Test 2- Upper Extremity

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Radiographs of the wrist and hand are commonly used to assess skeletal age.

-Ossification centers are usually obvious during the 1st year; however, they may appear before birth. -Each carpal bone usually ossifies from one center postnatally. -The centers for the capitate and hamate appear first.

The ____ metacarpal is the thickest and shortest of these bones.

1st (of the thumb)

The glenohumeral (shoulder) joint is almost directly inferior to the _____

AC joint

From lateral to medial, the four carpal bones in the proximal row are

Scaphoid Lunate Triquetrum Pisiform

______ makes up the condyle of the humerus

The distal end of the humerus—including the trochlea, capitulum, olecranon, coronoid, and radial fossae—

_____ is the primary feature of the head of the scapula

The glenoid cavity

______ form the superior appendicular skeleton

The pectoral girdle and bones of the free part of the upper limb

From lateral to medial, the four carpal bones in the distal row are

Trapezium Trapezoid Capitate Hamate

The glenoid cavity

] a shallow, concave, oval fossa, directed anterolaterally and slightly superiorly—that is considerably smaller than the ball (head of the humerus) for which it serves as a socket.

Scaphoid

a boat-shaped bone that articulates proximally with the radius. It has a prominent scaphoid tubercle and is the largest bone in the proximal row of carpals.

The spine of the scapula continues laterally as the flat, expanded ______ , which forms the subcutaneous point of the shoulder and articulates with the acromial end of the clavicle.

acromion

the clavicle's lateral half is concave anteriorly, and its acromial end is flat where it articulates with the _____

acromion of the scapula at the acromioclavicular (AC) joint

the lesser tubercle projects _____ from the humerus

anteriorly

The clavicles and scapulae of the pectoral girdle are supported, stabilized, and moved by _____

axio-appendicular muscles that attach to the relatively fixed ribs, sternum, and vertebrae of the axial skeleton.

Each metacarpal consists of a

base, shaft, and head. -The proximal bases of the metacarpals articulate with the carpal bones. -The distal heads of the metacarpals articulate with the proximal phalanges and form the knuckles of the hand

The triangular body of the scapula is thin and translucent superior and inferior to the spine of the scapula, although its ______, are somewhat thicker.

borders, especially the lateral one

Proximally, the smooth superior aspect of the discoid head of the radius is concave for articulation with the ______ of the humerus during flexion and extension of the elbow joint.

capitulum

The clavicle forms one of the bony boundaries of the _____

cervico-axillary canal (passageway between the neck and arm), affording protection to the important neurovascular bundle supplying the upper limb.

The______ connects the upper limb to the trunk

clavicle (collar bone)

The carpus is markedly ____ from side to side posteriorly and ____ anteriorly.

convex concave

The medial two thirds of the shaft of the clavicle are _____ anteriorly, whereas the lateral third is ___ anteriorly. These curvatures increase the resilience of the clavicle and give it the appearance of an elongated capital S.

convex concave

Anteriorly, the _____ receives the coronoid process of the ulna during full flexion of the elbow.

coronoid fossa

Two fossae (hollows) occur back to back superior to the trochlea

coronoid fossa olecranon fossa

Projecting posteriorly, the _______ lies between otherwise shallow grooves for the passage of the tendons of forearm muscles.

dorsal tubercle of the radius

The shaft of the clavicle has a _____ in a horizontal plane.

double curve -Its medial half is convex -Its lateral half is concave

The carpus (wrist) is composed of

eight carpal bones, arranged in proximal and distal rows of four Located at the junction of forearm and hand, these small bones give flexibility to the carpus.

The shaft of the radius, in contrast to that of the ulna, gradually _____ as it passes distally.

enlarges

The shaft of each metacarpal begins to ossify during ____

fetal life. -Ossification centers appear postnatally in the heads of the four medial metacarpals and in the base of the 1st metacarpal. -By age 11, ossification centers of all carpal bones are visible

Each digit (finger) has three phalanges except for the _____, which has only two

first (the thumb)

The metacarpus forms the skeleton of the palm of the hand between the carpus and phalanges. It is composed of

five metacarpal bones (metacarpals).

Superolaterally, the lateral surface of the scapula has a ______, which receives and articulates with the head of the humerus at the glenohumeral joint

glenoid cavity

At the narrow distal end of the ulna is a small but abrupt enlargement, the______

head of the ulna with a small, conical ulnar styloid process.

The subclavian groove (groove for the subclavius)

in the medial third of the shaft of the clavicle is the site of attachment of the subclavius muscle.

The ulna

is the stabilizing bone of the forearm and is the medial and longer of the two forearm bones

The styloid process of the radius is ____ than the ulnar styloid process

larger (and extends farther distally)

The greater tubercle is at the

lateral margin of the humerus

Because the acromion is a lateral extension of the scapula, the AC joint is placed____

lateral to the mass of the scapula and its attached muscles

the clavicle's medial half is convex anteriorly, and its sternal end is enlarged and triangular where it articulates with the ____

manubrium of the sternum at the sternoclavicular (SC) joint.

The clavicle serves as a

moveable, crane-like strut (rigid support) from which the scapula and free limb are suspended, keeping them away from the trunk so that the limb has maximum freedom of motion. The strut is movable and allows the scapula to move on the thoracic wall at the "scapulothoracic joint," increasing the range of motion of the limb. Fixing the strut in position, especially after its elevation, enables elevation of the ribs for deep inspiration.

The conoid tubercle

near the acromial end of the clavicle, gives attachment to the conoid ligament, the medial part of the coracoclavicular ligament by which the remainder of the upper limb is passively suspended from the clavicle.

The shallow constriction between the head and body defines the ______

neck of the scapula.

Posteriorly, the _______ accommodates the olecranon of the ulna during full extension of the elbow

olecranon fossa

The articulation between the ulna and humerus primarily allows _____

only flexion and extension of the elbow joint, although a small amount of abduction and adduction occurs during pronation and supination of the forearm.

Superior to the capitulum anteriorly, a shallower _____ accommodates the edge of the head of the radius when the forearm is fully flexed.

radial fossa

On the lateral side of the coronoid process is a smooth, rounded concavity, the ____, which receives the broad periphery of the head of the radius.

radial notch

The head of the radius also articulates peripherally with the _______

radial notch of the ulna; thus, the head is covered with articular cartilage.

The neck of the radius is a constriction distal to the head. The oval ______ is distal to the medial part of the neck and demarcates the proximal end (head and neck) of the radius from the shaft.

radial tuberosity

The _____ is the lateral and shorter of the two forearm bones

radius

medial border of the scapula

runs parallel to and approximately 5 cm lateral to the spinous processes of the thoracic vertebrae; hence it is often called the vertebral border

lateral border of the scapula

runs superolaterally toward the apex of the axilla; hence it is often called the axillary border. The lateral border is composed of a thick bar of bone that prevents buckling of this stress-bearing region of the scapula.

The scapula is capable of considerable movement on the thoracic wall at the physiological _____, providing the base from which the upper limb operates.

scapulothoracic joint

The clavicle transmits _____ from the upper limb to the axial skeleton.

shocks (traumatic impacts)

The superior surface of the clavicle, lying just deep to the skin and platysma (G. flat plate) muscle in the subcutaneous tissue, is ____

smooth.

The convex posterior surface of the scapula is unevenly divided by a thick projecting ridge of bone, the ______

spine of the scapula

Although it is designated as a long bone, the clavicle has no medullary (marrow) cavity. It consists of _____

spongy (trabecular) bone with a shell of compact bone.

The superior appendicular skeleton articulates with the axial skeleton only at the _______, allowing great mobility.

sternoclavicular joint

The inferior surface of the clavicle is rough because

strong ligaments bind it to the 1st rib near its sternal end and suspend the scapula from its acromial end.

The concave costal surface of most of the scapula forms a large ____

subscapular fossa.

The beak-like coracoid process

superior to the glenoid cavity, and projects anterolaterally. This process also resembles in size, shape, and direction a bent finger pointing to the shoulder, the knuckle of which provides the inferior attachment for the passively supporting coracoclavicular ligament

The shaft of the humerus has two prominent features:

the deltoid tuberosity laterally, for attachment of the deltoid muscle, and the oblique radial groove (groove for the radial nerve, spiral groove) posteriorly.

The deltoid tubercle of the scapular spine

the prominence indicating the medial point of attachment of the deltoid.

The humerus (arm bone), the largest bone in the upper limb, articulates with ____

the scapula at the glenohumeral joint, and the radius and ulna at the elbow joint

The ulna does not reach—and therefore does not participate in ______

the wrist (radiocarpal) joint

The shaft of the ulna is

thick and cylindrical proximally, but it tapers, diminishing in diameter, as it continues distally

Arm bones are positioned to

transmit forces received by the radius (via the hands) to the ulna for transmission to the humerus.

The spine and acromion serve as levers for the attached muscles, particularly the

trapezius.

Also, near the acromial end of the clavicle is the ______

trapezoid line to which the trapezoid ligament attaches; it is the lateral part of the coracoclavicular ligament.

Most of the length of the shafts of the radius and ulna is essentially _____ in cross section

triangular with a rounded, superficially directed base and an acute, deeply directed apex

The scapula (shoulder blade) is a

triangular flat bone that lies on the posterolateral aspect of the thorax, overlying the 2nd-7th ribs

The olecranon and coronoid processes form the walls of the ____

trochlear notch - "grips" (articulates with) the trochlea of the humerus

The lateral border terminates in the______

truncated lateral angle of the scapula, the thickest part of the bone that bears the broadened head of the scapula

Inferior to the coronoid process is the ____

tuberosity of the ulna for attachment of the tendon of the brachialis muscle

The two forearm bones serve together to form the second unit of an articulated mobile strut (the first unit being the humerus)

ulna and radius

The distal end of the radius is essentially four sided when sectioned transversely. Its medial aspect forms a concavity, the _____, which accommodates the head of the ulna. Its lateral aspect becomes increasingly ridge-like, terminating distally in the ______

ulnar notch styloid process of the radius.

For articulation with the humerus, the ulna has two prominent projections:

(1) the olecranon, which projects proximally from its posterior aspect (forming the point of the elbow) and serves as a short lever for extension of the elbow, and (2) the coronoid process, which projects anteriorly.

Trapezium

a four-sided bone on the lateral side of the carpus. It articulates with the 1st and 2nd metacarpals, scaphoid, and trapezoid bones.

Capitate

a head-shaped bone with a rounded extremity is the largest bone in the carpus. It articulates primarily with the 3rd metacarpal distally, and with the trapezoid, scaphoid, lunate, and hamate.

The condyle of the humerus has two articular surfaces:

a lateral capitulum for articulation with the head of the radius, and a medial, spool-shaped or pulley-like trochlea for articulation with the proximal end (trochlear notch) of the ulna.

Lunate

a moon-shaped bone between the scaphoid and triquetral bones. It articulates proximally with the radius and is broader anteriorly than posteriorly.

Triquetrum

a pyramidal bone on the medial side of the carpus. It articulates proximally with the articular disc of the distal radio-ulnar joint.

More medially is the impression for the costoclavicular ligament, _______

a rough, often depressed, oval area that gives attachment to the ligament binding the 1st rib (L. costa) to the clavicle, limiting elevation of the shoulder.

The radius proximal end includes

a short head, neck, and medially directed tuberosity

The spine of the scapula divides the posterior surface into which two fossas?

a small supraspinous fossa and a much larger infraspinous fossa

Pisiform

a small, pea-shaped bone that lies on the palmar surface of the triquetrum.

The 3rd metacarpal is distinguished by

a styloid process on the lateral side of its base

Hamate

a wedge-shaped bone on the medial side of the hand. It articulates with the 4th and 5th metacarpal, capitate, and triquetral bones. It has a distinctive hooked process, the hook of the hamate, that extends anteriorly.

Trapezoid

a wedge-shaped bone that resembles the trapezium. It articulates with the 2nd metacarpal, trapezium, capitate, and scaphoid bones.

The ________ separates the greater and lesser tubercles

intertubercular sulcus (bicipital groove) provides protected passage for the slender tendon of the long head of the biceps muscle.

The superior border of the scapula

marked near the junction of its medial two thirds and lateral third by the suprascapular notch, which is located where the superior border joins the base of the coracoid process. The superior border is the thinnest and shortest of the three borders.

The inferior end of the humeral shaft widens as the _____ forms

medial and lateral supra-epicondylar (supracondylar) ridges form, and then end distally in the especially prominent medial epicondyle and the lateral epicondyle, providing for muscle attachment.

The radial nerve and profunda brachii artery lie in the _________ as they pass anterior to the long head and between the medial and the lateral heads of the triceps brachii muscle.

oblique radial groove

Inferior to the radial notch on the lateral surface of the ulnar shaft is a prominent ridge, the _____

supinator crest.

Between the supinator crest and the distal part of the coronoid process is a concavity, the ______

supinator fossa The deep part of the supinator muscle attaches to the supinator crest and fossa

The spherical head of the humerus articulates with

the glenoid cavity of the scapula.

The junction of the head and neck with the shaft of the humerus is indicated by

the greater and lesser tubercles, which provide attachment and leverage to some scapulohumeral muscles

The anatomical neck of the humerus is formed by

the groove circumscribing the head and separating it from the greater and lesser tubercles. it indicates the line of attachment of the glenohumeral joint capsule. The surgical neck of the humerus, a common site of fracture, is the narrow part distal to the head and tubercles

______ form the inferior appendicular skeleton.

the pelvic girdle and bones of the free part of the lower limb


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