L: Osteology and circulation of the upper limbs

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What shape is the clavicle?

S shaped

Which surface of the clavicle is smooth?

The superior surface

Which surface of the clavicle is rough?

The inferior surface

Which end of the clavicle is round?

The proximal end

Which end of the clavicle is flat?

The distal end

Is the conoid tubercle of the clavicle more proximal or more distal?

More distal

Are the ligaments of the sterno-clavicular joint strong or weak?

Very strong

What exists as part of the sternoclavicular joint?

An articular disc

What lines the sternoclavicular joint?

Fibrocartilage

What ligaments exist as part of the acromioclavicular joint?

• acromioclavicular ligament

• coracoclavicular ligament - trapezoid ligament, conoid ligament

What 3 angles does the scapula have?

superior, inferior and lateral

What 3 fossae does the scapula have?

Supraspinous, infraspinous and subscapular

What 3 borders does the scapula have?

Medial, lateral and superior

Where is the glenoid fossa located on the scapula?

Laterally (connects to the humerus)

Where is the spine of the scapula located?

Posteriorly

What does the suprascapular notch become on a patient?

Suprascapular foramen

What ligament is associated with the supra scapular notch?

Upper transverse scapular ligament

What are the two necks of the proximal humerus called?

Anatomical neck (angle), surgical neck (straight)

What are tubercles?

Protrusions

What are the names of the tubercles of the proximal humerus?

The greater tubercle and lesser tubercle

What is the indent between the two tubercles of the humerus called?

The inter tubercular sulcus

What are the lips of the intertubercular groove called?

The medial and lateral lips

What are the lumps and lines on the humerus for?

Muscle attachment

What is the glenohumoral joint capsule thickened by?

Ligaments

What are the three glenohumeral ligaments?

Superior, middle, inferior

What other ligaments help to form the glenohumeral joint?

• coracohumeral ligament

• transverse humeral ligament

• long head of biceps

What muscles are near the glenohumeral joint?

Rotator cuff muscles

What 4 bursae exist at the glenohumeral joint?

Subacromial (sub deltoid) SASD, subscapular, subcoracoid, coracobrachial

What would be affected from a mid shaft fracture of the humerus?

The spiral groove and the radial nerve could be damaged

What nerve would be damaged from a surgical neck fracture of the humerus?

Axillary nerve

What nerve would be affected from a supracodylar fracture of the humerus?

The median nerve

What nerve can be affected from a fractured “elbow”?

The ulnar nerve

What fossa does the trochlea of the humerus associate with?

The coronoid fossa

What fossa does the capitulum of the humerus associate with?

The radial fossa

What is the fossa on the posterior distal end of the humerus called?

Olecranon fossa

On which bone is the supinator crest located?

The ulna

What is the line extending from the radial tuberosity on the radius called?

The oblique line

What two joints make up the elbow joint?

Humero-ulnar joint and humero-radial joint

What joint does the elbow joint share a capsule with?

The proximal radio-ulnar joint

What ligament wraps around the proximal head of the radius?

The annular ligament

What ligament is affected in “pulled elbow”?

The annular ligament

What bursae exist at the elbow?

Olecranon bursae, deep intratendinous bursa, superficial subcutaneous bursa

What is Colles’ fracture?

A fracture of the distal end of the radius, causing a lump (back of the hand)

What type of joint is the “middle” radio-ulnar joint?

Syndesmosis - a fibrous joint

What type of disc exists at the distal radio ulnar joint?

A fibrous disc

What ligaments are involved in the distal radio ulnar joint and are they weak or strong?

Anterior and posterior radio-ulnar ligaments - weak

What recess aids the movement of the distal radio-ulnar joint?

Sacciform recess

Are the radius and ulnar crossed in supination or pronation?

Pronation

How many bones are there in the hand?

27

How many phalanges are there?

14

How many metacarpals are there?

5

What type of bone are metacarpals?

Long bones

How many carpals are there?

8

What type of bones are carpals?

8

Which carpal is sesamoid?

Pisiform

What carpal bones exist in the proximal row from thumb to pinky?

Scaphoid, Lunate, Triquetrum, Pisiform

What carpals exist in the distal row from thumb to pinky?

Trapezium, Trapezoid, Capitate, Hammate

Which bone is not involved in the wrist joint?

The ulna

How is the ulna separated from the wrist joint?

A fibrocartilage disc

Which ligaments are involved in the wrist joint?

Palmar and dorsal radio-carpal ligaments, palmar ulna-carpal ligaments, radial and ulnar collateral ligaments

What type of joints are intercarpal joints?

Plane joints

What movement occurs in intercarpal joints (plane joints)?

Sliding movements

What movement occurs at the midcarpal joint?

Abduction/extension

What type of joint is the pisiotriquetral joint?

A small specialised synovial joint

What type of joint is the first carpal-metacarpal joint?

Saddle joint

What type of joint are carpal-metacarpal joints 2-5?

Condyloid joints

What is notable about the carpal metacarpal joint capsule?

It is continuous - not including the 1st C-MC

What forms the roof of the carpal tunnel?

Flexor retinaculum

Where does the flexor retinaculum connect medially?

The hook of hamate and pisiform

Where does the flexor retinaculum connect laterally?

Tubercle of trapezium and scaphoid

What type of joints are metacarpal-phalangeal?

Condylar joints

What ligaments are involved in metacarpal-phalangeal joints?

Collateral and palmar ligaments

What type of joints are interphalangeal joints?

Hinge joints

What ligaments are involved in interphalangeal joints?

Collateral and palmar ligaments

What joints are intermetacarpal joints continuous with?

Carpal-metacarpal joints

What ligaments are involved in intermetacarpal joints?

Palmar, dorsal and interosseous ligaments

What movement can occur at interphalangeal joints?

Flexion and extension

What movements can occur and metacarpal-phalangeal joints?

Flexion and extension

Adduction and abduction

Which digit acts as the axis for movement?

The middle finger

What is flexion of the thumb?

Bringing it across the palm

What is abduction of the thumb?

Bringing it towards the forearm (like a lego hand)

Where does the right subclavian artery begin?

The brachiocephalic trunk

Where does the left subclavian artery begin?

The aortic arch

Where do the subclavian arteries end?

The lateral border of the 1st rib

What do the subclavian arteries become after the lateral border of the 1st rib?

The axillary artery

What are two relevant branches of the axillary artery?

• dorsal scapular artery

• supra scapular artery

Where does the axillary artery begin and end?

The lateral border of the 1st rib to the inferior of Teres major

Does the axillary artery cross anteriorly or posteriorly to the pectoralis minor?

Posteriorly

How many parts does the axillary artery split into?

3

Where does the 1st part of the axillary artery split?

Before pec. minor

Where does the 2nd part of the axillary artery split?

Behind pec. minor

Where does the 3rd part of the axillary artery split from the pec. minor?

After pec. minor

How many branches does part 1 of the axillary artery have?

1

How many branches does part 2 of the axillary artery have?

2

How many branches does part 3 of the axillary artery have?

3

What is the 1st branch off the axillary artery?

Superior thoracic artery

What are the two branches of the 2nd part of the axillary artery?

Thoraco-acromial artery and lateral thoracic artery

What are the 3 branches off the 3rd part of the axillary artery?

Subscapular artery, anterior circumflex humeral artery, posterior circumflex humeral artery

What arteries are involved in the scapular anastomosis?

• suprascapular artery

• subscapular artery

• dorsal scapular artery

• circumflex scapular artery (branch of the subscapular artery)