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Semester 4 FS Exam 2 > Elbow biomechanics > Flashcards

Elbow biomechanics Flashcards

1
Q

Bones of the elbow complex

A

Humerus
Ulna
Radius

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2
Q

Joints of the elbow complex

A

Elbow joints

Forearm joints

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3
Q

Distal humerus has what

A

Trochlea
Capitulum
Fossae
Epicondyles

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4
Q

Trochlea - description

A

Hour glass shape
Projects more distally on the medial side
Divided by tochlear groove

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5
Q

What does the trochlea articulate with

A

The trochlear notch of the ulna

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6
Q

Capitulum - description

A

Spherically shaped

Projects anterior-lateral

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7
Q

Capitulum articulates with

A

head of the radius

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8
Q

Fossae - description

A

Coronoid fossa
Radial fossa
Olecranon fossa

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9
Q

Which side are these located on:
Coronoid fossa
Radial fossa
Olecranon fossa

A

Coronoid fossa = ANT
Radial fossa = ANT
Olecranon fossa = POST

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10
Q

Epicondyles of the humerus are located where

A

Medial and Lateral

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11
Q

Proximal ulna has what

A 
Trochlear notch
Radial notch
Olecranon process
Coronoid process
Ulnar tuberosity
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12
Q

Trochlear notch - description

A

Semicircular concave surface
Divided by trochlear ridge
Nonarticulating surface

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13
Q

Radial notch - description

A

Faces laterally

Receives articulating circumference of the radial head

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14
Q

Where is the olecranon process

A

top of the trochlear notch

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15
Q

Where is the coronoid process

A

bottom of the trochlear notch

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16
Q

Ulnar tuberosity is located where

A

Under the coronoid process

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17
Q

What attaches at the ulnar tuberosity

A

brachialis

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18
Q

Proximal radius - what is located there

A

Articular fovea
Articular circumference
Radial tuberosity

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19
Q

Articular fovea - description

A

cup shaped concave surface

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20
Q

Articular circumference - description

A

convex rim articulates with the radial notch

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21
Q

Radial tuberosity - what attaches there

A

biceps

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22
Q

Elbow joints

A

Humeroulnar joint

Humeroradial joint

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23
Q

Humeroulnar Joint - articulation between what

A

Humerus and ulna

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24
Q

Humeroulnar joint - what type of joint

A

Hinge joint - Uniaxial diarthrodial joint

1 DF

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25
Q

Arthrokinematics of humeroulnar joint - Flex/Ext

A

Sagittal plane

Frontal axis

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26
Q

Humeroulnar joint - slide/glide
Open chain
Closed chain

A

of concave ulna on convex trochlea of the humerus
Open chain = same direction (ulna moves with respect to humerus) cave on vex
Closed chain = opp direction (hum with respect to ulna) vex on cave

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27
Q

End ROM extension - humeroulnar

A

Bony - olecranon impact in fossa

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28
Q

End ROM flexion - humeroulnar

A

soft tissue approximation (biceps)

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29
Q

Close packed position of humeroulnar

A

full extension and supination

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30
Q

Humeroradial joint includes what

A

Radial head and capitulum ball and shallow socket

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31
Q

Humeroradial joint - arthrokinematics - flex/ext

A

Sagittal plane

Frontal axis

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32
Q

Humeroradial joint - slide/glide

A

of radial head on capitulum (concave on convex)

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33
Q

Humeroradial joint - extension

A

no contact between the articulating surfaces

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34
Q

Humeroradial joint - flexion

A

rim of the head reaches the radial fossa

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35
Q

Humeroradial joint - close packed position

A

90 degrees of flexion and about 5 degrees of supination

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36
Q

Osteokinematics of the elbow joint - Active ROM with respect to flexion

A

135-145 degrees (with forearm supinated) becomes smaller with pronation

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37
Q

Osteokinematics of the elbow joint - Passive ROM with respect to flexion

A

150-160 degrees (supinated again and is smaller with pronation)

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38
Q

Humeroulnar osteokinematics - trochlea to trochlear notch

A 
Not a perfect fit
Nonarticulating surface (middle)
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39
Q

Humeroulnar osteokinematics - orientation of the trochlear notch and ROM

A

Superior orientation will increase extension

Anterior orientation will increase flexion

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40
Q

Carrying angle - what leads to us having a carrying angle

A

Trochlea projection on the medial side is more distal resulting in a lateral deviation of the ulna with respect to the humerus

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41
Q

What is the typical carrying angle

A

10-15 degrees

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42
Q

Humeroradial joint - capitulum orientation is

A

Anterior

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43
Q

Humeroradial joint - contact is limited in

A

extension (there is a gap)

44
Q

Humeroradial joint - contact increases with

A

flexion

45
Q

Humeroradial joint - stress in the joint increases with

A

Extension - up until about 90 degrees and then goes away when separates

46
Q

Humeroradial joint - stress in the joint decreases with

A

flexion

47
Q

Stress in a joint -

A

The force in relationship to the contact area

Stress = force/area

48
Q

Elbow complex - joint capsule

A

Loose
Humeroulnar
Humeroradial
Proximal radioulnar

49
Q

Elbow complex - stabilizing structures - Ligaments

A

Medial collateral
Lateral collateral
Annular

50
Q

Medial Collateral ligament - portions

A

Ant post and trans portions

51
Q

Medial collateral ligament - resists what

A

Valgus deviation and I/E Rot.

Resist an inc in the carrying angle

52
Q

Lateral collateral ligament - Portions

A 
radial collateral (ant)
lateral ulnar collateral (post)
Accessory LCL (runs into annular)
53
Q

Lateral collateral ligament - resists

A

Varus deviation and I/E Rot

54
Q

Annular ligament resists

A

Lateral and distal subluxation of the radius

Holds the head of the radius in the radial fossa

55
Q

Elbow complex - MCL - anterior is tight in

posterior is tight in

A

Ant - taut in ext
Post - taut in flex
Transverse - small and does not attach to humerus

56
Q

Elbow complex - annular ligament - sublux

A

Traction force on the forearm can cause distal subluxation of the proximal radioulnar joint

57
Q

Elbow complex - annular ligament - how does the subluxation occut

A

Adult force pulls radius distally

Weight of the child force pulls ulna proximally

58
Q

Forearm bones - proximal

A

Head of radius

Radial notch on ulna

59
Q

Forearm bones - distal

A

Head of ulna

Ulnar notch on radius

60
Q

Forearm joints -

A

Proximal (sup) radioulnar
Distal (inf) radioulnar
Middle radioulnar

61
Q

Proximal (Sup) Radioulnar Joint includes what

A

Head of radius (convex) on radial notch of ulna (concave)

62
Q

Arthrokinematics of the proximal radioulnar joint

A

Radius spins on capitulum and in radial notch

63
Q

What encircles the radial head for stability - Proximal radioulnar joint

A

Annular ligament encircles the radial head for stability

64
Q

What is the close packed position of the proximal (sup) radioulnar joint

A

Full extension and about 5 degrees of supination

65
Q

Distal (inf) radioulnar joint - is made up of what

A

Head of ulna (convex) on the ulnar notch of the radius (concave)

66
Q

Close packed position of the distal radioulnar joint

A

5 degrees of supination

67
Q

Distal (inf) radioulnar joint - articular disc
Shape
Base
Apex

A

Triangular shape
Base at ulnar notch
Apex at styloid process of ulna

68
Q

Distal (inf) radioulnar joint - articular disc - what does it do

A

Binds the ulna and radius
Proximal surface to ulna
Distal surface to carpal bones

69
Q

Arthrokinematics of the Distal (inf) radioulnar joint -

A

Ulnar notch spins on ulnar head and disc

70
Q

Middle radioulnar joint

A

Interosseous margins

Interosseous membrane

71
Q

Forearm ligaments

A 
Anterior radioulnar ligament
Posterior radioulnar ligament 
Interosseous membrane 
Quadrate ligament (ext of annular) 
Oblique cord
Annular ligament
72
Q

Radioulnar joint - what type

A 
Diarthrodial uniaxial - pivot 
1 DOF (supination and pronation)
73
Q

Plane/Axis of Radioulnar joint - sup and pron

A 
Longitudinal axis (head of radius to head of ulna)
Transverse plane
74
Q

Total ROM of the radioulnar joint

A

150 degrees (at 90 of elbow flexion)

75
Q

Radioulnar joint - supination - radius and ulna

A

they are parallel to each other

76
Q

Radioular joint - supination - limited by

A

tension of anterior radioulnar ligament and oblique cord

77
Q

Radioulnar joint - pronation - radius and ulna

A

Radius crosses over ulna

78
Q

Radioulnar joint - pronation - limited by

A

Radius/ulna bone to bone contact
Post radioulnar ligament
Post fibers of MCL
Tension of biceps when elbow ext

79
Q

Radioulnar relationship during sup/pron

A

Ulna remains in more or less same position
Radius rotates about radioulnar joint axis
Radius tips relative to its supinated position
This opens gap at radial side of elbow joint
The ulna undergoes slight abduction in pronation

80
Q

Role of interosseous membrane in transmitting force

Interosseous membrane fiber orientation = ?

A

Force is transmitted through hand - radius - int mem - ulna - humerus
Orientation = distal on ulna to prox on radius

81
Q

Principal flexors of the elbow joint - and attachments

A

Biceps brachii - radial tuberosity
Brachialis - ulnar tuberosity
Brachioradialis - styloid of radius

82
Q

Weak flexors of the elbow joint

A

Pronator teres

Long wrist and finger flexors

83
Q

Primary extensors of the elbow joint - name mm and attachment

A

triceps brachii - olecranon process of ulna

84
Q

Weak extensors of the elbow joint - name mm and attachment

A

Anconeus - lat epicondyle to post ulna

85
Q

Main pronators of the radioulnar joint - name mm and locations

A

Pronator teres - proximal

Pronator quadratus - distal

86
Q

Weak pronators of the radioulnar joint

A

Brachioradialis (from supinated position to mid way)

87
Q

Main supinators of the radioulnar joint

A 
Biceps brachii (prime) 
Supinator
88
Q

Weak supinators of the radioulnar joint

A

Brachioradialis (from pronated position to mid way)

89
Q

Biceps contribution to elbow joint stability - with elbow extended - biceps contraction

A

Compresses the elbow joint

90
Q

Biceps contribution to elbow joint stability - with elbow flexed - biceps contraction

A

distracts the elbow joint

91
Q

Biceps effectiveness as a supinator

A

changes with elbow flexion angle

most effect at 90 flex

92
Q

The greater the net muscle force required, the greater the

A

bone on bone joint force

93
Q

Which epicondyle is more pronounced

A

Medial

94
Q

Post view of the humerus - what is not visible

A

capitulum

It is anteriorly oriented on the lateral aspect

95
Q

Radial notch is located where

A

on the proximal ulna - lat side

96
Q

Ulnar notch is located where

A

on the distal radius

97
Q

Radial tuberosity is oriented which way

Implication

A

medially

biceps is a supinator

98
Q

Ulnar tuberosity is located where

A

under the coronoid process

is an ant structure

99
Q

Joint force is usually coming from what

A

muscle force rather than from the external load

100
Q

What is required to balance external load torque

A

net muscle balance force

101
Q

Changes in moment arm with elbow joint angle

Optimal angle for peak ma

A

between 102 and 108 = largest ma
BUT doesnt mean they are producing max force here
When look at length - they are actually all at a smaller length

102
Q

axis of the elbow joint is where

A

between the epicondyles

103
Q

When look at ma and length where is the optimal flexion angle to produce max torque

A

75-85 degrees of flexion

104
Q

Elbow forces and torques with crutch walking - optimal degree of flexion

A

About 20-25

105
Q

Elbow forces and torques with crutch walking - why is having too much flexion bad?

A

Even though triceps are at good length and ma, the ma from the load has been multiplied so the crutches have to work harder

106
Q

Elbow forces and torques with crutch walking - why is having too much extension bad?

A

Because then the triceps are too long and we want them to actually work
Also force coming through wrist (radius)

Semester 4 FS Exam 2 (1 decks)

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