Anatomy of the Shoulder (glenohumeral) & Hip (acetabulofemoral) Joints - MCQ/SBA (for BM5 NLM1)

What type of joint is found at the glenohumeral and acetabulofemoral joints?

Synovial, ball & socket (multi-axial)

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Hyaline cartilage lines the articulating joint heads in synovial joints. What is it's primary purpose?

To reduce friction between the articulating bones

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The innermost section of a synovial joint is lined by a synvoial membrane. What does this secrete?

Synovial fluid

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Name the two structures which surround the synovial membrane to form the whole synovial joint.

Fibrous capusle & ligaments

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Correctly identify the two key differences between the shoulder and hip joints.

Hip joint has a tight capsule and tight ligaments, whereas the shoulder joint does not

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In relation to the shoulder and hip joints, what is the labrum?

A fibrocartilaginous ring that attaches and acts around the joint fossa to deepen it

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What is a bursa?

A small sca filled with synovial fluid that acts to reduce friction between bones/tendons/muscles

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Identify the two main muscles that are attached to the anterior of the shoulder joint and permit flexion of that joint.

Pectoralis Major & anterior fibres of Deltoid

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Identidy the main muscles that are attached to the posterior of the shoulder joint and permit extension of that joint.

Latissimus Dorsi & posterior fibres of Deltoid

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Name the main muscle principally responsible for abduction at the shoulder joint (clue: it's found laterally).

Deltoid (middle fibres)

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Name the main muscles principally responsible for adduction at the shoulder joint (clue: they're found medially).

Latissimus Dorsi, Teres Major & Pectoralis Major

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What are the rotator cuff muscles?

Infraspinatus, Supraspinatus, Teres Minor & Subscapularis

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Name the main muscles that cause flexion at the hip joint (clue: found anterior to the joint).

Illiopsoas & Quadraceps Femoris

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Name the main muscles that cause extension at the hip joint (clue: found posterior to the joint)

Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris

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Name the principle muscles involved in the adduction of the leg at the hip joint.

Adductor Longus, Adductor Brevis & Adductor Magnus

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Identify the muscles that are principally involved in the abduction of the leg at the hip joint.

Gluteus Maximus, Gluteus Medius, Gluteus Minimus & Tensor Fasciae Latae

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Other than the gluteus muscles, identify three muscles in the deep gluteal region that are involved in rotation at the hip joint.

Piriformus, Obturator Internus & Gemelli

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Name the parts of the humerus and scapula that articulate with each other to form the shoulder joint

Head of Humerus & Glenoid Fossa

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Name the parts of the femur and pelvis that articulate with each other to form the hip joint.

Head of Femur & Acetabulum

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What is the name of the joint where the clavicle and scapula articulate?

Acromioclavicular joint

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Which ligament stabilises the sternoclavicular joint?

Costoclavicular ligament

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What separates the two articulating surfaces at the sternoclavicular joint?

A fibrocartilaginous disk

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Identify the three functions of the fibrocartilaginous disk that separates the articular surfaces at the sternoclavicular joint

Prevent medial clavicular displacement, shock absorber, increased joint congruency

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Which ligaments attach directly to the ilieum and stabilise the sacroiliac joint?

Interosseous & Sacroiliac ligaments

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What type of joint is the Symphysis Pubis?

Secondary Cartilaginous

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The glenohumeral joint is very mobile, but this comes at the expense of its stability. What bony injury is common at the shoulder joint?

Anterior dislocation

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The capsule that covers the long head (tendon) of biceps brachii is thickened, forming a ligament over the intertubercular groove. Name that ligament!

Transverse humeral ligament

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What is contained within the acetabular fossa?

Fat pad

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Which ligament is located anteriorly between the ilium and intertrochanteric line?

Iliofemoral ligament

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Which ligament is located anteriorly between the pubis and interotrochanteric line?

Pubofemoral ligament

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Which ligament is located posteriorly and spirals between the ischium and greater trochanter?

Ischiofemoral ligament

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Which ligament attaches between the acetabular notch and the fovea capitis

Ligamentum Teres

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A broken neck of femur is a serious injury, particularly in the elderly, as it can damage the blood supply to the head of the femur. What condition would this cause?

Avascular Necrosis

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What is the axilla?

An anatomical space

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The axilla is a 3D pyramidal shaped anatomical space located between the upper part of the thorax and the arm. What does it contain?

Vessels, nerves & lymphatics

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What forms the anterior and posterior borders of the axilla?

Anterior - Pectoralis Major & Minor, Posterior - Scapula

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What forms the medial and lateral borders of the axilla?

Medial - Ribs & Serratus Anterior, Lateral - Humerus

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The axilla conatins the axillary artery, axillary vein, brachial plexus and the axillary lymph nodes. Why might the axillary lymph nodes be important clinically?

They can be the site of metastases in breat cancer cases

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The contents of the axilla are surrounded by a thin layer of fascia called the axillary sheath. What is the clinical relevence of this sheath?

It can be the site of injection of local anaesthesia (regional nerve block) to anaesthetise the upper limb

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What are the superior, medial and lateral border of the femoral triangle?

Superior - Inguinal ligament, Medial - Adductor Longus, Lateral - Sartorius

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Name the nerve found in the femoral triangle.

Femoral nerve

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Name the three trunks formed from the five roots, and note which spinal nerve(s) innervate each.

Superior trunk (C5&6), Middle trunk (C7), Inferior trunk (C8&T1)

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What are the two divisions made by the brachial plexus?

Anterior & Posterior

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After divisions, the brachial plexus splits into cords, classified as posterior, lateral and medial. From which trunk(s) does the lateral cord come?

Anterior division of the superior & middle trunks

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What are the two terminal branches of the posterior cord?

Radial & Axillary

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Which spinal nerves form the lumbar plexus?

L1-L4

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Which spinal nerves form the sacral plexus?

L4-S3

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How are dermatomes clinically examined?

By assessing cutaneous sensation using a pin

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How are myotomes clinically assessed?

By assessing muscular sensation using a reflex examination

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Which spinal nerves form the femoral nerve?

L2, L3, L4

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Which spinal nerves form the Obturator nerve?

L2, L3, L4

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Which spinal nerves form the Sciatic nerve?

L4, L5, S1, S2, S3

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Which spinal nerves form the Lumbosacral trunk?

L4, L5

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Which spinal nerves form the lateral femoral cutaneous nerve?

L2, L3

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A patient comes into your clinic, and after a consultation, a poor Achilles reflex test and an extensive examination, you diagnose a herniation of the L5-S1 disc. What are the likely symptoms that the patient would have presented with?

Tingly/sensory change over the posterior of the leg/lateral aspect of foot, ankle weakness, weak eversion

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Which spinal nerves form the superior gluteal nerve?

L4, L5, S1

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Which spinal nerves form the inferior gluteal nerve?

L4, L5, S1, S2

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Anatomy of the Shoulder (glenohumeral) & Hip (acetabulofemoral) Joints - MCQ/SBA (for BM5 NLM1)

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