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114 Cards in this Set
- Front
- Back
Composition of Bones
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25-30% water,
Calcium phosphate & calcium Carbonate, collagen (protein) |
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l
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l
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Effusion
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Injury or irritation to the synovial layer causing over secretion of synovial fluid
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What is the nutruitonal source for cartiliage?
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Synovial fluid
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What parts of joints are innervated?
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Outer layer of joint capsule, ligaments, bursae
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What part of joints are not innervated?
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Disks, articular cartigae, synovial membrane
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Common site for Bracial Plexus Compression
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between the anterior and middle scalenes,
1st rib and clavicle, Under pectorialis Minor |
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Common compression site for Median Nerve
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LIgament of Struthers
Two head of pronator teres Anterior interosseous branch Carpal tunnel |
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Common compression sites for Radial Nerve
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Radial tunnel (PIN)
Near Snuffbox |
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Common Compression site for Ulnar nerve
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Cubital Tunnel
Guyon's Canal |
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What bone transmits forces from upper limb to axial skeleton?
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Clavicle, attaches sternum to scapula
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Common site for Bracial Plexus Compression
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between the anterior and middle scalenes,
1st rib and clavicle, Under pectorialis Minor |
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Four fossas of the scapular
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Glenoid, Supraspinatus, Infraspinatus, Subscapular
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Ligaments of Sternoclaviclar joint
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Costoclaivcular, anterior & posterior SC, interclavicular
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Common compression site for Median Nerve
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LIgament of Struthers
Two head of pronator teres Anterior interosseous branch Carpal tunnel |
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Common compression sites for Radial Nerve
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Radial tunnel (PIN)
Near Snuffbox |
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Movements of SC joint
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Elevation & depression, portractiona and retraction, Rotation
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Only true articulation between axial skeleton and upper limb
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sternoclavicular joint
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Common Compression site for Ulnar nerve
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Cubital Tunnel
Guyon's Canal |
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What bone transmits forces from upper limb to axial skeleton?
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Clavicle, attaches sternum to scapula
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Ligaments of Acromioclavicular joint
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Acromioclavicular, Coracoclavicular (trapezoid, conoid)
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Four fossas of the scapular
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Glenoid, Supraspinatus, Infraspinatus, Subscapular
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Ligaments of Sternoclaviclar joint
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Costoclaivcular, anterior & posterior SC, interclavicular
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Movements of SternoClavicular joint
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Elevation & depression, portraction and retraction, Rotation
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Only true articulation between axial skeleton and upper limb
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sternoclavicular joint
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Ligaments of Acromioclavicular joint
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Acromioclavicular, Coracoclavicular (trapezoid, conoid)
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What portion of the GH joint capsule is loose to allow mobility?
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Inferior portion
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What are the ligaments of the GH joint?
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Coracohumeral, Coracoacromial, Three gleno-humeral ( Superior, Inferior and MIddle)
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Bursae of the GH joint
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Subdeltoid (subacromial)
Subscapular |
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Is the Scapulothoracic Joint a "true" articulation
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No, Slides between scapula and thoracic wall
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What are the contents of the Subacromial space?
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Subacromial bursa, supraspinatuous muscle and tendon, superior joint capsule, Longe head of biceps tendon
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subacromial arch formed by what structures?
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Acromion, Coracoid porcess, Coracoacromial ligament
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Whats the difference between extrinisic and intrinsic shoulder muscles?
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Extrinsic: arise from axial skeleton and inser on scapula Intrinsic: arise from scapular or clavicle and insert of humerus
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Upward rotations of scapula
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Upper & lower trapezius Serratus anterior
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Downward roation of scapula
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Levator scapulae, Rhomboids major and minor, Asssist: Pect major and Lats
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Elevation of scapula
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upper Trapezius, Levator scapulae
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Depression of scapula
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Pectoralis Minor, Lower trapezius
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Protraction of scapula
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Serratus Anterior, Pectoralis MInor
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retraction of scapula
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Rhomboids major & minor, MIddle trapezius
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Flexion of humerus
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Coracobrachialis, Clavicular head of pec major, Anterior Deltoid, Short head of biceps
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Extension of humerus
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Teres Major/Latissimus, Sternalhead of pect major, Post Deltoid, Infraspinatous/Teres Minor, Long head of Triceps
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Depression of scapula
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Pectoralis Minor, Lower trapezius
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Protraction of scapula
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Serratus Anterior, Pectoralis MInor
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retraction of scapula
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Rhomboids major & minor, MIddle trapezius
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Flexion of humerus
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Coracobrachialis, Clavicular head of pec major, Anterior Deltoid, Short head of biceps
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Extension of humerus
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Teres Major/Latissimus, Sternalhead of pect major, Post Deltoid, Infraspinatous/Teres Minor, Long head of Triceps
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Abduction of Humerus
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Middle Deltoid, Supraspinatous
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Adduction of Humerus
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Sternal head of pect major, Latissimus/Teres major, Coracobrachialis
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External Rotation of Humerus
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Teres Minor, Infraspinatous, Posterior Deltoid
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Internal Rotation of Humerus
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Subscapularis, Teres Major/Latissimus, Anterior Deltoid, Pec Major
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Horizontal Adduction of humerus
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Clavicular head of pec major, Anterior deltoid
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Horizontal Abduction of humerus
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Post Deltoid
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What is initial scapul-humera rhythm for initial 30* of abduction?
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4:1 ratio
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scapul-humeral rhythem for abduction from 30 to 180*
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4:5 ratio
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Clinical picture of Adhesive Capsulitis?
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IR LImited, ER limited, Pain free when shoulder immobile, Pain increases with AROM
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What fold is adhered with Adhesive capsulitis?
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Inferior fold
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Humeroulnar joint of elbow formed by what bones?
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Trochlea of humerus & Trochlear notch of ulna
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Humeroradial joint of elbow formed by what bones?
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Capitulum of humerus & radial head of radius
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Muscles of elbow flexion
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Biceps brachii, Bracialis, Brachioradialis (assist), Pronator Teres (assist)
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Muscles of elbow extension
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Triceps, Anconeous
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Proximal radio-ulnar joint
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Radial head and glides into radial notch of ulna
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Distal radio-ulnar joint
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Ulnar nothc slides around the head of the ulna
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Ulnar head is more prominent in ____ and less prominent in full ____
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Pronation, Supination
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Muscles for supination
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Supinator, Biceps brachii
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Muscles for pronation
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Pronator teres, Pronator Quadratus
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Colles Fracture: dorsal or volar dislocation of radius?
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Dorsal
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Superfical muscles of Forearm flexors
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Pronator Teres, FCR (to base of 2&3 metacarpals), Palmaris Longus ( to aponeurosis), FDS (PIP), FCU( Pisiform, 5th metacarpal) All arise from Medial epi
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Deep muscles of forearm flexors
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FDP, FPL, Pronator Quadratus
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1st DC
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APL, EPB
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2nd DC
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ECRL, ECRB
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3rd DC
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EPL
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4th DC
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EDC, EI
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5th DC
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EDM
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6th DC
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ECU
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Distal Volar Angulations of radius
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11 degress dorsal > volar radius (rule of 11s)
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Distal Radial inclination of radius
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22 degrees radial > ulnar side (rule of 11s)
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Distal axial loading forces from gripping to radius and ulnar
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82% radial, 18% ulnar
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Proximal Carpal bones
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Scaphoid, Lunate, Triquetrum, Pisiform (mobile row)
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Distal carpal row bones
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Trapezium, trapezoid, capitate, Hamate (taut ligaments)
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Which area of TFCC is vascularized and unvascularized?
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Central: Unvascularized
Peripherial: Vascularized |
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Which wrist column is force bearing? Control Column?
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Central column is force bearing
Ulnar column is control column |
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Components of Central Column
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Radius, lunate, proximal 2/3 scaphoid, copaitate, trapezoid, 2nd and 3rd metacarpals
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Components of Ulnar Column
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Ulnar styloid, TFCC, triquetrum proximal hamate, 4th & 5th metacarpals
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Radio-carpal joint
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Radius, scaphoid, lunate
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Midcarpal joint
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Between proximal and distal carpals rows
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Carpal glides during Radial deviation
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Triquetrum translates radially & dorsally on hamate
Lunate and scaphoid FLEX |
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Carpal glides during Ulnar deviation
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Triquetrum glides distally on hamate.
Lunate and scaphoid EXTEND |
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Carpal glides during wrist extension
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Scaphoid and Lunate EXTEND
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carpal glides during wrist Flexion
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Lunate and Scaphoid FLEX
Palmer flexion occurs at midcarpals and radiocarpal joint |
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Space of Poirier
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Weak area between capitate and lunate
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Grip strength max and min at what wrist position?
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Max at 20* ext
Min at 40* flexion |
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Functional wrist ROM
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40/40
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Normal Scaphoid-Lunate angle
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47*
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In ulnar deviation, proximal row _____?
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Extends
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In Radial deviation, proximal row _____?
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Flexes
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Triquetral-Lunate Dissociation
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-VISI
-Scaphoid and Lunate FLEX -Triquetrum EXTEND Clicking with UD to RD |
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Scapholunate dissociation
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DISI
-Lunate & Triquetrum EXTEND -Scaphoid FLEX --Clicking with UD |
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Palmar midcarpal instability
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-Ulnar arm of arcuate ligament disrupted
-May be caused by abnormal tilt of s/p DRF -Noted snap into ext |
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MP collateral ligaments Taut in ____, Loose in ____
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Taut in Flexion
Loose in Extension |
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MP capsule Loose packed position is_____, closed packed in _____.
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Loose packed in Extension
Closed packed in Flexion |
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IP Collaterals Taut in ____, Loose in _____
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Taut in Extension
Loose in Flexion |
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IP capsular Loose packed and closed packed position?
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Loose packed in Flexion
Closed packed in Ext |
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Muscles of Thumb Flexion and Nerve Innervation
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FPB-Median
FPL- Median |
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Muscles of Thumb Ext
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EPB- Radial
EPL- Radial |
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Muscles of Thumb ABD
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APB-Median
APL-Radial |
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Muscles of Thumb ADD
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Add Pollicis-Ulnar
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Muscles of Thumb Opposition
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Opponens pollicis-Median
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Flexors of MCP
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Primary: Dorsal & Palmar Interossei- (Ulnar N)
Assists: Lumbricals (Med and Ulnar N), FDS (med n), FDP (Med & ulnar N) |
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IP Flexors
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FDS- (med n)
FDP (med and ulnar n) |
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Muscles of Finger Extension
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Ext Digitorum (rad n)
Lateral Bands with assit from lubricals and interossei |
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Muscles of Finger Abduction
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Dorsal Interossei (ulnar n)
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Muscles fo Finger ADD
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Palmer Interossei (Ulnar n)
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Lumbrical muscles originate from what side of the FDP?
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Radial side
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Palmer and Dorsal Interesseous act as abd or add?
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PAD: Palmar ADD
DAB: Dorsal ABD |