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