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6. MSK > Upper Limb Bones > Flashcards

Upper Limb Bones Flashcards

1
Q

What time of bone is the scapula?

A

A flat bone.

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2
Q

How many muscles attach to the scapula?

A

17.

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3
Q

Which side of the scapula is the costal surface?

A

The side facing the ribcage.

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4
Q

What is the subscapular fossa?

A

The concave depression over most of the costal surface.

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5
Q

Which muscle originates from the subscapular fossa?

A

The subscapularis.

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6
Q

Where does the coracoid process originate from?

A

The superolateral surface of the costal scapula.

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7
Q

Which muscles attach and originate from the coracoid process?

A

Biceps brachii and pectoralis major attach to the coracoid process.
Coracobrachialis originates here.

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8
Q

Which side of the scapula is the lateral surface?

A

The side facing the humerus.

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9
Q

Where is the site of the glenohumeral joint?

A

The lateral surface of the scapula.

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10
Q

What is the glenoid fossa?

A

A shallow cavity which articulates with the humerus to form the glenohumeral joint. The superior part of the lateral border articulates with the humerus.

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11
Q

What is the supraglenoid tubercle?

A

A roughening immediately superior to the glenoid fossa.

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12
Q

What muscle attaches to the supraglenoid tubercle?

A

The long head of the biceps brachii.

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13
Q

What is the infraglenoic tubercle?

A

A rougherning immediately inferior to the glenoid fossa.

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14
Q

What muscle attaches to the infraglenoid tubercle?

A

The long head of the triceps brachii.

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15
Q

Which side of the scapula is the posterior surface?

A

The side facing outwards.

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16
Q

What is the most prominent feature of the posterior surface?

A

The spine.

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17
Q

What is the spine of the scapula?

A

A transverse line across the scapula that divides it into two.

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18
Q

What is the infraspinous fossa?

A

The area below the spine of the scapula.

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19
Q

What muscle originates from the infraspinous fossa?

A

Infraspinatous.

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20
Q

What is the supraspinous fossa?

A

The area above the spine of the scapula.

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21
Q

Which muscle originates from the supraspinous fossa?

A

Supraspinatous.

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22
Q

What is the acromion?

A

Projection of the spine that arches over the glenohumeral joint and articulates with the clavicle.

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23
Q

What can fractures of the scapula be caused by?

A

Severe chest trauma, e.g. from high speed collisions.

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24
Q

Why does a fractures scapula not need much intervention?

A

The tone of the surrounding muscles hold the pieces in place for healing.

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25
Q

Which muscle pulls the scapula against the ribcage?

A

The serratus anterior.

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26
Q

What causes winging of the scapula and how?

A

Long thoracic nerve damage. This nerve innervates the serratus anterior so damage to it means the serratus anterior isn’t innervated. So the serratus anterior no longer holds the scapula against the ribcage and the scapula wings when pushing the arm.

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27
Q

What type of bone is the clavicle?

A

A long bone.

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28
Q

What are the three main functions of the clavicle?

A

Attach the upper limb to the trunk, protect underlying neurovascular structures supplying the upper limb, and transmit force from the upper limb to the axial skeleton.

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29
Q

What is the shape of the clavicle when facing forwards?

A

The medial aspect is convex and the lateral aspect is concave.

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30
Q

What does the sternal end of the clavicle articulate with?

A

The manubrim of the sternum.

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31
Q

What is the inferior surface of the sternal end marked by?

A

A rough oval depression for the costoclavicular ligament.

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32
Q

Which muscles originate from the shaft of the clavicle?

A

Deltoid, trapezius, subclavius, pectoralis major, sternocleidomastoid and sternohyoid.

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33
Q

Which two ligaments attach at the acromial end of the clavicle?

A

Conoid ligament at the conoid tubercle, trapezoid ligament at the trapezoid line.

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34
Q

Why is the clavicle the most commonly fractures bone in the body?

A

Because one of its functions is to transmit forces from the upper limb to the axial skeleton.

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35
Q

What do fractures of the clavicle commonly result from?

A

A fall onto the shoulder or on an outstretched hand.

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36
Q

Where is the common fracture site of the clavicle?

A

Medial 2/3 and lateral 1/3.

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37
Q

How is the clavicle displaced after fracture?

A

Inferiorly by weight of arm and medially by pectoralis major. Medial end is pulled superiorly by sternocleidomastoid muscle.

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38
Q

What nerve can be damaged by fracture of the clavicle?

A

Suprascapula nerve by the upwards movement of the medial part of the fracture.

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39
Q

What causes the waiter’s tip position after clavicle fracture?

A

The suprascapula nerve is damaged so the lateral rotators of the arm aren’t innervated and there is unopposed medial rotation of the upper limb.

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40
Q

What does the proximal humerus articulate with?

A

The scapula at the glenohumeral joint.

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41
Q

What are the important anatomical features of the proximal humerus?

A

Head, anatomical neck, surgical neck, greater and lesser tubercles and intertubercular sulcus.

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42
Q

What is a tubercle?

A

A round nodule, signifying the attachment site of muscles or ligaments.

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43
Q

Which part of the humerus articulates with the glenoid cavity?

A

The head when it projects medially.

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44
Q

What does the anatomical neck of the humerus connect?

A

The head and the tubercles.

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45
Q

Where is the greater tubercle of the humerus?

A

Laterally on the humerus. It has an anterior and posterior face.

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46
Q

Which muscles attach at the greater tubercle of the humerus?

A

Three of the rotator cuff muscles - supraspinatus, infraspinatus and teres minor.

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47
Q

Where is the lesser tubercle of the humerus?

A

More medially on the bone than greater tubercle. It only has an anterior face.

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48
Q

Which muscles attach at the lesser tubercle of the humerus?

A

The fourth rotator cuff muscle - subscapularis.

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49
Q

What is the intertubercular sulcus/ groove of the humerus?

A

The deep depression separating the two tubercles.

50
Q

Which tendon runs through the intertubercular sulcus of the humerus?

A

The long head of the biceps brachii.

51
Q

What are the lips of the intertubercular sulcus of the humerus?

A

The edges.

52
Q

What attaches to the lips of the intertubercular sulcus of the humerus?

A

The tendons of the pectoralis major, teres major and latissimus dorsi.

53
Q

Where is the surgical neck of the humerus?

A

Fromt he tubercles to the shaft of the humerus.

54
Q

How does a fracture to the surgical neck of the humerus occur?

A

By a direct blow to the area or by falling on an outstretched hand.

55
Q

What structures are at risk with a fracture of the surgical neck of the humerus?

A

The axillary nerve and posterior circumflex artery.

56
Q

Why may a patient with a fracture surgical neck of the humerus be unable to abduct their arm?

A

The axillary nerve has been damaged so the deltoid and teres minor muscles are paralysed so the patient won’t be able to abduct their arm.

57
Q

What is the deltoid tuberosity of the humerus?

A

The roughened surface on the lateral side of humeral shaft.

58
Q

What attaches to the deltoid tuberosity?

A

The deltoid muscle.

59
Q

What is the radial groove?

A

A shallow depression running diagonally down the posterior surface of the humerus, parallel to the dletoid tuberosity.

60
Q

What lies in the radial groove?

A

The radial nerve and profunda brachii artery.

61
Q

Which muscles attach anteriorly to the shaft of the humerus?

A

Coracobrachialis, deltoid, brachialis, brachioradialis.

62
Q

Which muscles attach posteriorly to the shaft of the humerus?

A

Medial and lateral heads of the triceps.

63
Q

What is the main concern with a fracture to the mid-shaft of the humerus?

A

Damage to the radial nerve and profunda brachii artery, which are bound tightly in the radial groove.

64
Q

Why does fracturing the mid-shaft of the humerus lead to wrist drop?

A

Because the radial nerve is damaged so can’t innervate the extensors of the wrist. This leads to unopposed flexion of the wrist.

65
Q

What does the humerus articulate with distally?

A

The ulna and radius at the elbow joint.

66
Q

What are the medial and lateral supraepicondylar ridges formed from?

A

Medial and lateral borders of the humerus respectively.

67
Q

Which muscles attach to the lateral supraepicondylar ridge?

A

Many of the extensor muscles in the posterior forearm.

68
Q

Where can the ulnar nerve be palpated in the distal region of the humerus?

A

Along the posterior side of the medial epicondyle.

69
Q

Which part of the humerus articulates with the ulna?

A

The trochlea.

70
Q

What is lateral to the trochlea that articulates with the radius?

A

The capitulum.

71
Q

What are the three depressions on the distal portion of the humerus?

A

Coronoid, radial and olecrannon fossae.

72
Q

How do supraepicondylar fractures of the humerus occur?

A

By falling on a flexed elbow.

73
Q

How can Volkmanns ischaemic contracture occur from distal humeral fractures?

A

Direct damage of swelling interferes with blood supply to the forearm from the brachial artery. This leads to fibrotic, short muscle fibres and uncontrolled flexion of the hand.

74
Q

How can the ulnar claw be a result of distal humerus fractures?

A

A medial epicondyle fracture could damage the ulnar nerve, causing ulnar claw.

75
Q

What does the ulna articulate with proximally?

A

The radius at the radio-ulnar joint.

76
Q

What are the key landmarks of the proximal ulna?

A

Olecranon, coronoid process, trochlear notch, radial notch and tuberosity of ulna.

77
Q

What is the olecranon of the ulna?

A

A large projection of bone that extends proximally, forming part of the trochlear notch.

78
Q

What muscle attaches to the olecranon of the ulna?

A

Triceps brachii muscle, to the superior surface.

79
Q

What is the coronoid process of the ulna?

A

The ridge of bone that projects outwards in an anterior manner to form part of the trochlear notch.

80
Q

What is the trochlea notch of the ulna?

A

Formed by the olecranon and coronoid process, it is wrench shaped and articulate with the trochlea of the humerus.

81
Q

What is the radial notch of the ulna?

A

The area on the lateral surface of the trochlear notch that articulates with the head of the radius.

82
Q

What is the tuberosity of ulna?

A

A roughening immediately distal of the coronoid process.

83
Q

What attaches to the tuberosity of the ulna?

A

the brachialis muscle.

84
Q

How does the width of the shaft of the ulna change?

A

It decreases in width as it moves distally.

85
Q

What are the three surfaces of the shaft of the ulna?

A

Anterior, posterior and medial.

86
Q

Which muscle attaches to the anterior surface of the shaft of the ulna?

A

Pronator quadratus.

87
Q

What are the three borders of the shaft of the ulna?

A

Posterior, interosseous and anterior.

88
Q

What attaches to the interosseous border of the shaft of the ulna?

A

Interosseous membrane.

89
Q

What is the ulnar styloid process?

A

The rounded head at the distal projection of the ulna.

90
Q

What is the common cause of a fracture of just the ulna?

A

Blow to the ulna, fractures the shaft.

91
Q

What happens to the ulna when it only is fractured?

A

The normal muscle tone pulls the proximal ulna posteriorly.

92
Q

When can the olecranon of the ulna be fractured?

A

When the patient falls on a flexed elbow.

93
Q

What happens to the fragments in a fracture of the olecranon?

A

Triceps brachii displace part of the fragment proximally.

94
Q

Why are fractures of both the ulna and radius not uncommon?

A

Because the interosseous membrane means force of trauma can be transmitted to the other via the membrane.

95
Q

What are the two classical ulna and radius fractures?

A

Monteggias fracture from force behind ulna and Galeazzis fracture of the distal radius.

96
Q

Where does the radius lie?

A

Laterally and parallel to the ulna in the forearm.

97
Q

Where are the four articulations of the radius?

A

At the elbow joint - head of radius with the capitulum of the humerus.
At the proximal radioulnar joint - radial head and radial notch of the ulna.
At the wrist joint - distal end of radius and carpal bones.
At the distal radioulnar joint - ulnar notch and head of ulna.

98
Q

What are the three bony landmarks of the proximal radius?

A

Head, neck and radial tuberosity.

99
Q

What is the neck of the proximal radius?

A

A narrow area of bone between the radial head and radial tuberosity.

100
Q

What is the head of the radius?

A

A disk shaped structure with a concave articulating surface.

101
Q

What happens to the diameter of the shaft of the radius as it moves distally?

A

It expands.

102
Q

What attaches in the roughening in the middle of the lateral surface of the shaft of the ulna?

A

Pronator teres muscle.

103
Q

What is the styloid process of the radius?

A

The lateral side projection at the distal end of the radius.

104
Q

What is the ulnar notch of the radius?

A

The concavity in the medial surface of the distal region of the radius, which articulates with the head of the ulna to form the distal radioulnar joint.

105
Q

What articulates with the two facets on the distal surface of the radius?

A

The scaphoid and lunate carpal bones. This makes up the wrist joint.

106
Q

What is the Colles fracture of the radius?

A

The most common radial fracture on the distal radius from falling on an outstretched hand. Structures distal to the fracture are displaced posteriorly - dinner fork deformity.

107
Q

What are fractures of the radial head?

A

From falling on an outstretched hand, the radius head is forced into the capitulum of the humerus, causing it to fracture.

108
Q

What is a Smiths fracture of the radius?

A

From falling onto the back of the hand. Opposite of Colles fracture, as the distal fragment is now place anteriorly.

109
Q

What are the three categories of hand bones?

A

Carpal bones, metacarpals and phalanges.

110
Q

What are the two rows of carpal bones and the bones in them, lateral to medial?

A

Proximal row: scaphoid, lunate, triquetrum and pisiform.

Distal row: trapezium, trapezoid, capitate and hamate.

111
Q

What type of bone is the carpal bone, pisiform?

A

A sesamoid bone, formed within the tendon of the flexor carpi ulnaris.

112
Q

What are the two most commonly fractured carpal bones?

A

Scaphoid and lunate, from falling on an outstretched hand.

113
Q

What is the clinical presentation of a scaphoid fracture?

A

Pain in the anatomical snuffbox area.

114
Q

Why does a fracture of the scaphoid need to be investigated quickly?

A

Because the blood supply to the proximal bone can be cut off and lead to avascular necrosis which can cause arthritis later in life.

115
Q

When does a lunate fracture occur?

A

With hyperextension at the wrist.

116
Q

What nerve can be damaged with lunate fracture?

A

Median nerve.

117
Q

How are the metacarpal bones named?

A

I to V from the thumb, moving laterally, to the little finger.

118
Q

What does each metacarpal consist of?

A

A base, shaft and head.

119
Q

What attaches to the metacarpals?

A

Interoessei muscles.

120
Q

What are the two common fractures of the metacarpals?

A

Boxers fracture - 5th metacarpal neck from clenched fist striking a hard object, finger looks shorter.
Bennetts fracture - 1st metacarpal base from hyperabduction of the thumb.

121
Q

How do the phalanges differ in the thumb to the rest of the fingers?

A

Only distal and proximal phalanges in the thumb, rather than distal, middle and proximal phalanges in the other fingers.

6. MSK (30 decks)

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