Topic 4 Flashcards
list the bones that make up the wrist joint complex
scaphoid
lunate
triquetrum - pisiform
trapezium
trapezoid
capitate
hamate
radiocarpal joint
synovial, biaxial, ellipsoid
movements - flex/ex, abduction/adduction
articular surfaces - proximal surface of the scaphoid, lunate and triquetral and distal surface of radius.
joint capsule - attaches to the articular margins of bones and reinforced by capsular ligaments at sides, anteriorly and posteriorly.
synovial membrane - usually restricted to radiocarpal joint, sometimes communicates with synovial cavity of inferior RU joint.
TFCC
explain what the TFCC is and does
triangular fibrocartilage complex - ligamentous and cartilaginous complex of structures. Formed by the triangular fibrocartilage (articular disc) and ligaments ulnotriquetral, ulnolunate, palmer and dorsal radioulnar ligaments and ulnar collateral ligament.
function - stabilises distal and radioulnar joints, transmits and distributes loads from carpal bones to ulnar, and facilitates complex movements of the wrist.
commonly injured by acute or repetitive loading in an extended position wrist.
ligaments of the radiocarpal joint
are all capsular ligaments
collateral ligaments - radial collateral limits adduction and ulnar collateral limits abduction.
dorsal and palmer ligaments - fibres generally run inferiorly and medially ensuring the carpal move with the ulnar and radius during pronation and supination.
dorsal - limits flexion and palmer - limits extension.
mid-carpal joint
synovial, biaxial, condyloid
movements - flex/ex in transverse axis and AB/AD in anteroposterior axis.
articular surfaces - distal surfaces of scaphoid, lunate and triquetral and proximal surfaces or trapezium, trapezoid, capitate and hamate.
articular capsule - attaches to articular margins of bones, reinforced by capsular ligaments at sides, anteriorly and posteriorly.
synovial membrane and cavity - cavity is complex, extensive and irregular, may extend distally between bones of distal row (therefore therer is some communication between midcarpal joint and distal joints).
ligaments of midcarpal joint
all ligaments are capsular
collateral ligaments same as radiocarpal joint
dorsal and palmer intercarpal - fibres of the palmer intercarpal ligaments converge on capitate, dorsal limits flexion and palmer limits extension.
movements of the radiocarpal and midcarpal joint
in both RC and MC joint contribute to flexion/extension range
in adduction the RC joint contributes more than the MC.
in abduction the MC contributes more than the RC.
intercarpal joints
Synovial, mostly multi-axial, plane - only has slight movement
connected by extensive array of ligaments
flexor retinaculum acts as an accessory intercarpal ligament
most commonly injured ligament = the scapholunate ligament - its function is to prevent lunate dislocating from scaphoid.
common carpometacarpal joint
synovial, multiaxial, plane
increased mobility as you move laterally to medially.
2nd CMC = least mobile??
5th CMC = most mobile - less articulations.
joint capsule attaches to articular margins, one common cavity usually communicates with midcarpal joint cavity.
l
ligaments of common carpal joint
dorsal and palmer CMC ligaments
commonly two bands to each metacarpal
dorsal - limits flexion
palmer - limits extension
carpometacarpak joint - thumb
synovial, biaxial, saddle
movements:
- flex/ext in AP axis
- AB/AD in transverse axis
- opposition in longitudinal axis (combination of ad,ab and flex.ext).
articular capsule - attaches to articular margins, relatively loose because is needs to be mobile.
ligaments
posterior and anterior oblique ligament - tension in these ligaments help pull the thumb into/out of conjuct rotation.
metacarpophalangeal joint
synovial, biaxial, condyloid
movements - flex/ext and AB/Ad
articular surfaces - base of MC and head of adjacent phalanx.
ligaments:
- collateral ligametns - limit flexion and prevent Add/Abd in flexion.
- palmer ligaments - fibrocartilage plate forms part of articular surfaces, limits extension, grooved to house long flexor tendons.
- deep transverse MC ligaments - keep y MC heads together, particularly important for weight bearing.
interphalangeal joint
synovial, uniaxial, hinge
movements - flexion/extension
ligaments - collateral - limit flexion and palmer - limit extension.
