Joints: Hands & Feet Flashcards
(82 cards)
1
Q
The hand has 4 sets of ligament groups.
purple
red
blue
yellow
A
purple: antebrachium (forearm bones) to carples
red: carple-carple
blue: Carple - metacarple
yellow: Metacarple - metacarple
2
Q
8
A
ulnar collateral ligament
3
Q
9
A
radial collateral ligament
4
Q
11
A
dorsal radiocarple ligaments
5
Q
10
A
palmer radio carple joint
red
6
Q
12
A
palmer ulnocarple ligament
blue outlined orange ligament
7
Q
8 and 9
A
radial and ulnar collateral ligaments
8
Q
13
A
radiate carple ligament
9
Q
14
A
pisohamate ligament
blue
10
Q
15
A
palmar intercapals
11
Q
17
A
pisometacarpal ligament
red
12
Q
22
A
palmar metacarpal ligaments
13
Q
16
A
dorsal intercarpal ligaments
14
Q
19
A
dorsal carpometacarpal ligaments
15
Q
20
A
dorsal metacarpal ligaments
16
Q
1
A
phalageal collateral ligaments
Collateral ligaments (Medial & Lateral), has 2 parts: - Dense Cord-like: passes from heads of metacarpal to base of Phalanges, prevents spreading of fingers during flexion.
- Thin Fan-like: passes anteriorly to attach to palmar plates.
17
Q
The wrist is what kind of joint, how many axes of movement, and which bones participate in the joint?
A
Ellipsoid or Condyloid type of Joint. 2 axes of movements.
- Articulation between the carpal articular facet of the Radius + the articular disk and the
proximal row of the carpal bones except the Pisiform bone.
* The triquetrum bone participates and contacts the articular disk only in ulnar abduction
and loses contact in radial abduction!
** Ulna doesn’t participate in the joint!!!
18
Q
What are the movements of the wrist joint?
A
Movements: 2 axis joint:
- Palmarflexion / Dorsiflexion (Transverse Axis through Lunate and Capitate)
- Adduction (Ulnar Abduction) / Abduction (Radial Abduction) the axis is (Dorsopalmar through the head of Capitate)
- Combined motions produce rotation.
19
Q
Adduction or ulnar deviation of the wrist is caused by which muscles and to what degree?
A
Adduction
(35-40º)
Extensor Carpi Ulnaris
Flexor Carpi Ulnaris
20
Q
Abduction or radial deviation of the wrist is caused by which muscles and to what degree?
A
Abduction
(25-30º)
Extensor Carpi Radialis longus
Extensor Carpi Radialis Brevis
Abductor Pollicis longus
Flexor Carpi Radialis
21
Q
palmarflexion of the wrist is caused by which muscles and to what degree?
A
Palmarflexion
(60-90º)
Flexor Carpi Radialis
Flexor Carpi Ulnaris
Abductor Pollicis longus
Flexor of the digits
Deep and superficial
22
Q
dorsiflexion of the wrist is caused by which muscles and to what degree?
A
dorsiflexion
(40-90º)
Extensor Carpi Radialis longus
Extensor Carpi Radialis Brevis
Extensor Carpi Ulnaris
Extensors of the digits (minimally)
23
Q
the carpal tunnel is what and contains what tendons, nerve?
A
an area made by the hook of the hamate, tubercle of the trapizium, as well as the capitate, and trapazoid bones.
The flexor retinaculum and palmaris longus complete the tunnel as the roof.
It contains the tendons of the flexor digitorum superficialis and profundus, the median nerve, and the fleor pollicis longus.
The flexor carpi radialis is off to the side byt the tubercle of the trapizium
24
Q
the guyon canal is what? contains what and is composed of what?
A
is a semi-rigid longitudinal canal in the wrist that allows passage of the ulnar artery and ulnar nerve into the hand.
The roof of the canal is made up of the superficial palmar carpal ligament, while the deeper flexor retinaculum and hypothenar muscles comprise the floor.
25
Intercarple joints are what kind of joint and what sort of movement?
- Plane type of joints, connecting the carpal bones with each other.
* Gliding movements between the carpal bones, which occur together with the movements of the Radiocarpal (wrist) joint and augment them and increase the overall range of mobility and flexibility
* Palmarflexion / Dorsiflexion at the Midcarpal joint, aiding the wrist joint and initiating it moves. Some investigators say that the Dorsiflexion and radial abduction occur in this joint only. Proximal row is more flexible than the distal one.
26
Carpometacarpal (CMC) and Intermetacarpal (IM) Joints are what type of joint?
Plane type of joints
## Footnote
**except for the 1st CMC joint of the thumb, which is Saddle joint.**
27
describe the joint composition of the CMC and IM joints, including the thumb
The medial 4 CMC joints and the IM joints have a common joint cavity and capsule.
* The 1st CMC joint of the thumb has a separate loose joint capsule (Fibrous and Synovial layers) that facilitates the free movements of the joint.
28
thumb joint movments?
The 1st CMC joint of the thumb is a 2 axes joint allowing:
- Abduction / Adduction of the thumb. (Dorso-palmar axis)
- Flexion / extension of the thumb (vertical axis in the anatomical position)
- Combined movements of the above producing Circumduction.
29
Adduction of the thumb is caused by which muscles?
Adductor Pollicis
Extensor Pollicis longus
1st Dorsal interossious
30
Abduction of the thumb is caused by which muscles?
Abduction of thumb
35-40º
Abductor Pollicis longus
Abductor Pollicis Brevis
Opponens Pollicis
Flexor Pollicis Brevis -Superficial Head
31
extension of the thumb is caused by which muscles?
Abductor Pollicis longus
Extensor Pollicis longus
Extensor Pollicis Brevis
32
flexion of the thumb is caused by which muscles?
Opponents Pollicis
Adductor Pollicis
Flexor Pollicis Longus
Flexor Pollicis Brevis
33
Metacarpophalangeal joints are what type of joint, how many axis?
Metacarpophalangeal (MP) joints:
- Spheroidal (Ball & Socket) shaped joints but restricted into 2 axes (ellipsoid functionally).
- Joint capsule attaches to the margins of articulation (Fibrous and Synovial layers).
34
mp joint movements are ?
* Flexion / Extension (Transverse axis)
* Abduction / Adduction (in relation to the middle finger, away from it is abduction, towards it is adduction).
* Combined movements of the above to produce Circumduction
* **\* 1st MP joint of thumb has only Flexion / Extension.**
35
The interpharangeal joint is what kind of joint, what kind of movement?
Hinge type of joints.
```
1 axis (Transverse) joint:
Flexion / Extension
```
36
1
anterior talofibular ligament
37
2
posterior talofibular ligament
38
3
calcaneofibular ligaments
39
1
posterior tibiotalar ligament
40
3
anterior tibiotalar ligament
41
2
tibiocalcaneal ligament
42
4
tibionavicular ligament
43
1
joint capsule
44
2, importance?
plantar calcaneonavicular ligament (also known as the spring ligament
This ligament not only serves to connect the calcaneus and navicular, but supports the head of the talus, forming part of the articular cavity in which it is received.
45
3
medial ligament of the ankle
46
5
calcaneo fibular ligaments
47
6
cervical ligament
48
7
bifurcate ligament
49
4
line of transmission of the weight of the body
50
5 and 6
Calcaneal line of transmission
Midfoot and forefoot transmission
51
Under 11, bottom line
the plantar aponeurosis
52
8, 9
long plantar ligament
53
10
plantar calcaneonavicular ligament
54
11
intrinsic muscles of the foot
55
Upper Ankle (Talocrural) (Ankle) Joint is what type of joint and what articuluates with what?
- Hinge type Synovial joint. 1 axis of movement.
- Between the Malleolar Mortise (Formed by the Malleolar articular facet of tibia on medial malleolus, Inferior articular surface of tibia & Malleolar articular facet of Fibula
on lateral malleolus) and the Trochlea of Talus with the Medial & Lateral Malleolar facets.
56
upper ankle joint articulation between the tibia, fibula, and trochlea? # places
So the tibia articulates with the talus in 2 places:
A. Inferior articular surface of tibia forms the roof of the Malleolar mortise, articulating with the trochlea of talus, transferring the whole body weight to the talus
B. The medial Malleolar facet of medial malleolus articulates with the medial Malleolar facet of talus
The fibula articulates with the talus in 1 place:
The Malleolar articular facet of lateral malleolus of fibula articulates with the lateral Malleolar facet of trochlea
57
What are the movements of the upper ankle joint and what muscles aid in this?
Dorsiflexion
(25-45°)
Tibialis anterior
Extensor Digitorum Longus
Extensor Hallucis longus
Plantarflexion
(30-60°)
Triceps Surae
Flexor Hallucis longus
Tibialis Posterior
Flexor Digitorum longus
58
Joint capsule is thin but reinforced by strong collateral ligaments, the upper ankle joint is stabilized by 7 ligaments
Lateral Collateral Ligament of Ankle:
1. Anterior Talofibular ligament
2. Posterior Talofibular ligament
3. Calcaneofibular ligament
Medial Collateral ligaments of Ankle (Deltoid Ligament): reinforces the joint capsule medially, prevents subluxation (partial dislocation)
of the joint during Foot Eversion (Pronation).
1. Tibionavicular part
2. Tibiocalcaneal part
3. Anterior Tibiotalar
4. Posterior Tibiotalar
59
Compound joint, formed by 2 joints
Subtalar Joint and Talocalcaneonavicular Joint
60
The subtalar (talocalcaneal joint) is where and what kind of joint?
- Subtalar (Talocalcaneal) Joint:
- Pivot type of joint. 1 rotatory oblique axis of movement
- Between the Posterior Calcaneal articular surface of Talus and the Posterior Talar
articular surface of Calcaneus
61
The subtalar joint has what kind of capsule and is stabilized by which ligaments
Joint capsule is loose & thin, attaching to the margins of the bones.
Ligaments: strengthen the joint capsule:
-Medial / Lateral Talocalcaneal ligaments
-Posterior Talocalcaneal ligament
- Interossious Talocalcaneal ligament: very strong, lies in the Tarsal Sinus, separates the Subtalar from the Talocalcaneonavicular joint
62
Talocalcaneonavicular Joint is what kind of joint? 2 types
- The Talocalcaneal part is Plane type of joint (Middle & Anterior calcaneal articular surfaces of
Talus/calcaneus)
-the Talonavicular part is Spheroidal
(Ball & Socket) type of joint that functions as Pivot joint due to the many ligaments that restricts it (Head of Talus and the Talar articular surface on the
Navicular bone)
63
Talocalcaneonavicular Joint movement
Supinator muscles of the foot (adductor,
plantarflexor and medial rotator muscles):
(30°) – Inversion:
m. triceps surae,
m. tibialis posterior,
m. flexor hallucis longus,
m. flexor digitorum longus,
m. tibialis anterior,
m. extensor hallucis longus.
Pronator muscles of the foot (abductor, dorsalflexor and lateral rotator muscles):
(30°) – Eversion:
m. peroneus longus,
m. peroneus brevis,
m. extensor digitorum longus,
m. peroneus tertius.
64
In summary the Upper Ankle joint (Talocrural) permits Hinge movements . The Lower Ankle joint (Subtalar & Talocalcaneonavicular) permits Rotation
movements which are Trochoid.
65
what are the two amputation lines and where are they located?
Chopart's Joint line (Transverse Tarsal Joint): Between Talus, Calcaneus Navicular &
Cuboid bones.
Lisfranc's Joint line: Between Tarsals & Metatarsals
66
What are the two arches of the foot?
longitutional arch - medial part: It is made up by the calcaneus, the talus, the navicular, the three cuneiforms, and the first, second, and thirdmetatarsals
lateral part: calcaneus, the cuboid, and the fourth and fifth metatarsals
The transverse arch is composed of the three cuneiforms, the cuboid, and the five metatarsal bases
67
the arch of the foot is supported by what tendons, ligaments and muscles?
longitutional arch:
tendon of the Tibialis posterior
tendon of the Tibialis anterior
plantar aponeurosis
Peronæus longus
long plantar and the plantar calcaneocuboid ligaments
transverse arch:
interosseous, plantar, and dorsal ligaments
short muscles of the first and fifth toes (especially the transverse head of the Adductor hallucis)
tendon the Peronæus longus
68
Metatarsophalangeal Joints are what kind of joint, ennervated by which nerves? Blood supply?
Spheroidal (Ball & Socket) anatomically shaped joints but restricted into 2 axes
(Condyloid or Ellipsoid functionally).
Digital nerves
Lateral Metatarsal artery, a branch of Dorsalis Pedis artery
69
Tarsometatarsal Joints are what kind of joint, ennervated by which nerves? Blood supply?
Plane type of Synovial joints. Gliding or Sliding movements occur at them.
Planter aspect: Medial / Lateral plantar nerves
Dorsal aspect: Deep Fibular nerve
Also Sural nerve
Anterior Tibial artery via lateral tarsal artery, a branch of Dorsalis Pedis artery
70
Interphalangeal Joints are what kind of joint, ennervated by which nerves? Blood supply?
Hinge type of Synovial joints.
Digital nerves
Digital branches of Plantar Arch
71
Intermetatarsal Joints are what kind of joint, ennervated by which nerves? Blood supply?
Plane type of Synovial joints. Little individual movement occurs in them.
Digital nerves
Lateral Metatarsal artery, a
branch of Dorsalis Pedis artery
72
Metatarsophalangeal Joint have what kind of movements? What joint?
Spheroidal (Ball & Socket) anatomically shaped joints but restricted into 2 axes
(Condyloid or Ellipsoid functionally).
Movements: 2 axes joint:
Flexion / Extension
Abduction / Adduction (Restricted by collateral ligaments)
Combined Circumduction
73
Metatarsophalangeal Joint have what kind of movements? What joint?
hinge
Movements: 1 axis joint:
Flexion / Extension
74
Plantarflexion of the big toe is caused by what muscles?
Plantarflexion
Flexor Hallucis Longus
Flexor Hallucis Brevis
Abductor Hallucis
| (40°)
75
dorsiflexion of the big toe is caused by what muscles?
Dorsiflexion
Extensor Hallucis Longus
Extensor Hallucis Brevis
| (55°)
76
abduction of the big toe is caused by what muscles?
abduction
Abductor Hallucis
77
adduction of the big toe is caused by what muscles?
Adductor Hallucis
78
Dorsiflexion of the toes is caused by what muscles?
Dorsiflexion
Extensor Digitorum Longus
Extensor Digitorum Brevis
| (55°)
79
Plantarflexion of the toes is caused by what muscles?
Plantarflexion
Flexor Digitorum Longus
Flexor Digitorum Brevis
Lumbricals
Flexor Digit Minimi Brevis
| (40°)
80
Abduction of the toes is caused by what muscles?
Abduction
Dorsal Interossious
Abductor Digiti Minimi
81
Adduction of the toes is caused by what muscles?
Adduction
## Footnote
Plantar Interossious
Opponens Digiti Minimi
82
