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WEEK 23:
Introduction to the upper limb I:
| Question | Answer |
|---|---|
| if a muscle crosses a joint it must | act on that joint |
| skeletal muscles can only | pull (NOT PUSH) |
| Hilton's law | joint tends to be innervated by a branch of a nerve which also supplies a muscle extending and acting across the joint. Another branch of the nerve often supplies the overlying skin. |
| 4 main regions of the upper limb | shoulder, arm/ brachium, forearm/ antebrachium, and hand |
| conoid ligament and trapezoid ligament | are medial and lateral parts of the coracoclavicular ligament |
| angles of the scapula | superior, inferior and lateral angles |
| borders of the scapula | superior, medial, and lateral borders |
| supination muscles in radio-ulnar joints (2) | supinator and biceps brachii |
| types of glenohumeral dislocation/ shoulder dislocation | anterior (95%), posterior, and inferior glenohumeral joint dislocation/ shoulder dislocation |
| all muscles in the glenohumeral joint (3) | axio-appendicular muscles (indirect action), scapulohumeral muscles (direction action), and shunt muscles (other) |
| other muscles (apart from indirect and direct action muscles) in glenohumeral joint | shunt muscles |
| joints in the shoulder region (3) | sternoclavicular, acromioclavicular, and glenohumeral |
| sternoclavicular type of joint | saddle type of synovial joint functioning as a ball and socket joint |
| acromioclavicular type of joint | plane type of synovial joint |
| glenohumeral type of joint | ball and socket type of synovial joint |
| sternoclavicular articulation | sternal end of the clavicle articulates with manubrium and 1st costal cartilage |
| sternoclavicular ligaments (3) | anterior and posterior sternoclavicular ligament (anteriorly and posteriorly), interclavicular ligament (superiorly), and costoclavicular ligament (inferiorly) |
| sternoclavicular muscles and movement | muscles dont directly act on this joint and movements closely mimic the reciprocal movements of the scapula (extension/ circumduction 45* backwards up till 180* upwards) |
| acromioclavicular articulation | acromial end of clavicle articulates with acromion of scapula |
| acromioclavicular ligaments (3) | coracoclavicular ligament, acromioclavicular ligament, and coraco-acromial ligament |
| acromioclavicular muscles | no muscles connect the articulating bones to move the AC joint BUT axio-appendicular muscles that attach to and move the scapula cause the acromion to move on the clavicle |
| movements of acromioclavicular joint | elevation/ depression from posterior view, protraction/retraction in superior view, and upward rotation/ downward rotation (eg raising hand) from posterior view |
| glenohumeral muscles which cause direct action | scapulohumeral muscles |
| AC joint dislocation | aka shoulder separation usually caused by direct trauma (FOOSH injuries) |
| glenohumeral articulation | humeral head articulates with glenoid cavity of scapula |
| glenohumeral ligaments (3) | Glenohumeral ligament, Coracohumeral ligament, and Transverse humeral ligament |
| glenohumeral muscles which cause indirect action | axio-appendicular muscles |
| movements of GH joint (6) | abduction and adduction (up to 90*), flexion and extension, lateral and medial rotation |
| glenohumeral joint dislocation | aka shoulder dislocation split into different types (anterior- 95%, posterior and inferior shoulder dislocation) |
| radius location when supine | lateral to body when supine |
| ulna location when supine | medial to body when supine |
| chief extensor muscles in elbow joint (1) | triceps brachii |
| chief flexor muscles in elbow joint (2) | brachialis and biceps brachii |
| elbow joint type | hinge type of synovial joint |
| elbow joint articulation (2) | humero-ulnar and humero-radial articulations |
| elbow joint ligaments (2) | Radio collateral ligament and Ulnar collateral ligament |
| elbow joint muscles | Chief flexors – brachialis and biceps brachii. Chief extensor – triceps brachii. |
| pronation muscles in radio-ulnar joints (2) | pronator quadratus and pronator teres |
| elbow joint movement | flexion and extension |
| dislocation of elbow joint | commonly due to FOOSH injuries with the most common being posterior dislocations (90%) where radius and ulna displaced behind humerus, head of radius and coronoid process can be fractures and ulnar nerve at risk of injury |
| radio-ulnar joint type | pivot type of synovial joint |
| radio-ulnar joint articulation | proximal (head of radius articulates with radial notch of ulna) and distal (rounded head of ulna articulates with ulnar notch on medial side of distal end of radius) - basically top and bottom link |
| radio-ulnar joint ligaments (2) | proximal (annular ligament) and distal (anterior and posterior distal radio-ulnar ligaments which strengthen fibrous layer of joint capsule) |
| radio-ulnar joint muscles | Supination (supinator and biceps brachii) and Pronation (pronator quadratus and pronator teres) |
| radio-ulnar joint movement (2) | supination and pronation |
| subluxation of radial head | aka pulled elbow or nursemaid elbow mostly in children where radial head slips out of annular ligament |
| pneumonic to remember carpal bones (wrist bones) | so long to pinky here comes the thumb |
| carpal bones (8) | scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, and trapezium |
| wrist joint (radio carpal) type of joint | condyloid (ellipsoid) type of synovial joint in wrist |
| wrist joint (radio carpal) articulation | distal end of radius and articular disc of distal radio-ulnar joint articulate with proximal row of carpal bones (except for pisiform) |
| wrist joint (radio carpal) ligaments (4) | Supination – palmar radiocarpal ligaments. Pronation – dorsal radiocarpal ligaments. Medially – ulnar collateral ligament. Laterally – radial collateral ligament. |
| wrist joint (radio carpal) movement produced primarily by | movement at wrist produced primarily by the 'carpi' muscles of the forearm |
| wrist joint (radio carpal) movement (4) | extension (dorsiflexion) and flexion of wrist , abduction and adduction and wrist |
| colles fracture | distal radial fracture with dorsal angulation which is common in the elderly (eg osteoporosis) and secondary to FOOSH injuries (wrist up for a high five) |
| smoth fracture | distal radius fracture with volar angulation caused by fall on a flexed wrist (wrist down like swatting a fly) |
| intercarpal joint of the hand type of joint | plane synovial joint |
| intercarpal joint of the hand - articulation types and joints | joints between proximal carpals, joints between distal carpals, midcarpal joint (between proximal and distal carpal rows) and pisotriquetral (articulation of pisiform with palmar surface of triquetrum) |
| intercarpal joint of the hand ligaments (3) | anterior, posterior, and interosseous ligaments (which unite carpals) |
| carpometacarpal (CMC) joint of thumb | saddle joint |
| carpometacarpal (CMC) and intermetacarpal (IM) type of joint | plane type of synovial joint EXCEPT for carpometacarpal (CMC) joint of the thumb (which is a saddle joint) |
| carpometacarpal (CMC) and intermetacarpal (IM) articulation | CMC – distal row of carpals articulate with metacarpals. CMC joint of thumb – trapezium and base of 1st metacarpal. IM – adjacent metacarpals articulate with each other. |
| ligaments around the CMC joints | palmar and dorsal |
| metacrapophalangeal (MCP) and interphalangeal (IP) type of joint | condyloid type of synovial joint in hand |
| metacrapophalangeal (MCP) and interphalangeal (IP) articulation | MCP heads articulate with bases of phalanges, and IP heads articulate with more distal IP heads |
| metacrapophalangeal (MCP) and interphalangeal (IP) ligaments (4) | medial and lateral collateral ligaments mainly reinforce these joints, and there are palmar and deep transverse metacarpal ligaments |
| common musculoskeletal (MSK) injuries (6) | Fracture of the surgical neck of humerus Scaphoid fracture FOOSH injuries Rotator cuff tears Frozen shoulder Tennis elbow and student elbow |
| ligaments between metacarpals | interosseous IM ligaments |
| types of distal metacarpal ligaments (2) | superficial and deep transverse metacarpal ligaments |
Created by:
kablooey
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