Upper Limb 1
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Questions and Answers

Which structures are particularly at risk during a clavicle fracture?

  • Subclavian vessels and brachial plexus (correct)
  • Rib cage bones
  • Shoulder ligaments
  • Cervical vertebrae

    • Which structure does the capitulum of the humerus articulate with?

  • Scapula
  • Radius (correct)
  • Clavicle
  • Ulna

    • The trochlea of the humerus articulates with the radius.

    False

    What is the term for the forearm?

    <p>antebrachium</p> Signup and view all the answers

    The olecranon process is located at the ______ end of the ulna.

    <p>proximal</p> Signup and view all the answers

    Match the following features of the ulna with their descriptions:

    <p>Olecranon process = Forms the elbow point Coronoid process = Anterior projection below the trochlear notch Trochlear notch = Surface that articulates with the humerus Styloid process = Small pointed projection on the head of the ulna</p> Signup and view all the answers

    What occurs during pronation of the forearm?

    <p>Only the radius rotates while the ulna remains fixed.</p> Signup and view all the answers

    Why does the ulna not participate in the rotational movement during forearm pronation?

    <p>Joint shape between the ulna and humerus restricts movement.</p> Signup and view all the answers

    Which carpal bone is known to be commonly fractured and is the largest in the proximal row?

    <p>Scaphoid</p> Signup and view all the answers

    Which carpal bone is notable for its hook-like process?

    <p>Hamate</p> Signup and view all the answers

    Which carpal bone articulates with the first metacarpal?

    <p>Trapezium</p> Signup and view all the answers

    Which bone in the proximal row is described as moon-shaped and critical for wrist motion?

    <p>Lunate</p> Signup and view all the answers

    Which bony prominence is NOT a border of the carpal tunnel?

    <p>Capitate</p> Signup and view all the answers

    What type of joint is the acromioclavicular joint?

    <p>Synovial plane joint</p> Signup and view all the answers

    What common injury is associated with the acromioclavicular joint?

    <p>Acromioclavicular joint separation</p> Signup and view all the answers

    Where does the tendon of the long head of the biceps brachii muscle travel?

    <p>Through the intertubercular groove of the humerus</p> Signup and view all the answers

    How is the tendon of the long head of the biceps brachii muscle related to the shoulder joint?

    <p>It lies within the synovial membrane but not in the cavity</p> Signup and view all the answers

    What function does the unique arrangement of the tendon provide?

    <p>Allows smooth movement while protecting the tendon</p> Signup and view all the answers

    What is the primary function of the coracoacromial ligament?

    <p>To stabilize the shoulder joint and restrict upward dislocation of the humeral head</p> Signup and view all the answers

    The subacromial bursa is located between the acromion and the humeral head.

    <p>True</p> Signup and view all the answers

    What do the subacromial and subdeltoid bursae help to reduce during shoulder movement?

    <p>Friction</p> Signup and view all the answers

    The floor of the carpal tunnel is formed by the distal row of carpal bones.

    <p>False</p> Signup and view all the answers

    The ___________ nerve is the primary nerve involved in carpal tunnel syndrome.

    <p>Median</p> Signup and view all the answers

    What anatomical structure forms the superior border of the carpal tunnel?

    <p>Flexor Retinaculum</p> Signup and view all the answers

    Which of the following tendons is responsible for flexing the thumb and passes through the carpal tunnel?

    <p>Flexor Pollicis Longus Tendon</p> Signup and view all the answers

    Which condition is most commonly associated with compression of the median nerve in the carpal tunnel?

    <p>Carpal Tunnel Syndrome</p> Signup and view all the answers

    What structures contribute to the floor of the carpal tunnel?

    <p>Proximal row of carpal bones</p> Signup and view all the answers

    List the contents of the carpal tunnel.

    <p>Median nerve and flexor tendons (flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus)</p> Signup and view all the answers

    What forms the roof of the carpal tunnel?

    <p>Flexor retinaculum</p> Signup and view all the answers

    List the attachments for the flexor retinaculum.

    <p>The flexor retinaculum attaches to the pisiform and hook of the hamate on the ulnar side and to the scaphoid and tubercle of the trapezium on the radial side.</p> Signup and view all the answers

    List the ligaments that stabilize the wrist joint medially, laterally, anteriorly and posteriorly.

    <p>Ulnar collateral ligament, Radial collateral ligament, Palmar radiocarpal ligament, Dorsal radiocarpal ligament</p> Signup and view all the answers

    Study Notes

    Clavicle Anatomy and Function

    • The clavicle is a bone located in the shoulder, connecting the shoulder blade to the breastbone.
    • It is positioned near the subclavian vessels, which carry blood to the arm, and the brachial plexus, a group of nerves that control the arm and hand.
    • The clavicle acts as a protective barrier for these structures.

    Clavicle Fractures and Complications

    • A fracture of the clavicle can damage the subclavian vessels and the brachial plexus.
    • Injury to the subclavian vessels can restrict blood flow to the arm, leading to complications.
    • Damage to the brachial plexus can cause weakness, numbness, or paralysis in the arm and hand.
    • Therefore, a clavicle fracture can pose a significant risk to the health and function of the arm.

    Humerus Articulations

    • The capitulum of the humerus articulates with the radius.
    • The trochlea of the humerus articulates with the ulna.

    Condyle vs. Epicondyle

    • A condyle is a bony projection that forms a joint with another bone.
    • An epicondyle is a bony projection that serves as an attachment site for muscles.

    Forearm Terminology

    • The forearm is also known as the antebrachium.

    Orientation of the Ulna

    • The olecranon process is a prominent projection on the proximal end of the ulna that forms the elbow point.
    • The coronoid process is an anterior projection located below the trochlear notch.
    • The trochlear notch is a semi-circular indentation on the proximal ulna that articulates with the humerus to form the elbow joint.
    • The head of the ulna is a rounded projection located on the distal end of the ulna.
    • The styloid process of the ulna is a small pointed projection on the head of the ulna.

    Pronation

    • Pronation is the movement of the forearm that turns the palm to face posteriorly.
    • It's a movement that involves the rotation of the radius bone.
    • The ulna remains fixed during pronation, due to its joint structure with the humerus, which limits rotation.
    • The radius rotates around the ulna, enabling the palm to move from an anterior (forward-facing) to a posterior (backward-facing) position.

    Carpal Bone Location and Number

    • Eight carpal bones are located in the wrist, acting as a bridge between the forearm and hand.
    • Organized into two rows: a proximal row and a distal row.

    Proximal Row

    • Scaphoid: Largest bone, boat-shaped, important for wrist movement and prone to fractures.
    • Lunate: Moon-shaped, articulates with the radius, crucial for wrist motion.
    • Triquetrum: Pyramidal shape, located medially, connects to the wrist's articular disc.
    • Pisiform: Small, pea-shaped, sits atop the triquetrum, a sesamoid bone for the flexor carpi ulnaris.

    Distal Row

    • Trapezium: Irregular shape, located under the thumb, connects to the first metacarpal (thumb).
    • Trapezoid: Small, wedge-shaped, connects to the second metacarpal.
    • Capitate: Largest carpal bone, centrally located, connects to the third metacarpal.
    • Hamate: Notable for its hook-like process, connects with the fourth and fifth metacarpals.

    Carpal Bone Features

    • Articulations: Each carpal bone forms joints with adjacent bones (metacarpals and other carpals), enabling wrist movements.
    • Ligaments: Multiple ligaments bind the carpal bones together, contributing to wrist stability.
    • Clinical Importance: Injuries and fractures are common, particularly in the scaphoid due to its poor blood supply.

    Arrangement and Movement

    • Mnemonic devices can aid in remembering carpal bone order (e.g., "Some Lovers Try Positions That They Can't Handle" for proximal row, "The Can't Hammer" for distal).
    • The carpal arrangement allows for diverse movements including flexion, extension, and rotation, in conjunction with forearm motion.

    Carpal Tunnel Bony Borders

    • The carpal tunnel, a narrow passageway in the wrist, is formed by the carpal bones and the flexor retinaculum.
    • Four bony prominences create the borders of the carpal tunnel and serve as attachment points for the flexor retinaculum.
    • These bony prominences are:
      • Hook of the Hamate: Located on the palmar surface of the hamate bone, a small bone in the wrist.
      • Tubercle of the Scaphoid: Located on the palmar surface of the scaphoid bone, the largest bone in the proximal row of carpals.
      • Tubercle of the Trapezium: Located on the palmar surface of the trapezium bone, a small bone in the wrist.
      • Pisiform: A small, pea-shaped bone located on the palmar surface of the triquetrum bone.

    Carpal Tunnel Borders

    • The carpal tunnel, a narrow passageway in the wrist, is bordered by four bony prominences.
    • These prominences serve as attachment points for the flexor retinaculum, a thick band of connective tissue that forms the roof of the tunnel.
    • The four bony prominences are:
      • Hook of the Hamate: A projection on the hamate bone, located on the pinky finger side of the wrist.
      • Tubercle of the Scaphoid: A small bump on the scaphoid bone, located on the thumb side of the wrist.
      • Tubercle of the Trapezium: A bump on the trapezium bone, located on the thumb side of the wrist.
      • Pisiform: A small, pea-shaped bone located on the pinky finger side of the wrist.

    Acromioclavicular Joint

    • Synovial plane joint with limited mobility
    • Common site for injuries like acromioclavicular separation, often from falls onto outstretched arms

    Biceps Brachii Tendon

    • Travels through the intertubercular groove of the humerus
    • Attaches to the supraglenoid tubercle of the scapula
    • Situated outside the shoulder joint's synovial cavity, despite passing through it
    • Surrounded by a synovial membrane sheath, allowing for smooth movement while protecting the tendon

    Coracoacromial Ligament

    • Extends from the coracoid process of the scapula to the acromion
    • Forms a protective arch over the shoulder joint
    • Restricts upward dislocation of the humeral head

    Subacromial and Subdeltoid Bursae

    • Located around the shoulder joint
    • Reduce friction between the acromion and the head of the humerus
    • Subacromial bursa is located between the acromion and the humeral head
    • Subdeltoid bursa is situated beneath the deltoid muscle
    • Both bursae facilitate smooth motion

    Carpal Tunnel Borders

    • Bony Prominences: The carpal tunnel is outlined by four bony landmarks:
      • Hook of the Hamate
      • Tubercle of the Scaphoid
      • Tubercle of the Trapezium
      • Pisiform
    • Flexor Retinaculum: Forms the superior border of the carpal tunnel and acts as a ligament, holding the tendons together.
    • Carpal Bones: The carpal bones form the inferior border of the carpal tunnel.
    • Floor of the Carpal Tunnel: The proximal row of carpal bones creates the floor of the carpal tunnel.
    • Distal Row of Carpal Bones: The distal row doesn't contribute to the tunnel's floor but plays a role in wrist movement.

    Carpal Tunnel Contents

    • Median Nerve: The main nerve that courses through the carpal tunnel, it is responsible for sensation in the hand and movement in some fingers.
    • Flexor Tendons: Several tendons pass through the carpal tunnel, facilitating finger flexion:
      • Flexor Digitorum Superficialis Tendons - Flex the fingers
      • Flexor Digitorum Profundus Tendons - Flex the distal finger joints
      • Flexor Pollicis Longus Tendon - Flexes the thumb

    Clinical Significance

    • Carpal Tunnel Syndrome: Compression of the median nerve within the carpal tunnel, often due to swelling from injury, repetitive motions, or medical conditions.
    • Understanding the Anatomy: Knowledge of the carpal tunnel's borders is essential for diagnosing and managing conditions like carpal tunnel syndrome.

    Carpal Tunnel Borders

    • Bony Prominences: The carpal tunnel is formed by four key bony prominences: Hook of the Hamate, Tubercle of the Scaphoid, Tubercle of the Trapezium, and Pisiform. These prominences serve as attachment points for the flexor retinaculum, which forms the superior border of the carpal tunnel.

    • Superior Border: The flexor retinaculum forms the superior border of the carpal tunnel.

    • Inferior Border: The carpal bones form the inferior border of the carpal tunnel.

    • Floor: The proximal row of carpal bones forms the floor of the carpal tunnel. The distal row of carpal bones does not contribute to the floor but is important for wrist function.

    Carpal Tunnel Contents

    • Median Nerve: The median nerve is the primary nerve that passes through the carpal tunnel.

    • Flexor Tendons: The carpal tunnel houses the tendons of several muscles that flex the fingers and thumb:

      • Flexor Digitorum Superficialis Tendons: These tendons flex the fingers.
      • Flexor Digitorum Profundus Tendons: These tendons flex the distal joints of the fingers.
      • Flexor Pollicis Longus Tendon: This tendon flexes the thumb.

    Clinical Relevance

    • Carpal Tunnel Syndrome: The confined space of the carpal tunnel can lead to compression of the median nerve. This is especially common when swelling occurs due to injury, repetitive motion, or underlying medical conditions.
    • Diagnosis and Treatment: Understanding the anatomical borders of the carpal tunnel is crucial for diagnosing and treating conditions such as carpal tunnel syndrome.

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