WEEK 6 (Upper extremities) Flashcards
1
Q
How is the upper limb suspended from the trunk?
A
By muscles and by the STERNOCLAVICULAR JOINT between the clavicle and the sternum
2
Q
Based on the position of the upper limb’s major joints and component bones, what is the upper limb divided into?
A
Shoulder, arm, forearm and hand
3
Q
What is the shoulder?
A
The area of upper limb attachment to the trunk
4
Q
What is the arm?
A
The part of the upper limb between the shoulder and the elbow joint
5
Q
Where is the forearm located?
A
Between the elbow joint and the wrist joint
6
Q
Where is the hand located?
A
Distal to the wrist joint
7
Q
What does the bone framework of the shoulder consist of?
A
- The Clavicle and Scapula (which form the Pectoral girdle/Shoulder girdle)
- Proximal end of the humerus
8
Q
What is distinguishable about the Clavicle?
A
- the only bony attachment between the trunk and the upper limb
- Acromial (end) of the clavicle is flat
- Sternal (medial) end is more robust and quadrangular in shape
9
Q
What is the anatomy of the ends of the Clavicle that allow for articulation?
A
- Acromial end has a small oval facet on its surface for articulation with a similar facet on the medial surface of the Acromion of the scapula
-Sternal end has much larger facet for articulation (mainly with the Manubrium of the sternum)
10
Q
What is distinguishable about the inferior surface of the lateral third of the clavicle?
A
It possesses a distinct tuberosity consisting of a tubercle (CONOID TUBERCLE) and lateral roughing (TRAPEZOID LINE) for attachment of CORACOCLAVICULAR LIGAMENT
11
Q
Describe the Scapula
A
- large, flat triangular bone
- contains THREE ANGLES (lateral, superior and inferior)
- contains THREE BORDERS (superior, lateral and medial)
- contains TWO SURFACES (costal and posterior)
- contains THREE PROCESSES (acromion, spine and coracoid process)
12
Q
What is the Glenoid cavity?
A
- a shallow, comma shaped cavity that marks the lateral angle of the scapula
- articulates with the head of the humerus to form the Glenohumeral joint
13
Q
What is the site of attachment for the long head of the triceps brachii muscle?
A
The infraglenoid tubercle which is inferior to the Glenoid cavity
14
Q
What is the Supraglenoid tubercle?
A
A tubercle located superior to the glenoid cavity and is the site of attachment for the long head of the Biceps brachii muscle
15
Q
What is the function of the Spine of the Scapula?
A
Subdivides the posterior surface of the scapula into a small, SUPERIOR SUPRASPINOUS FOSSA and a much larger INFRASPINOUS FOSSA
16
Q
What is the Acromion?
A
- an anterolateral projection of the spine
- arches over the glenohumeral joint
- articulates via a small oval facet on its distal end with the Clavicle
17
Q
How is the Costal surface of the scapula characterised?
A
By a shallow concave SUBSCAPULAR FOSSA over much of its extent
17
Q
How is the Costal surface of the scapula characterised?
A
By a shallow concave SUBSCAPULAR FOSSA over much of its extent
18
Q
What is the difference between the lateral border of the scapula and the medial border & superior border?
A
- lateral border of the scapula is strong and thick for muscle attachment
- medial & superior border is thin and sharp
19
Q
What is the superior border marked on its lateral by?
A
- CORACOID PROCESS
- SUPRASCAPULAR NOTCH
20
Q
What is the Coracoid process?
A
a hook-like structure that projects anterolaterally and is positioned directly inferior to the lateral part of the clavicle
21
Q
Where can the suprascapular notch be found?
A
The supra scapular notch (for supra scapular nerve and vessels) lies immediately medial to the root of the coracoid process
22
Q
What does the proximal end of the humerus consist of?
A
- the Head
- the Anatomical neck
- the Greater and Lesser tubercles
- the Surgical neck
- the Superior half of the shaft of the humerus
23
Q
What is distinguishable about the humerus head?
A
- half-spherical in shape
- projects medially and superiorly to articulate with the Glenoid cavity of the scapula
24
How can the anatomical neck of the humerus be determined?
- very short
- formed by narrow constriction immediately distal to the head
- lies between the head and the greater and lesser tubercles laterally
lies between the head and the shaft more medially
25
What are the greater and lesser tubercles of the humerus?
- prominent landmarks on the proximal end of the humerus
- serve as attachment sites for the four ROTATOR CUFF MUSCLES of the GLENOHUMERAL JOINT
26
A deep intertubercular sulcus (bicipital groove) separates _________________________ and continues inferiorly onto the proximal shaft of the humerus
lesser and greater tubercles
27
The tendon of the long head of the ______________________ passes through this sulcus
Biceps branchii
28
Describe the lateral lip of the Intertubercular sulcus
continuous inferiorly with a large V-shaped DELTOID TUBEROSITY on the lateral surface of the humerus midway along its length, which is where the DELTOID MUSCLE inserts onto the humerus
29
Where can the Surgical neck be found?
In the horizontal plane between the expanded proximal part of the humerus (HEAD, ANATOMICAL NECK and TUBERCLES) and the narrower shaft
30
Why is the surgical neck one of the sites where the humerus commonly fractures?
the surgical neck is weaker than more proximal regions of the bone
31
What does the shaft of the humerus look like in a cross-sectional view?
Triangular with anterior, lateral and medial borders with anterolateral, anteromedial and posterior surfaces
32
What are the important features of the Radial groove?
- passes diagonally down the bone
- marks the middle part of the posterior surface and adjacent part of the anterolateral surface
- shallow
33
Which groove can the radial nerve and the profound brachii artery lie in?
radial groove
34
Describe the distal end of the humerus
- bone becomes flattened in the anterioposterior plane
- borders expand as the LATERAL SUPRAEPICONDYLAR RIDGE (lateral supracondylar ridge) and the MEDIAL SUPRAEPICONDYLAR RIDGE (medial supracondylar ridge)
- bears a condyle, two epicondyles and three fossae
35
What are the important features of the lateral supraepicondylar ridge?
- more pronounced than the medial ridge
- roughened for the attachment of muscles found in the posterior compartment of the forearm
36
What is the forearm?
The part of the upper limb that extends between the elbow joint and the wrist joint
37
What are the two parallel bones that make up the forearm?
Radius & Ulna
38
What is distinguishable about the Radius?
- lateral in position
- small proximally where it articulates with humerus
- large distally where it forms the wrist joint with the Carpal bones of the hand
39
What is distinguishable about the Ulna?
- medial in the forearm
- large proximally and small distally
40
What does the proximal end of the radius consist of?
a head, a neck and the radial tuberosity
41
Describe the head of the radius
A thick disc shaped structure oriented in the horizontal plane
42
Why is the circular superior surface of the radius concave?
for articulation with the capitum of the humerus
43
Why is the thick margin of the radial disc broad medially?
for articulation with the radial notch of the proximal end of the ulna
44
What is the radial tuberosity & what is important about it?
Radial tuberosity is a large blunt projection on the medial surface of the radius immediately inferior to the neck
Much of its surface is roughened for the attachment of the biceps brachii tendon
45
Where can the oblique line of the radius be found?
It continues diagonally across the shaft of the bone from the inferior margin of the radial tuberosity
46
What's important about the proximal end of the Ulna?
- much larger than the proximal end of the radius
- consists of the olecranon, coronoid process, trochlear notch, radial notch and the tuberosity of the ulna
46
What is the Olecranon?
A large projection of bone that extends proximally from the Ulna
47
What is the anatomy of the Olecranon?
Its anterolateral surface is articular and contributes to the formation of the TROCHLEAR NOTCH which articulates with the TROCHLEA of the humerus
48
What is the superior surface of the Olecranon marked by?
A large roughened impression for the attachment of the triceps brachii muscle
49
What are the properties of the posterior surface of the Olecranon?
- smooth
- shaped triangularly
- palpated as the "tip of the elbow"
50
What is the anatomy of the Coronoid process?
- projects anteriorly from the proximal end of the ulna
- superolateral surface is articular and participates with the Olecranon forming the TROCHLEAR NOTCH
- lateral surface is marked by the RADIAL NOTCH for articulation with the head of the radius
51
What is the attachment site of the Supinator muscle in the Ulna?
Supination crest
52
What is distinguishable about the anterior surface of the coronoid process?
- triangular
- apex is directed distally
- has a number of roughenings for muscle attachment
53
What is the "Tuberosity of the Ulna"?
- Largest roughening for muscle attachment in the coronoid process
- Located at the apex of the anterior surface
- Attachment site for the Brachial muscle
54
What is the anatomy of The shaft of the radius?
- narrow proximally
- continuous with the radial tuberosity and neck
- much broader distally expanding to form distal end
55
What is the shaft of the radius triangular in cross section with?
- THREE BORDERS (anterior, posterior and interosseous)
- THREE SURFACES (anterior, posterior and lateral)
56
Where does the anterior border of the shaft of the radius begin?
on the medial side of the bone as a continuation of the radial tuberosity
57
In the superior third of the bone, the anterior border crosses the shaft diagonally, from medial to lateral, as the ________________ of the radius
Oblique line
58
What is the Interosseous border?
A sharp attachment site for interosseous membrane which links to the radius and the ulna
59
What is the posterior surface of the radius characterised by?
The presence of a large DORSAL TUBERCLE
60
What is the medial surface of the radius marked by?
A prominent facet for articulation with the distal end of the ulna
61
What is distinguishable about the lateral surface of the radius?
- diamond shaped
- extends distally as a RADIAL STYLOID PROCESS
62
What is the distal end of the radius marked by?
Two facets for articulation with two CARPAL BONES (the SCAPHOID and LUNATE)
63
The shaft of the Ulna is triangular in cross section and is in cross section with what?
- THREE BORDERS (anterior, posterior and interosseous)
- THREE SURFACES (anterior, posterior and medial)
64
What is the difference between the anterior border and posterior border of the Shaft and distal end of ulna?
- Anterior border is smooth and rounded
- Posterior border is sharp and palpable along its entire length
65
What is distinguishable about the Interosseous border of the shaft and distal end of the Ulna?
- sharp
- attachment site for the interosseous membrane (joins the ulna to the radius)
66
How can the distal end of the Ulna be distinguished?
- small
- has a rounded head (anterolateral and distal part of the head is covered by articular cartilage)
- ulnar styloid process
67
What is the hand?
Region of the upper limb distal to the wrist joint
68
What can the hand be subdivided by?
- The wrist (carpus)
- The metacarpus
- The digits (five fingers including the thumb)
69
What are the three groups of bones in the hand?
- 8 CARPAL BONES (bones of the wrist)
- 5 METACARPALS (bones of the metacarpus)
- PHALANGES (bones of the digits - the thumb has only two; the rest of the digits have three)
70
Which bones of the hand tend to function as a unit and form much of the bony framework of the palm?
- carpal bones
- metacarpals of the index
- middle, ring and little fingers (metacarpals II to V)
71
What is distinguishable about the metacarpal of the thumb?
- functions independently
- increased flexibility at the CARPOMETACARPAL JOINT to provide opposition of the thumb to the fingers
72
How are the small carpal bones of the wrist arranged?
In two rows (a proximal and distal row each consisting of four bones)
73
What bones form the proximal row of the Carpal bones of the wrist?
- SCAPHOID (boat-shaped)
- LUNATE (crescent shape)
- TRIQUETRUM (three-sided bone)
- PISIFORM (pea-shaped)
74
What bones form the distal row of the Carpal bones of the wrist?
- TRAPEZIUM (irregular four-sided bone)
- TRAPEZOID (four-sided)
- CAPITATE (contains a head)
- HAMATE (contains a hook)
75
Which digits are each Metacarpal related to?
- Metacarpal I is related to the thumb
- Metacarpal II to V are related to the index, middle, ring and little fingers respectively
76
What does each metacarpal consist of?
- a base
- a shaft (body)
- a head
77
What do the bases of the metacarpals articulate with?
- with carpal bones
- with each other
78
What do all the heads of the metacarpals articulate with?
The proximal phalanges of the digits
79
What do the heads of the metacarpals form?
The knuckles on the dorsal surface of the hand when fingers are flexed
80
How many phalanges does each digit have?
- The thumb has 2 (proximal and a distal phalanx)
- The rest of the digits have 3 (a proximal, a middle and a distal phalanx)
81
What does each phalanx consist of?
- a base
- a shaft (body)
- a head
82
What does the base of each Phalanx articulate with?
The head of the related metacarpal bone
83
What is distinguishable about the head of each distal Phalanx?
- non-articular
- flattened into a crescent-shaped Palmar tuberosity (which lies under the Palmar pad at the end of the digit)
84
What are the three joints in the shoulder complex?
- Sternoclavicular
- Acromioclavicular
- Glenohumeral
85
Where can the Sternoclavicular joint be found?
Between the proximal end of the clavicle and the CLAVICULAR NOTCH of the MANUBRIUM OF THE STERNUM
86
The ___________________ is surrounded by a joint capsule and reinforced by four ligaments
Sternoclavicular joint
87
What four ligaments reinforce the sternoclavicular joint?
- ANTERIOR and POSTERIOR STERNOCLAVICULAR LIGAMENTS
- INTERCLAVICULAR LIGAMENT (links the ends of the two clavicles to each other and to the superior surface of the manubrium of the sternum)
- COSTOClAVICULAR LIGAMENT (positioned laterally to the joint and links proximal end of the clavicle to the first rib and related costal cartilage)
88
What is the Acromioclavicular joint?
A small synovial joint between an oval facet on the medial surface of the acromion and similar facet on the acromial end of the clavicle
89
The Acromioclavicular joint is surrounded by a joint capsule and is reinforced by?
Acromioclavicular ligament & Coracoclavicular ligament
90
What is the acromioclavicular ligament?
A small ligament superior to the acromioclavicular joint and passes between adjacent regions of the clavicle and acromion
91
What is the coracoclavicular ligament?
- not directly related to joint
- spans the distance between the coracoid process of the scapula and the inferior surface of the acromial end of the clavicle
- comprises of an anterior TRAPEZOID LIGAMENT (which attaches to the trapezoid line on the clavicle) and a posterior CONOID LIGAMENT (which attaches to the related conoid tubercle)
92
What is the Glenohumeral joint (shoulder joint)?
Articulation between the Humerus of the arm and the Scapula
93
What is distinguishable about the Glenohumeral joint?
It is a synovial ball and socket articulation between the head of the humerus and the glenoid cavity of the scapula
94
What do the two articular parts of the condyle articulate with?
the CAPITULUM and the TROCHLEA articulate with the two bones of the forearm
95
What are the properties of the Capitulum?
- articulates with the radius of the forearm
- lateral in position and hemispherical in shape
- projects anteriorly and inferiorly
96
What are the properties of the Trochlea?
- articulates with the ulna of the forearm
- pulley shaped
- lies medial to the capitulum
97
What is distinguishable about the elbow joint?
It's a complex joint involving three separate articulations which share a common synovial cavity
98
What do the joints between the trochlear notch of the ulna, trochlea of the humerus and between the head of the radius and the capitulum of the humerus have in common?
- primarily involved with hinge-like flexion and extension of the forearm
- together are the principal articulations of the elbow joint
99
Which joints are involved with pronation and supination of the forearm?
The joint between the head of the radius and the radial notch of the Ulna & the proximal radio-ulnar joint
100
What is the distal radio-ulnar joint?
A joint that occurs between the articular surface of the head of the ulna (with the Ulnar notch on the end of the radius and with a fibrous articular disc which separates the radio ulnar joint from the wrist joint)
101
What is the wrist joint?
A synovial joint between the distal end of the radius and the articular disc overlying the distal end of the ulna, the scaphoid, lunate and triquentrum
102
What is distinguishable about the Carpal joints?
- synovial joints between the carpal bones share a common articular cavity
- joint capsule of the joints is reinforced by numerous ligaments
103
How many carpometacarpal joints are there?
5 carpometacarpal joints between the metacarpals and the related distal row of carpal bones
104
What is distinguishable about Metacarpophalangeal joints?
- joints between the distal heads of the metacarpals and the proximal phalanges of the digits are condylar joints
- capsule of each joint is reinforced by the PALMAR LIGAMENT and by medial and lateral COLLATERAL LIGAMENTS
