Bones and Joints of Upper Limb

Question 1

What is the only upper limb bone that articulates with the axial skeleton

Answer 1

clavicle

Question 2

What kind of bone is the clavicle?

Answer 2

long bone

Question 3

Identify the following on the clavicle:
* sternal end
* shaft
* acromial end
* costal tuberosity/ tubercle
* groove for subclavius
* conoid tubercle
* trapezoid line
* impression for costoclavicular ligament

Answer 3

• medial end
• body
• lateral end
• attachment point of the inferior aspect of the sternal end of clavicle; aka impression of the costoclavicular ligament

Question 4

Sternoclavicular joint
* joint type
* what bones articulate here
* what ligaments stabilize the joint

Answer 4

• synovial saddle joint
• sternal end of clavicle and manubrium of sternum
• anterior sternoclavicular ligament
• posterior sternoclavicular ligament
• interclavicular ligament
• costoclavicularligament

Question 5

How can you tell the difference between the superior and inferior surface of the clavicular shaft

Answer 5

superior: smooth

inferior: rough (ligament attachment points)

Question 6

Acromioclavicular joint
* type of joint
* what bones articulate here
* what ligaments stabilize the joint

Answer 6

• plane type synovial
• acromial end of clavicle and acromion
• acromioclavicular ligament, coracoclavicular ligament (conoid ligament and trapezoid ligament)

Question 7

scapulothoracic joint
* type of joint
* formed by what
*permits what type of movement

Answer 7

• remember its a functional/ physiological joint not a bony one
• gliding of serratus anterior (lies over posterior rib cage) over subscapularis (anterior scapula)
• permits the movement of scapula over rib cage

Question 8

What movements can occur at the glenohumeral joint

Answer 8

flexion
extension
abduction
adduction
horizontal flexion
horizontal extension
internal rotation
external rotation
circumlocution/circumduction

Question 9

What stabilizes the glenohumeral joint

Answer 9

• glenohumeral ligaments (superior, middle, inferior)
• coracohumeral ligament
  Long head of bicieps tendon can be a stabilizer of the head of the humerus in the glenoid cavity

*glenoid labrum (passive)

Question 10

Define: shoulder dislocation

Answer 10

loss of articulation between the humeral head and glenoid fossa

Question 11

Define: shoulder subluxation

Answer 11

partial loss of articulation

Question 12

What type of shoulder dislocation is most common?

Answer 12

anterior

Question 13

Differentiate between type 1, 2, and 3 shoulder separation

Answer 13

Type 1: stretch/mild tearing of acromioclavicular ligament

Type 2: complete tear of the acromioclavicular ligaments

Type 3: tear of the coracoclavicular and acromioclavicular

Question 14

What is a step defect

Answer 14

seen after collarbone and shoulder blade separation (type 3)

Question 15

What is a slap lesion
How can it occur?

Answer 15

superior labrum, anterior to posterior tear occurring where the biceps tendon anchors to the labrum.

Can be acute/traumatic (fall on outstretched arm, traction on arm) or chronic (due to labral degeneration through repetetitive overhead activity or aging)

can also affect biceps tendon

Question 16

Identify on surface anatomy

• parts of the deltoid
• triceps brachii (long head, lateral head, medial head)
• biceps brachii
• brachialis
• brachioradialis
• lateral / medial epicondyle
• olecranon
• extensor carpi radialis longus

Question 17

What do the dorsal and ventral rami of C5-T1 supply

Answer 17

• Dorsal rami: motor muscles of back and spine and skin of these areas
• Ventral rami: supply the 5 roots of the brachial plexus

Question 18

Differentiate between dorsal and ventral root vs rami

Answer 18

dorsal root (sensory) and
ventral root (motor) come directly off the spinal cord

dorsal and ventral rami are mixed and contain both motor and sensory axons

Question 19

Elbow joint
* joint type
* ligaments involved
* what 2 articulations make up the joint

Answer 19

• hinge
• ulnar collateral and radial collateral ligaments
• humeroulnar articulation
• humeroradial articulation

Question 20

Identify the following on the humerus
* head
* anatomical neck
* surgical neck
* greater tubercle
* superior, middle, and inferior facets of the tubercle
* lesser tubercle
* intertubercular groove/sulcus/ bicipital groove
*deltoid tuberosity
* radial groove
* medial and lateral supracondylar ridges
* lateral and medial epicondyles
*trochlea
*capitulum
* olecranon fossa
* coronoid fossa
* radial fossa

Question 21

What is the importance of the superior, middle, and inferior facets of the humerus?

Answer 21

they all are insertion points for different muscles
* superior: supraspinatus
* middle: infraspinatus
* inferior: teres minor

Question 22

What is the importance of the lesser tubercle?

Answer 22

insertion point for anterior muscle subscapularis

Question 23

what holds the tendon of the biceps brachii in place?

Answer 23

transverse humeral ligament

Question 24

What is another name for the forearm

Answer 24

antebrachial region

Question 25

Describe the radius and ulnar relative to each other

Answer 25

radius is lateral to the ulna

Question 26

What tethers the radius and ulna together? What is another one of its functions?

Answer 26

interosseous membrane transmits load from the wrist to the elbow and between the radius and ulna

Question 27

Identify the following on the radius * proximal end * shaft (anterior, posterior, and medial/interosseous) * distal end * radial tuberosity * radial styloid process * ulnar notch

Question 28

How can you tell the proximal to distal end of the radius

Answer 28

thinner in diameter at the top and wider toward the bottom

Question 29

Identify the following on the ulna * olecranon * coronoid process * trochlear notch * ulnar tuberosity * radial notch * supinator crest * ulnar styloid process * head of ulna

Question 30

Radioulnar joints * joint type * articulations * ligaments

Answer 30

proximal radioulnar joint: head of radius and radial notch of the ulna * stabilized by annular radial ligament * pivot joint distal radioulnar joint: ulnar notch of the radius and head of ulna * anterior and posterior ligaments * gliding joint

Question 31

How many bones are there in each hand

Answer 31

27 * 8 carpal * 5 metacarpal * 14 phalanges

Question 32

List the carpal bones from proximal to distal and lateral to medial

Answer 32

proximal row: scaphoid, lunate, triquetrum, pisiform, distal row: trapezium, trapezoid, capitate, hamate

Question 33

metacarpophalangeal and interphalangeal joints * articulations * joint type * movement permitted

Answer 33

metacarpophalangeal: proximal end of phalanx with the metacarpal distal ends * condyloid type synovial * flexion/extension and abduction/adduction interphalangeal: between the phalanges * hinge type * flexion/extension

Question 34

radiocarpal joint * joint type * formed by what bones * what movements are permitted

Answer 34

* condyloid joint * scaphoid, lunate, triquetrum, distal end of radius * distal radius and triquetrum articular indirectly through articular disc known as triangular fibrocartilage complex * the ulna does not contribute to the wrist joint * flexion/extension; abduction/adduction

Question 35

intercarpal joints * joint type * what bones articulate here

Answer 35

plane type carpal bones occur between adjacent carpal bones in each row

Question 36

midcarpal joint * what is it * what movement does it permit

Answer 36

complex joint between two rows of carpal bone * primary joint invlved in radial and ulnar deviation at the wrist

Question 37

carpometacarpal joints * joint type * what bones articulate here

Answer 37

* plane except thumb which is saddle joint * distal surface of the carpal interacts with the proximal surface of the metacarpal

Question 38

intermetacarpal joints

Answer 38

how metacarpal 2-4 articulate with one another

Question 39

What are your tips to identify laterality and posterior/anterior view of the radius

Answer 39

anterior view: the radial styloid process points laterally (top of the triangle); the radial tuberosity should point medially. the anterior aspect of the distal end should appear smooth. if you see a tubercle, you're viewing it from the back side

Question 40

What are your tips to identify laterality and posterior/anterior view of the ulna

Answer 40

anterior view: olecranon fossa faces forward left ulna: radial notch on right side and styloid process on left right ulna: radial notch on left side and styloid process on right

Question 41

What are your tips to identify laterality and posterior/anterior view of the humerus

Answer 41

anterior view: intertubulcar groove faces you left humerus: head faces left right humerus: head faces right

Question 42

Identify the following on the scapula * acromion * articular facet of acromion * coracoid process * spine * glenoid cavity * infraglenoid tubercle * supraglenoid tubercle * borders (medial, lateral/axillary, superior) * inferior angle * lateral angle * superior/medial angle * infraspinous fossa * supraspinous fossa * subscapular fossa