Bones and Joints of Upper Limb

Question 1

Which is larger: the lateral or medial epicondyle of the humerus?

Answer 1

Medial epicondyle

Question 2

How many carpal bones do we have per wrist?

Answer 2

8 carpal bones

Question 3

Name the carpal bones of the proximal row

Answer 3

Scaphoid, lunate, triquetrum and pisiform

Question 4

Name the carpal bones of the distal row

Answer 4

Trapezium, trapezoid, capitate and hamate

Question 5

What shape is the clavicle?

Answer 5

S shaped

Convex medially and concave laterally

Question 6

Name the 3 fossa of the scapula

Answer 6

Subscapular fossa
Supraspinous fossa
Infraspinous fossa

Question 7

Which process is more anterior on the scapula?

Answer 7

Coracoid process

Question 8

Which is higher, the anatomical or surgical neck of the humerus?

Answer 8

Anatomical neck

Question 9

Name the 2 fossa of the anterior distal humerus

Answer 9

Radial fossa

Coronoid fossa

Question 10

Name the fossa of the distal posterior humerus

Answer 10

Olecranon fossa

Question 11

Which sides do the capitulum and trochlea lay on?

Answer 11

Capitulum = lateral
Trochlea = medial

Question 12

What are the articulating surfaces of the glenohumeral joint?

Answer 12

Head of humerus and glenoid cavity of scapula

Question 13

How is the glenoid cavity deepened?

Answer 13

Glenoid labrum

Question 14

What features make the shoulder joint unstable?

Answer 14

Glenoid cavity is shallow
Disproportion of articular surfaces
Multiplanar movements
Lax capsule

Question 15

Where does the capsule of the shoulder joint attach?

Answer 15

Glenoid labrum and margins of glenoid cavity

Anatomical neck of humerus (except medially it attaches to the surgical neck)

Question 16

Why is there a small opening in the joint capsule of the shoulder anteriorly?

Answer 16

The synovial membrane communicates with the subscapular bursa

Question 17

What are the 3 extra capsular ligaments of the shoulder called?

Answer 17

Coracoacromial
Coracohumeral
Transverse humeral

Question 18

How many intra capsular ligaments of the shoulder are there and what are they called?

Answer 18

3

Superior, middle and inferior

Question 19

What structures form the coracoacromial arch?

Answer 19

Coracoacromial ligament
Acromion
Coracoid process

Question 20

What does the coracoacromial arch help to prevent?

Answer 20

Upper displacement of the humerus

Question 21

Name the rotator cuff muscles

Answer 21

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 22

Which is the only rotator cuff muscle to attach to the lesser tubercle of the humerus and why?

Answer 22

Subscapularis
This is the only anterior muscle of the rotator cuff muscles. The others are posterior so insert on the greater tubercle of the humerus.

Question 23

Which tendon passes under the coracoacromial arch?

Answer 23

Supraspinatus tendon

Question 24

What is painful arc syndrome and what causes painful arc syndrome?

Answer 24

Pain on abduction of the arm between 50-130 degrees

Inflammation of the subacromial bursa

Question 25

What does the subacromial bursa facilitate?

Answer 25

Movement of the supraspinatus tendon under the CAA | Movement of the deltoid muscle over the capsule and greater tubercle

Question 26

What does the subscapular bursa facilitate?

Answer 26

Movement of the subscapularis tendon over the scapula

Question 27

Which muscles act to flex the shoulder?

Answer 27

Pectoralis major Anterior fibres of deltoid Biceps brachii Coracobrachialis

Question 28

Which muscles act to extend the shoulder?

Answer 28

Posterior fibres of deltoid Latissimus dorsi Teres major

Question 29

Which muscles act to abduct the shoulder?

Answer 29

``` 0-15 = supraspinatus 15-90 = deltoid >90 = trapezius and serratus anterior ```

Question 30

What muscles act to adduct the shoulder?

Answer 30

Pectoralis major Teres major Latissimus dorsi

Question 31

Which muscles act to medially rotate the shoulder?

Answer 31

Subscapularis Teres major Pectoralis major Latissimus dorsi

Question 32

Which muscles act to laterally rotate the shoulder?

Answer 32

Infraspinatus | Teres minor

Question 33

What is the most common shoulder dislocation?

Answer 33

Inferior and anterior | Clinically defined as anterior dislocation because the humeral head is pulled anteriorly by the muscles

Question 34

What separates the distal radio-ulnar joint from the wrist joint?

Answer 34

A fibrous articular disc

Question 35

What forms the floor of the anatomical snuffbox?

Answer 35

Scaphoid and trapezium bones

Question 36

Which of the carpals is a sesamoid bone and which tendon does it reside in?

Answer 36

Pisiform | Flexor carpi ulnaris tendon

Question 37

Which bones form the wrist joint?

Answer 37

Radius, scaphoid and lunate

Question 38

Why can we adduct the wrist much further than we can abduct?

Answer 38

The radial styloid process extends further distally than the ulnar styloid process

Question 39

Name the ligaments of the wrist joint

Answer 39

``` Palmar radiocarpal Dorsal radiocarpal Palmar ulnocarpal Radial collateral Ulnar collateral ```

Question 40

How many bands does the ulnar collateral ligament of the elbow have and what do we call them?

Answer 40

3 | Anterior, posterior and oblique

Question 41

Which 2 ligaments blend at the elbow joint?

Answer 41

Radial collateral ligament and annular ligament of radius

Question 42

Which are the 2 bursae that can give rise to problems at the elbow?

Answer 42

Subcutaneous olecranon bursa | Subtendinous olecranon bursa

Question 43

Which way will the elbow normally dislocate?

Answer 43

Posteriorly | Humerus displaced anteriorly

Question 44

Describe pulled elbow

Answer 44

Failure of annular ligament of radius to hold the radius in place Common in children Head of radius subluxates

Question 45

What do we call the superior extension of capsule at the distal radio-ulnar joint that allows twisting of the capsule?

Answer 45

Sacciform recess

Question 46

What ligaments are present at the wrist?

Answer 46

Radial and ulnar collateral ligaments Palmar radiocarpal Dorsal radiocarpal

Question 47

At which point is the clavicle weakest?

Answer 47

At the junction of the medial 2/3 and lateral 1/3

Question 48

Which muscles are responsible for adduction of the upper limb after a dislocation?

Answer 48

Pectoralis muscles

Question 49

Why does the clavicle often fracture at the joint between the lateral third and the medial two thirds?

Answer 49

This is its weakest point | It changes direction and shape here

Question 50

Which muscle is responsible for pulling the medial part of the clavicle up after a fracture?

Answer 50

Sternocleidomastoid muscle