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MSK elbow, forearm, wrist > biomechanics elbow, forearm, wrist > Flashcards

biomechanics elbow, forearm, wrist Flashcards

1
Q

Flexion/extension, shorten/lengthen, upper extremity

A

humero ulnar joint
humero radial joint

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2
Q

rotation- pronate/supination

A

proximal radioulnar joint
distal radioulnar joint

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3
Q

functional range of motion of the elbow

A

30 to 130°

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4
Q

capsular pattern for the elbow

A

Flexion greater than extension

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5
Q

bony stability of the humeroulnar joint

A

interlocking of trochlea groove of humorous into ulnar trochlear

coronoid process into coronoid fossa
olecranon into olecranon fossa

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6
Q

Coronoid process prevents

A

Posterior displacement with flexion

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7
Q

olecranon prevents

A

Hyper extension

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8
Q

elbow capsule

A

humeral ulnar, humero radial, proximal radioulnar joints

anterior and posterior are weak

Laterally reinforced with ligaments

Max volume is 70 to 80° of flexion

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9
Q

Medial collateral ligament

A

anterior- 1° of vagus restraint through all elbow motion

Posterior - taught in full flexion

Transverse -no role in stability

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10
Q

Lateral collateral ligament complex

A

lateral collateral ligament

Lateral ulnar collateral ligament

Annular ligament

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11
Q

lateral (radial) collateral ligament

A

Fan shaped
lateral epicondyle to annular ligament

primary restraint to varus/ supination

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12
Q

lateral ulnar collateral ligament

A

lateral epicondyle to supinator crest, ulna, and annular ligament

tight extreme flexion and any varus

secondary restraint to varus/supination

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13
Q

annular ligament

A

Restraint- traction, lateral subluxation

Secondary restraint to varus/supination

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14
Q

Axis of motion for the elbow

A

movement is through center of trochlea and capitulum

medial trochlea More distal

Carrying angle is about 13°

mediately deviate with flexion
Laterally deviate with extension

Increased angle may impact ulnar nerve

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15
Q

Limits to elbow extension

A

anterior capsule
Flexor muscles
Bony olecranon process

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16
Q

limits to elbow flexion

A

soft tissue
Posterior capsule
Extensor muscles
Bony- Radial head and coronoid process

Function limited with forearm in mid to full pronation

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17
Q

humero ulnar joint positions

A

closed- full extension and supination
Open - 70° flexion and 10° supination

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18
Q

humeroradial joint positions

A

closed- 90 degrees flexion 5° supination
Open -full extension and supination

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19
Q

closed and open pack positions during elbow injury

A

Closed packed joints often fracture associated bones

Open packed joints often dislocate

20
Q

monteggia fx

A

fx proximal ulna
radial head dislocation

21
Q

role of interosseous membrane

A

binds radius to ulna
muscle attachments
Transfers force from radius to ulna

22
Q

Wight bearing from hand to forearm is through

A

the radius

The interosseous membrane distributes portion load to ulna

23
Q

Axis of motion for proximal and distal radio ulnar joints

A

Radial head through ulnar head

24
Q

proximal radial ulnar joint

A

within capsule with HU and HR joints

Annular ligament

25
Q

Annular ligament

A

allows spin
Binds radius to ulna
Prevents radial head displacement

26
Q

distal radioulnar joint

A

palmar RU lig
dorsal RU lig
articular disc

27
Q

palmar RU lig

A

tight in supination

28
Q

dorsal RU lig

A

tight in pronation

29
Q

articular disc (TFCC)

A

binds to distal radius ulna
dual articular surface
separates RU and RC joints
central portion avascular

30
Q

RU joint arthro

A

pivot
one dof
rom-150
pronation- 75
supination-85

functional- 50 each
capsular pattern- pro> sup

31
Q

pronation at RU jt

A

radial head spins in annular lig/radial notch
radius rotates over ulna

32
Q

supination at RU

A

radial head spins in annular ligament radial notch

radius unwinds from ulna

33
Q

treatment considerations for PRU and DRU

A

PRU- roll glide opposite (it only spins)

DRU- roll glide same

34
Q

limits to supination

A

pronator teres
pronator quadratus
TFCC
palmar DRUJ
IOM

35
Q

limits to pronation

A

supinator
biceps
TFCC
dorsal DRUL lig

36
Q

brachialis

A

prime mover- inserts close to joint of action

unaffected by forearm position due to insertion on ulna

37
Q

biceps brachii

A

prime mover

most effective 80-100 elbow flexion and with shoulder in extension

good supinator at 90 flexion

38
Q

brachioradialis

A

stability muscle - inserts far from joint of action

strongest at 90-120 elbow flexion with forearm in mid position

39
Q

pronator teres

A

small role in elbow flexion

40
Q

triceps

A

not influences by forearm position due to ulnar insertion

max torque 90 flexion

primarily medial head lateral and long head active with higher resistance or speed of contraction

41
Q

anconeus

A

helps initiate elbow extension
may stabilize against varus force

42
Q

supinator

A

supinator
functions regardless of elbow position

43
Q

biceps brachii- supination

A

used with higher force activity and when combined with flexion

good supinator at 90 flexion

44
Q

radial wrist extensors

A

supination

45
Q

brachioradialis

A

can derotate forearm to neutral

46
Q

forearm pronators

A

pronator teres
pronator quadratus
flexor carpi radialis
palmaris longus
brachioradialis

MSK elbow, forearm, wrist (8 decks)

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