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gross anat b1 > upper limb joints > Flashcards

upper limb joints Flashcards

1
Q

gleno-humeral joint
Classification:

A

Type: synovial
Subtype: ball and socket

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2
Q

Articular surfaces of gleno-humeral joint

A

Medially: glenoid cavity
Laterally: head of the humerus
Articular surfaces are covered by hyaline cartilage Articular cartilage doesn’t have perichondrium One of the most mobile joints of the body Mobility is at the cost of stability
Anatomically a weak joint

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3
Q

Stabilizing factors of gh joint

A

Coraco-acromial arch forms the secondary socket Musculotendinous cuff
Glenoidal labrum
Surrounding muscles

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4
Q

Coraco-acromial arch: gh j

A

Formed by coracoid process, acromion process and coraco-acromial ligament

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5
Q

Musculotendinous cuff (rotator cuff):

A

Formed by the capsular ligament, supraspinatus, infraspinatus, teres minor and
subscapularis muscles

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6
Q

Glenoidal labrum

A

Made up of white fibro-cartilage
Deepens the glenoid fossa

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7
Q

Muscles: gh j

A

Long head of biceps prevents upward displacement of head
Long head of triceps prevents downward displacement of the head

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8
Q

Ligaments of the joint: gh j

A

Capsular ligament (articular capsule)
- enforced by 3 glenohumeral lig
Coracohumeral ligament- Extends from the root of the coracoid process to the greater tubercle
Transverse humeral ligament- Bridges the gap between greater and lesser tubercles
Glenoidal labrum

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9
Q

Capsular ligament: gh j

A

Medial attachment:
To the glenoidal labrum
Supraglenoid tubercle is intracapsular

Lateral attachment:
To the anatomical neck of the humerus
Inferiorly it extends up to the surgical neck

Capsule is reinforced by 3 glenohumeral ligaments (superior, middle and inferior)

Capsule and surrounding 4 muscles (subscapularis, supraspinatus, infraspinatus and teres minor) form rotator cuff

Capsule has openings for tendon of long head of biceps and subscapular bursa

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10
Q

Tendon of long head of biceps at gh j

A

intracapsular but extrasynovial

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11
Q

Relations of shoulder joint:

A

Anterior:
Anterior fibres of deltoid, short head of biceps and coracobrachialis and subscapularis
Posterior:
Infraspinatus, teres minor and posterior fibres of deltoid
Superior:
Coracoacromial arch, subacromial bursa,deltoid and supraspinatus
Inferior:
Long head of triceps, axillary nerve and posterior circumflex humeral vessels

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12
Q

Blood supply: gh j

A

Anterior and posterior circumflex humeral vessels
Subscapular vessels
Suprascapular vessels

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13
Q

Nerve supply:

A

Axillary, musculocutaneous, suprascapular and lateral pectoral nerves

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14
Q

Scapular-humeral mechanism:

A

-Scapula and upper limb are suspended from the clavicle by coracoclavicular ligament
-Scapula can rotate on the chest wall to change the position of glenoid fossa
- Coracoclavicular ligament forms the axis of rotation of scapula
-180 degrees of abduction is possible
-For every 3 degrees of abduction, 2 degrees occurs at the shoulder joint and one degree by the rotation of scapula
-Scapula is rotated by the combined actions of serratus anterior and trapezius muscles

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15
Q

Applied anatomy: gh j

A

Dislocations:
-Most commonly dislocated large joint (antero-inferior)
-Axillary nerve can be damaged

Frozen shoulder (adhesive capsulitis):
- pain and loss of motion or stiffness in the shoulder
-in older athletes
-Due to Inflammation of the joint
-Movements are restricted and painful

Rotator cuff tendinitis:
AKA subacromial bursitis, suprspinatus tendinitis or pericapsulitis
Cause: excessive overhead activity
painful abduction
Can lead to rupture of supraspinatus tendon

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16
Q

Elbow joint type

A

Type: Synovial
Subtype: Hinge
It is a compound and an uniaxial joint
It has humero-radial and humero-ulnar components
The two components and superior radioulnar joint are collectively called ‘cubital articulation’

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17
Q

Articular surfaces: e j

A

Superiorly: Capitulum and trochelea of humerus
Inferiorly: head of the radius and trochlear notch of ulna
- Articular surfaces are covered by articular cartilage
-Anatomically a strong joint

18
Q

Ligaments: e j

A

Capsular ligament
Lateral (radial) collateral ligament
Medial (ulnar) collateral ligament-Anterior ligament,Posterior ligament,transverse ligament

19
Q

Capsular ligament: e j

A

Superior attachment:
To the lower end of humerus
Coronoid, raidal and olecranon fossae are intracapsular
Inferior attachment:
To the margin of trochlear notch of ulna and annular ligament

20
Q

Lateral (radial collateral) ligament:

A

Triangular, fan shaped
Extends from lateral epicondyle to annular ligament
Gives origin to supinator and extensor carpi radialis brevis muscles

21
Q

Medial (ulnar collateral) ligament:

A

Triangular in shape
Apex is attached to the medial epicondyle
Has anterior, posterior and oblique bands
Anterior band is attached to coronoid process Posterior band is attached to olecranon process Related to ulnar nerve
Gives origin to flexor digitorum superficialis muscle

22
Q

relations e j

A

Anterior relations:
Brachialis, tendon of biceps, brachial artery and median nerve
Posterior relations:
Triceps and anconeus
Medial relations:
Ulnar nerve, flexor carpi ulnaris and common flexor origin
Lateral relations:
Supinator, extensor carpi radialis brevis, common extensor tendon

23
Q

Blood supply: e j

A

Anastomosis around the elbow joint

24
Q

Nerve supply: ej

A

Median, radial, ulnar and musculocutaneous nerves

25
Q

Carrying angle ej

A

Angle of 170 degrees, between long axis of the arm and forearm
Factors responsible for carrying angle:
1. Medial flange of trochlea is 6mm lower than that of lateral
2. Obliquity of the coronoid process

26
Q

Applied anatomy: e j

A

Dislocations: Posterior dislocation is associated with
fracture of coronoid process
Distension:
In backward direction
Capsule is weak posteriorly
Aspiration of fluid can be done by inserting a needle on either side of olecranon

Subluxation (pulled elbow):
-Head of the radius slips out of the grip of annular ligament
-Seen in children
-Happens when the forearm is suddenly pulled in pronation

Tennis elbow:
Abrupt pronation, leading to pain over the lateral epicondyle( lateral epicondylitis)
Causes:
1. Sprain of radial collateral ligament
2. Sprain of extensor carpi radialis brevis
3. Inflammation of bursa deep to the extensor carpi radialis brevis

golfer’s elbow
- medial epicondylitis

Student’s elbow
- Inflamed and enlarged subcutaneous olecranon bursa due to resting of elbow on surface.

27
Q

Radioulnar joints
Classification:

A

Superior and inferior radioulnar joints:
Type: Synovial
Subtype: Pivot
Middle (intermediate) radioulnar joint:
Type: Fibrous
Subtype: Syndesmosis

28
Q

Articular surfaces and lig of superior radioulnar joint:

A

Head of the radius
Radial notch of ulna and annular ligament

Ligaments:
Capsular ligament, annular ligament, quadrate ligament

29
Q

Articular surfaces and lig of inferior radioulnar joint:

A

Articular surfaces of the inferior radioulnar joint:
Head of the ulna
Ulnar notch of the radius
Ligaments:
Capsular ligament
Triangular articular disc

30
Q

Nerve supply: ru j

A

Superior radioulnar joint:
Median, radial and musculocutaneous nerves
Inferior radioulnar joint:
Anterior and posterior interosseous nerves

31
Q

Blood supply: ru j

A

Superior radioulnar joint:
Anastomosis around the elbow
Inferior radioulnar joint:
Anterior interosseous artery

32
Q

Muscles ru j

A

Muscles producing supination:
Biceps brachii, supinator and brachioradialis
Muscles producing pronation:
Pronator teres, pronator quadratus, flexor carpi radialis and brachioradialis

33
Q

Middle (intermediate) radioulnar joint:

A

-Between shafts of radius and ulna

Functions of interosseous membrane:
-Binds radius to ulna
-Gives attachment to muscles
-Weight transmission

34
Q

Wrist Joint (Radiocarpal joint)
Classification:

A

Type: Synovial
Subtype: Ellipsoid

35
Q

Articular surfaces: wj

A

Proximal:
Distal end of radius and articular disc of inferior radioulnar joint
Distal:
Scaphoid, lunate and triquetral bones

36
Q

Ligaments: wj

A

Capsular ligament
Anterior (palmar radiocarpal)
Posterior (dorsal radiocarpal
Medial collateral
Lateral collateral

37
Q

relation wj

A

Anterior relations:
Long flexor tendons with their synovial sheaths
Median nerve
Posterior relations:
Long extensor tendons with their synovial sheaths
Lateral relation:
Radial artery

38
Q

muscles + movement

A

Flexion:
Flexor carpi radialis, flexor carpi ulnaris
Palmaris longus, flexors of fingers

Extension:
Extensor carpi radialis longus Extensor carpi radialis brevis Extensor carpi ulnaris
Long extensors of digits

Adduction:
Flexor carpi ulnaris
Extensor carpi ulnaris

Abduction:
Flexor carpi radialis
Extensor carpi radialis longus Extensor carpi radialis brevis Abductor pollicis longus Extensor pollicis brevis

39
Q

List and describe some clinical complications with joints

A
  1. Sprains
    - Damage to cartilage, ligaments due to forceful twisting of joint
  2. Bursitis
    - Inflammation of a bursa
    - Overuse of a joint
  3. Arthritis
    - Inflamed, swollen, painful joints
    - Osteoarthritis
    - Gout
  4. Dislocation of joint
    - Articular surfaces of joint are abnormally displaced
  5. Subluxation:
    - Partial contact is still remained
  6. Neuropathic joint
    - Sensation is completely lost, prone to mechanical damage
40
Q

Describe and draw the Synovial Joint

A

Structure:

  1. Articulating ends of the bones taking part in the synovial joints are enclosed in a fibrous capsule.
  2. The articular surfaces of the bones are lined by articular cartilage.
    - The articular cartilage is a thin layer of hyaline cartilage covering the epiphysis where bone takes part in a joint.
    - Articular cartilage has no perichondrium (lacks nerve supply and capacity to regenerate), the only nutritional source is the synovial fluid.
    - Degeneration of the articular cartilage as age advances is the root cause of osteoarthritis.
  3. Internal surface of fibrous capsule and the non-articular parts of articulating bones inside the joint cavity are lined by synovial membrane.
  4. The joint cavity is filled with synovial fluid (secreted by synovial membrane). This synovial fluid is a lubricant and provides nutrition to articular cartilages.
  5. In some joints, the fibrocartilaginous articular discs may be present and the fibrous capsule is strengthened by ligaments (true, and accessory)

Altogether, the synovial joints allow for free movements.

gross anat b1 (23 decks)

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