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Comps > CH. 1 Functional Anatomy and Biomechanics (Upper Extermity) > Flashcards

CH. 1 Functional Anatomy and Biomechanics (Upper Extermity) Flashcards

1
Q

Upper Extermity Neuro Screen

Action to be tested: Neck flexion, Neck extension, neck rotation, neck lateral-bending

Muscles:?

Myotomes:?

Reflexes:?

Cord Segment:?

Nerves:?

A

Upper Extermity Neuro Screen

Action to be tested: Neck flexion, Neck extension, neck rotation, neck lateral-bending

Muscles: Sternocleidomastoid, trapezius, other deep neck muscles

Myotomes: n/a

Reflexes: n/a

Cord Segment: C1-C4

Nerves: Cervical Spinal Accessory Nerve

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2
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder shrug, scapular upward rotation

Muscles:?

Myotomes:?

Reflexes:?

Cord Segment:?

Nerves:?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder shrug, scapular upward rotation

Muscles: Upper trapezius

Myotomes: C4

Reflexes: n/a

Cord Segment: C1-C4

Nerves: Spinal Accessory Nerve

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3
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder horizontal adduction

Muscles:?

Myotomes:?

Reflexes:?

Cord Segment:?

Nerves:?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder horizontal adduction

Muscles: Pectoralis major/ minor

Myotomes: n/a

Reflexes: n/a

Cord Segment: C5-C8, T1

Nerves: Medial/Lateral Pectoral Nerve

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4
Q

Upper Extermity Neuro Screen

Action to be tested: Scapular downward rotation

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Scapular downward rotation

Muscles: Pectoralis minor

Myotomes: n/a

Reflexes: n/a

Cord Segment: C8-T1

Nerves: Medial Pectoral Nerve

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5
Q

Upper Extermity Neuro Screen

Action to be tested: Shulder protraction, scapular upward rotation

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder protraction, scapular upward rotation

Muscles: Serratus anterior

Myotomes: n/a

Reflexes: n/a

Cord Segment: C5-C7

Nerves: Long Thoracic Nerve

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6
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder elevation, Scapular downward rotation

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder elevation, scapular downward rotation

Muscles: Levator scapula

Myotomes: n/a

Reflexes: n/a

Cord Segment: C5

Nerves: Dorsal Scapular Nerve

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7
Q

Upper Extermity Neuro Screen

Action to be tested: Scapular adduction, elevation, and downward rotation

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Scapular adduction, elevation, and downward rotation

Muscles: Rhomboids

Myotomes: n/a

Reflexes: n/a

Cord Segment: C4-C5

Nerves: Dorsal Scapular Nerve

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8
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder abduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder abduction

Muscles: Supraspinatus

Myotomes: n/a

Reflexes: n/a

Cord Segment: C4-C6

Nerves: Suprascapular Nerve

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9
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder lateral rotation

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder lateral rotation

Muscles: Infraspinatus

Myotomes: n/a

Reflexes: n/a

Cord Segment: C4-C6

Nerves: Suprascapular Nerve

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10
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder medial rotation, adduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder medial rotation, adduction

Muscles: Latissimus dorsi, teres major, & subscapularis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C5-C8

Nerves: Subscapular & Thoracodosal Nerves

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11
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder abduction, flexion, extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder abduction, flexion, extension

Muscles: Deltoid

Myotomes: C5

Reflexes: n/a

Cord Segment: C5-C6

Nerves: Axillary Nerve

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12
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder lateral rotation

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder lateral rotation

Muscles: Teres minor

Myotomes: n/a

Reflexes: na/

Cord Segment: C4-C5

Nerves: Axillary Nerve

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13
Q

Upper Extermity Neuro Screen

Action to be tested: Elbow flexion, forearm supination

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Elbow flexion, forearm supination

Muscles: Biceps brachii

Myotomes: C6

Reflexes: C5

Cord Segment: C5-C6

Nerves: Musculocutaneous Nerve

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14
Q

Upper Extermity Neuro Screen

Action to be tested: Shoulder flexion, adduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Shoulder flexion, adduction

Muscles: Coracobrachialis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C7

Nerves: Musculocutaneous Nerve

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15
Q

Upper Extermity Neuro Screen

Action to be tested: Elbow flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Elbow flexion

Muscles: Brachialis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C5-C6

Nerves: Musculocutaneous Nerve

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16
Q

Upper Extermity Neuro Screen

Action to be tested: 4th & 5th digit DIP flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 4th & 5th digit DIP flexion

Muscles: Flexor digitorum (ulnar portion)

Myotomes: n/a

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Ulnar Profundus

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17
Q

Upper Extermity Neuro Screen

Action to be tested: Wrist ulnar flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Wrist ulnar flexion

Muscles: Flexor carpi ulnaris

Myotomes: C7

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Ulnar Nerve

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18
Q

Upper Extermity Neuro Screen

Action to be tested: Thumb adduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Thumb adduction

Muscles: Adductor pollicis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C8-T1

Nerves: Ulnar Nerve

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19
Q

Upper Extermity Neuro Screen

Action to be tested: 5th digit abduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 5th digit abduction

Muscles: abductor digiti

Myotomes: n/a

Reflexes: n/a

Cord Segment: C8-T1

Nerves: Ulnar quinti Nerve

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20
Q

Upper Extermity Neuro Screen

Action to be tested: 5th digit opposition

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 5th digit opposition

Muscles: Opponens digiti

Myotomes: n/a

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Ulnar quinti nerve

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21
Q

Upper Extermity Neuro Screen

Action to be tested: 5th digit MCP flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 5th digit MCP flexion

Muscles: Flexor digiti quinti

Myotomes: n/a

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Ulnar brevis Nerve

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22
Q

Upper Extermity Neuro Screen

Action to be tested: 2nd-5th digit MCP flexion, adduction, & abduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves:

A

Upper Extermity Neuro Screen

Action to be tested: 2nd-5th digit MCP flexion, adduction, & abduction

Muscles: Interossei

Myotomes: n/a

Reflexes: n/a

Cord Segment: C8-T1

Nerves: Ulnar Nerve

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23
Q

Upper Extermity Neuro Screen

Action to be tested: Forearm pronation

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Forearm pronation

Muscles: Pronator teres, pronator quadratus

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C7

Nerves: Median Nerve

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24
Q

Upper Extermity Neuro Screen

Action to be tested: Wrist radial flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Wrist radial flexion

Muscles: Flexor carpi radialis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C7

Nerves: Median Nerve

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25
Q

Upper Extermity Neuro Screen

Action to be tested: Wrist flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Wrist flexion

Muscles: Palmaris longus

Myotomes: n/a

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Median Nerve

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26
Q

Upper Extermity Neuro Screen

Action to be tested: 2nd-5th digit proximal IP flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 2nd -5th digit proximal IP flexion

Muscles: Flexor digitorum sublimis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Median Nerve

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27
Q

Upper Extermity Neuro Screen

Action to be tested: Thumb IP flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Thumb IP flexion

Muscles: Flexor pollicis longus

Myotomes: n/a

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Median Nerve

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28
Q

Upper Extermity Neuro Screen

Action to be tested: 2nd-3rd digit distal IP flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 2nd-3rd digit distal IP flexion

Muscles: Flexor digitorum

Myotomes: n/a

Reflexes: n/a

Cord Segment: C7-T1

Nerves: Median profundus nerve (radial portion)

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29
Q

Upper Extermity Neuro Screen

Action to be tested: Thumb abduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Thumb abduction

Muscles: Abductor pollicis brevis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-T1

Nerves: Median Nerve

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30
Q

Upper Extermity Neuro Screen

Action to be tested: Thumb MCP flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Thumb MCP flexion

Muscles: Flexor pollicis brevis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-T1

Nerves: Median/Ulnar Nerves

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31
Q

Upper Extermity Neuro Screen

Action to be tested: Thumb opposition

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Thumb opposition

Muscles: Opponens pollicis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C8-T1

Nerves: Median Nerve

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32
Q

Upper Extermity Neuro Screen

Action to be tested: 2nd-5th digit MCP flexion, IP extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 2nd-5th digit MCP flexion, IP extension

Muscles: Lumbricals

Myotomes: n/a

Reflexes: n/a

Cord Segment: C8-T1

Nerves: Median/Ulnar Nerves

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33
Q

Upper Extermity Neuro Screen

Action to be tested: Elbow flexion

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Elbow flexion

Muscles: Brachioradialis

Myotomes: n/a

Reflexes: C6

Cord Segment: C5-C6

Nerves: Radial Nerve

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34
Q

Upper Extermity Neuro Screen

Action to be tested: Elbow extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Elbow extension

Muscles: Triceps brachii, anconeus

Myotomes: n/a

Reflexes: C7

Cord Segment: C6-C8

Nerves: Radial Nerve

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35
Q

Upper Extermity Neuro Screen

Action to be tested: Wrist radial extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Wrist radial extension

Muscles: Extensor carpi radialis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C8

Nerves: Radial nerve

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36
Q

Upper Extermity Neuro Screen

Action to be tested: 2nd-5th digit MCP, IP extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 23nd-5th digit MCP, IP extension

Muscles: Extensor digitorum communis, Extensor digiti quinti proprius

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C8

Nerves: Radial nerve

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37
Q

Upper Extermity Neuro Screen

Action to be tested: Wrist ulnar extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Wrist ulnar extension

Muscles: Extensor carpi ulnaris

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C8

Nerves: Radial nerve

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38
Q

Upper Extermity Neuro Screen

Action to be tested: Forearm supination

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Forearm supination

Muscles: Supinator

Myotomes: n/a

Reflexes: n/a

Cord Segment: C5-C6

Nerves: Radial nerve

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39
Q

Upper Extermity Neuro Screen

Action to be tested: Thumb MCP abduction

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Thumb MCP abduction

Muscles: Abductor pollicis longus

Myotomes: C8

Reflexes: n/a

Cord Segment: C7-C8

Nerves: Radial nerve

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40
Q

Upper Extermity Neuro Screen

Action to be tested: Thumb extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: Thumb extension

Muscles: Extensor pollicis longus, Extensor pollicis brevis

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C8

Nerves: Radial nerve

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41
Q

Upper Extermity Neuro Screen

Action to be tested: 2nd digit extension

Muscles: ?

Myotomes: ?

Reflexes: ?

Cord Segment: ?

Nerves: ?

A

Upper Extermity Neuro Screen

Action to be tested: 2nd digit extension

Muscles: Extension indicis proprius

Myotomes: n/a

Reflexes: n/a

Cord Segment: C6-C8

Nerves: Radial nerve

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42
Q

What is the osteology of the shoulder region?

A
  • humerus
  • scapula
  • clavicle
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43
Q

Describe the Humerus

A
  • proximal end of humerus is approximatly half a spheroid
  • Articular surface is covered by hyaline cartilage
  • Head is retroverted 20°-30°
  • Longitudinal axis of head is 135° from axis of neck
44
Q

Describe the Scapula

A
  • Large, flat triangular bone that sits over the 2nd to the 7th ribs
  • Costal surface and a dorsal surface
  • three angles: medial, superior, and lateral
  • Lateral angle bears glenoid fossa, which faces anteriorly, laterally, and superiorly
  • Pear shape of fossa allows for freer range of motion (ROM) in abduction and flexion
  • Concave shape receives convex humeral head
  • Orientation of the glenoid fossa places true abduction at 30° anterior to frontal plane
45
Q

Describe the Clavicle

A
  • Extends laterally and links manubrium to acromion
  • connects shoulder complex to axial skeleton
46
Q

what is the Arthrology of the shoulder region?

A
  • glenohumeral
  • sternoclavicular
  • arcomioclavicular
  • scapulothoracic
47
Q

Describe the Glenohumeral joint

A
  • Convex humeral head articulates with a concave glenoid fossa
  • Glenoid fossa is verry shallow
48
Q

Describe the Sternoclavicular joint

A
  • Convex (superior/inferior) and concave (anterior/posterior) articulates with reciprocal shape of sternum
  • Both articulations covered with fibrocartilage
49
Q

Describe the Acromioclavicular joint

A
  • A plane joint with relatively flat surfaces
50
Q

Describe the Scapulothoracic joint

A
  • A “clinical” articulation
51
Q

what are the noncontractile structures of the shoulder region?

A
  • Ligaments
    • Arcomioclavicular
    • Trapezoid
    • Conoid
    • Sternoclavicular
  • Subacromial bursa
  • Shoulder capsule
  • Glenoid labrum
  • associated nerves and vessles
52
Q

Describe the Shoulder capsule

A
  • Attaches medially to glenoid margin, glenoid labrum, coracoid process
  • Attaches laterally to humeral anatomical neck and descends approximatly 1cm on the shaft
  • Supported by tendons of supraspinatus, infraspinatus, teres minor, subscapularis, and long head of the triceps below
  • Inferiorly capsule is least supported and most lax.
53
Q

Describe the Coracohumeral Ligament

A
  • Base of the coracoid process to greater and lesser tubercle of humerus
  • Primary function to:
    • reinforce bicep tendon
    • reinforce superior capsule
    • prevent caudal dislocation of humerus
  • Becomes Taut with external rotation
54
Q

Describe Coracoacromial Ligament

A
  • Strong triangular ligament that runs from coracoid to acromion
  • Not a “true” ligament; connects two points of the same bone
55
Q

Describe the Glenohumeral Ligaments

A
  • Three bands (superior, middle, and inferior) located on anterior glenohumeral joint
  • Reinforce anterior gelnohumeral capsule
56
Q

Describe the Transverse humeral Ligament

A
  • Broad band passing over the top of bicipital groove
  • Acts as a retinaculum for long biceps tendon
57
Q

Describe the Glenoid Labrum

A
  • Glenoid labrum is a fibrocartilaginous ring that deepens the glenoid fossa
  • Attached to capsule superiorly and inferiorly as well as to the long head of the biceps tendon superiorly
  • Internal surface covered with articular cartilage, which is thicker peripherally and thinner centerally
  • Aids in lubrication, as in meniscus of the knee, and serves to protect the bone
58
Q

Describe the Bursa (subacromial bursa)

A
  • Multiple bursa found within this region
  • Primary bursa involved with pathology is subacromial bursa between deltoid and capsule
    • also runs under acromion and coracoacromial ligament and between the supraspinatus tendon
59
Q

Describe the Glenohumeral joint arthrokinematics/osteokinematics

A
  • occurs in opposite directions
    • with elevation of humerus, head of humerus moves in an inferior direction because of convex moving on concave
  • Rolling-gliding occurs during elevation of the humerus, so that the instantaneous centers of rotation varies considerably during the complete range
  • At approximately 75° of elevation, external rotation (conjunct rotation) occurs, preventing compression of creater tubercle against the acromion
60
Q

What is the ratio of movement called of the glenohumeral with the scapulothocracic joint?

A

Scapulothoracic and glenohumeral rhythm (scapulohumeral rhythm)

61
Q

Describe Scapulohumeral rhythm

A
  • the ratio of movement of the glenohumeral with the scapulothoracic joint
  • with 180° of abduction, there is a 2:1 ratio of movement between the two joints
  • First 30°-60° of elevation occurs mainly in the glenohumeral joint
  • 120° of movement occurs at glenohumeral joint
  • Final 60° of movement occurs at scapulothoracic joint
62
Q

What are the requirements for full elevation of the shoulder

A
  • scapular stabilization
  • inferior glide of the humerus
  • external rotation of the humerus
  • rotation of the clavicle at the sternoclavicular joint
  • scapular abduction and lateral rotation of the acromioclavicular joint
  • straightening of thoracic kyphosis
63
Q

What is the osteology and arthrology of the elbow region?

A
  • ulnohumeral
  • radiohumeral
  • superior radioulnar
  • inferior radioulnar
64
Q

Describe the Humeroulnar joint

A
  • Distal end of the humerus (trochlea) articulates with the proximal end of the ulna
  • Trochlea and trochlea notch face anteriorly at a 45° angle, allowing space between ulna and humerus during flexion
65
Q

Describe the Humeroradial joint

A
  • Distal end of humerus (capitulum) articulates with the convex oval facet of the proximal radius
66
Q

Describe the Proximal Radioulnar joint

A
  • Radial head is ovid and cone-shaped
  • Medial radius articulates with radial notch (of ulna)
67
Q

Describe Distal Radioulnar joint

A
  • Convex ulna articulates with concave radius (opposite to proximal articulation of these two bones)
68
Q

What are the Noncontractile structures of the elbow region?

A
  • Ligaments
    • Medial collateral
    • radial collateral
    • annular
  • Elbow capsule
  • Bursea
  • Nerves and vessles
69
Q

Describe the elbow capsule

A
  • Encloses entire elbow joint complex.
  • It is thin, both anteriorly and posteriorly
  • Continous medially with ulnar collateral ligament, and laterally with radial collateral ligament
70
Q

Describe the Ulna collateral ligament

A
  • Ligament is triangular shaped consisting of three parts
    • anterior band
      • strong and cord like
    • posterior band
      • weak and fan like
    • oblique band
  • Reinforces humeroulnar joint medially
71
Q

Describe the Radial Collateral ligament

A
  • Ligament is fan-shaped, and runs from the lateral epicondyle of the humerus to the annular ligament
  • Reinforces humeroradial joint laterally and is stronger (histologically) than ulnar collateral ligament.
72
Q

Describe the Annular Ligament

A
  • An osteofiberous ring attached to medial ulna and encircles the radial head
  • Cone shaped, inner surface is lined with fibrocartilage
  • Protects radial head, espically in semiflexion, where it is very unstable.
  • Taut in extremes of pronation and supination
73
Q

Describe the Quadrate Ligament

A
  • Extends from radial notch (ulna) to the neck of the radius
  • Reinforces inferior joint capsule
  • Maintains radial head in opposition to ulna
  • Limits amount of spin in supination and pronation
74
Q

Describe the Distal radioulnar ligament

A
  • Anterior radioulnar ligament: primarily strengthens capsule
  • Posterior radioulnar ligament: primarily strengthens capsule
75
Q

Describe the Bursa of the elbow region

A
  • Olecranon bursa located on posterior aspect of elbow over olecranon process
76
Q

Describe the blood supple of the elbow region

A
  • Elbow joint receives blood supply from brachial artery, anterior ulnar recurrent artery, posterior ulnar recurrent artery, radial recurrent artery, and middle collateral branch of the deep brachial artery.
77
Q

Describe the stability of the elbow joint

A
  • Elbow joint complex possesses significant inherent stability
  • Main contributor to bony stability is articulation between the trochlea (humerus) and trochlear fossa (ulna)
  • Medial collateral ligament provides strong resistance to valgus forces
  • Resistance of lateral collateral ligament to varus forces minimal, due to its attachment to another soft tissue structure (annular ligament)
  • Functionally, this relationship is beneficial, since functional activities place tensile forces medially and compressive forces laterally.
    • Therefore, the lateral ligament does not have to be as strong as the medial ligament.
78
Q

Describe the Elbows biomechanics

A
  • Conjunct rotations
    • Ulna pronates slightly with extension. Ulna supinates slightly with flexion
    • Proximal ulna glides medially during extension and laterally during flexion
    • Flexion/extension of elbow is accompanied by a screw-home mechanism with conjunct rotation of the ulna.
      • Ulna externally rotates (or supinates) during elbow flexion and internally rotates (or pronates) during elbow extension.
79
Q

What is the Osteology of the Wrist and Hand region?

A
  • Radius
  • Ulna
  • Carpals
  • Metacarpals
  • Phalanges
80
Q

Describe the Osteology of the Wrist and Hand region

A
  • Radius is biconcave relative to carpals
  • Ulna is convex at its distal end rleative to the triquetrum
  • Proximal aspect of the proximal row is biconvex
    • Distal aspect of the proximal row is concave at lunate/capitate and triquetrum/hamate atriculations
    • Scaphoid is convex anterior/posterior and concave medial/lateral relative to trapezium/trapezoid.
    • Capitate is convex, and articulates with concavities if scaphoid, hamate and trapezoid
  • Metacarpal heads are biconvex, and bases are generally flat relative to distal row of carpals
  • Phalanges’ proximal ends are mostly biconcave, with a ridge running down the center, dividing it into two surfaces
    • Distal end is pulley-shaped, and mostly biconvex, with a groove running through the center.
81
Q

What is the Arthrology of the Wrist and Hand region?

A
  • Radiocarpal
  • Midcarpal
  • Carpometacarpal
  • Metacarpophalangeal (MCP)
  • Interphalangeal (IP)
82
Q

Describe the Dorsal radiocarpal joint

A
  • limits flexion, pronation, and possibly radial deviation
83
Q

Describe the Radiate Ligament

A
  • Stabilizes hand for any impact
  • the ligament that extends from the capitate bone to the scaphoid, lunate, and triquetrum on the palmar side of the wrist.
84
Q

Describe the Radiocarpal joint

A
  • Convex scaphoid and lunate articulate with concave radius
85
Q

Describe the Midcarpal joint

A
  • Articulation between four proximal and four distal carpal bones is known as midcarpal joint
  • Functional rather than anatomical joint
  • Can be devided into middle pillar (lunate and triquetrum with capitate and hamate) and lateral pillar (scaphoid with trapezoid and trapezium)
86
Q

Describe the Carpometacarpal joint

A
  • First CMC (thumb) is a saddle articulation with trapezium being convex in medial/lateral direction and concave in anterior/posterior direction
  • First metacarpal is opposite in shape to trapezium
  • the 2nd-5th CMC joints are essentially flat between bases of metacarpals and distal row of carpals
87
Q

Describe the Metacarpalphalangeal (MCP) joint

A
  • consist of convex metacarpals with concave proximal phalanges
88
Q

Describe the Proximal Interphalangeal joint (PIP)

A
  • Consist of convex distal aspects of proximal phalanges with concave proximal aspect of middle phalanges.
89
Q

Describe the Distal Interphalangeal Joint (DIP)

A
  • Consist of convex distal aspects of middle phalanges with concave proximal aspect of distal phalanges.
90
Q

What are the Noncontractile structures of the Wrist and hand region?

A
  • Ligaments
    • Volar carpal
    • Radiocarpal
    • Collateral
    • Palmar
  • Extensor hood
  • Capsules
  • Volar plate
  • Nerves and Vessels
91
Q

Describe the Collateral ligaments of the fingers

A
  • Run from the lateral condyle to the distal phalanx and lateral volar plate
  • All fibers tighten with flexion
  • Volar fibers tighten with extension
92
Q

Describe the Accessory collateral ligaments of the fingers

A
  • Run from the condylar head to the volar plate
  • Lax in flexion but taut in extension.
93
Q

Describe the Transverse ligaments of the fingers

A
  • Present at MCP joints
  • Provide stability linking MCP joints and providing reinforcement to anterior capsule
94
Q

Describe the Radial collateral ligament of the wrist

A
  • Limits ulnar deviation
95
Q

Describe the Ulnar collateral ligament of the wrist

A
  • Limits radial deviation
96
Q

Describe the Palmar Ulnocarpal ligament of the wrist

A
  • Limits extension and supination
97
Q

Describe the Palmar Radiocarpal ligament of the wrist

A
  • Limits extension and supination through the knuckles
98
Q

Describe the Extensor hood

A
  • Fibrous mechanism on the dorsum of each finger tht is a fibrous expansion of the extensor digitorum tendon
  • Its purpose is to assist with extension of the PIP and DIP joints
99
Q

Describe the finger capsule

A
  • MCP, PIP and DIP joints all have fibrous capsules that are strong but lax and supported by ligaments
100
Q

Describe the wrist capsule

A
  • Radfiocarpal joint shares a fibrous capsule (which is thicker palmarly and dorsally) with midcarpal joint, but usually has its own synovial membrane
101
Q

Describe the volar plate

A
  • Present on palmar aspect of the MCP, PIP and DIP joints
  • Thickenting of capsule
  • Functions to increase articular surface during extension and protect joint volarly
  • Volar plate more mobile at MCP than ar IP’s
102
Q

Describe the Nerves of the Wrist and Hand

A
  • Ulnar Nerve innervates the hypothenar region (palmarly and dorsaly), 5th digit, and medial half of 4th digit
  • Median Nerve innervates the remainder of the palmar surface not innervated by the ulnar nerve and also innervates the dorsal portions of the 2nd, 3rd, and lateral half of the 4th digit from the DIP joint to the tip of the finger
  • Radial Nerve innervates the remainder of the dorsum of the hand not innervated by the ulnar or median nerves
103
Q

Describe the Blood supply to the wrist and hand

A
  • Blood supply from the ulna and radial arteries
  • Merge to form the palmar arch and then send digital btanches that run up the medial and lateral aspects of each digit
104
Q

Describe the Biomechanics of the PIP and DIP joints

A
  • During flexion digits rotate radially to enhance grasp and opposition
105
Q

Describe the Biomechanics of the MCP joints

A
  • During flexion digits rotate radially to enhance grasp and opposition
106
Q

Describe the Biomechanics of the 1st CMC joint

A
  • Due to position of trapezium (anteriorly and medially rotated relative to other carpals) the plane of flexion/extension is perpendicular to other digits
  • During flexion/extension it is concave moving on convex
  • During abduction/adduction, it is convex moving on concave
  • During flexion and abduction, the 1st metacarpal rotates ulnarly
  • During extension and adduction, the 1st metacarpal rotates radially
107
Q

Describe the biomechanics of the wirst

A
  • Flexion
    • Proximal aspect of scaphoid/lunate glide dorsally relative to radius
  • Extension
    • Proximal aspect of scaphoid/lunate glide ventrally relative to radius
  • Radial deviation
    • Proximal row glides ulnarly
    • proximal surface of scaphoid rotates palmarly
  • Ulnar deviation
    • Proximal row glides radially as a unit

Comps (3 decks)

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