Upper Limb - Bones and Joints

  • What bones make up the shoulder girdle? Which make up the different portions of the upper limb?

    • Shoulder Girdle: Clavicle and Scapula

    • Arm: Humerus

    • Forearm: Radius and Ulna

    • Wrist: Carpals (8)

    • Hand: Metacarpals and Phalanges

  • Know each bone, its general information, what joints it interacts with, what features go with which bone, and any information listed for each feature. Specific questions are listed below (not comprehensive):

    • Where is the only point of contact between the upper limb and axial skeleton?

      • Clavicle

        • Occurs at the sternoclavicular joint.

    • Which end of the clavicle articulates medially? Laterally?

      • Sternal end (rounded) Medial

        • Articulates with manubrium of sternum at sternoclavicular joint.

      • Acromial End (Flattened) Lateral

        • Articulates with acromion of scapula at acromioclavicular joint.

    • Which bone typically breaks in a FOOSH fracture? What is a FOOSH fracture?

      • Fallen on an outstretched hand, and the clavicle normally gets fractured.

    • What are the attachments for the Trapezoid Line, Conoid Tubercle and Costal Tuberosity?

      • Trapezoid Line: Attachment for trapezoid ligament

      • Conoid Tubercle: Attachment for conoid ligament

      • Costal Tuberosity: Attachment for costoclavicular ligament

    • Which bone is also known as the shoulder blade?

      • Scapula

    • Which borders make up the superior angle of the scapula? Inferior angle?

      • Superior Angle: Medial Border and Superior border

      • Inferior Angle: Medial Border and Lateral Border

    • Which feature of the scapula articulates with the clavicle? With the humerus?

      • Acromion Process (clavicle)

      • Coracoid Process (Muscle attachment)

    • How is the posterior scapula split?

      • Due to the spine

    • What muscle associate with the various places on the scapula?

      • Supraspinous fossa: Supraspinatus m.

      • Infraspinous Fossa: Infraspinatus m.

      • Subscapular Fossa: Subscapularis m.

      • Glenoid Fossa: Articulation w/ humerus

    • Which bone(s) is/are found in the arm? Forearm?

      • Humerus (Arm):

        • Head: Smooth rounded superior end

          • Articulates with glenoid fossa at glenohumeral joint.

        • Anatomical Neck: Just distal to head

        • Surgical Neck: Where tubular shaft begins; common area of fracture.

        • Greater tubercle/ Lesser tubercle: Anchoring sites for mm. of the rotator cuff

        • Intertubercular groove: Long head of biceps brachii tendon

        • Deltoid Tuberosity: Lateral attachment of deltoid m.

    • What structure travels in the intertubercular groove?

      • Bicep brachii tendon

    • Which epicondyle of the humerus is more prominent?

      • Greater Tubercle

    • What are the names of the two condyles at the distal end of the humerus? Which is medial/lateral?

      • Medial/ Lateral epicondyles: Attachment for forearm mm.

      • Medial epicondyle fore prominent

    • Which features of the humerus, ulna, and radius articulate at the elbow joint?

      • Capitulum: Articulates with head of radius (lateral)

      • Trochlea: Articulates with trochlear notch of ulna (medial)

      • Olecranon Fossa: Posterior depression for olecranon process of ulna

      • Coronoid Fossa: Anterior depression for coronoid process of ulna

    • Is the ulna medial or lateral? Is the radius medial or lateral?

      • Radius: Lateral (thumb)

      • Ulna: Medial (Pinky)

Radius and Ulna – Proximal End

  • Ulna:

    • Olecranon Process: Forms point of elbow.

    • Trochlear notch: Deep fossa that articulates with trochlea of humerus.

    • Coronoid Process: Anterior “lip” of the proximal ulna

    • Radial notch: indent where head of radius articulates

    • Ulnar/Brachialis tuberosity: attachment for brachialis m.

  • Radius:

    • Head: Articulates with capitulum of humerus & radial notch of ulna

    • Radial/ Bicipital tuberosity: attachment site of biceps brachii m.

    • Is the head of the radius proximal or distal? Is the head of the ulna proximal or distal?

      • Head of radius –

      • Head of ulna – distal end

    • Is the styloid process of the radius proximal or distal? What about the styloid process of the ulna?

      • Styloid process of radius and ulna – distal end

    • How many carpals are there?

      • 8

  • Which three carpal bones help make the carpal tunnel?

    • What are the names of the bones in the palm of the hand? How are they numbered?

      • Metacarpals

        • 5 total

        • Numbered I-V

          • Lateral to medial

          • Thumb to pinky

        • Knuckles

    • What are the names of the bones in the fingers? How many does the thumb have and what are their names? How many do the remaining fingers have and what are their names?

      • Phalanges

        • Singular: phalanx

        • Plural: Phalanges

        • 14 total

          • 5 proximal

          • 4 middle

          • 5 distal

  • Know the different joints of the upper limb. Know which bones/features articulate at each and any additional information mentioned for each.

    • Proximal

      • Sternoclavicular

        • Only point of bony connection b/w upper limb and axial skeleton

        • Sternal end of clavicle and manubrium

        • Strengthened by costoclavicular ligament

      • Acromioclavicular

        • Limited movement

        • Acromial end of clavicle and acromion

        • process

        • • Strengthened by:

          • Acromioclavicular ligament

          • Trapezoid ligament

          • Conoid ligament

      • Glenohumeral

        • A.k.a. shoulder joint

        • Ball-and-socket joint between head of humerus and glenoid fossa

        • Greatest freedom of movement of any joint in the body

          • Unstable: shallow glenoid fossa/large humeral head

        • Strengthened and stabilized by:

          • Glenoid labrum: cartilaginous lip attached to margin of glenoid fossa

          • What does this help do?

        • Strengthened and stabilized by:

          • Rotator cuff mm.: 4 muscles that surround shoulder joint

Pull head of humerus into glenoid fossa

  • Consists of:

Subscapularis m.

Supraspinatus m.

Infraspinatus m.

Teres minor m.

  • Elbow (humeroradial, humeroulnar, proximal radioulnar)

    • Humeroradial

      • Between head of radius and capitulum of humerus

      • Strengthened by lateral/radial collateral ligament

    • Humeroulnar Joint

      • Between trochlear notch of ulna and trochlea of humerus

      • Strengthened by medial/ulnar collateral ligament

    • Proximal radioulnar joint

      • Between head of radius and radial notch of ulna

      • Strengthened by annular ligament which wraps around head of radius

      • Why stabilize radial head?

    • Distal radioulnar

      • Produces movement of supination and pronation

      • Between head of ulna and ulnar notch of radius

    • Radiocarpal

      • A.k.a. wrist joint

      • Between distal end of radius and scaphoid/ lunate

    • Midcarpal

      • Between proximal and distal rows of carpals

    • Distal

      • Carpometacarpal

        • Between carpals and metacarpals

        • Little movement except for thumb • Wide range of motion

      • Metacarpophalangeal (MCP)

        • A.k.a. MCP joint

        • Between metacarpals and proximal phalanges

      • Interphalangeal (IP)

        • More commonly referred to as IP joint

        • Between phalanges

        • PIP joint

          • Between proximal/middle phalanges

        • DIP joint

          • Between middle/distal phalanges