Elbow and Wrist

trochlear groove of the humerus

is where the ulna runs

radial tuberosity

insertion of biceps brachii

ulnar tuberosity

insertion of brachialis

Lister's tubercle

located on distal radius on dorsum, feels like a small longitudinal prominence

proximal transverse arch formed from...

distal carpals

proximal transverse arch:

- static and _________

- forms __________ tunnel

rigid

carpal

distal transverse arch is made up of..

heads of metacarpals

distal transverse arch:

- ______________ flexibility

- _______ objects

increased

grip

longitudinal arch

down the length of the hand

centered on the 2nd and 3rd metacarpals

longitudinal arch is ________ at the proximal end where it joins the wrist

stiff

why isn't the hand flat?

grip strength

shock absorption

increased grip contact (increased sensory feedback)

force distribution

humeroulnar joint (bones and landmarks, type, plane/axis, movement)

bones: trochlea of humerus and trochlear notch of the ulna

type: hinge - synovial

plane/axis: saggital/ML

movement: flexion/extension

humeroradial joint (bones and landmarks, type, plane/axis, movement)

bones: capitulum of humerus and radial head of radius

type: modified hinge - synovial

plane/axis: saggital/ML and transverse/longitudinal

movement: flexion/extension and pronation/supination

proximal radioulnar joint (bones and landmarks, type, plane/axis, movement)

bones: head of radius and radial notch of ulna

type: pivot - synovial

plane/axis: transverse/longitudinal

movement: pronation/supination

humeroradial joint is a limited...

ball and socket joint

compound synovial joint

all 3 joints are within the same synovial membrane and joint capsule

medial part of trochlea does not have a lot of contract with the humerus in full ________________

extension

in full _____________ the head of the radius doesn't have a lot of contact with the humerus

flexion

because of lack of contact only have about ____% stability under lateral stresses

50

carrying angle

The angle between the humerus and ulna when the arm is in anatomical position.

normal carrying angle

5-15 degrees away from line of humerus

cubitus valgus

angle over 15 degrees

head of humerus articulates very closely with humerus

cubitus varus

gunstock deformity

angle under 15 degrees

arthrokinematics at the elbow joint (OKC)

concave moving on convex

roll and glide in the same movement

arthrokinematics at the distal radioulnar joint

roll and glide in the same direction

arthrokinematics at the proximal radioulnar joint

supination: posterior rotation

pronation: anterior rotation

distal radioulnar (pivot - synovial)

- not much motion here

- _______ stabilized on __________

- head of ________ sitting in ulnar notch on __________

ulna/radius

ulna/radius

radiocarpal (wrist proper) - ellipsoid - synovial

flexion/extension

radial/ulnar deviation

circumduction

intercarpal joint type

plane (synovial)

carpometacarpal joint type

thumb = saddle

other = plane synovial

metacarphalangeal joint type

condyloid

flexion/extension and add/abduction

interphalangeal joint

hinge

flexion/extension

_________________ ligaments maintain integrity of a joint

collateral ligaments

extracapsular ligaments

medial collateral ligament

lateral collateral ligament

annular ligament

ulnar collateral ligament anterior band is strong and cord like:

taut during....

elbow full flexion and full extension

ulnar collateral ligament posterior band is weaker and fan shaped:

taut when...

elbow is flexed beyond 90 degrees (really flexed)

function of the transverse bands of the UCL

protects attachment points of the other two bands

radial tunnel

- extends from radial head to distal edge of supinator - radial nerve runs through

- common area for compression

cubital tunnel

medial epicondyle (top)

olecranon process (bottom)

cubital retinaculum (roof)

UCL posterior band (floor)

ulnar nerve

cubital fossa boundaries

medial: pronator teres

lateral: brachioradialis

superior: line connecting epicondyle

contents of cubital fossa

biceps tendon, brachial artery, medial nerve, radial nerve

interosseous membrane runs from proximal ___________ to distal __________

radius

ulna

Dorsal intercarpal ligament

dorsal radiocarpal ligament

dorsal radioulnar joint ligament

dorsal wrist and hand stabilizers

TFCC

ulnar collateral ligament

palmar ulnocarpal ligament

palmar radioulnar joint ligament

articular disc

distal radial collateral ligament (two segment)

attaches from the radial styloid process to the scaphoid bone and a portion of the trapezium

distal ulnar collateral ligament

attaches from the ulnar styloid process to the triquetrum and the pisiform

one band

function of the TFCC

- dorsal wrist stability against flexion and radial deviation

- takes some load off of the radius (disc portion)

- improve congruency in the joint

4 finger stabilizers

interphalangeal collateral ligaments (prevents medial and lateral forces)

palmar (volar) plate (prevents excessive extension)

dorsal capsule (orevents excessive flexion)

metacarpophalangeal collateral ligaments (prevents varus and valgus force to the fingers)

function of palmar aponeurosis

anchors skin to underlying structures

covers and protects long finger flexor tendons

ulnar: __________ side of palm

median: ____________ and ____________ side of palm

radial: most of the extensors

medial

middle/lateral

transverse carpal ligament is also known as

flexor retinaculum

flexor retinaculum: attaches from the hook of hamate and ___________ to the tubercle of the _________________ and tuberosity of the ________________

pisiform

trapezium

scaphoid

carpal tunnel

FDS, FDP, FPL, median nerve

extensor retinaculum: styloid process of the ulna , the pisiform and triquetrum to...

lateral border of radius

vascular anatomy in the hand

radial artery

ulnar artery

palmar arches

digital arteries