

Question 34

What are the anterior axio-appendicular muscles (shoulder girdle)?

Answer 34

- Deltoid, pectoralis major, pectoralis minor, teres major, serratus

Question 35

What are the scapulo humeral muscles (shoulder girdle)

Answer 35

- deltoid, biceps and the rotator cuff muscles

Question 36

What are the muscles in the anterior compartment of the arm?

Answer 36

- Biceps brachii, coracobrachialis, brachialis

Question 37

What are the muscles in the posterior compartment of the arm?

Answer 37

- Lateral head of triceps brachii, long head of triceps brachii and medial head of triceps brachii

Question 38

What are the muscles in the anterior compartment of the forearm?

Answer 38

- Wrist and finger flexors - Superficial: FCU, FCR (arise from common flexor origin) - Intermediate: flexor digitorum superficialis (arise from common flexor tendon, radius and ulna) - Deep: FDP, FPL, PQ (arise from radius, ulna and interosseous membrane)

Question 39

What is the common flexor origin for the muscles in the anterior compartment of the forearm?

Answer 39

- medial epicondyle

Question 40

Which muscle tendons pass through the carpal tunnel?

Answer 40

- 4 tendons of FDS, 4 tendons of FDP, tendon of FPL

Question 41

Which muscle tendon pass through the flexor retinaculum?

Answer 41

- flexor carpi ulnaris

Question 42

Which tendon is above the flexor retinaculum?

Answer 42

- tendon of palmaris longus

Question 43

What is the common extensor origin for the muscles in the posterior compartment of the forearm?

Answer 43

- Lateral epicondyle

Question 44

What are the muscles in the posterior compartment of the forearm?

Answer 44

- Wrist and finger extensors - Superficial: brachioradialis, (ECRL, ECRB, ECU -extends wrist), (EDC, EDM - extends digits) (arise from common extensor origin) - Deep: EI, (EPL, EPB, APL - for thumbs), supinator (arise from ulna radius and interosseous membrane)

Question 45

What are the intrinsic muscles of the hand?

Answer 45

- 4 thenar muscles - 3 hypothenar muscles - 4 lumbricals, 7 interossei (in palms)