Joints - Upper Extremity Flashcards

1
Q

Sternoclavicular Joint

A

Saddle Type Synovial Joint - sternal end of clavicle with manubrium of sternum

Divided into 2 compartments by a fibrocartilaginous articular disc that divides the joint cavity into 2 compartments

Joint surface is fibrocartilage rather than the typical hyaline cartialge

Ligaments:
1. Interclavicular ligament - located on top of the manubrium between the clavicles
Strengthens the capsule superiorly
2. Anterior and posterior sternoclavicular ligaments - run from the clavicle to the manubrium anteriorly and posteriorly
Restrain anterior and Posterior movement of the joint
3. Costoclavicular ligament - runs from first rib to inferior surface of the sternal end of the clavicle
Located external to the joint but it is the primary stabilizer
Orientation allows it to limit extremes of all motion (except depression since it is under the clavicle)

Movements of the SC joint: participates in scapulohumeral rhythm, producing elevation/depression, protraction/retraction, and upward and downward rotation of the scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acromioclavicular Joint

A

Plane type synovial joint between acromial end of the clavicle and the acromion of the scapula

Capsule is split into 2 compartments by a fibrocartilaginous disc

Fibrocartilage on articulating surfaces

Ligaments:
1. Acromioclavicular ligament - runs from acromion to clavicle on top of the joint
Reinforces the joint superiorly
2. Coracoclavicular Ligament - external to the joint; runs the scapula to the clavicle in 2 parts; together the parts anchor the clavicle to the scapula helping to maintain joint integrity and anchoring the clavicle to the coracoid process
Conoid Ligament: runs form the caracoid process of the scapula to the conoid tubercle of the clavicle
Trapezoid ligament: runs from the coracoid process to the trapezoid line

Movements of the AC joint: participates in scapulohumeral rhythm, producing elevation/depression, protraction/retraction, and upward and downward rotation of the scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Scapulothoracic Joint

A

Physiological Joint between musculoskepetal structures

Function: orientation of the glenoid fossa of the scapula

Movements: Same as AC and SC (closed kinematic chain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Glenohumeral Joint

A

Ball and socket type synovial joint between the head of the humerus and the glenoid cavity (which is enlarged by the glenoid labrum)

Poor joint congruity and laxity of the joint capsule help contribute to large ROM at this joint

Joint capsule runs from margin oft he glenoid cavity to the anatomical neck of the humerus and therefore encloses the biceps long head tendon. The capsule has 2 apertures:
One for the tendon of the long head of the biceps (between the tubercles)
One inferior to the coracoid process for communication between the bursa of subscalpularis and the synovial cavity of the GH joint

Movement: flexion and abduction require movement of the scapula; scapulohumeral rhythm –> 2:1 ratio; movement at ST created half form movement at AC and half from movement at SC

Arteries that supply the joint: circumflex humeral and suprascapular

Nerves that supply the GH joint: suprascapular, axillary, lateral pectoral

Bursae:
Subscapular: feeds into synovial capsule of joint
Subacromial: facilitates movement of supraspinatus tendon under the coracoacromial arch and the deltoid tendon over the GH joint capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Elbow Joint - Overview

A

modified hinge synovial joint

function: position the hand for manipulation; primarily used for flexion and extension (does some passive abduction and adduction); also active in pronation/supination

AT least 15 muscles cross the elbow but only brachialis acts exclusively at the elbow

Typical joint capsule unique in that it encloses 3 joints: humeroulnar, humeroradial, and proximal radioulnar; capsule is not as strong anteirorly because there are no reinforcing ligaments there

Vascular and neural elements:
Nerves: MC, ulnar, and radial
Arteries: Brachial Artery - splits into radial and ulnar arteries

Bursae:
1. Olecranon Bursae: subtendinous, tendonous, and subcutaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Elbow Joint - Ligaments

A
  1. Radial Collateral Ligament: aka lateral collateral lig. of the elbow
    one strong, fanlike band that starts the lateral epicondyle of the humerus and blends with the annular ligament; RESISTS VARUS STRESS AT THE ELBOW (pushing form medial to lateral)
  2. Ulnar Collateral Ligament: aka medial collateral lig of the elbow
    made up of 3 bands: anteiror (cord-like, strongest) posterior (fan-like, weakest) oblique (deepens the socket to reduce incongruency in the joint; RESISTS VALGUS STRESS; prevents gapping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Glenohumeral Joint - Ligaments

A
  1. Glenohumeral Ligament
    Has 3 bands: superior, middle, inferior
    on the anterior aspect of the joint capsule, reinforces the joint anteriorly
  2. Coracohumeral ligament
    Runs from the base of the coracoid process to the greater tubercle of the humerus –> RESTRAINS inferior movement, and posterior movement in the adducted arm
  3. Coracoacromial Arch
    completely extrinsic tot he joint; formed by the coracoacromial ligament which runs between the coracoid process and the acromion
    prevents superior displacement of the humerus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Radiocarpal Joint

A

Wrist Joint

between the articular disc of the distal radioulnar joint at the distal end of the radius and the proximal row of carpal bones except the pisiform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Intercarpal Joints

A

Articulations between adjacent bones of the proximal row, adjacent bones of the distal row, and between the distal and proximal rows of carpal bones.

Ligaments can be anterior, posterior, or interosseous

Movements: Gliding

Midcarpal joints are the ones between the proximal and distal rows of carpal bones - there is some flexion/extension and radial/ulnar deviation there

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Carpometacarpal Joints

A

First CMC is the most unique - it is the only one that is a saddle joint; most digit 1 movement happens at CMC (it has flexion/extension, abduction/adduction, and circumduction at this joint

2, 3, and 4 are relatively stable at this joint

digit 5 also has some movement

between the distal row of carpal bones and the 5 metacarpal bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Intermetacarpal Joints

A

4 articulations between the bases of adjacent metacarpals; facilitate movement between the metacarpals at the carpometacarpal joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Metacarpophalangeal joints

A

Between the 5 metacarpals and the 5 proximal phalanges

This is where the most movement occurs for digits 2-5

There are COLLATERAL LIGAMENTS supporting the joint on both sides

Deep Transverse Metacarpal ligament binds the metacarpals to the proximal phalanges

In the thumb, this joint only allows flexion and extension; there is a lot of movement at the joint proximally

the other digits can flex, extend, abduct, adduct, and passively rotate at these joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Proximal Interphalangeal Joints

A

Between proximal and middle (distal in the case of the thumb) phalanges of all digits

Ovoid articulations hwere the proximal part of the joint is the concave surface

Collateral ligaments on both sides of joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Distal Interphalangeal Joints

A

Between Middle and Distal Phalanges of digits 2-5

Collateral ligaments on both sides of joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Proximal Radioulnar Joint

A

Pivot Type Synovial Joint

Enclosed in the articular Capsule of the elbow joint

active in pronation and supination with the DRU joint

Ligaments: annular ligament - encircles the head of the radius and holds it in the radial notch of the ulna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Distal Radioulnar Joint

A

Pivot Type Synovial Joint

Triangular fibrocartilage complex (TFCC) fills the space between the ulnar styloid and the radius for articulation with the carpal bones

Anterior and Posterior ligaments support the capsule

17
Q

Wrist

A

Condyloid Type synovial joint

Distal end of the radius and the TFCC articulate with the proximal row of carpal bones except the pisiform

Ligaments:
Palmar radiocarpal - anterior reinforcement
Dorsal radiocarpal - posterior reinforcement
Ulnar collateral - medial reinforcement
Radial collateral - lateral reinforcement