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MBBS II MSS > L01 - UPPER LIMB BONES AND JOINTS > Flashcards

L01 - UPPER LIMB BONES AND JOINTS Flashcards

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1
Q

What are the upper limb regions?

A
  1. Shoulder
  2. Arm (brachium)
  3. Forearm (antebrachium)
  4. Hand (manus)
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2
Q

Name of digits of the hand?

A 
1 = thumb/ Pollex 
2 = Index finger 
3 = Middle finger 
4 = Ring finger 
5 = Little finger/ Digitus minimus
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3
Q

Name all the bones in the superior appendicular skeleton (free upper limb)

A 
Scapula 
Clavicle
Humerus 
Radius and Ulna 
Carpals 
Metacarpals 
Phalanges
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4
Q

Describe the shape of the clavicles?

A

S shape, double curvature in horizontal plane

Medial 2/3 of the shaft is convex anteriorly

Lateral 1/3 of shaft is concave anteriorly, flattened

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5
Q

Compare the 2 ends of the clavicles? What do they articulate with?

A

Sternal end: enlarged, triangular where it articulates with manubrium of sternum at sternoclavicular joint

Acromial end: Flat where it articulates with acromion of the scapula at acromioclavicular joint

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6
Q

Compare the superior and inferior surface of the clavicle?

A 
Superior = smooth 
Inferior = rough, with tubercules, ridges and grooves

(where strong ligaments bind the clavicle to the 1st rib near sternal end and suspend the scapula at the acromial end )

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7
Q

Location and attachment of conoid tubercule?

A

Conoid tubercule = near acromial end of clavicle

Attach to conoid ligament (medial part of coracoclavicular ligament) to suspend the upper limb

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8
Q

Location and attachment of subcalvian groove?

A

Medial 1/3 of shaft of clavicle at inferior surface

Attach subclavius muscle

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9
Q

3 roles of the clavicles?

A

1) Transmit shock from upper limb to axial skeleton
2) Boundary of cervicoaxillary canal&raquo_space; protect neurovascular bundle supplying upper arm
3) Crane- like strut to suspend the scapula and upper limb, keeping them away from the trunk for maximum freedom of motion

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10
Q

What are the bony prominence/ features of the scapula?

A
  • Acromion
  • Glenoid fossa
  • Inferior angle
  • Superior angle
  • Coracoid process
  • Spine of scapula
  • Scapular notch
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11
Q

What are the fossas on the anterior and posterior surfaces of the scapula?

A

Posterior surface: Convex:
- Supraspinous fossa and Infraspinous fossa divided by Spine of Scapula

Anterior/ Costal surface: Concave:
- Subscapular surface, large

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12
Q

Role of the 3 fossa of the scapula?

A

For muscle attachment

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13
Q

Medial attachment of deltoid muscle?

A

Deltoid tubercule of the scapular spine = medial point of deltoid attachment

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14
Q

Describe the shape and function of the glenoid fossa?

A

Shallow, Concave, Oval, at lateral surface of scapula, forms glenoid cavity:

Receives and articulates with head of humerus ar glenohumeral joint

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15
Q

Location and function of the Scapular notch?

A

Superior border of scapula, at medial 2/3

Forms inferior border of foramen for suprascapular nerve and ligament

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16
Q

What are the tubercules at the superior and inferior edges of the glenoid fossa?

A

Supraglenoid tubercule and Infraglenoid tubercule

For muscle attachment

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17
Q

What attaches to the coracoid process?

A

Coracoid process provide inferior attachment for passively supporting coracoclavicular ligament

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18
Q

What are the bony features at the Head of the humerus?

A

Between surgical neck and head of humerus:

Lateral = Greater tubercule (palpable)

Medial = Lesser tubercule

In between greater and lesser tubercule = Intertubercular (bicipital) groove

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19
Q

What are the bony features at the shaft of humerus?

A

Deltoid tuberosity

Towards condyle inferiorly:

  • Lateral supracondylar ridge
  • Medial supracondylar ridge
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20
Q

Function of intertubercular bicipital groove?

A

Passage for tendon of Long head of bicep muscle

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21
Q

What are the bony prominence at the condyle of humerus?

A
  • Radial fossa (lateral)
  • Coronoid fossa (medial)
  • Lateral and medial epicondyle
  • Capitulum (lateral) and Trochlea (medial)
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22
Q

What are the grooves and fossa at the posterior surface of the humerus?

A

Groove for ulnar nerve
Groove for radial nerve (radial groove/ spiral groove)

Olecranon fossa

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23
Q

What passes through the radial groove of the humerus?

A

Radial nerve and deep artery

Pass between medial and lateral head of the triceps brachii muscle

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24
Q

What makes up the condyle of the humerus?

A

Trochlea, capitulum, olecranon, coronoid and radial fossa

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25
Function of lateral capitulum and medial trochlea at the condyle of humerus?
Lateral capitulum = articulation with the head of radius Medial trochlea = pulley-like, articulation with proximal end of ulna
26
Function of the coronoid fossa of humerus?
At anterior surface Receives the coronoid process of ulna during full extension of elbow
27
Role of olecronon fossa at the condyle of humerus?
At posterior surface Receives olecranon of ulna during full elbow extension
28
Role of radial fossa?
At anterior surface Receives head of radius during full elbow extension
29
Two bones of the forearm?
Radius and ulna Ulna is medial, longer, stabilizes the forearm
30
What forms the walls of the trochlear notch?
Olecranon and coronoid processes of proximal ulna
31
What links the shafts of radius and ulna together?
Interosseous membrane
32
What is the root of the brachialis muscle?
Inferior to the coronoid process = tuberosity of the ulna, where tendon of brachialis muscle attaches
33
Compare the diameter of ulna and radius from proximal to distal?
Ulna: Proximal = broad, Distal = thin Radius: Proximal = thin, Distal = broad
34
Location and function of the radial notch of proximal ulna?
Lateral side of coronoid process Receives broad periphery of head of radius
35
Location of styloid process on ulna?
Distal end
36
Location and function of Dorsal tubercule of radius?
At distal radius Lies between shallow grooves for passagee of tendons of forearm muscles
37
What demarcates the proximal head and shaft of the radius?
Radial tuberosity at medial proximal radius
38
What is the role of the interosseous membrane?
helps transmit force from raidus to ulna, thus to humerus
39
What are the carpal bones?
``` 8 bones (Some Lovers Try Positions That They Can't Handle) ``` Proximal row lateral to medial: Scaphoid (boat-shape), Lunate, Triquestral, Pisiform Distal row lateral to medial: Trapezium, Trapezoid, Capitate, Hamate
40
What does the trapezium carpal bone articulate with?
Scaphoid anteriorly Trapezoid medially 1st metacarpal, 2nd metacarpal
41
What does the trapezoid carpal bone articulate with?
Trapezium Scaphoid 2nd metacarpal Capitate
42
What does the capitate carpal bone articulate with?
``` Trapezoid Hamate Lunate Scaphoid 3rd metacarpal ```
43
What does the hamate bone articulate with ?
4th, 5th metacarpal Capitate Triquetral
44
What type of joint is most common in the body?
Synovial joints
45
Describe a synovial joint space.
Two ends of bones covered by articular hyaline cartilages Joint space enclosed by fibrous capsule Synovial membrane lines inner surface of joint capsule Synovial membrane secretes synovial fluid into joint cavity for lubrication
46
Describe the function of bursa?
Herniated synovial membrane that lubricates tendon or muscles that lie over it
47
What does the range of motion and joint stability depend on?
1. Shape of articular surfaces, (e.g. hinge joint = restricted movement) 2. Ligaments (strong or weak) 3. Muscle tone (= low level of contractile activity in relaxed muscles to stabilize joint)
48
Describe the structure of the sternoclavicular joint?
- Medial end of clavicle articulates with "socket" formed by manubrium and 1st costal cartilage - Fibrocartilaginous articular disc divides joint cavity into 2 compartments: synovial double-plane joint: allows sliding / gliding
49
What stabilizes the sternoclavicular joint?
Stabilized by the costoclavicular ligament (between clavicle and 1st costal cartilage) and the articular disc
50
Describe the structure of the Acromioclavicular joint?
synovial plane joint Small fibrocartilageinous articular disc: hangs down into joint cavity (not divided into 2 compartments)
51
What holds the clavicle to the scapula?
strong coracoclavicular ligament + Acromioclavicular joint >> Both move in unison
52
What is the ROM of the clavicles?
Elevation/ depression Protraction/ retraction Rotation Movement produced by muscles that act on either clavicle or scapula
53
Describe the shoulder joint structure?
synovial ball-and-socket joint - Loose cuff of synovial membrane, does not cover hyaline cartilage - Glenoid labrum: deepens glenoid fossa (increase SA), articulate with humeral head, very mobile but unstable - Fibrous capsule: weak, loose fitting inferiorly
54
What nerve is damaged when the arm is hyper-abducted?
Dislocation of the humeral head causes injury to the Axillary nerve
55
What is the ROM of the shoulder joint?
1) Flexion / extension 2) Abduction / adduction 3) Lateral / medial rotation 4) Circumduction
56
What produces the abduction of the shoulder joint from 0 to 180 degrees?
- 0-90o: locked by greater tubercle coming into contact with upper margin of glenoid (articulating surface used up at 90o) - 90-150o: involves lateral rotation of scapula (pectoral girdle) - 150-180o (full abduction): involves movement (tilting) of spinal column
57
What stabilizes the shoulder joint?
Rotator cuff: muscles tone 4 muscles: Supraspinatous, Infraspinatous, Teres minor, Subscapularis
58
What bursa exists at the shoulder joint?
Subacromial bursa: | Lies above shoulder joint between deltoid, supraspinatus
59
What is painul arc syndrome caused by?
subacromial bursitis Swelling and inflammation from old age >> cannot fully abduct the arm
60
Describe the structure of the elbow joint?
synovial hinge joint between: 1) Capitulum (pulley-shaped) of humerus 2) Trochlear notch (spanner-shaped) of ulna Seen from medial view
61
What are the joints in the elbow joint cavity?
Lateral Capitulum of humerus articulate with radius by Humeroradial joint Medial Trochlea of humerus articulate with ulna by Humeroulnar joint Proximal radioulnar joint (shared synovial cavity) between humeroradial and humeroulnar joint
62
What is the carrying angle?
long axis of arm and forearm forms a carrying angle of 160 to 170 degrees more pronounced in women
63
What movement of the arm makes the carrying angle ' disappear'?
Disappears when extended arm is pronated
64
What is the carrying angle used to dx?
Turner's syndrome
65
What ligaments stabilizes the elbow joint?
Capsule is thickened on either side to form collateral ligaments >>only allow flexion/ extension Ulnar collateral ligament – 3 bands: anterior, transverse, posterior Radial collateral ligament: not attached to radius but to annular ligament >> allows independent rotation of radius
66
What is the axis between humeral epicondyles and olecranon when the arm is extended/ flexed?
- Extended: straight line - Flexed: equilateral triangle To assess dislocation, fracture
67
What does the axis of pronation and supination of arm pass through?
Axis passes through Centre of radial head and Base of styloid process of ulna During pronation and supination: Ulna does not rotate, Radius rotates and crosses over (carries wrist and hand with it)
68
Describe the Proximal radioulnar joint structure?
synovial pivot joint Head of radius rotates within complete circle formed by: Radial notch of ulna + Annular ligament (attaches to radial collateral ligament then to radius)
69
What stabilizes the proximal radioulnar joint?
Quadrate ligament
70
Describe the structure of Distal radioulnar joint?
Synovial pivot joint between head of ulna and ulnar notch of radius Triangular articular disc at distal end of ulna helps bind the radius and ulna together
71
Describe the structure of wrist radiocarpal joint?
synovial ellipsoid joint Anterior Concave surface = radius + triangular articular disc (cartilage) *Ulna isn't involved* Inferior Convex surface = 3 carpal bones in proximal row (no pisiform): Scaphoid, Lunate, Triquetral
72
What stabilizes the wrist radioulnar joint?
Capsule thickens to form radial and ulnar collateral ligaments (like elbow joint)
73
Describe the ROM of abduction and adduction of wrist radioulnar joint?
- Abduction (15o): restricted by Scaphoid carpal bone - Adduction (45o): radial styloid process lies 1-1.5cm lower than ulnar styloid process = more space on ulnar side, restricted by pisiform bone
74
Describe the ROM of flexion and extension of wrist radioulnar joint?
Flexion (80-90o) Extension (~70o): less free Wrist joint and intercarpal joints are both involved
75
What are the 5 types of joints in the hand?
``` Intercarpal Carpometacarpal Intermetacarpal Metacarpophalangeal Interphalangeal ```
76
Which intercarpal joints are involved in the flexion and extension of the wrist?
Midcarpal joint between the proximal and distal rows of carpal bones
77
Describe the structure of the carpometacarpal joints (CMC)?
Digit II to V = synovial plane joint Thumb = Synovial SADDLE joint (greater ROM, allows flexion, extension, abduction, adduction, rotation, opposition)
78
What ROM does opposition of thumb involve?
Opposition = combination of abduction, flexion, medial rotation Saddle joint of thumb + relatively mobile 4th and 5th CMC joints are involved
79
What type of joint are Intermetacarpal joints?
Synovial plane joints
80
What type of joints are Metacarpophalangeal joints?
synovial ellipsoid / condylar joints
81
Describe the ROM of MCP joints?
Can abduct and adduct only when joint is extended (when collateral ligaments are slack) Flexion = collateral ligament is taut = stabilize joints on 2 sides
82
Describe the interphalangeal joint structure and ROM?
Synovial hinge joints allowing flexion and extension only
83
How many interphalangeal joints are there in the hand?
Thumb = 1 joint, proximal and distal phalanges Digit II to V = 2 joints, Proximal interphalangeal joint (PIP) & Distal interphalangeal joint (DIP) separating proximal, middle and distal phalanges

MBBS II MSS (31 decks)

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