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Anatomy > Upper Limb Joints > Flashcards

Upper Limb Joints Flashcards

1
Q

Sternoclavicular joint (SC)

A

. Only articulation btw upper extremity and axial skeleton
. Saddle-shaped synovial joint btw med. clavicle, manubrium, and 1st. Costal cartilage
. Has fibrocartilaginous articular disc

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2
Q

Where does articular disc attach in SC joint and function?

A

. Inf. To 1st costal cartilage
. Sup. To med. clavicle
. Ant. And post. Edges attach to fibrous joint capsule
. Resists sup. And med. dislocation of clavicle and provides additional mobility

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3
Q

Ligaments in SC joint and functions

A

. Ant. And post. Sternoclavicular ligaments: resist sup. And lat. dislocation
. Costoclavicular ligament: goes from inferomedial clavicle to 1st costalcartilage/rib, strongest ligament, resists sup. Dislocation of clavicle
. Interclavicular ligament: spans sup. Manubrium, resists lat. dislocation

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4
Q

Motions of sternoclavicular joint

A

. Anteroposterior axis: elevation/depression of pectoral girdle
. Vertical axis: protraction/retraction of pectoral girdle
. Circumduction: rotary motion combining above movement

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5
Q

T/F clavicle will fracture before sternoclavicular ligaments rupture

A

T

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6
Q

Acromioclavicular joint (AC) structure

A

. Plane-type btw lat. clavicle and acromion process

. Incomplete wedge-shaped articular disc

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7
Q

AC joint ligaments

A

. Acromioclavicular ligament (intrinsic)

. Coracoclavicular ligament (extrinsic)

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8
Q

Acromioclavicular ligament structure and function

A

. Thickening of sup. Joint capsule

. Resists sup. Dislocation

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9
Q

Coracoclavicular ligament span, portions, and functions

A

. Main supper of AC joint
. Resists sup. Dislocation of clavicle, suspends clavicle and supports weight of upper extremity
. Runs from inferolateral clavicle to coracoid process
. Conoid ligament: med. vertically oriented portion extending from root of coracoid
. Trapezoid ligament: lat, horizontally oriented portion extending from body of coracoid

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10
Q

Motion of AC joint

A

Gliding movements enabling rotation of scapula

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11
Q

Shoulder separation

A

. Dislocation of AC joint
. Common athletic injury
. Rupture of acromioclavicular and coracoclavicular ligaments and inferomedial dislocation of acromion
. Graded

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12
Q

Glenohumeral (shoulder) joint structure

A

. Ball and socket synovial joint btw glenoid fossa and humerus head
. Glenoid labrum
. Fibrous joint capsule attaches to margins of glenoid fossa and anatomical neck of humerus
. Thin ad loose except at extreme ROM
. Pierced by tendons of Bicep long head

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13
Q

Glenoid labrum

A

.Fibrocartilaginous ring encircling glenoid fossa

. Improves congruence by deepening (slightly) the fossa

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14
Q

Excess friction w/in intertubercular groove can ____

A

Fray biceps brachii long head tendon causing it to rupture

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15
Q

Shoulder joint ligaments and functions

A

. Glenohumeral ligaments (sup., middle., inf.): intrinsic, reinforce ant. Capsule
. Coracohumeral ligament (intrinsic): reinforces sup. Capsule and resists inf. Dislocation
. Coracoacromial ligament (extrinsic): prevents sup. Dislocation of humerus
. Transverse humeral ligament: bridges intertubercular groove creating canal for long head bicep tendon

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16
Q

Coracohumeral ligament structure

A

. Goes from base of coracoid process to greater tubercle of humerus
. Ligament is free at ant. Margin but fuses w/ capsule posteriorly

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17
Q

Coracoacromial ligament structure

A

. Bridges coracoid process and acromion to form coracoacromial arch

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18
Q

Shoulder joint bursae

A

. Subscapular bursa

. Subacromial (subdeltoid) bursa

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19
Q

Subscapular bursa

A

. Btw tendon of subscapularis m. And neck of scapula

. Communicates w/ synovial cavity of glenohumeral joint

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20
Q

Subacromial (subdeltoid) bursa

A

. Sup. To supraspinatus tendon
. Doesn’t normally communicate w/ joint cavity
. Reduces friction from overlying coracoacromial arch and deltoid m.

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21
Q

Adhesive capsulitis

A

. Inflammation of rotator cuff tendons causing thickening of glenohumeral joint capsule
. Reduces ROM

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22
Q

Calcific tendonitis

A

. Ca deposits in rotator cuff tendons

. common cause of shoulder pain

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23
Q

What limits range of abduction in gelenohumeral joint?

A

Greater tubercle of humerus

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24
Q

What limited range of extension in glenohumeral joint?

A

. Muscular and ligamentous tension

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25
Q

How rotator cuff tendons contribute to glenohumeral joint integrity

A

. Tendons fuse w/ and reinforce fibrous joint capsule

. Tonic muscle contraction maintains contact btw humeral head and glenoid fossa to stabilize joint

26
Q

Where is glenohumeral joint weakest?

A

Inferiorly

27
Q

Subluxation

A

Partial displacement of bone in joint

28
Q

Common subluxation/dislocations in glenohumeral joint

A

. Inferior in older adults

. Ant. Dislocations w/ excessive force to abducted, extended arm rupturing ant. Joint capsule

29
Q

Elbow joint articulations and functions

A

. Hinge-type synovial joint w/ 2 articulations
. Humeroulnar aritculation btw trochlea of humerus and trochlear notch of ulna, permits flexion/extension and minor ab/adduction
. Humeroradial articulation btw capitulum of humerus and head of radius, allow flexion/extension and rotation

30
Q

Elbow joint capsule

A

. Lose and thin ant. And post.

. Strengthened med. and lat. by intrinsic ligaments

31
Q

Elbow joint ligaments paths

A

. Ulnar (med) collateral ligament: strong intrinsic, extends from med. epicondyle of humerus to coronoid and olecranon processes of ulna
. Radial (lat.) collateral ligament: fan-shaped intrinsic, from lat. epicondyle of humerus to blend distally w/ annular ligament of prox. Radioulnar joint

32
Q

Second most common joint dislocation and what typically causes it?

A

. Post. Dislocation of elbow

. Caused by hyperextension or fall onto flexed forearm and can be accompanied by rupture of ant. Capsule

33
Q

Wrist (radiocarpal) joint structure

A

. Condyloid synovial joint btw distal radius and triangular ligament and scaphoid, lunate, and triquetrum
. Fibrous joint capsule goes from distal radius and ulna to prox. Row of carpal bones

34
Q

Triangular ligament and function

A

. Extrinsic ligament of radiocarpal joint
. Prevents ulnar head from articulating w/ prox. Carpals
. When wrist fully adducted force can be transmitted from triquetrum to ulna

35
Q

Intrinsic ligaments of wrist joint paths and functions

A

. Palmar and dorsal radiocarpal ligaments: thickenings of ant. And post. Capsule, limits fl/extension of wrist
. Radial collateral ligament: radial styloid process to scaphoid, limits adduction
. Ulnar collateral ligament: ulnar styloid process to triquetrum and pisiform, limits abduction

36
Q

Radiocarpal joint motion

A

. Limited rotation and translation possible, but mostly biaxial
. Transverse axis: fl/extension, greater flexion, extension limited from muscular tension and structure of distal radius
. Anteroposterior axis: ab/adduction, greater adduction, abduction limited by radial styloid process
. Circumduction: rotary motion combining overeats

37
Q

Proximal radioulnar joint and ligament

A

. Pivot-type synovial joint btw head of radius and radial notch of ulna
. Synovial cavity continuous w/ elbow joint
. Annular ligament: holds radial head in contact w/ radial notch of ulna, forms osseotendinous ring where radial head rotates

38
Q

Nursemaid’s elbow

A

. Inf. Displacement of radial head
. Occurs in small children from lifting/pulling child by pronated forearm
. Fixed by firm supination of flexed forearm

39
Q

Middle intermediate) radioulnar joint

A

. Mobile radioulnar syndesmosis

. Formed by interosseous membrane uniting radial and ulnar shafts

40
Q

Distal radioulnar joint

A

. Pivot-type synovial joint btw ulnar head and ulnar notch of distal radius
. Articular disc (triangular ligament/fibrocartilage)

41
Q

Articular disc of distal radioulnar joint properties

A

. Triangular fibrocartilaginous disc from styloid process of ulna to med. edge of ulnar notch of radius
. Separates synovial cavity of distal radioulnar joint from radiocarpal joint
. Forms pivot for distal radius during pro/supination

42
Q

Triangular fibrocartilage complex (TFCC)

A

. Articular disc of distal radioulnar joint and its ligaments (radioulnar, ulnotriqetral, and ulnolunate)
. Degenerative/traumatic TFCC tears common cause of med. wrist pain

43
Q

Radioulnar joint functions

A

. 3 radioulnar joints coordinate pro/supination
. Motion occurs around oblique axis extending from center of radial head through distal radioulnar articulation
. Pronation: distal end of radius rotates ant. And med. around stationary ulnar head
. In fully prone state: distal radius lies anteromedial to ulnar head so radial shaft crosses ulnar shaft ant.

44
Q

Collies fracture

A

. Scaphoid fractures at bone’s narrow waist

. Accompanies by extension fracture of distal radius

45
Q

Scaphoid fractures caused by ___

A

FOOSH

46
Q

Transverse carpal (midcarpal) joint structure

A

. Composite joint from many articulations btw prox. And distal carpal rows
. Functions as condyloid joint, head of capitatte and hamate articulate w/ socket formed by scaphoid, lunate, and triquetral bones
. S-shaped synovial cavity reinforced by many intercarpal ligaments

47
Q

Movements of transverse carpal joints

A

. Limited gliding movement in all cardinal planes from individual articulations
. Contributed significantly to all wrist movements

48
Q

Carpometacarpal and intermetacarpal joints in digits II-V

A

. Plane-type synovial joints btw distal carpals and metacarpal bases
. Share common joint space and fibrous capsule reinforced by carpometacarpal and intermetacarpal ligaments

49
Q

Carpometacarpal joints in II-V movements

A

. Limits fl/extension

. 5th carpometacarpal joint permits limited rotations during opposition

50
Q

1st carpometacarpal joint

A

. Saddle-shaped synovial joint btw trapezium and metacarpal I
. Highly mobile w/ separate joint capsule
. Contributes significantly to all movements of thumb

51
Q

Metacarpophalangeal (MP) joint structure

A

. Condyloid synovial joints btw heads of metacarpals and prox. Phalanges
. Fibrous capsules deficient post. And are replaced by extensor tendon assemblies

52
Q

MP joint ligaments paths

A

. Palmar plate (extrinsic): fibrocartilage plate attaches metacarpal head to phalangeal base
. Med. and lat. collateral ligaments (intrinsic): unite metacarpal head w/ prox. Phalangeal base and palmar plate
. Deep transverse metacarpal ligaments (extrinsic): connect adjacent palmar plates (II-V only)

53
Q

Palmar plate function

A

. Reinforces ant. Capsule and creates socket for metacarpal head

54
Q

Med. and lat. collateral ligament of MP joint functions

A

. Reinforce med. and lat. aspects of fibrous capsule

. Tighten w/ flexion limiting abd/adduction of flexed joint

55
Q

MP joint motions

A

. Allows fl/extension and abd/adduction

56
Q

Skier/gamekeeper thumb

A

. FOOSH w/ thumb in abduction causing dislocation fo 1st MP joint
. Rupture of med. (ulnar) collateral ligament

57
Q

T/F dislocation of MP joints II-V are common in adults

A

F, uncommon

58
Q

Interphalangeal (IP) joints

A

. Thumb only has 1
. Formed btw heads (distal) and bases (prox) of adjacent phalanges
. Similar to MP joints: palmar plates attach adjacent phalanges, joint capsules w/ med. and lat. collateral ligaments
. Hinge joints: uniaxial fl/extension only
. Anteroposterior compression of articular surfaces and tension of collateral ligaments prevent abd/adduction

59
Q

Dislocations of IP joints occur most frequently at ___ and how does it happen?

A

DIP
. Hyperextension in combo w/ axial compression (jammed finger) causes dorsal dislocation of distal phalanx and may rupture palmar plate

60
Q

Hilton’s law

A

Joints receive sensory innervation via articular branches of named nerves innervation muscles that act across them

61
Q

How superficial joints are innervated

A

. Not directly crossed by muscle

. Supplied by articular branches of cutaneous nerves that supply adjacent skin

62
Q

Joint blood supply

A

. Major joints supplied by articular branches from assoc. arterial anastomotic networks and vessels that form them
. Minor joints supplied by articular branches of adjacent arteries

Anatomy (49 decks)

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