Osteology: Appendicular Skeleton Upper Limbs
Naming of Digits
- 1st: Thumb - pollex/pollicies - 2nd: Index - inditis - 3rd: Middle - potent - 4th: Ring - annular -5th: Pinky/pinkie: digiti minimi 1st: Great toe: hallux/hallucis
Pectoral Girdle
4 bones: 2 clavicles, 2 scapulae Attaches upper limb to axial skeleton
Glenohumeral Joint
Ball and Socket Joint: multiaxial, circumduction Joint capsule: superior, middle, inferior Coracohumeral ligament Insertions of rotator cuff muslces, also attach to joint capsule exterior Tendon of biceps brachii long head runs inside capsule Anchored by transverse humeral ligament Glenoid Labrum Bursae
Acromioclavicular Joint
Bones and landmarks: Scapula Acromion process Coracoid process Clavicle Distal end - acromial end trapezoid line conoid tubercle Ligaments: Acromioclavicular ligament Joint capsule - synovial planar Coracoacromial ligament Coracoclavicular ligament trapezoid ligament conoid ligament
Carrying Angle of the Forearm
Cubitus - elbow joint Normale = 5° to 15° from the torso Varus - elbow deviated laterally, forearm medially deviated Valgus - elbow deviated medially, forearm laterally deviated
Rotator Cuff
Four muscles: -supraspinatus -infraspinatus -teres minor -subscapularis
Elbow or Cubitus
Humeroulnar Hinge - uniaxial flexion/extension Humeroradial Hinge - uniaxial flexion/extension Pivot - uniaxial supination/pronation Radioulnar pivot - uniaxial proximal joint capsule Supporting ligaments ulnar collateral ligaments radial collateral ligament anular ligament Olecranon Bursa
Joints and Ligaments of Fingers
Metacarpophalangeal (MCP) -1st proximal knuckle - condyloid biaxial abduction/adduction flexion/extension/hyperextension -deep transverse metacarpal ligament attached to heads of MC2-5 Interphalangeal Joints (IP) -Hinge Uniaxial Flexion/extension -Joint capsule at knuckle second knuckle = PIP third knuckle = DIP 'thumb' knuckle = IP -Supported by collateral ligaments
Carpal Tunnel
Nine flexor tendons flexor digitorum superficialis (4) flexor digitorum profundus (4) flexor pollicis longus (1) Median nerve flexor retinaculum Tenosynoium - anterior and posterior source of tendonitis and swelling in the tunnel
Ligaments of Wrist
Palmar carpal ligament aka volar carpal proximal to wrist forms tunnel of Guyon (ulnar tunnel or canal for ulnar nerve) Flexor retinaculum aka transverse carpal ligament forms carpal tunnel distal to wrist Extensor retiniaculum superficial to extensor tendons dorsal Anterior radiocarpal aka volar/palmar Posterior radiocarpal aka dorsal Radial collateral ligament Ulnar collateral ligament Interosseal membrane ligament (between bones of the antebrachium) Syndesmosis - fibrous and amphiarthrotc
Movements of Fingers
Pronation Supination Digital Flexion Diigital Extension Lateral Abduction Medial Abduction Abduction and Adduction of digits Adduction Abduction
Movements of Forearm
Pronation Supination Extension Flexion Adduction Abduction
Dislocation vs Separation of Shoulder
Shoulder dislocation involves humerus Ligaments involved? No Shoulder separation involves clavicle Ligaments involved? Yes
Joints of Wrist and Hand
Wrist: Distal Radioulnar Pivot Uniaxial Radiocarpal/radioscaphoid Condyloid Biaxial radial/ulnar deviation flexion/extension/hyperextension Ulnocarpal/ulnotriiquetral Triangular Fibrocartilage Complex (TFCC) Intercarpal Carpometacarpal (CMC) Saddle = 1st digit biaxial abduction/adduction/opposition flexion/extension/hyperextension Gliding = digits 2-5 uniaxial abduction/adduction flexion/extension/hyperextension
Sternoclavicular
Bones: clavicle - sternal end Manubrium of sternum Rib 1 aka manubrioclavicular saddle - biaxial/multiaxial movements: elevation/depression, protraction/retraction, moves with scapula Supporting ligaments/structures Capsular ligament/joint capsule intra-articular disc/ligament fibrocartiolaginous interclavicular ligament costoclavicular ligament clavicular dislocation posterior most dangerous