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MSK > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What does the radius articulate with?

A

The capitulum of the humerus at the elbow, and with the carpal bones at the wrist; with the ulna at the proximal and distal radioulnar joints

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2
Q

What is the significance of the radial tuberosity?

A

Place of attachment of the biceps brachii

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3
Q

What are the names of the projections of the radius at the distal end?

A

The lateral side projects distally as the styloid processOn the medial side there is the ulnar notch (articulates with ulna)

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4
Q

What is a Colles fracture?

A

FOOH, fracturing the radius, resulting in posterior displacement of the wrist and hand, it produces what is known as the dinner fork deformity

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5
Q

What is a Smiths fracture?

A

Falling onto the back of the hand, fracture of the distal radius; it is the opposite of a Colles’ fracture, as the distal fragment is now placed anteriorly

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6
Q

What bony landmarks articulate between the humerus and the ulna?

A

The trochlea of the humerus, the trochlear notch (formed by the coronoid process and olecranon) of the ulna

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7
Q

Describe the location and function of the radial notch

A

Found on the lateral surface of the trochlea notch, receives the broad periphery of the radial head

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8
Q

What is the significance of the tuberosity of the ulna?

A

It is where the brachialis muscle attaches

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9
Q

How many borders does the shaft of the ulna have?

A

3, it is triangular

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10
Q

Which border of the ulna shaft can be palpated on the postero-medial side of the arm?

A

The posterior border

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11
Q

Name the important feature of the distal end of the ulna

A

The styloid process; it projects from the posterior medial part of the bone. It is smaller and more proximal than the styloid process of the radius

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12
Q

How does the ulna participate in the wrist joint?

A

It doesn’t reach the wrist joint, and hence does not

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13
Q

Describe how a fracture of the olecranon process might occur, and what happens

A

Fall on a flexed elbow; one of the fragments can be pulled proximally by the triceps, although this depends on where the fracture occurs

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14
Q

Describe the palpation and importance of the olecranon

A

Can be palpated at the elbow, on the posterior side; the superior surface is the place of attachment of the triceps brachii

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15
Q

What is the importance of the interosseous membrane in respect to a fracture of either the radius or ulna?

A

A fracture of one bone is likely to be associated with the dislocation of the nearest joint

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16
Q

Describe the position of the proximal ulna fragment following a fracture of the shaft

A

Points posteriorly

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17
Q

Describe Monteggia’s fracture

A

Usually caused by a force from behind the ulna; the shaft of the ulna is fractured, and the head of the radius dislocates anteriorly at the elbow

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18
Q

Describe Galeazzi’s fracture

A

Fracture to the radius, the ulna head is dislocated at the distal radio-ulnar joint

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19
Q

What are the three functions of the interosseous membrane between the radius and ulna?

A

Holds the radius and ulna together during pronation and supination of the forearm; provides attachment for muscles; transfers force from the radius to the ulna

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20
Q

Name the carpal bones in the proximal and distal rows

A

Proximal: scaphoid, lunate, triquetrum, pisiformDistal: trapezium, trapezoid, capitate, hamate

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21
Q

What is the shape of the lunate bone?

A

Crescent shaped

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22
Q

What type of bone is the pisiform? Name the tendon of relevance

A

Sesamoid, formed in the tendon of the flexor carpi ulnaris

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23
Q

What does the trapezium articulate with?

A

The metacarpal of the thumb

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24
Q

What is the name of the projection on the palmar surface of the hamate?

A

The hook of hamate

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25
Q

Which two carpal bones are most commonly fractured? How?

A

The scaphoid and lunate; fall on outstretched hand

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26
Q

What is the main clinical sign of a fractured scaphoid?

A

Tenderness/pain in the anatomical snuffbox

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27
Q

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

A

Fracture can cut off the blood supply to the proximal part, causing it to undergo avascular necrosis

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28
Q

In which direction are the metacarpal bones numbered?

A

Thumb (I) to little finger (V)

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29
Q

Describe the two heads of the pectoralis major

A

There is a clavicular head (attaches to the clavicle) and a sternocostal head (attaches to the sternum/ribs)

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30
Q

Where do the heads of the pectoralis major convene?

A

The edge of the intertubecular groove of the humerus

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31
Q

What is the action of the pectoralis major?

A

The two heads can work independently and synergistically; together, they act to adduct and medially rotate the humerus at the shoulder, the clavicular head also performs flexion

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32
Q

Where do the fibres of the pectoralis minor attach?

A

The corocoid process of the scapula; this attachment forms a ‘bridge’, which vessels passing into the upper limb must pass underneath

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33
Q

Compare the size and location of the pectoralis minor to the pectoralis major

A

Pectoralis minor is much smaller and lies posterior to the pectoralis major

34
Q

What is the innervation of the pectoralis minor

A

Medial pectoral nerve

35
Q

Which border of the axilla does the pectoralis minor contribute to?

A

Anterior wall

36
Q

What is the action of the serratus anterior?

A

Main action is to rotate the scapula, allowing the arm to be raised over 90 degrees. It also holds the scapula against the ribcage

37
Q

What is the innervation of the serratus anterior?

A

Long thoracic nerve

38
Q

What causes winging of the scapula?

A

Damage to the long thoracic nerve, resulting in paralysis of the serratus anterior

39
Q

Describe the structure and location of the pectoralis major

A

Large, fan shaped, most superficial in region. It makes up most of the anterior wall of the axilla.

40
Q

What is the innervation of the pectoralis major?

A

Innervation is by the medial and lateral pectoral nerves, derived from the brachial plexus

41
Q

What action is changed with winging of the scapula?

A

When pushing the affected limb, the scapula is no longer held against the rib cage (no serratus anterior action), and protrudes out of the back

42
Q

How can damage to the long thoracic nerve occur?

A

Trauma to the shoulder, repetitive movements involving the shoulder or by structures becoming inflamed and pressing on the nerve

43
Q

What is the anatomical position?

A

Person standing upright, facing forward, hands by side, feet parallel and toes pointing forward

44
Q

What are the three anatomical planes?

A

Sagittal, Coronal, Transverse

45
Q

Distinguish between medial and lateral

A

Lateral is away from the midline, medial is towards the midline (the midline being a line in sagittal plane, splitting the right and left halves evenly)

46
Q

Distinguish between anterior and posterior

A

Anterior refers to the ‘front’ and posterior to the ‘back’

47
Q

Distinguish between superior and inferior

A

Refers to the vertical axes; superior means ‘higher’, inferior means ‘lower’

48
Q

Distinguish between proximal and distal

A

“Used mainly to describe limbs; they describe the position of a structure with reference to its origin, proximal meaning closer to the origin and distal meaning further away “

49
Q

Distinguish between flexion and extension

A

Flexion refers to a movement that decreases the angle between two body parts, extension refers to a movement that increases the angle between two body parts

50
Q

Distinguish between abduction and adduction

A

Abduction is a movement away from the midline, adduction is a movement towards the midline

51
Q

Distinguish between elevation and depression

A

Elevation refers to a movement in a superior direction, depression refers to a movement in an inferior direction

52
Q

Distinguish between pronation and supination

A

Occurs only when the fore-arm is semi-flexed; pronation moves the palm of the hand so that it is facing posteriorly, supination moves the palm of the hand so that it is facing anteriorly

53
Q

Distinguish between dorsiflexion and plantarflexion

A

Both terms describe movement at the ankle. Dorsiflexion refers to extension so that the foot points more superiorly, plantarflexion is flexion at the ankle so that the foot points more inferiorly

54
Q

Distinguish between opposition and reposition

A

Opposition brings the thumb and little finger together, reposition is a movement that places the thumb and the little finger away from each other

55
Q

Which side of the scapula is termed the costal surface?

A

The side facing the ribcage (anterior)

56
Q

Which muscle originates from the costal surface, and to what does it attach?

A

The subscapularis muscle, to the subscapular fossa

57
Q

What is the name of the hook like projection originating from the superior and lateral aspect of the scapula?

A

The coracoid process

58
Q

Name 3 features of the lateral border of the scapula

A

The glenoid fossa, the supraglenoid tubercle, the infraglenoid tubercle

59
Q

What are the four prominent features of the posterior surface of the scapula?

A

The spine, the infraspinous fossa, the supraspinous fossa, and the acromion

60
Q

How would a fracture of the scapula occur?

A

Severe chest trauma, such as in a high speed road collision or in a crushing injury

61
Q

Why does a fracture of the scapula not require much intervention?

A

The muscle tone should hold the pieces together in order for healing to occur

62
Q

What type of bone is the clavicle?

A

Long bone

63
Q

Describe the medial and lateral attachments of the clavicle

A

Medial attachment to sternum, lateral attachment to acromion of the scapula

64
Q

Where is the conoid tubercle? What function does it serve?

A

Found near the acromial end of the clavicle; it is the attachment point of the conoid ligament, the medial part of the coracoclavicular ligament

65
Q

What is the lateral part of the coracoclavicular ligament and where does it attach?

A

Trapezoid ligament, attaches to the trapezoid line, near the acromial end of the clavicle

66
Q

What is the impression at the sternal end of the clavicle for?

A

The binding of the costoclavicular ligament

67
Q

What are the three functions of the clavicle?

A

Attaches limb to upper trunk, protects underlying neurovascular structures, transmits force from upper limb to axial skeleton

68
Q

How do fractures of the clavicle occur? What structures are at risk?

A

Fall onto shoulder/outstretched hand. There can be some nervous damage, due to the close proximity of the supraclavicular nerves

69
Q

What happens to the lateral end of the clavicle after a clavicular fracture?

A

It is displaced inferiorly by the weight of the arm, and medially by the pectoralis major

70
Q

What happens to the medial end of the clavicle after a clavicular fracture?

A

The medial end is pulled superiorly by the sternocleidomastoid muscle

71
Q

Why can a fracture of the clavicle result in ‘waiter’s tip’

A

There can be damage of the supraclavicular nerves; they innervate the lateral rotators of the upper limb; loss off function will result in unopposed medial rotation

72
Q

Where is the greater tubercle on the humerus? What is its major purpose?

A

Located laterally, it has a posterior and anterior face; it serves as the attachment site for 3 rotator cuff muscles

73
Q

What does the head of the humerus do?How does it project?

A

Projects medially and superiorly to articulate with the glenoid cavity

74
Q

What does the trochlea articulate with?

A

The ulna; the trochlea is located medially and extends onto the posterior of the bone

75
Q

Which bony landmark is located laterally to the trochlea? What does it do?

A

The capitulum, which articulates with the radius

76
Q

What are the three fossae of the humerus?

A

Coronoid, radial and olecranon

77
Q

What type of bones are the carpals?

A

Irregular

78
Q

What are the nerve roots of the pectoral nerves?

A

C7, C8, T1

79
Q

What is the action of the pectoralis minor?

A

Depresses the shoulder tip (infermedial rotation of the scapula)

80
Q

What clinical term is given to describe numbness and tingling? What clinical term is used to describe loss of feeling or sensation?

A

Paraesthesia; anaesthesia is loss of feeling or sensation

81
Q

Where is the axis of rotation in movements of pronation and supination

A

The axis passes longitudinally along the head of the radius (proximally) and through the distal radio-ulnar joint at the wrist

82
Q

What will avascular necrosis of the scaphoid (weeks after injury) look like on X-ray?

A

The proximal segment will look less opaque as it is being resorbed

MSK (8 decks)

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