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CJ Atlas of Prosthetics > Chapter 5- Kinesiology and Functional Characteristics of the Upper Limb > Flashcards

Chapter 5- Kinesiology and Functional Characteristics of the Upper Limb Flashcards

1
Q

What is the functional capacity of the upper limb determined by?

A

The shoulder complex
Elbow
Wrist
Hand developing multiple spheres of action

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2
Q

Where does the upper limb usually reach to, in normal standing position?

A

Mid-thigh

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3
Q

What is integrated into the reaching action, to reach further down than mid-thigh?

A

Integration of gait

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4
Q

When the upper limb is maintained in neutral rotation at the shoulder the motion is what?

A

Restricted

No elbow action is possible in this plane

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5
Q

With the upper limb in complete external rotation, while moving in a circle in the frontal plane, which portion of the circle is easier to move through?

A

The outer circle- away from the body

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6
Q

With the upper limb in complete internal rotation, while moving in a circle in the frontal plane, which portion of the circle is easier to move through?

A

Inner half of the circle- through the body

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7
Q

Which joints determine the motion during elevation of the upper extremity in the frontal plane?

A

Scapulohumeral
Scapulothoracic
Acromioclavicular
Sternoclavicular

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8
Q

What helps establish smooth motion during elevation of the upper extremity?

A

External rotation

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9
Q

Beyond 90 degrees of elevation, external rotation helps do what?

A

Free the greater tuberosity from the acromial process

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10
Q

What else is offered after the 90 degrees of elevation and external rotation?

A

More humeral articular surface to the opposing glenoid

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11
Q

From 0-30 degrees of elevation the motion occurs at what joint?

A

Scapulohumeral

With variable motion

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12
Q

What degrees of elevation is the setting phase of the scapular motion?

A

0-30 degrees

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13
Q

What happens in the last 150 degrees of elevation?

A

The scapulohumeral joint motion and scapulothoracic motion of upward rotation participate at a ration of 2 to 1 as measured in the frontal plane

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14
Q

What is the total contribution of motion of the scapulohumeral joint?

A

130 Degrees

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15
Q

What is the motion of the clavicle in the first 90 degrees of elevation?

A

Elevated at the sternoclavicular joint about 40 degrees

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16
Q

What is the motion of the clavicle in the second 90 degrees of elevation?

A

Rotates on its long axis for another 40-50 degrees

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17
Q

What is the combined acromioclavicular motion during the initial and terminal phases of elevation?

A

20 degrees

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18
Q

What are the motor units responsible for scapulohumeral elevation?

A

Middle segment of the deltoid

Rotator cuff- Supraspinatus, Infraspinatus, teres minor, subscapularis

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19
Q

What action does the deltoid do?

A

Acts as the upper vector component of the force couple

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20
Q

What action does the rotator cuff do?

A

Stabilizes the humeral head

Acts as the lower vector force of the couple

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21
Q

The deltoid action potential reaches a maximum at what degree?

A

110 degrees then maintains a plateau level of activity

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22
Q

The supraspinatus reaches a peak activity level at what degree?

A

110 degrees then diminishes

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23
Q

The subscapularis reaches peak activity level at what degree?

A

100 degrees, then maintains a plateau of activity up to 130 degrees then diminishes

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24
Q

The teres minor reaches peak activity level at what degree?

A

120 degrees then maintains that plateau of activity

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25
Q

The infraspinatus is different from the others because of what?

A

It continues to increase activity throughout the whole elevation process.

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26
Q

Which muscle also acts as an external rotator?

A

Posterior segment of the deltoid

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27
Q

What are the motor units acting during the upward roation of the scapula?

A

Upper and lower trapezius

Lower digitations of the serratus anterior

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28
Q

What creates the internal rotation of the upper extremity?

A

Subscapularis
Pectoralis major
Anterior segments of the deltoid

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29
Q

What creates adduction of the upper extremity?

A

Pectoralis major
Anterior segments of the deltoid
Coracobrachialis

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30
Q

During the anterior adduction-internal rotation of the arm in the frontal plane, the scapula is in what position?

A

Abducted

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31
Q

What muscles create the abducted position of the scapula?

A

Serratus anterior

Pectoralis minor

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32
Q

The posterior adduction in the frontal plane is caused by what muscles?

A

Latissimus dorsi
Teres major
Long head of the triceps
Posterior segment of the deltoid

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33
Q

What creates the internal rotation during posterior adduction in the frontal plane?

A

Latissimus dorsi

Teres major

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34
Q

During posterior adduction in the frontal plane, the scapula does what and with which muscles?

A

Scapula is adducted
Middle segment of trapezius
Rhomboid
Latissimus dorsi

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35
Q

What motion does the scapula make when the arm is coming from the maximum elevated position and is brought down in the outer circle of the frontal plane?

A

Downward rotation

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36
Q

What produces the downward rotation of the scapula in the frontal plane?

A

Latissimus dorsi
Lower segment of the pectoralis major
Levator scapulae

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37
Q

What are the depressors of the shoulder complex?

A 
Latissimus dorsi
Lower segment of the trapezius
Lower segment of the pectoralis major
Pectoralis minor
Subclavius
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38
Q

What are the elevators of the scapula?

A

Levator scapulae
Upper segment of the trapezius
Rhomboids

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39
Q

What muscles create the elevation or flexion of the upper limb in the sagittal plane?

A

Anterior segment of the deltoid
Biceps
Coracobrachialis
Clavicular head of the pectoralis major

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40
Q

Which muscles controls the motion when the upper extremity is elevated to 90 degrees in the frontal plane and then traces an arc of 165 degrees in the transverse plane?

A

Flexors and extensors of the scapulohumeral joint

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41
Q

With the elbow bent at 90 degrees, palm up, what is the degree of movement in the transverse plane?

A

80 degrees internally

60 externally

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42
Q

With the upper extremity lifted to a 90 degree angle in the frontal plane, and the elbow bent at 90 degrees, what are the degrees of movement in the sagittal plane?

A

90 degrees upward

70 degrees down

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43
Q

What is the degree of motion of the elbow joint?

A

150 degrees

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44
Q

During motion, what is the plane of motion for the elbow joint determined by?

A

The shoulder and its position

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45
Q

What are the main flexors of the elbow?

A

Brachialis

Biceps

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46
Q

What are the accessory flexors of the elbow?

A

Brachioradialis

Pronator Teres

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47
Q

Which flexor of the elbow is active at any rotational position of the forearm and any speed with or without load applied to the flexing forearm?

A

Brachialis

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48
Q

When does the biceps get activated?

A

When slight resistance is applied and supinated

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49
Q

When might the biceps be activated in pronation?

A

When significant resistance is applied

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50
Q

When does the brachioradialis get activated during flexion?

A

When flexing rapidly at any rotational position

As a reserve flexor during resistance

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51
Q

When does pronator teres get activated during flexion?

A

Only when resistance is encountered during flexion

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52
Q

What is the main extensor of the elbow?

A

Triceps

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53
Q

What is the assistant muscle of the extensors of the elbow?

A

Anconeus

54
Q

What is the baseline worker for extension?

A

Medial head of triceps

55
Q

Which other muscle segment is minimally active during extension?

A

Lateral head

56
Q

When are the long head and lateral head of the triceps usually fully activated?

A

When resistance is applied

57
Q

What is the average ROM of pronation and supination of the forearm?

A

173 degrees measured at the level of the hand

156 degrees measured at the wrist

58
Q

What creates the difference in ROM degrees during supination and pronation between the level of the hand and the level of the wrist?

A

Radiocarpal and midcarpal joints

59
Q

What is the average ROM and range of ROM for just pronation?

A

62 degrees

Range 49-84 degrees

60
Q

What is the average ROM and range of ROM for just supination?

A

104 degrees

Range 86-122 degrees

61
Q

Where is the axis for pronation-supination?

A

Extends from the center of radial head to the distal end of the radius and passes to the radial and ulnar styloid processes
Average-Passes through the distal end of the radius in line with the third metacarpal.

62
Q

During pronation which direction does the ulnar head displace?

A

Laterally

63
Q

During pronation-supination, when rotational motion occurs along an axis passing through the middle finger and near the radial styloid process, what does the ulna do?

A

Traces a much larger arc of motion than the radius

64
Q

During pronation-supination, when rotational motion occurs along the line of the little finger, what does the radius do?

A

Radial styloid creates a large arc around the ulna

65
Q

What determines the axis of rotation during supination-pronation?

A

The peripheral point of fixation through the finger or tool held in the hand.

66
Q

Which membrane relaxes and tenses during pronation and supination?

A

Interosseous membrane

67
Q

When is the interosseous membrane the smallest?

A

During pronation

68
Q

When is the interosseous membrane the biggest?

A

Neutral

69
Q

Which muscle pronates the forearm?

A

Pronator quadratus

Pronator teres

70
Q

Which of the forearm pronators is the main muscle?

A

Pronator quadratus

71
Q

Which of the forearm pronators assists the main muscles?

A

Pronator teres

72
Q

When is the the pronator teres activated?

A

More speed required

Resistance applied

73
Q

What are the accessary pronators of the forearm?

A

Flexor or carpi radialis
Palmaris longus
These muscle’s activation are controversial

74
Q

What is the main supinator muscle for the forearm?

A

Supinator

75
Q

What is the secondary supinator muscle?

A

Biceps

76
Q

When is the biceps activated for supination?

A

Fast supination

Resistance is applied

77
Q

What are the accessory supinators?

A

Extensor carpi radialis longus

Extensor carpi radialis brevis

78
Q

What are the movements of the wrist?

A

Flexion
Extension
Lateral deviation
Slight pronation-supination

79
Q

What is the average arc of the wrist for flexion and extension and the range?

A

121 degrees

84-169

80
Q

What is the average arc of just extension and range?

A

55 degrees

31-79 degrees

81
Q

What is the average arc of just flexion and range?

A

66 degrees

38-102 degrees

82
Q

Which joints of the wrist participate in flexion and extension?

A

Radiocarpal joint

Midcarpal joint

83
Q

At neutral, the ROM of flexion for the midcarpal joint is what?

A

40 degrees

84
Q

At neutral, the ROM of flexion for the radiocarpal joint is what?

A

26 degrees

85
Q

What is the percentage of contribution of the midcarpal joint and radiocarpal joint during wrist flexion?

A

Midcarpal-60%

Radiocarpal-40%

86
Q

What is the average ROM at the midcarpal joint for extension?

A

19 degrees

87
Q

What is the average ROM at the radiocarpal joint for extension?

A

37 degrees

88
Q

What is the percentage of contribution of the midcarpal joint and radiocarpal joint during wrist extension?

A

Midcarpal- 33.5%

Radiocarpal- 66.5%

89
Q

Which carpal bone belongs in the proximal row functionally and during extension, and to the proximal row during flexion?

A

Scaphoid

90
Q

What type of fractures occurs when the wrist is in extension?

A

Scaphoid

Distal end of radius

91
Q

When are the carpal bones more rigid?

A

During wrist extension

92
Q

When are the carpal bones more flexible?

A

During wrist flexion

93
Q

Which muscles flex the wrist?

A

Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus

94
Q

Which muscles are the accessory flexors of the wrist?

A

The long digital flexors

95
Q

Which muscles extend the wrist?

A

Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris

96
Q

WHich muscles are the accessory extensors of the wrist?

A

Digital extensors

97
Q

What is the average lateral wrist deviation?

A

40 degrees
30 degrees ulnar direction
15 degrees on the radial side

98
Q

How do you make the ulnar deviation range greater?

A

Supinate the hand

99
Q

When can the full profile of the scaphoid be seen?

A

Ulnar deviation

100
Q

What is pronation of the wrist?

A

Extension and radial deviation

101
Q

What is supination of the wrist

A

Flexion

Ulnar deviation

102
Q

Where is the center of rotation during radioulnar deviation?

A

Head of the capitate

103
Q

What are the radial deviators of the wrist?

A 
Abductor pollicis
Extensor pollicis brevis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Long extesnors of the index
Flexor carpi radialis
104
Q

What are the ulnar deviators of the wrist?

A

Extensor carpi ulnaris
Flexor carpi ulnaris
Long extensors of the middle, ring, and little fingers

105
Q

At what degree is the grip power the greatest?

A

35 degrees of extension

106
Q

At what degree is the grip power at its weakest?

A

Full extension

107
Q

What is the descending order of muscle recruitment to make a soft fist when the wrist is extended?

A

Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor carpi radialis longus

108
Q

What happens when you make a tight fist when the wrist is extended?

A

All the muscles used to make a soft fist are maximally active

109
Q

What is the descending order of muscle recruitment when gently extending the fingers as the wrist is held in extension?

A

Extensor carpi ulnaris

Flexor carpi ulnaris

110
Q

What is the descending order of muscle recruitment when forcefully extending the fingers as the wrist is held in extension?

A

Extensor carpi radialis brevis
Palmaris longus
Extensor carpi radialis longus
Flexor carpi radialis

111
Q

What is the muscle that flexes the distal joint of the fingers?

A

Flexor profundus

112
Q

What is the muscle that flexes the middle joint of the fingers?

A

Flexor superficialis

113
Q

What are the muscle that flex the metacarpophalangeal joint?

A

Intrinsic muscles

114
Q

Extension of the metacarpophalangeal joint is controleld by what?

A

Long extensor

115
Q

An indirect action occurs on what in the wrist, when extending the metacarpophalangeal joint, and through what attachment?

A

Extension exerted by the long extensor on the proximal phalanx
Through volar attachment of the trasnverse or quadrilateral lamina

116
Q

A direct action occurs on what in the wrist, when extending the metacarpophalangeal joint?

A

A tendinous attachment of the long extensor to the dorsum of the proximal phalanx

117
Q

What is the percentage of people who have the long extensor to the dorsum of the proximal phalanx?

A

38.5% of people

118
Q

The side motion and rotation of the fingers is determined by what?

A

Intrinsic muscles

119
Q

The dorsal interossei does what motion to the fingers?

A

Abducts

Spreads

120
Q

The volar interossei does what motion to the fingers

A

Adducts

121
Q

What boney surface is the thumb?

A

Conoid surface

122
Q

How many phases make up opposition?

A

Two

123
Q

What are the phases of opposition?

A

Stage I-Thumb is positioned against the pulp of a corresponding finger
Stage II- Clamping of the thumb pad against the opposed finger

124
Q

What are the muscles and nerve involved in stage I of opposition?

A

Abductor pollicis brevis
Opponens
Superficial head of the short flexor
Median nerve

125
Q

What are the muscles and nerve involved in stage II of opposition?

A

Adductor
Deep head of short flexor
Ulnar nerve

126
Q

What are the two groups of functional hand activities?

A

Nonprehensile

Prehensile

127
Q

What are included in nonprehensile activities?

A 
Touching
Feeling
pressing down
Tapping
Vibrating
Lifting
Pushing
Stirring
128
Q

What are included in prehensile activities?

A

Precision

Power grips

129
Q

What are the precision grips?

A

Palmer
Tip
Lateral/key

130
Q

What are the power grips?

A

Cylindrical
Hook
Spherical

CJ Atlas of Prosthetics (7 decks)

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