Joints of the Upper Limb: Learning Objectives and Review Questions

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True/False

1. The transverse humeral ligament bridges the intertubercular sulcus.
2. Stability of the sternoclavicular joint is provided for by 3 named local ligaments.
3. The coracohumeral ligament is a thickening of the glenohumeral ligament.
4. Shoulder separation results from rupturing acromioclavicular and coracoclavicular ligaments.
5. Mobility of a joint comes at the expense of stability. A golf ball on a tee.
6. The glenohumeral joint capsule lies between the supraspinatus tendon and the long head biceps tendon.
7. Between the greater tubercle of the humerus and the coracoacromial arch, when the arm is laterally rotated, is the subacromial bursa.
8. The glenohumeral ligaments are demonstrated as external thickenings of the posterior wall of the glenohumeral joint cavity.
9. The ulnar collateral ligament extends distally to blend with the annular ligament.
10. The ulnar collateral ligament resists varus force.
11. The radial collateral ligament extends distally to blend with the annular ligament.
12. The annular ligament is attached to the radius and to the ulna.
13. The triangular fibrocartilagenous complex (TFCC) contributes to stability of the proximal radioulnar joint.
14. The origin of the long head of the biceps blends with the glenoid labrum.
15. The subacromial bursa intervenes inferior to the acromion and superior to the supraspinatus tendon as this tendons blends into the joint capsule.
16. Structures at risk during shoulder separation include the acromioclavicular, trapezoid, and conoid ligaments.
17. The far lateral margin of the subacromial bursa is called the subdeltoid bursa.
18. A tear in the supraspinatus tendon may open a communication between the subacromial bursa and synovial joint cavity of the glenohumeral joint.
19. An articular disc divides the sternoclavicular joint into two synovial cavities.
20. In general, an articular disc increases range of mobility (but not always).
21. The sternoclavicular joint provides the only bony link between the scapula and the skeleton.
22. The costoclavicular ligament assists stability of the acromioclavicular ligament.
23. The subscapularis muscle inserts on the medial lip of the crest of the greater tubercle.
24. The supraspinatus tendon of insertion creates a specialization of the internal joint capsule.
25. The infraspinatus muscle inserts intermediately between the supraspinatus, superiorly, and the teres major, inferiorly.
26. The teres minor muscle inserts on the medial lip of the intertubercular sulcus immediately superior to the teres major.
27. The subscapularis bursa communicates with the synovial joint capsule of the glenohumeral joint.
28. The glenoid labrum, at the infraglenoid tubercle, blends with the tendon of the long head of the biceps.
29. The long head of the biceps is intracapsular and extrasynovial at the glenohumeral joint.
30. The long head of the biceps aids in approximating the head of the humerus to the glenoid fossa.
31. The glenohumeral joint capsule attaches to the margins of the surgical neck of the humerus.
32. The intertubercular tendinous sheath is continuous with the synovium of the glenohumeral joint.
33. The glenohumeral joint capsule is relatively lax at the inferior margin and this dislocation vulnerable to forced abduction.
34. The anterior glenohumeral joint capsule is strengthened by the glenohumeral ligaments.
35. The trochlear of the humerus articulates with the head of the radius.
36. The olecranon fossa of the humerus receives the olecranon of the ulna on maximum flexion.
37. The ulnar notch of the proximal radioulnar joint receives the radial head.
38. The annular ligament stabilizes the head of the radius without ever attaching to the radius.
39. The radial tuberosity faces anterior when in anatomical position (supination of the forearm).
40. The medial (ulnar) collateral ligament of the elbow has three named bands.
41. The radial collateral attaches to the ulna and to the annular ligament.
42. The distal radiolulnar joint allows the radius to pivot medially on the ulnar during pronation.
43. The MP and IP joints are all hinge joints.
44. The central slip of the extensor hood extends distal to the lateral bands to insert on the base of the distal phalanx.
45. A lateral view of the extensor hood can be verified by the presence of two tendons blending with the region of the lateral cord.
46. In the case that two tendons are blending on the same side of the extensor hood that the view is lateral, then the distal tendon is a lumbrical.
47. All MP and IP joints have collateral ligaments.
48. The deep transverse metacarpal ligament is at the level of the metacarpophalangeal joint.
49. The vinculae are mesotendons that transport synovial fluid to the distal tendon.

Essay

1. Discuss the Shoulder Joint. Include articulations, stabilization, contents, cavities, relationships, boundaries, fascial specializations, vascularization, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury.
2. Discuss the Elbow Joint. Include articulations, stabilization, contents, cavities, relationships, boundaries, fascial specializations, vascularization, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury.
3. Discuss the Wrist Joint. Include articulations, stabilization, contents, cavities, relationships, boundaries, fascial specializations, vascularization, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury.

Short Answer and Definitions

1. Glenohumeral ligaments
2. Glenoid labrum
3. Transverse humeral ligament
4. Coracoacromial arch
5. Rotator cuff tear (supraspinatus tendon)
6. Acromioclavicular joint
7. Costoclavicular joint
8. Coracoid process
9. Distal radioulnar joint
10. Articular disk at the wrist
11. Anular ligament
12. Radiocarpal joint