Lecture 10 Flashcards
1
Q
A physiological joint (no true articulation)
A
scapulothoracic joint
2
Q
Movements of this joint is provided by the muscles attached to scapula ( subscapularis & serratus anterior)
A
scapulothoracic joint
3
Q
Any movement at the scapulothoracic joint will result in movement of which two joints?
A
acromioclavicular and sternoclavicular
4
Q
Provides a movable base for the Humerus, hence increasing arm ROM at shoulder joint
A
scapulothoracic joint
5
Q
Helps deltoid function with proper tension with arm above 90 degrees
A
scapulothoracic joint
6
Q
Provides Glenohumeral stability for overhead work
A
scapulothoracic joint
7
Q
Absorbs shocks to outstretched arms
A
scapulothoracic joint
8
Q
What are the movements of the scapulothoracic joint?
A
- Protraction (spine)
- Retraction (spine)
- Elevation (ribcage)
- Depression (ribcage)
- Upward rotation (scapula)
- Downward rotation (scapula)
9
Q
What are the articular surfaces of the sternoclavicular joint?
A
- Facet on the medial end of the clavicle (aka sternal facet)
- Facet on manubrium of sternum
10
Q
What type of joint is the sternoclavicular joint?
A
modified saddle
11
Q
What is the only synovial connection of the upper limb to the axial skeleton?
A
sternoclavicular joint
12
Q
What are the 3 main ligaments of the sternoclavicular joint?
A
- Sternoclavicular: reinforce joint capsule front & back
- Interclavicular: reinforce joint superiorly
- Costoclavicular: anchor clavicle to first rib
13
Q
What are the movements of the sternoclavicular joint?
A
- elevation of clavicle
- depression of clavicle
- protraction
- retraction
- rotation of clavicle
14
Q
With scapular protraction, the clavicle?
A
retracts
15
Q
With scapular retraction, the clavicle?
A
protracts
16
Q
The clavicle rotates posteriorly when the arm?
A
abucts
17
Q
The clavicle rotates anteriorly when the arm?
A
adducts
18
Q
What are the articular surfaces of the acromioclavicular joint?
A
- Facet on the lateral end of the clavicle (aka acromial facet)
- Facet on the medial end of the acromion
19
Q
What type of joint is the acromioclavicular joint?
A
plane synovial joint
20
Q
What movement does the acromioclavicular joint have?
A
slide and glide
21
Q
Acromioclavicular joint moves as a result of?
A
scapular movement
22
Q
What are the ligaments associated with the acromioclavicular joint?
A
- acriomioclavicular ligament
- trapezoid ligament
- conoid ligament
23
Q
A strong fibrous band that reinforces the superior aspect of the acromioclavicular joint
A
acriomioclavicular ligament
24
Q
Extends from the coracoid process of the scapula to the trapezoid line on the inferior lateral end of the clavicle
A
Trapezoid Ligament
25
Extends from the base of the coracoid process of the scapula to the conoid tubercle on the inferior aspect of the lateral clavicle
Conoid Ligament
26
The trapezoid and the conoid ligaments make up the?
Coracoclavicular Ligament
27
Anchors the lateral end of the clavicle and prevents superior dislocation of the AC joint
Coracoclavicular Ligament
28
What are the articular surfaces of the glenohumeral joint?
- glenoid fossa of the scapula
- the head of the humerus
29
What are the articular surfaces covered by in the glenohumeral joint?
hyaline cartilage
30
What type of joint is the glenohumeral joint?
ball & socket synovial joint (multi-axial – 3 degrees of freedom)
31
What are the movements of the glenohumeral joint?
- Flexion/extension
- Adduction/abduction
- Internal/external rotation
- Circumduction
32
The head of the humerus is much __ than the glenoid cavity, only approximately __ of the head of the humerus fits into the glenoid fossa
larger; 1/3
33
A ring of fibrocartilage attached to the margins of the glenoid cavity
Glenoid Labrum
34
What widens and deepens the glenoid cavity allowing articular surfaces to be congruent?
glenoid labrum
35
Where does the capsule of the glenohumeral joint attach?
to the margins of the glenoid cavity medially and to the anatomical neck of the humerus laterally
36
What covers the capsule of the glenohumeral joint?
covered from inside by the synovial membrane
37
Anteriorly the glenohumeral joint capsule is reinforced by 3 supplemental bands called the?
superior, middle and inferior glenohumeral ligaments
38
Bridges the upper part of the bicipital groove of the humerus (between the greater and lesser tubercles), converts the intertubercular groove into a canal, and functions as a ‘retinaculum’ for the tendon of the long head of the biceps brachii, holding the synovial sheath and tendon in place during glenohumeral movements
transverse humeral ligament
39
From the coracoid process of the scapula to the greater tubercle of the humerus. (Intrinsic Ligament)
coracohumeral ligament
40
An extrinsic, protective structure formed by the smooth inferior aspect of the acromion and coracoid processes of the scapula,
coracoacromial arch
41
What bridges the gap between protective structure formed by the smooth inferior aspect of the acromion and coracoid processes of the scapula?
coracoacromial ligament
42
This arch overlies the head of the humerus, preventing its superior displacement from the glenoid cavity
Coracoacromial arch
43
What are the three bursa surrounding the glenohumeral joint?
- subacromial bursa
- Subdeltoid bursa
- subscapular bursa
44
Which bursa is between acromion and the tendon of the supraspinatus muscle?
subacromial bursa
45
Facilitates movements of the supraspinatus tendon under the coracoacromial arch and of the deltoid over the fibrous capsule and greater tubercle of the humerus
Subacromial bursa
46
Where is the subdeltoid bura?
between deltoid & fibrous capsule
47
Where is the subacromial bursa subject to impingement?
beneath arcomial arch
48
What are the degrees of flexion and extension of the glenohumeral joint?
- Extension: 45° to 50°.
- Flexion to 180°
49
Adduction (in the frontal plane starting from position of reference) of the glenohumeral joint is only possible when combined with?
- extension
- flexion
50
The joint capsule is very loose and permits free movements. It is least supported inferiorly where dislocation commonly occurs. Such a dislocation may damage the closely related axillary nerve.
The capsular ligaments
51
What plane is flexion and extension in?
sagittal plane
52
What plane is adduction and abduction in?
coronal/frontal
53
What axis does rotation occur in?
longitudinal
54
What is the degree of medial and lateral rotation of the glenohumeral joint?
- Lateral rotation: to 80°
- Medial rotation: to 95°
55
What axis does horizontal adduction and abduction of the shoulder joint take place?
vertical axis
56
What are the degrees of horizontal adduction and abduction in the glenohumeral joint?
- Horizontal adduction: range 140
- Horizontal abduction : range 30°
57
What muscles are involved in horizontal adduction?
Ant. deltoid, subscapularis, pectoralis major, pectoralis minor, serratus anterior, coracobrachialis, and short H. of biceps
58
What muscles are involved in horizontal abduction?
Post. deltoid, infraspinatus, teres major, teres minor, rhomboid muscles, trapezius, latissimus dorsi
59
What 3 joints are a part of the elbow complex?
- Humero-ulnar (Trochlea of humerus articulates with the trochlear notch of the ulna)
- Humero-radial (Capitulum of humerus articulates with the head of the radius
- Proximal Radio-ulnar
60
What joints do we typically think of as “elbow” joint?
humero-ulnar and humero-radial
61
What type of joint is the elbow joint?
synovial hinge (one degree of freedom)
62
What movements does the elbow joint permit?
flexion and extension
63
Why is the elbow joint a very strong joint structurally?
due to the bony configuration (primarily between the humerus and ulna) and the collateral ligaments (radial collateral and ulnar collateral ligaments).
64
What are the articular surfaces of the humerus in the elbow joint?
- trochlea (medial)
- capitulum (lateral)
65
What are the articular surfaces of the ulna and radius in the elbow joint?
- the trochlear notch of the ulna, which articulates with the trochlea and has corresponding shape
- head of radius (fovea)
66
What receives the olecranon process during extension?
olecranon fossa
67
What does the capsule of the elbow joint house?
- the true elbow joint
- superior radioulnar joint
68
Where can the axis of motion of the elbow joint be located?
on humans slightly distal to the epicondyles of the humerus (not horizontal)
69
With the elbow at full extension and the forearm supinated (i.e. anatomical position), the forearm deviates laterally in relation to the humerus; this is the?
Carrying angle
70
The trochlea extends more distally than the capitulum; hence the axis for flexion and extension is not?
fully perpendicular to the humeral shaft
71
What are the ranges of motion of the carrying angle?
5-19 degrees
72
Typically __ have a more pronounce carrying angle by 0 - 6 degrees, due to the wider pelvic girdle exhibited in __
women
73
What is the purpose of the carrying angle?
permits arm to be swung without contacting the hips
74
Common deformity in which the extended forearm is deviated towards midline of the body
Cubitus varus
75
Deformity of a limb in which part of it is deviated towards the midline of the body
varus
76
Medical deformity in which the elbow is turned in
Cubitus valgus
77
What is the main function of the elbow joint ligaments?
keep the articular surfaces in apposition
78
What are the ligaments of the elbow joint?
- medial (ulnar) collateral ligament)
- lateral (radial) collateral ligament)
79
What ligaments will also keep the half-ring fitted to the pulley and prevent all sideways movements in the elbow joint?
- medial (ulnar) collateral ligament)
- lateral (radial) collateral ligament)
80
What strengthens the capsule of the elbow joint?
- anterior ligament
- oblique anterior ligament
81
What muscle does extension of the elbow depend?
triceps brachii (aconeus exerts minor action)
82
What is the strongest head of the triceps brachii?
lateral
83
What are the 3 major flexor muscles of the elbow joint?
- brachialis
- brachioradialis
- biceps brachii
84
What is the degree of active elbow flexion?
145
85
What is the degree of passive elbow flexion?
160
86
Who may have hyperextension of 5-10 degrees of the elbow complex?
women and children
87
What type of joint is the superior radio-ulnar joint?
synovial pivot joint
88
What is the movement of the superior radio-ulnar joint?
rotation
89
What are the 2 cylindrical surfaces of the superior radio-ulnar joint?
- head of radius (cupped surface of head (fovea))
- fibro-osseous ring (radial notch of ulna + annular ligament)
90
Strong fibrous band attached by its ends to the anterior and posterior margins of the radial notch of the ulna and lined internally by cartilage continuous with that lining the radial notch
annular ligament
91
What are the articular surfaces of the inferior radio-ulnar joint?
- head of ulna
- ulnar notch of radius
92
What type of joint is the inferior radio-ulnar joint?
synovial pivot joint (one degree of movement)
93
What is at the distal edge of the ulnar notch?
articular disc
94
What is the articular disc of the inferior radio-ulnar joint attached to?
base of styloid process of the ulna
95
What is the purpose of the articular disc of the radio-ulnar joint?
bind the radius & ulna together & separate the distal radioulnar joint & ulna from radiocarpal joint
96
What are the proximal and distal surfaces of the disc covered by?
articular hyaline cartilage
97
What ligaments support the inferior radio-ulnar joint anteriorly and posteriorly?
palmar (anterior) and dorsal (posterior) radioulnar ligaments
98
A ligament connection, lies between the bodies of the radius and ulna.
interosseous membrane
99
What type of joint is the middle radioulnar joint?
amphiarthrosis, syndesmosis joint
100
What muscles act on the radio-ulnar joint?
- biceps
- supinator
- pronator quadratus
- pronator teres
101
What is the degree of supination of the radio-ulnar joint?
90
102
What is the degree of pronation of the radio-ulnar joint?
80
103
Can you squeeze your fist maximally without contracting your triceps brachii?
No:
- To stabilize the elbow (not waste energy in elbow movement)
- To stabilize the proximal attachments of the finger and wrist muscles
104
What joints are a part of the articular complex of the wrist?
- radio-carpal joint
- mid-carpal joint
- intercarpal joints
105
Where is the radio-carpal joint?
b/w distal end of radius, disc of distal radiocarpal joint, & proximal row of carpal bones (except pisiform)
106
What type of joint is the raido-carpal joint?
condyloid (ellipsoid) joint
107
What are the movements of the radio-ulnar joint?
- adduction/abduction
- flexion/extension
108
What type of joint is the mid-carpal joint?
synovial planara joint
109
What are the movements of the mid-carpal joint?
slide and glide
110
Where is the mid-carpal joint?
b/w proximal and distal rows of carpal bones (except pisiform)
111
Where are the intercarpal joints?
b/w the proximal or distal carpal bones
112
What type of joint are the intercarpal joints?
synovial planar joints
113
What are the two groups of ligaments of the radio-carpal joint?
- collateral ligaments
- anterior & posterior ligaments
114
What is the lateral collateral ligamentof the wrist attached to?
attached to the styloid process of the radius and the scaphoid bone
115
What is the medial collateral ligament attached to?
styloid process of ulna and the pisiform and triquetrum bones
116
What are the anterior and posterior ligaments of the radio-carpal joint?
- posterior and anterior radio-carpal ligament
- posterior and anterior ulno-carpal ligament
117
What ligament becomes "taut" during adduction of the radio-carpal joint?
lateral (radial) collateral ligament
118
What ligament becomes "taut" during abduction of the radio-carpal joint?
medial (ulnar) collateral ligament
119
What ligament becomes "taut" with flexion of the radio-carpal joint?
posterior ligament
120
What ligament becomes "taut" with the extension of the radio-carpal joint?
anterior ligament
121
Where is the axis of abduction and adduction of the radio-carpal joint?
capitate, located proximally to base of MC III
122
What is the degree of radial deviation of the radio-carpal joint?
15
123
What is the degree of ulnar deviation of the radio-carpal joint?
30
124
In general the range of abduction and adduction is __ when the wrist is fully flexed or extended, because of the tension developed in carpal ligaments
minimal
125
What is the degree of wrist flexion and extension at the radiocarpal joint?
85
126
Which muscles are involved in wrist flexion?
- Flexor Carpi Radialis
- Flexor Carpi Ulnaris
- Palmaris Longus
- Flexor Digitorum Superficialis
- Flexor Digitorum Profundus
- Flexor Pollicis Longus
127
Which muscles are involved in wrist extension?
- Extensor Carpi Radialis Longus
- Extensor Carpi Radialis Brevis
- Extensor Carpi Ulnaris
- Extensor Digitorum
- Extensor Digiti Minimi
- Extensor Pollicis Longus
- Extensor Pollicis Brevis
- Extensor Indicis
128
Which muscles are involved in wrist adduction?
- Flexor Carpi Ulnaris
- Extensor Carpi Ulnaris
129
Which muscles are involved in wrist abduction?
- Flexor Carpi Radialis
- Extensor Carpi Radialis Longus
- Extensor Carpi Radialis Brevis
- Abductor Pollicis Longus
- Extensor pollicis longus (weak)
- Extensor pollicis brevis (weak)
130
What type of joint is the carpometacarpal joint I?
synovial saddle joint (3 DOF)
131
Where is carpometacarpal joint I located?
between 1st metacarpal and trapezium
132
What are the movements of the carpometacarapl joint I?
- abduction/adduction (in a right angle to palm)
- flexion/extension (parallel to palm)
- opposition (rotation of 1st metacarpal on trapezium)
- 15-20 degree rotation
133
T/F: A common joint cavity is found between the four distal carpals, the CMC joints, and into the intermetacarpal joints
True
134
Which carpometacarpal joints (2-5) has the least degree of motion? Which has the most? Middle?
- 2nd & 3rd = least (2 or less)
- 4th = middle (10-15)
- 5th = most (25-30)
135
What type of joint are the metacarpophalangeal joints?
synovial condyloid joints
136
Where are the metacarpophalangeal joints?
b/w heads of metacarpal bones & base of proximal phalanges of digits
137
How many DOF does metacarpophalangeal joints have?
2
138
What attaches the heads of the metacarpals to the bases of the phalanges?
medial & lateral collateral ligaments
139
What supports the metacarpophalangeal joints ventrally?
palmar plates (ligaments)
140
When the metacarpophalangeal joints are in 90 degrees flexion, which ligaments are 'taut'?
collateral ligaments
141
What are the two interphalangeal joints?
- proximal interphalangeal joints
- distal interphalangeal joints
142
Which digit only has one IP joint?
1 (thumb)
143
What type of joints are IP joints?
hinge (1 DOF)
144
In full flexion and extension, the MCP joint of the thumb cannot perform?
any significant abduction or adduction due to the tightening of surrounding joint ligaments
145
in semiflexion of the thumb, how much adbuction/adduction can occur?
approx. 5-10 degrees
146
What are the extrinsic muscles of the digits?
- Extensor Digitorum
- Extensor Indicis
- Extensor Digiti Minimi
- Extensor Pollicis Longus
- Extensor Pollicis Brevis
- Abductor Pollicis Longus
- Flexor Digitorum Superficialis
- Flexor Digitorum Profundus
- Flexor Pollicis Longus
147
What are the intrinsic muscles of the digits?
Central muscles
- Four Lumbricals
- Three Palmar Interossei
- Four Dorsal Interossei
- Adductor Pollicis
Thenar Muscles:
- Opponens Pollicis
- Abductor Pollicis Brevis
- Flexor Pollicis Brevis
Hypothenar Muscles:
- Opponens Digiti Minimi
- Abductor Digiti Minimi
- Flexor Digiti Minimi Brevis
- Palmaris brevis
148
Which muscles flex digits 2-5?
- FDS
- FDP
- Lumbricals
- Dorsal interossei
- Palmar interossei
- Flexor digiti minimi
149
Which muscles extend digits 2-5?
- Ext. digitorum
- Ext. digiti minimi
- Ext. indicis
- Lumbricals
- Dorsal interossei
- Palmar interossei
150
Which muscles abduction digits 2-5?
- Dorsal interossei
- Abductor digiti minimi (digit V)
151
Which muscles adduct digits 2-5?
- palmar interossei
152
Which muscles oppose digits 5?
- opponens digiti minimi
153
Which muscles flex the thumb?
- FPL
- FPB
154
Which muscles extend the thumb?
- EPL
- EPB
155
Which muscle adducts the thumb?
adductor pollicis
156
Which muscles abduct the thumb?
- abductor pollicis longus
- abductor pollicis brevis
157
Which muscle opposes the thumb?
- opponens pollicis
158
