Lecture 9: Upper Extremity Arthrology Flashcards

1
Q

Sternoclavicular Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Sternal Facet on Sternal end of Clavicle and notch of the Manubrium

2. What is the joint type?

Sellar/Saddle Synovial

    1. What ligaments are involved?*
  • Fibrous capsule
  • Costoclavicular Ligament (rib to clavicle)
  • Anterior Sternoclavicular Ligament (thickenings of fibrous capsule)
  • Posterior Sternoclavicular Ligament
  • Interclavicular Ligament (one clavicle to the other)
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2
Q

Acromioclavicular Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What three ligaments are involved?
A

1. What are the bones involved?

Acromial end of Clavicle and facet of the acromion of Scapula

2. What is the joint type?

Planar Synovial

    1. What ligaments are involved?*
  • Fibrous Capsule with Articular Disc
  • Acromioclavicular Ligament (from Acromion to Clavicle, most of what holds the joint together)
  • Coracoclavicular Ligament (has two parts corresponding to the tubercle / line of the sternum)
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3
Q

What two Ligaments make up the Coracoclavicular Ligament?

A

Conoid Ligament

Trapezoid Ligament

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4
Q

What are the two ways that can cause shoulder separation?

A
  1. Landing on elbow: dislocaiton of acromioclavicular ligament without ligament rupture
  2. Landing directly on shoulder: dislocaiton of acromioclavicular ligament with rupture of coracoclavicular ligament
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5
Q

Glenohumeral Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Glenoid Cavity of Scapular Head and Head of Humerus

2. What is the joint type?

Spheroidal Synovial (Balla and Socket) Joint

    1. What ligaments are involved?*
  • Fibrous Capsule (no articular disc)
  • Glenohumeral Ligament
  • Coracoacromial Arch and Ligament (protects from superior dislocation of the humerus)
  • Coracohumeral Ligament (goes from the base of the coracoid process to the humerus)
  • Transverse Humeral Ligament
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6
Q

What all makes up the Coracoacromial Arch?

A
  • Acromion (bony process on scapula)
  • Coracoid Process (lateral edge on superior scapular)
  • Coracoacromial Ligament
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7
Q

What does the Transverse Humeral Ligament do?

A
  • Goes from the Greater Tubercle of the Humerus to the Lesser Tubercle of the Humerus
  • Holds the Long Head of the Biceps Brachii Tendon in the Intertubercular Groove.
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8
Q

What are the two most likely ways to incur a glenohumeral dislocation?

A

-Anteriorly or Inferiorly (think throwing a baseball)

The Coracoacromial Arch stops Superior and Posterior Dislocation

The Humerus would strike the Acromion of the Scapula posteriorly

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9
Q

What two Bursa are associated with the Synovial Membrane of the Glenohumeral Joint?

A

Subacromial Bursa (doesn’t communicate w/ synovial membrane)

Subscapular Bursa (communicates w/ synovial membrane)

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10
Q

Elbow Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A
    1. What are the bones involved?*
  • Humeral Condyle
  • Trochlear Notch of Ulna
  • Head of Radius
    1. What is the joint type?*

Ginglymus/Hinge Joint

    1. What ligaments are involved?*
  • Fibrous capsule
  • Radial Collateral Ligament of the Elbow
  • Ulnar Collateral Ligament of the Elbow
  • Annular Ligament of the Elbow (Ulna -> wraps around the joint -> Ulna)
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11
Q

What ligament is likely to tear if the elbow dislocates posteriorly?

A

Medial (Ulnar) Collateral Ligament of the Humerus

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12
Q

What seven bursae are present in the elbow?

A
  1. Subcutaneous Bursa of the Lateral Epicondyle of the Humerus
  2. Subcutaneous Bursa of the Medial Epicondyle of the Humerus
  3. Bursa of Anconius
  4. Bursa at the Origin of Extensor Carpi Radialis Brevis

Olecranon Burase:

  1. Subtendinous Olecranon Bursae
  2. Intratendinous Olecranon Bursae
  3. Subcutaneous Olecranon Bursae
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13
Q

What disease is characterized by excessive friction between olecranon and skin?

A

Subcutaneous Olecranon Bursitis

Also called Student’s / Miners / Dart Thrower’s Elbow

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14
Q

How many different articulations are there between radius and ulnar?

A

Three

  1. Proximal Radioulnar Joint
  2. Middle Radioulnar Joint
  3. Distal Radioulnar Joint
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15
Q

Proximal Radioulnar Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligament is involved?
A

1. What are the bones involved?

Radius and ulna

2. What is the joint type?

Trochoid Synovial: primary site of Pronation/Supination (pivot motion)

    1. What ligaments are involved?*
  • Annular Ligament (holds radial head together by going ulna to ulna
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16
Q

What is Nursemaid’s Elbow?

A

Dislocation of radial head out of annular ligament

  • pulled elbow
  • most often seing pullling on arm of child
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17
Q

Medial Radioulnar Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Radius and Ulna

2. What is the joint type?

Syndesmosis Fibrous Joint

    1. What ligaments are involved?*
  • Oblique Cord (b/t coronoid process of ulna and radial body)
  • Interosseous membrane (acts like a “sheet”)
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18
Q

Distal Radioulnar Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Radius and Ulna

2. What is the joint type?

Trochoid Synovial: Same as the proximal to allow for Supination and Pronation

    1. What ligaments are involved?*
  • Articular Disc of Distal Radioulnar Joint
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19
Q

What is the Sacciform Recess?

A

Protrusion of Synovial Membrane from the Annular Ligament of the Elbow

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20
Q

Radiocarpal Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Distal End of Radius and Proximal Row of Carpal Bones

2. What is the joint type?

Condyloid Joint

    1. What ligaments are involved?*
  • Fibrous Capsule
  • Dorsal Radiocarpal Ligament
  • Dorsal Ulnocarpal Ligament
  • Palmar Radiocarpal Ligament
  • Palmar Ulnocarpal Ligament
  • Medial (Ulnar) Collateral Ligament of the Wrist
  • Lateral (Radial) Collateral Ligament of the Wrist
21
Q

What blocks out the ulna at the radiocarpal joint?

A

The Articulating Disc

22
Q

Intercarpal Joints

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Between bones of the hand

2. What is the joint type?

Planar Synovial

    1. What ligaments are involved?*
  • Dorsal/Palmar Intercarpal Ligaments (easy)
  • Interosseous Intercarpal L.
  • Pisohamate Ligament
23
Q

Midcarpal Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Between Proximal and Distal Row of Carpal Bones

2. What is the joint type?

Technically Sellar Synovial but ligaments prevent from moving

    1. What ligaments are involved?*
  • articular capsule
24
Q

First Carpometacarpal Joint

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Trapezium to 1st metacarpal bone

2. What is the joint type?

Sellar Synovial (more flexible)

    1. What ligaments are involved?*
  • Fibrous capsule (separate from the other Carpometacarpal joints)
  • Palmar Carpometacarpal Ligaments
  • Dorsal Carpometacarpal Ligaments
25
Q

2nd - 5th Carpometacarpal Joints

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Distal Carpal Row to 2nd-5th metacarapl

2. What is the joint type?

Planar Synovial

    1. What ligaments are involved?*
  • -*Palmar Carpometacarpal Ligaments
  • Dorsal Carpometacarpal Ligaments
  • Pisometacarpal Ligament (Pisiform to the 5th Metacarpal)
  • Radiate Carpal Ligament (fanning out from the Capitate)
26
Q

Intermetacarpal Joints

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Between fingers (in palm) - 4 of them

2. What is the joint type?

Planar Synovial

    1. What ligaments are involved?*
  • Palmar Intermetacarpal Ligaments
  • Dorsal Intermetacarpal Ligaments
  • Interosseus Intermetacarpal Ligament (runs between the metacarpals)
27
Q

Metacarpophalangeal Joints

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Between carpal bones and phalanges

2. What is the joint type?

Condylar Synovial

    1. What ligaments are involved?*
  • Medial Collateral Ligaments of the Metacarpophalangeal Joint (of a given digit)
  • Lateral Collateral Ligaments of the Metacarpophalangeal Joint (of a given digit)
  • Palmar Ligament of the Metacarpophalangeal Joint (of a given digit) [acts as a floor for tendons]
  • Deep / Superficial Transverse Ligaments (join the heads of the metacarpals together)
28
Q

What ligament is sprained in Bull Rider’s Thumb?

What may avulse in severe cases?

A

Lateral Collateral Ligament of the Metacarpophalangeal Joint of the First Digit (lateral side of thumb)

The lateral part of the Proximal Phalanx of the First Digit

29
Q

What causes Skier’s/Gamekeeper’s Thumb?

A

Laxity or rupture of both Medial and Lateral Collateral Ligaments of the Metacarpophalangial Joint of the First Digit

-both ligaments of thumb injured

30
Q

Interphalangeal Joints

  1. What are the bones involved?
  2. What is the joint type?
  3. What ligaments are involved?
A

1. What are the bones involved?

Thumb: 1st Interphalangeal Joint (b/t proximal and distal phalanges)

2nd-5th Metacarpals

1st-4th Proximal Interphalangeal Joint (b/t proximal and intermediate phalanges)

1st-4th Distal Interphalangeal Joint (b/t intermediate and distal phalanges)

2. What is the joint type?

Ginglymous/Hinge Joint

    1. What ligaments are involved?*
  • Medial/Lateral Collateral Ligaments of the Proximal/Distal Interphalangeal Joint (of a given digit)
  • Palmar Ligament of the Proximal/Distal Interphalangeal Joint (of a given digit)
  • The first digit only has one interphalangeal joint, so its ligaments are just named … Ligament of the Interphalangeal Joint of the First Digit (no Distal/Proximal)*
31
Q

What is “Baseball” or “Mallet” Finger?

A

Sudden hyperflexion of a Distal Interphalangeal Joint avulsing the attachment of an extensor tendon away from the Distal Phalanx

32
Q

What does the sternoclavicular joint do?

A

Rotation during protraction and retraction of scapular on thoracic wall (sellar joint)

33
Q

For thumb extension, what is the easiest motion?

A

Thumbs up sign!

34
Q

What is the name of the structure made of the Deep Cervical Fascia between the Subclavius and the Pectoralis Minor?

A

The Costocoracoid Membrane

35
Q

When the Deep Cervical Fascia comes out of the neck heading inferiorly, what muscles does it invest?

A

Subclavius

Pectoralis Minor

36
Q

What is the name of the Deep Cervical Fascia surrounding the Pectoralis Minor M.?

A

Clavipectoral Fascia

37
Q

Inferior to Pectoralis Minor M., what does the Deep Cervical Fascia become?

What does that structure do?

A

Suspensory Ligament of the Axilla

Holds up the Axillary Fascia

38
Q

What separates the anterior and posterior compartments of the Brachial Fascia?

A

The Medial and Lateral Intermuscular Septum

39
Q

Which septum of the Brachium has a compartment for the Brachial Artery?

A

The Medial Intermuscular Septum

40
Q

What is the major structure which separates the anterior and posterior compartments of the antebrachium?

A

The Interosseous Membrane of the Medial Radioulnar Joint

41
Q

What palmar and dorsal structures of the wrist are both thickenings of the Antebrachial Deep Fascia?

A

The Extensor Retinaculum and the Palmar Carpal Ligament

42
Q

What extra special structure of the palmar wrist adds extra support, and is not made of fascia.

A

The Flexor Retinaculum (Transverse Carpal Ligament)

43
Q

What is a Synovial Cyst?

A

Accumulation of mucopolysaccaride fluid in the Synovial Sheath due to irritation

-normally painless

44
Q

What do we call the thickened region of Palmar Fascia, which continues from / to the Palmaris Longus M. if present?

A

The Palmar Aponeurosis

45
Q

What is the Retinacula Cutis?

A

Small ligaments which anchor the skin of the palm to the Palmar Aponeurosis

46
Q

What is the Superficial Transverse Metacarpal Ligament?

A

Thin band that stretches across the roots of the four fingers, forming weblike structure on top of palmar aponeurosis

-Beneath it the digital vessels and nerves pass to their destinations.

47
Q

What do the Fibrous Digital Sheaths do?

What helps keep this lubricated?

A

Hold Flexor / Extensor Tendons to the bones of the fingers.

More Synovial Sheathes

48
Q

What is Dupuytren Contracture?

What is the obvious symptom?

A

Disease resulting in the shortening, thickening and fibrosis of the Palmar Aponeurosis and Palmar Fascia.

Partial flexion of 4th and 5th digits.