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85 Cards in this Set
- Front
- Back
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fibrous joints
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held together by fibrous connective tissue; synarthrosis: relatively immobile
eg: sutures connect flat bones in skull, gomphosis hold teeth in jaws, syndesmoses are interosseous membranes between long bones: forearm, leg |
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cartilaginous joints
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held together by hyaline or fibrocartilage; amphiarthrosis: somewhat moveable
eg: symphyses are fused: midline including intervertebral joints, symphysis pubis, sternomanubrial joints; synchondroses are mostly developing joints fused by hyaline cartilage which are fused and replaced by bone (synostosis) after maturation |
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synovial joint
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bones capped by hyaline cartilage, but separated by a space and linked by an articular capsul; freely moveable (diarthrosis) and are located throughout the body
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synovial cavity
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space within articular capsule
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synovial membrane
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tissue on inner surface of cavity that secretes synovial fluid
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articular disc
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fibrocartilage disc found in some synovial joints
eg knee, TMJ |
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sternoclavicular joint
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interclavicular ligament, costoclavicular ligament; articular disc prevents medial dislocation
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acromioclavicular joint
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coracoclavicular lig: trapezoid & conoid parts; coracoacromial lig.; limits upward movement of humerus
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clavicle
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supports scapula so arm can move down vertically; stabilizes shoulder during adduction of arm
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shoulder joint
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ball & socket joint between head of humerus & glenoid fossa (enlarged by glenoid labrum)
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capsule
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thin & loose, inferior part is the weakest area; aperture for long head of biceps
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capsular ligaments
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glenohumeral: thickening of anterior capsule; coracohumeral: strengthens superior part of capsule
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extracapsular ligaments
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transverse humeral lig spans bicipital groove; coracoacromial lig limits superior movement
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mobility of shoulder joint
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shallow glenoid cavity & lax capsule
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stability
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rotator cuff muscles are the major source of stability for the shoulder joint
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bursae
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subacromial, subdeltoid
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humeroulnar jt
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trochlea of humerus and trochlear notch of ulna; flexion and extension at elbow joint
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humeroradial jt
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capitulum of humerus with head of radius; flexion and extension at elbow joint
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proximal radio-ulnar jt
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head of radius with radial notch on ulnar side; pronation and supination
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ulnar collateral lig
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traingular shaped lig with upper & lower bands; ulnar nerve passes between bands posterior to medial epicondyle
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radial collateral
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attached to annular lig
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annular lig
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sling around head of radius to form proximal radioulnar jt
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ulna
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large proximal end with trochlear notch; small distal end with round head and styloid process
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radius
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small proximal end with round head; large distal end with wide base and styloid process
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proximal carpal bones
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scaphoid, lunate, triquetrum, pisiform
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distal carpal bones
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trapezium, trapezoid, capitate, hamate
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wrist (radio-carpal) jt
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base of radius articulates with: scaphoid, lunate, triquetrum; ulna is separated from carpal bones by articular disc; extension
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midcarpal jt
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complex joints between proximal and distal rows of carpal bones (except pisiform); flexion
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radial collateral lig
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from styloid process of radius to scaphoid; limits adduction
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ulnar collateral lig
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from ulnar styloid process to triquetrum & pisiform; limits abduction
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superficial anterior layer
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origin: CFO
tendons insert on radius, metacarpals, fascia |
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intermediate anterior layer
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origin: CFO, radius, ulna
insert: middle phalanges |
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deep anterior layer
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O: radius and ulna
I: distal phalanges (except pronator quad) |
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pronator teres
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O: CFO
I: radius median nerve pronates forearm |
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palmaris longus
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I: palmar aponeurosis
absent in 15% median n. |
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flexor carpi radialis
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I: MC 2, 3
median n. flexes and radially deviates wrist |
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flexor carpi ulnaris
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I: MC 5
ulnar n. flexes and ulnar deviates wrist pisiform bone develops within tendon (sesamoid bone) |
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flexor digitorum superficialis
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I: middle phalanges of 4 fingers, splits its tendons
median n. flexes fingers |
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flexor digitorum profundus
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I: distal phalanges, its tendon passing through FDS tendon
median n. to radial half ulnar n. to ulnar half |
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flexor pollicis longus
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I: distal phalanx of thumb
median n. |
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pronator quadratus
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extends from ulna to radius
pronates forearm median n. |
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median nerve to forearm
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deep to bicipital aponeurosis; through pronator teres; runs down center of forearm deep to FDS
innervates: pronator teres, flexor carpi radialis, palmaris longus, half of FDP, flexor pollicis longus, pronator quadratus |
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ulnar nerve to forearm
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posterior to medial epicondyle; through flexor carpi ulnaris; down ulnar side of forearm deep to flexor carpi ulnaris
innervates: flexor carpi ulnaris, half of FDP |
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ulnar nerve compression
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Arcade of Struthers, cubital tunnel, flexor carpi ulnaris heads
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posterior superficial layer
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O: CEO or supracondylar ridge; tendons insert on metacarpals, phalanges
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posterior deep layer
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O: radius and ulna
I: radius, distal phalanges, and all bones of thumb |
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brachioradialis
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I: radius
radial n. flexes elbow and maintains half pronated position |
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extensors carpi radialis longus and brevis
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I: MC 2, 3
radial n. extend and radially deviate wrist |
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extensors digitorum and digiti minimi
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I: extensor expansions over middle and distal phalanges
radial n extends fingers |
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extensor carpi ulnaris
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I: MC 5 with double tendon
radial n. extend wrist and ulnar deviate |
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supinator
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(deep) inserts onto radius
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abductor pollicis longus
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I: MC1
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extensor pollicis longus and brevis
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I: proximal and distal phalanx of thumb
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extensor indicis
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I: extensor expansion of index finger
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extensor retinaculum
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CT sheet holds down extensor tendons; tendons wrapped by synovial sheaths; "ganglion": fluid filled vesicle in synovial sheath
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extensor expansions
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extensor tendons broaden out over MCP joints, divide into 3 slips and insert onto middle and distal phalanges; insertion of lumbricals and interossei muscles; CT slips interconnect tendons to coordinate their actions
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radial nerve
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anterior to lateral epicondyle; deep to brachioradialis; deep radial nerve to posterior compartment; superficial radial nerve to dorsal skin, superficial to snuffbox tendons
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anatomical snuffbox
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space between tendons of: extensor pollicis longus and brevis, abductor pollicis longus
landmarks for bones: scaphoid, trapezium, radial styloid process |
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radial artery
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crosses floor; passes between first two metacarpal bones to enter palm of hand
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proximal radio-ulnar joint
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annular ligament permits rotation of head of radius around ulna; interosseus membrane links bones together
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distal radio-ulnar joint
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triangular articular disc connects base of radius to ulnar styloid process; rotational movement around styloid process during pronation and supination
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palmar aponeurosis
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protective covering over tendons
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superficial transverse ligament
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across palmar side of MCP jts
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tendon coverings of hand
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fibrous flexor sheaths: enclose flexor tendons in fingers
synovial sheaths: around tendons flexor retinaculum and transverse carpal ligament |
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thenar muscles
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abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
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hypothenar muscles
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abductor digiti minimi, flexor digiti minimi, opponens digiti minimi
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lumbricals
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originate from tendons of flexor digitorum profundus, insert into dorsal expansions
1,2: median n. 3,4: ulnar n. flexor pollicis longus doesn't have lumbrical |
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adductor pollicis, palmar interossei, dorsal interossei
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all insert onto bases of proximal phalanges, sesamoid bones at insertion of adductor pollicis and flexor/abductor pollicis brevis
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dorsal interossei muscles
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abduct fingers from midline; LI 4 is located on 1st; 1st dorsal interossei and adductor pollicis both act to clench thumb against index finger
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palmar interossei
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adduct fingers toward miline
Pad & Dab |
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Tata movement
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lumbricals and interossei act together to flex MC-P jt; extend IP jt; movement from ulnar nerve case
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carpal-metacarpal jts
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saddle jt between trapezium & metacarpal 1: flexibility for thumb
4, 5 more mobile than 2, 3 due to differences in conformation of carpal articular surfaces |
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metacarpal-phalangeal (MCP) jts.
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condyloid; allows flex-extension & adduction-abduction
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interphalangeal (IP) jts
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PIPs and DIPs: proximal and distal interphalangeal jts.; Bi-condyloid facets that allow only flexion-etension and little adduction-abduction
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palmar ligament of finger
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thickened anterior portions of MCP & IP jts
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deep transverse lig of finger
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interconnect MCP jts, except thumb; allows for greater mobility of thumb; cf big toe
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collateral lig of fingers
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CT bands on each side of jt; support all MCP & IP jts;
at MCP jts: flexion tautens collateral lig, limiting adduction-abduction; extension relaxes lig: permitting adduction-abduction |
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link (retinacular) lig
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borders of extensor expansions; link IP joints to flex or extend together
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dermatome
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area of skin innervated by one spinal segment (eg C5)
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myotome
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area of muscle innervated by one spinal segment; usually 2-3 segments per muscle
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carpal tunnel
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space formed by flexor retinaculum/transverse carpal lig spanning across carpal bones; flexor retinaculum lies deep to palmar aponeurosis
structures: median nerve, flexors digitorum and superficialis & profundus, flexor pollicis longus, flexor carpi radialis |
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carpal tunnel syndrome
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median n. is compressed; carpal tunnel size reduced due to local inflammation or tenosynovities, dislocation of carpal bones, arthritis
often associated with diabetes mellitus which compromises nerve function symptoms: loss of sensation in 3 1/2 digits, loss of function of thenars and lumbricals 1,2: thenar wasting: "ape hand" |
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tunnel of guyon or ulnar tunnel
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space between pisiform and hook of hamate, interconnected by pisohamate lig, floor of tunnel is flexor retinaculum, roof of tunnel is palmar carpal lig
contents of tunnel: ulnar nerve, ulnar artery and veins |
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ulnar nerve entrapment
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claw hand due to lack of MC-P flexion and IP extension in fingers: two fingers remain extended because of 2 lumbricals innervated by median nerve; atrophy of interossei, cutaneous loss of 1 1/2 digits
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nerve distribution
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area of skin innervated by one peripheral nerve, eg lateral cutaneous nerve to forearm
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