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MSK > Upper Limb Bones > Flashcards

Upper Limb Bones Flashcards

1
Q

What is another name for the scapula?

A

Shoulder blade

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2
Q

The scapula connects the upper limb to the main trunk of the body by articulating with which two bones? At which two joints?

A

Humerus - glenohumeral joint

Clavicle - acromioclavicular joint

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3
Q

What is the rough shape of the scapula?

A

Triangular (and flat)

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4
Q

What is another term for the anterior surface of the scapula? Why is it give this name?

A

Costal

This side faces the ribcage

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5
Q

The costal surface of the scapula has a concave depression over most of its surface called…

A

The subscapular fossa

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6
Q

Name a muscle that originates from the subscapular fossa.

A

Subscapularis

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7
Q

Which hook-like projection lies just underneath the clavicle on the superolateral surface of the costal scapula?

A

Coracoid process

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8
Q

Name a muscle that attaches at the coracoid process.

A

Pectoralis minor

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9
Q

Name two muscles that originate at the coracoid process.

A

Coracobrachialis

Biceps brachii

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10
Q

The lateral surface of the scapula faces which bone?

A

Humerus

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11
Q

What is the name given to the shallow cavity which articulates with the humerus to form the glenohumeral joint?

A

Glenoid fossa

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12
Q

Where is the glenoid fossa located on the scapula?

A

The superior part of the lateral border

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13
Q

What is meant by the term tubercle?

A

A roughening of the bone

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14
Q

Where is the supraglenoid tubercle? Which muscle attaches here?

A

Immediately superior to the glenoid fossa

Long head of the biceps brachii

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15
Q

Where is the infraglenoid tubercle? Which muscle attaches here?

A

Long head of the triceps brachii

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16
Q

The majority of which group of muscles attaches at the posterior surface of the scapula?

A

Rotator cuff muscles

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17
Q

Which structure of the posterior surface of the scapula ‘divides’ it in two?

A

Spine of the scapula

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18
Q

Is the infraspinous fossa, convex or concave in shape? Which muscle originates here?

A

Convex

Infraspinatus

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19
Q

Is the supraspinous fossa, convex or concave in shape? How does its shape and size compare to the infraspinous fossa? Which muscle originates here?

A

Convex

Smaller and more convex that infraspinous fossa

Supraspinatus

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20
Q

What is the name given to the projection of the spine of the scapula that arches over the glenohumeral joint? What articulates here?

A

Acromion

Scapula with the clavicle at the acromioclavicular joint

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21
Q

What bones articulate at the glenohumeral joint?

A

The glenoid fossa of the scapula with the humerus

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22
Q

Which bones articulate at the acromioclavicular joint? What is the position of this compared to the glenohumeral joint (shoulder joint)?

A

The clavicle and the acromion of the scapula

Superior to the shoulder joint

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23
Q

Are fractures of the scapula relatively common or uncommon?

A

Uncommon

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24
Q

Fractures of the scapula usually indicate severe…

A

Chest trauma

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25
Q

How is a fractured scapula treated?

A

Without much intervention, tone of surrounding muscles holds pieces of scapula together for healing to occur

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26
Q

Where does the serratus anterior originate and attach? What nerve innervates it?

A

Originates from ribs 1-8
Attaches at the costal face of the scapula
Long thoracic nerve

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27
Q

Damage to the long thoracic nerve can have what effect on the scapula?

A

Winged scapula

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28
Q

What is another name for the clavicle?

A

Collarbone

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29
Q

What sort of bone is the clavicle classed as?

A

Long bone

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30
Q

What are the three main functions of the clavicle?

A

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

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31
Q

The clavicle is an S shaped bone, which end forms the convex and which end forms the concave aspects of the clavicle?

A

Medial end is convex

Lateral end is concave

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32
Q

What is another name for the medial and lateral ends of the clavicle?

A

Medial - sternal

Lateral - acromial

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33
Q

What is a facet with regards to anatomy?

A

A small smooth area on a bone that is usually an articular surface

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34
Q

What articulations are there at the sternal end of the clavicle?

A

Articulation of the clavicle with the manubrium of the sternum at the sternoclavicular joint

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35
Q

The inferior end of the sternal clavicle is marked by a rough oval depression, what is this for?

A

The costoclavicular ligament

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36
Q

What articulations take place at the acromial end of the clavicle?

A

Acromion of the scapula with the clavicle at the acromioclavicular joint

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37
Q

Which two ligaments attach at the acromial end of the clavicle? At which structures? Which is more medial?

A

Conoid ligament at the conoid tubercle

Trapezoid ligament at the trapezoid line

Conoid ligament is more medial

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38
Q

The conoid tubercle makes up the _________ part of the _____________________ ligament. The trapezoid ligament makes up the ________ part of the _______________ ligament

A

Medial
Coracoclavicular
Lateral
Coracoclavicular

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39
Q

The coracoclavicular ligament is a very strong structure, what is its function?

A

To suspend the weight of the upper limb from the clavicle

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40
Q

Is the clavicle commonly fractured?

A

Yes, most commonly fractured bone in the body

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41
Q

What is a common cause of clavicle fractures?

A

FOOSH

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42
Q

What is the most common area for fracture of the clavicle? What is the most common point of fracture of the clavicle?

A

Middle 1/3 (thinnest here)

Junction of the medial 2/3 and lateral 1/3

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43
Q

What happens to the two fragments of the clavicle in a clavicle fracture?

A

Medial fragment is displaced superiorly by the sternocleidomastoid muscle

Lateral fragment is displaced inferiorly by the weight of the arm and medially by the pectoralis major

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44
Q

What nerves may be damaged in a fracture of the clavicle? What do these nerves innervate? What can this result in?

A

The suprascapular nerves

Lateral rotators of the upper limb

Unopposed medial rotation of the upper limb (waiters tip)

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45
Q

The head of the humerus is connected to the greater and lesser tubercles by the…

A

Anatomical neck

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46
Q

What is the position of the greater tubercle on the humerus? Is it on the anterior or posterior surface of the humerus?

A

Laterally on the humerus

Has an anterior and posterior face

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47
Q

The greater tubercle serves as attachment site for which three of the rotator cuff muscles?

A

Supraspinatus
Infraspinatus
Teres minor

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48
Q

What is the location of the lesser tubercle on the humerus? Is it located on the anterior or posterior face of the humerus?

A

More medially located

Has only an anterior face

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49
Q

Which muscle attaches at the lesser tubercle?

A

Subscapularis

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50
Q

What is the name given to the groove between the tubercles? What runs through this groove?

A

Intertubercular sulcus

The tendon of the long head of the biceps brachii

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51
Q

What are the edges of the intertubercular sulcus known as? What connects here?

A

Lips

Tendons of the pectoralis major, teres major and latissimus dorsi

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52
Q

Where is the surgical neck on the humerus?

A

Runs from the tubercles to the shaft of the humerus

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53
Q

The surgical neck of the humerus is a common site for…

A

Fracture of the humerus

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54
Q

What can cause fracture of the surgical neck of the humerus? (2)

A

Direct blow to the area

FOOSH

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55
Q

In a surgical neck fracture, what two nearby neurovascular structures can be affected?

A

Axillary nerve

Posterior circumflex artery

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56
Q

Axillary nerve damage will result in paralysis of which two muscles?

A

Deltoid and teres minor muscles

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57
Q

Name two bony landmarks on the shaft of the humerus.

A

Deltoid tuberosity

Radial groove

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58
Q

What is the deltoid tuberosity?

A

A roughened surface on the lateral side of the humeral shaft where the deltoid muscle attaches

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59
Q

Where does the radial groove run?

A

Diagonally down the posterior surface of the humerus parallel to the deltoid tuberosity

60
Q

What two structures run in the radial groove?

A

Radial nerve

Profunda brachii artery

61
Q

What muscles attach anteriorly to the humerus alongside its shaft? (4)

A

Coracobrachialis
Deltoid
Brachialis
Brachioradialis

62
Q

What muscles attach posteriorly to the shaft of the humerus? (2)

A

Medial and lateral heads of the triceps

63
Q

A mid-shaft fracture could easily damage which structures? Why?

A

Radial nerve and profunda brachii artery

They are tightly bound in the radial groove

64
Q

The radial nerve innervates the ______________ of the wrist. In the case of damage to this nerve, what will occur?

A

Extensors

Unopposed flexion of the wrist - ‘wrist drop’

65
Q

The lateral and medial borders of the humerus form medial and lateral __________ __________. What is found immediately distally to these?

A

Supraepicondylar ridges

Lateral and medial epicondyles

66
Q

Compare the structure of the lateral supraepicondylar ridge compared to the medial supraepicondylar ridge.

A

Lateral ridge is more roughened as it is the site of attachment for many of the extensor muscles in the posterior forearm

67
Q

Which is larger, the medial or lateral epicondyle

A

Medial epicondyle

68
Q

Where does the ulnar nerve pass into the forearm?

A

Along the posterior side of the medial epicondyle

69
Q

Where are the trochlea and capitulum located?

A

Both on the distal end of the humerus
Trochlea is located medially
Capitulum is located laterally

70
Q

Does the trochlea or the capitulum extend to the posterior of the humerus?

A

The trochlea

71
Q

Name the three depressions found on the distal portion of the humerus. What is their function?

A

Coronoid fossa
Radial fossa
Olecranon fossa

They accommodate the forearm bones during movement at the elbow

72
Q

What articulations are there at the proximal region of the humerus?

A

Articulation with the scapula at the glenohumeral joint

73
Q

What articulations are there at the distal end of the humerus?

A

Ulna articulates with the trochlea
Radius articulates with the capitulum

At the elbow joint

74
Q

Name two common fractures of the distal humerus.

A

Supracondylar fracture

Medial epicondyle fracture

75
Q

What is the common cause of a supracondylar fracture?

A

Falling onto a flexed elbow

76
Q

Direct damage or swelling as a result of a supracondylar fracture can affect which vessel? Leading to what?

A

Brachial artery

Volkmann’s ischaemic contracture

77
Q

What can Volkmann’s ischaemic contracture cause?

A

Uncontrolled flexion of the hand

Damage to the median, ulnar or radial nerves

78
Q

What nerve can be damaged in a medial epicondyle fracture? What can this result in?

A

Ulnar nerve

Ulnar claw
Loss of sensation over medial 1.5 fingers of the hand on dorsal and palmar surfaces

79
Q

What are the two bones in the forearm? Which is located more medially?

A

Ulna and radius

Ulna

80
Q

What is the general role of the ulna? What is the general role of the radius?

A

Acts as a stabilising bone

Pivots to produce movement

81
Q

What does the proximal end of the ulna articulate with?

A

The trochlea of the humerus at the elbow joint

82
Q

Name 5 landmarks of the proximal ulna.

A 
Trochlea notch 
Radial notch 
Tuberosity of ulna 
Coronoid process 
Olecranon
83
Q

What is the olecranon? Which muscle attaches here?

A

Projection of bone that extends proximally forming part of the trochlear notch

Triceps brachii to its superior surface

84
Q

What is the coronoid process?

A

The ridge of the bone projecting outwards anteriorly forming part of the trochlear notch

85
Q

What forms the trochlear notch? What rough shape does it it take? What does it articulate with?

A

Olecranon and coronoid process

Wrench shaped

The trochlea of the humerus

86
Q

Where is the radial notch located? What does this articulate with?

A

On the lateral side of the trochlear notch

The head of the radius

87
Q

Where is the tuberosity of ulna? Which muscle attaches here?

A

Immediately distal to the coronoid process

Brachialis muscle

88
Q

What is the rough shape of the ulnar shaft? How many surfaces and borders does it have? What happens to its width as it moves distally?

A

Triangular

Three surfaces, Three borders

Width decreases distally

89
Q

What are the three surfaces of the ulnar shaft?

A

Anterior
Posterior
Medial

90
Q

What are the three borders of the ulnar shaft?

A

Posterior
Interosseous
Anterior

91
Q

What muscle attaches at the anterior surface of the ulnar shaft?

A

Pronator quadratus muscle distally

92
Q

Which surface of the ulnar shaft is the site of attachment for many muscles?

A

Posterior

93
Q

Which border of the ulnar shaft is palpable along its entire length?

A

Posterior

94
Q

What is the interosseous border of the ulnar shaft the site of attachment for?

A

The interosseous membrane which spans the distance between the ulna and radius

95
Q

How does the ulna terminate at its distal end?

A

In a rounded head with a distal projection called the styloid process

96
Q

What articulations are present at the distal end of the ulna?

A

The head of the ulna articulates with the ulnar notch of the radius at the distal radio-ulnar joint

97
Q

What is the most likely fracture of the ulna? What causes it? What effect does this have on the proximal ulna?

A

A fracture in the shaft

Often the ulna being hit by an object

Pulled posteriorly by the normal muscle tone

98
Q

What can cause a fracture of the olecranon process? What can displace part of the fragment proximally?

A

Falling on a flexed elbow

Triceps brachii

99
Q

The interosseous membrane attaches…

What is the clinical significance of this with regards to fractures?

A

The ulna and radius

Force of trauma from one bone can easily be transmitted to the other - resulting in fractures of both forearm bones

100
Q

What are two classical fractures involving both the ulna and radius?

A

Monteggia’s fracture

Galeazzi’s fracture

101
Q

In a Monteggia’s fracture, which bone is fractured and which bone is dislocated?

A

Ulna - fractured

Radius - dislocated

102
Q

In a Galeazzi’s fracture, which bone is fractured and which bone is dislocated?

A

Ulna - dislocated

Radius - fractured

103
Q

The radius articulates in which four places?

A

Elbow joint
Proximal radioulnar joint
Wrist joint
Distal radioulnar joint

104
Q

How does the radius articulate at the elbow joint?

A

Elbow joint is partly formed by articulation of the head of the radius with the capitulum of the humerus

105
Q

How does the radius articulate at the proximal radioulnar joint?

A

Articulation between the radial head and radial notch of the ulna

106
Q

How does the radius articulate at the wrist joint?

A

Articulation between the distal end of the radius and the carpal bones

107
Q

How does the radius articulate at the distal radioulnar joint?

A

Articulation between the ulnar notch and head of the ulna

108
Q

Name 3 important bony landmarks of the proximal end of the radius (proximally to distally)

A

Head
Neck
Radial tuberosity

109
Q

Which muscle attaches at the radial tuberosity?

A

Biceps brachii

110
Q

What is the neck of the radius?

A

Narrow area of bone between the radial head and radial tuberosity

111
Q

The head of the radius is thicken on which side? Why? What rough shape does it take?

A

Medially
Forms part of the proximal radioulnar joint here
Disk shaped structure

112
Q

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

A

Increases

113
Q

What is the rough shape of the shaft of the radius? How many borders/surfaces does it have?

A

Triangular

3

114
Q

Where does the pronator teres muscle attach to the radius?

A

In the middle of the lateral surface of the shaft

115
Q

What shape does the distal region of the radius form?

A

Rectangular end

116
Q

The lateral side of the radius projects distally as the…

What structure exists on the medial surface of the distal radius? What joint does this form?

A

Styloid process

Ulnar notch, articulates with the head of ulna to form the distal radioulnar joint

117
Q

How is the wrist joint formed at the distal end of the radius?

A

Articulation of the radius with the scaphoid and lunate

118
Q

Name 3 common types of fractures of the radius, which is most common?

A

Colles’ fracture (most common)
Fractures of the radial head
Smith’s fracture

119
Q

What is a Colles’ fracture? What can cause it? What happens to structures distal to the fracture? What can this result in?

A

Fracture of the distal radius

FOOSH

Displaced posteriorly

Dinner fork deformity

120
Q

What is a common cause of fractures of the radial head? What happens to cause the fracture?

A

FOOSH

Radial head is forced into the capitulum of the humerus

121
Q

What causes a Smith’s fracture? What happens to the distal fragment of the radius?

A

Fall onto the back of the hand

Distal fragment displaced anteriorly (opposite of Colles’ fracture)

122
Q

The bones of the hand can be divided into which three categories? (Proximal to distal)

A

Carpal bones
Metacarpals
Phalanges

123
Q

How many carpal bones are there? Where are they located?

A

8

Wrist area

124
Q

How many metacarpals are there?

A

5

One for each digit

125
Q

How many phalanges are there? Where are they located?

A

In the fingers/thumb

Three for each finger
Two for the thumb

126
Q

How are the carpal bones organised?

A

Into two rows - proximal and distal

127
Q

What bones exist in the proximal row of the carpal bones? (Lateral to medial)

A

Scaphoid
Lunate
Triquetrum
Pisiform

128
Q

What type of bone is the pisiform? Where is it formed?

A

A sesamoid bone

Within the tendon of the flexor carpi ulnaris

129
Q

What bones exist in the distal row of the carpal bones? (Lateral to medial)

A

Trapezium
Trapezoid
Capitate
Hamate

130
Q

What is the hook of hamate?

A

A projection on the palmar surface of of the hamate

131
Q

Which carpals articulate with the radius to form the wrist joint?

A

Scaphoid and lunate

132
Q

What do the distal carpals articulate with?

A

The metacarpals

133
Q

What are the two carpal bones that are most commonly fractured? What is the usual mechanism of injury?

A

Scaphoid, Lunate

FOOSH

134
Q

What is the classical clinical feature of a scaphoid fracture?

A

Pain/tenderness in the anatomical snuffbox

135
Q

What are the dangers of a scaphoid fracture?

A

The blood supply of the proximal part of the scaphoid can be cut off causing it to undergo avascular necrosis

136
Q

Patients with missed scaphoid fracture are likely to develop…

A

Arthritis in later life

137
Q

A lunate fracture occurs when there is ___________________ of the wrist

A

Hyperextension

138
Q

A lunate fracture is associated with damage to which nerve?

A

Median nerve

139
Q

Where do the metacarpals articulate proximally and distally?

A

With the carpals proximally

With the proximal phalanges distally

140
Q

How is each metacarpal numbered?

A

I - V (thumb to little finger)

141
Q

What is the shape of the medial and lateral surfaces of the metacarpals? What is the purpose of this?

A

Concave

Allows attachment of the interoessei muscles

142
Q

Name two common fractures of the metacarpals. Which metacarpal does each fracture affect?

A

Boxer’s fracture - 5th metacarpal neck

Bennett’s fracture - 1st metacarpal base

143
Q

What usually causes a boxer’s fracture? What happens to the the distal part of the fracture and finger in this case?

A

Striking a hard object with a clenched fist

Displaced posteriorly. Shortening of finger

144
Q

What causes Bennett’s fracture?

A

Hyperabduction of the thumb

145
Q

What are phalanges?

A

The bones of the fingers

MSK (10 decks)

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