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MSK test 1 > upper extremity joints etc > Flashcards

upper extremity joints etc Flashcards

1
Q

Sternoclavicular joint, what type and what does it do? what bones

A

Type: Shallow saddle with articular disc
Functional type: diarthrotic, multiaxial
Movements: little to none

clavicle +manubrium of sternum

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2
Q

what ligaments strengthen Sternoclavicular joint?

A

sternoclavicular, interclavicular, and costoclavicular l

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3
Q

Acromioclavicular joint, what type and what does it do? what bones

A

Type: planar synovial joint
Functional type: Diarthrotic

Movements: gliding and rotation of scapula on clavicle

acromion + clavicle

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4
Q

what ligaments strengthen acromioclavicular joint?

A

acromioclavicular ligament, coracoclavicular ligament helps

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5
Q

Describe shoulder separation and identify the joint, bones and ligaments involved

A

can result from a fall on the shoulder with the impact taken by the acromion or from a fall on the outstretched arm
depending on where you fall,

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6
Q

what are the grades of shoulder seperation?

A

Shoulder Separation (Acromioclavicular Dislocation)
Grade 1- acromioclavicular ligament sprain
Grade 2- AC ligament tear
Grade 3- AC & coracoclavicular ligaments are torn

All three due to upward force from inferior humerus up to the AC joint
Think falling backwards and onto your elbows.

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7
Q

Glenohumeral joint what type and what does it do? what bones

A

Type: Ball & socket joint
Functional type: Diarthrotic; multiaxial
Movements: Flexion, extension ADduction, circumduction, rotation

scapula and humerus

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8
Q

ligaments and bursas of glenohumeral joint?

A

subacromial bursa

the glenohumeral ligaments, and the coracohumeral ligaments
coracoacromial ligament

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9
Q

what is coracoacromial arch?

A

formed by acoracoacromial L, prevents humerus from being displaced

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10
Q

describe glenohumeral dislocation, which direction does it go in and why, what position are you in when it happens?

A

Commonly dislocated -most occuring in Inferior direction (but are described as anterior)

Coracoacromial structures and the rotator cuff tend to prevent upward dislocation

Anterior dislocations occur most often in young adults
Hyperextension with lateral rotation

Humeral head is forced in an infero-anterior direction

Fibrous layer of joint capsule and glenoid labrum may tear

Anterior dislocation from a hard blow to the humerus while fully abducted

Tilts humeral head inferiorily and pushes it through the weaker part of the joint capsule

Joint capsule may tear such that the humeral head is positioned inferior to the glenoid cavity and anterior to the infraglenoid tubercle

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11
Q

what joints make up the elbow? what bones make it up, what type, what does it do?

A

hinge joint, synovial

ulnar, radial, humerus

flex and extend

Distal Radioulnar Joint

.Proximal Radioulnar Joint

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12
Q

what ligaments make up elbow?

A

ulnar collateral L, radial collateral L, annular L, also has

articular capsule

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13
Q

Explain dislocation of the Elbow joint and identify the ligamentous structures that are typically compromised as a result of this injury

A

The Elbow is capable of being dislocated posteriorly in response to force transmitted along the long axis of the Forearm, this usually involves a tear in the Ulnar Collateral L.

ulna removed from humerus?

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14
Q

Describe the bursae of the Elbow and which ones are susceptible to inflammation

A

theres alot, subcutaneous olecranon bursa inflammation

“students elbow”

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15
Q

What three joints bring together radius and ulna

A

Proximal Radioulnar Joint

Distal Radioulnar Joint

Intermediate part is fibrous syndysmosis

Compound joint!

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16
Q

Proximal Radioulnar Joint, what type, what does it do, bones?

A

synovial pivot joint

head of the radius articulates with the radial notch
of the ulna

allows pronation and supination by permitting the head of radius to rotate within the encircling annular ligament.

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17
Q

Intermediate fibrous dysmosis does what?

A

divides forearm into anterior and posterior portions

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18
Q

annular ligament

A

hold radial head of ulna, makes pivot

ulna, around radial head to ulna

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19
Q

Distal Radioulnar Joint what type, what does it do, bones?

A

a synovial pivot joint between

the head of the ulna and the ulnar notch of the radius

and allows pronation and supination

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20
Q

Describe “pulled elbow” and the mechanism by which the Radial head is dislocated

A

The Radial Head is capable of being dislocated out of the Annular L. to varying degrees, this injury typically occurs from pulling on the arm of a child, sometimes called “Nursemaid’s Elbow” or “Pulled Elbow.

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21
Q

Carpometacarpal Joints

what type and what does it do? what bones

A

synovial saddle (sellar) joints

between the carpal bone (trapezium) and the first metacarpal bone

allowing flexion and extension, abduction and adduction, and circumduction

plane joints between the carpal bones and the medial four metacarpal bones, allowing a simple gliding movement

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22
Q

what ligaments attach to Carpometacarpal Joints

A

radiate carpal L

carpometacarpal ligaments

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23
Q

metacarpophalangeal joints, what do they do?

what ligaments support them?

A

flexion, extension, adduction

LAteral and medial collateral ligaments

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24
Q

bull riders thumb

A

lateral collateral ligament of 1st metacarpophalangeal joint

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25
Q

skiiers thumb

A

Laxity or rupture of both collateral ligaments of the 1st Metacarpophalangeal Joints results in a hyperabduction of that joint and is referred to as “Skier’s Thumb,” or “Game-keeper’s Thumb

26
Q

Flexor Retinaculum, explain it

A
  • palmar carpal ligament!
  • origin for muscles of the thenar eminence
  • carpal (osteofascial) tunnel on the anterior aspect of the wrist
  • medially to the triquetrum, the pisiform, and the hook of the hamate and laterally to the tubercles of the scaphoid and trapezium
  • contains ulnar nerve, ulnar artery, palmaris longus tendon, and palmar cutaneous branch of the median nerve
27
Q

What does carpal tunnel contain?

A
  • median nerve and the tendons of flexor pollicis longus, flexor digitorum profundus, and flexor digitorum superficialis muscles
28
Q

Carpal tunnel syndrome

A
  • compression of the median nerve due to the reduced size of the osseofibrous carpal tunnel, resulting from inflammation of the flexor retinaculum
  • It leads to pain and paresthesia (tingling, burning, and numbness) in the hand in the area supplied by the median nerve and may also cause atrophy of the thenar muscles in cases of severe compression
29
Q

Synovial Sheath for Flexor Pollicis Longus

what does it do?

A

-Envelops the tendon of the flexor pollicis longus muscle

30
Q

Tenosynovitis, what is it and what can happen?

A
  • puncture injuries cause infection of the synovial sheaths of the digits
  • tendons of the second, third, and fourth digits have separate synovial sheaths so that the infection is confined to the infected digit, but rupture of the proximal ends of these sheaths allows the infection to spread to the midpalmar space
  • synovial sheath of the little finger is usually continuous with the common synovial sheath (ulnar bursa), and thus, infection may spread to the common sheath and thus through the palm and carpal tunnel to the forearm
  • infection in the thumb may spread through the synovial sheath of the flexor pollicis longus (radial bursa)
31
Q

Boutonniere deformity

A
  • abnormal flexion of the middle phalanx and hyperextension of the distal phalanx due to an avulsion of the central band of the extensor tendon to the middle phalanx or rheumatoid arthritis
32
Q

Mallet finger

A

-a finger with permanent flexion of the distal phalanx due to an avulsion of the lateral bands of the extensor tendon to the distal phalanx

33
Q

Trigger finger

A
  • tenosynovitis or occurs when the flexor tendon develops a nodule or swelling that interferes with its gliding through the pulley, causing an audible clicking or snapping
  • This condition may be caused by rheumatoid arthritis, repetitive trauma, and wear and tear of aging of the tendon
34
Q

Interphalangeal joint, where is it?

A

between the phalanx on a digit

35
Q

Tendons of the Flexor digitorum superficialis?

A

tendon splits into two medial and lateral bands and inserts on the base of the middle phalanx

36
Q

flexor digitorum profundus tendon ?

A

inserts on the base of the distal phalanx as a single tendon

37
Q

extensor digitorum tendon inserts where?

A
  • dorsum of the hand, a single central band of the extensor digitorum tendon inserts on the base of the middle phalanx
  • two lateral bands of the extensor digitorum tendon join to form a single band to insert on the base of the distal phalanx
38
Q

Extensor Expansion, what is it and how is it relevant?

A
  • expansion of the extensor tendon over the metacarpophalangeal joint and is referred to by clinicians as the extensor hood.
  • Provides the insertion of the lumbrical and interosseous muscles and the extensor indicis and extensor digiti minimi muscles
39
Q

mallet finger?

A

Sudden hyperflexion of the Distal Interphalangeal Joint can avulse the attachment of the long extensor tendon with that tendon away from the Distal Phalanx, a condition known as “Mallet Finger,”

40
Q

protraction and retraction of scapula?

A

sternoclavicular joint

41
Q

Bicipital Aponeurosis

A

Originates from the medial border of the biceps tendon, lies on the brachial artery and the median nerve, and blends with the deep fascia of the forearm

42
Q

Interosseous Membrane of the Forearm, describe it

A
  • dense connective tissue sheet between the radius and the ulna.
  • Its proximal border forms a gap through which the posterior interosseous vessels pass, and it is pierced (distally) by the anterior interosseous vessels.
  • attachments for the deep extrinsic flexor, extensor, and abductor muscles of the hand
43
Q

Palmar Aponeurosis

A
  • a triangular fibrous layer overlying the tendons in the palm and is continuous with the palmaris longus tendon, the thenar and hypothenar fasciae, the flexor retinaculum, and the palmar carpal ligament
  • Protects the superficial palmar arterial arch, the palmar digital nerves, and the long flexor tendons.

strong and sturdy

44
Q

Clavipectoral Fascia

A

holds axillary fascia in place, surrounds pectoralis minor

45
Q

Axillary Sheath

A

encloses axillary artery and brachial plexus

46
Q

Axillary Fascia:

A

Forms the floor of the axilla and is attached to the suspensory ligament of the axilla that forms the hollow of the armpit

47
Q

Palmar Carpal Ligament?

A

thickening of deep antebrachial fascia at the wrist, covering the tendons of the flexor muscles, median nerve, and ulnar artery and nerve

48
Q

lateral and medial intermuscular septa

A

separate arms into posterior and anterior compartments

medial has more neurovasculature

49
Q

extensor retinaculum

A

part of the antebrachial fascia that is thickened,

hold tendons of extensors in place

50
Q

Describe the synovial sheaths associated with the tendons of the muscles of the upper extremity and how their irritation may lead to a Synovial Cyst

A

Irritation of the Synovial Sheaths can cause an accumulation of mucopolysaccharide fluid that can form a usually painless lump known as a Synovial, or Ganglion Cyst. Infections of the Synovial Sheath can cause swelling in very specific and characteristic configurations that follow the shapes of these sheaths.

51
Q

why is fascia important in the brachial ad antebrachial arm?

A

Things like the palmar aponeurosis help in the flexion of the hand and wrist by “extending” other muscles like the palmar longus m., while things like the flexor retinaculum/ transverse carpal ligament help provide cover for nerves and vessels like the carpal tunnel contents (median n. Flexor digitorum profundus/superficialis

52
Q

Explain the mechanism of a “Dupuyren Contracture” and list the anatomical structures involved

A

Dupuytren Contracture is a disease resulting in the shortening, thickening and fibrosis of the Palmar Aponeurosis and Palmar Fascia, which results in a partial flexion of the 4th and 5th Digits

53
Q

fibrous digitial sheaths

A

hold tendons in place on phalanges

54
Q

thenar component

A

big thumb

55
Q

hypothenar compartment

A

little finger

56
Q

central compartment

A

blood supply and nerves

57
Q

tennis elbow, explain it?

A

chronic inflammation or irritation of the origin (tendon) of the extensor muscles of the forearm from the lateral epicondyle of the humerus as a result of repetitive strain.

58
Q

Golfer’s elbow, explain it?

A

painful condition caused by a small tear or an inflammation or irritation in the origin of the flexor muscles of the forearm from the medial epicondyle

59
Q

Cubital tunnel syndrome, explain it?

A
  • compression on the ulnar nerve in the cubital tunnel behind the medial epicondyle (funny bone), causing numbness and tingling in the ring and little fingers
  • tunnel is formed by the medial epicondyle, ulnar collateral ligament, and two heads of the flexor carpi ulnaris muscle and transmits the ulnar nerve and superior ulnar collateral or posterior ulnar recurrent artery
60
Q

Anatomic Snuffbox, explain it?

A
  • bounded medially by the tendon of the extensor pollicis longus muscle and laterally by the tendons of the extensor pollicis brevis and abductor pollicis longus muscles.
  • floor formed by the scaphoid and trapezium bones and crossed by the radial artery
61
Q

Ulnar Bursa, what does it cover?

A

tendons of both the flexor digitorum superficialis and profundus muscles

MSK test 1 (7 decks)

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