Exam 3 Flashcards
shoulder girdle is the _____,_____, and _____
scapula, clavicle, sternum
scapula attached to trunk _____ anteriorly and glides over _____ posterior rib cage
concave
convex
posterior rib cage rests on ribs __-__
2-7
scapular spine is around __
T4
clavicle is the only structure that
connects UE to axial skelton
clavicle is also called the
collarbone
clavicle connects to axial skelton at the __________ joint
sternoclavicular
sternum is a ____ bone in the __/____ thorax
flat
mid anterior
sternum attached to ______ and _____ ______of ribs
clavicle
costal cartilage
______ longest bone in UE
humerus
3 parts of sternum
manubrium
body
xiphoid process
parts of clavicle
sternal end
body
acromial end
glenohumeral joint is made of _____ and ______
humerus and scapula
glenohumeral joint
____(convex) articulates with ____ ____(concave)
head
glenoid fossa
bicipital groove runs between the
tubercles
bicipital groove is where the ____ head of ____ tendon run
long
biceps
axilla region compression injuries may affect the
_____ _____
_____&______ systems
_______, _______
brachial plexus
artery and venous
muscles tendons
phrenic nerve innervates the _______
diaphragm
arteries of UE in order
subclavian
axillary
anterior circumflex artery
posterior circumflex artery
brachial
radial / ulnar
anastomoses (collateral circulation)- form arch
anterior circumflex artery
posterior circumflex artery
both primary supplies to the _____ head which can cause No ___ _____
Humeral
blood supply
A FOOSH injury can be from ______ ______
avascular necrosis
glenohumeral is a __ degrees of freedom
and ___&____ , synovial joint
3
ball and socket
convex ____ head, _____ _____ fossa
humeral
concave glenoid
thin walled joint capsule in GH joint causes ______,______
subluxation, dislocating
Not stable but mobile
anterior joint reinforcement supports _____,_____,_____ glenohumeral ligaments
superior middle and inferior
superior joint reinforcement supports
coracohumeral ligament
glenoid labrum lines the ____ ____ and deepens ___ and keeps ____ head in joint
glenoid fossa
socket
humeral
glenohumeral does action and _________ follows
acromioclavicular
subcutaneous is a ____ nerve
sensory
musculocutaneous nerve innervates
C5-C7
axillary nerve innervates
C5-C6
radial nerve innervates
C5-T1
median nerve innervates
C6-T1
ulnar nerve innervates
C8-T1
acromioclavicular joint
______ process of _____articulates with lateral ____
acromion
scapula
clavicle
scaption has __ planes of motion
3
scaption is between the _____ and ____ motion
flexion and abduction
Scaption accessory motion is acromioclavicular and coracoacromial Ligaments due to ______ movements
scapular
acromioclavicular movement between ______ /_____
______ rotates on the ____
clavicle and scapula
clavicle rotates on the scapula
scapular motion stabilizes the _________ joint
acromioclavicular
ligaments of acromioclavicular
acromioclavicular
coracoacromial
sternoclavicular is a synovial joint. motion of shoulder ____ and then sternoclavicular follows
girdle
sternoclavicular joint
clavicle ___ and sternum ____
moves
stationary
ligaments of sternoclavicular
sternoclavicular (sternum- clavicle)
costoclavicular (1st rib- sternum)
interclavicular (between 2 claviclesg
sternoclavicular is movement of ____ on _____
clavicle on sternum
movements of sternoclavicular are
__________,_______,________,________,______
elevation
depression
protraction
retraction
rotation
glenohumeral flexion ROM
180
glenohumeral flexion prime movers
anterior deltoid
pectoralis major
biceps brachii
coracobrachialis - Stabilizer
glenohumeral flexion
osteo
superior / anterior
glenohumeral extension ROM
60
glenohumeral extension prime movers
posterior deltoid
latissimus doris
teres major
pectoralis major
glenohumeral extension
osteo
posterior
glenohumeral abduction ROM
180
glenohumeral abduction prime movers
supraspinatus
middle deltoid
glenohumeral abduction
osteo
superior / lateral
glenohumeral adduction ROM
0
glenohumeral adduction prime movers
pectoralis major
latissimus dorsi
teres major
glenohumeral adduction
osteo
medial
scaption ROM
180
which joint moves at scaption
acromioclavicular
scapular plane is ___ forward of ____ plane
30 degrees
frontal plane
scaption prime movers are
combo between flexors and abductors
glenohumeral internal (medial) rotation ROM
90
glenohumeral internal (medial) rotation prime movers
subscapularis
latissimus dorsi
teres major
pectoralis major
anterior deltoid
glenohumeral internal (medial) rotation
osteo
anterior/ medial
glenohumeral external lateral rotation ROM
100
glenohumeral external lateral rotation prime movers
infraspinatus
teres minor
posterior deltoid
glenohumeral external lateral rotation osteo
posterior / lateral
glenohumeral horizontal abduction ROM
45
glenohumeral horizontal abduction prime movers
posterior deltoid
infraspinatus
teres minor
glenohumeral horizontal abduction osteo
posterior
glenohumeral horizontal adduction ROM
130
glenohumeral horizontal adduction osteo
anterior
glenohumeral horizontal adduction prime movers
pectoralis major
anterior deltoid
scapulothoracic arthrokinematics
_____ scapula at ______ fossa
____ posterior thoracic wall
concave
subscapular
convex
scapular elevation prime movers
upper trapezius
levator scapulae
rhomboid major
rhomboid minor
scapular depression prime movers
lower trapezius
pectoralis minor
scapular protraction/ abduction prime movers
serratus anterior
pectoralis minor
scapular retraction / adduction prime movers
middle trapezius
rhomboid major and minor
scapulothoracic is only ______ and ______ attach here . not true joint
muscles and ligaments
coracoid process on ____
scapula
scapular upward rotation prime movers
serratus anterior
upper and lower trapezius
scapular downward rotation prime movers
levator scapula
rhomboid major
rhomboid minor
pectoralis minor
scapular winging is ___border of scapula moves away from thoracic
medial
abnormal scapular winging ___ anterior ___ dysfunction
serratus anterior / trap dysfunction
scapular tipping is _____ angle of scapula moves _____
inferior
posteriorly
scapular tipping abnormal
pec minor tightness
lower trapezius weakness
acromioclavicular ligament
first degree sprain is _____
second degree sprain is _____ and coracoclavicular ligament is ______
third degree sprain both ligaments are _____
stretched
ruptured
stretched
ruptured
shoulder is a __ joint muscle
biceps and triceps are a __ joint muscle
1
2
thoracic outlet anatomy
_____ middle scalene
below _____, 1st____ , _____ minor
anterior
clavicle
rib
pec
thoracic outlet pathophysiology
____scalene triangle, 1st __ -clavicle, below ___ and below pec _____
inner
rib
clavicle
pec minor
thoracic outlet signs / symptoms
_______,_____,coldness,_____,weakness
tingling
numbness
burning
what causes thoracic outlet problems?
compression of nerves, arteries, and veins
ligament injury at AC joint
acromioclavicular seperation
broken bone in children
clavicular fractures
fall on outstretched hand
humeral neck fracture
direct blow/ twisting force —
and spinal fracture is in the ____ nerve injury
midhumeral fracture
radial
benign tumors/ metastatic carcinoma lungs breast kidney prostate
pathological fractures
forced abduction, lateral rotation dislocated, humeral head anteriorly out of glenoid fossa
anterior shoulder dislocations
hemiplega from stroke no longer able to hold head of humerus in glenoid fossa
glenohumeral subluxation
overuse compression between acromial arch humeral head and soft tissue structures (swimmer’s shoulder)
impingement syndrome
inflammation and fibrosis of capsule leads to pain and loss of shoulder range of motion
(frozen shoulder)
adhesive capsulitis
distal tendinous insertions of rotator cuff group on greater/ lesser tubercle of humerus
torn rotator cuff
damage to glenoid labrum
limited Rom and pain
labrum tear
inflammation of supraspinatus tendon, accumulation of mineral deposits
calcific tendonitis
long head biceps proximal crosses humeral head changes direction into bicipital groove
bicipital tendonitis
irritation as it slides into groove
subluxing of biceps tendon
overloading the biceps causes it to ___ and ____ rotate
abduct
laterally
elbow motions are
flexion and extension
forearm motions are
supination and pronation
lateral epicondyle has what structures
capitulum and radial fossa
medial epicondyle has what structures
trochlea and coronoid fossa
olecranon fossa is ____
posterior
ulna has the ____ process (posterior) _____ process (anterior)
olecranon
coronoid
____ notch between trochlea and ulna
trochlear
____ notch where head fits into ulna
radial
radius has the head, ____, and ____ notch
tuberosity
ulnar
primary elbow joint is
humeroulnar joint
most motion with humeroulnar joint
flexion/ extension
trochlear ridge articulates with the ______ groove of ____
trochlear
ulna
olecranon articulates with the ____ fossa of humerus
olecranon
coronoid process articulates with the ——- fossa of humerus
coronoid
carrying angle
females:
males :
10-15
5
radiohumeral joint
head of ___ articulates with the ____ fossa and ______
radius
radial
capitulum
forearm joints are
distal radioulnar joint
proximal radioulnar joint
proximal radioulnar joint
radial head articulates with the ____ notch of ___
radial
ulna
distal radioulnar joint
ulnar notch of _____articulates with _____head
radius
ulnar
motion of radioulnar
pronation and supination
ligaments that have one single capsule
humeroulnar
radiohumeral
proximal radioulnar
medial collateral ligemanet has ___ portions blends into capsule
Limits a ____ stress
3
Valgus
MCL reinforced ____ side of ____
medial
capsule
LCL reinforces ________ articulation
radiohumeral
lateral collateral ligament limits a ___ stress
varus
encircles radial head
_____ ligament
annular
connects radial head to ulna inside capsule
quadrate ligament
quadrate ligament reinforces proximal ____ joint
radioulnar
______ _______\over use affects common extensor tendon into lateral epicondyle of humerus
“_____ elbow”
lateral epicondylitis
tennis
______ ________ inflammation of common flexor tendon into medial epicondyle
“_____elbow”
medial epicondylitis
golfers
____ ____ ____ overuse of medial epicondyle
____ stress on elbow
little league elbow
valgus
____ compression, ___ dislocation on little league elbow
lateral
medial
under age 5 strong traction of force on arm
radial head subluxation under annulur ligament
pulled elbow / nursemaids elbow
great force on elbow when it’s slightly flexed
ulna slides posteriorly to distal humerus
elbow dislocation
common fracture in children falling on outstretched hand
distal humerus fracture above condyles
DANGER to ____ artery
supracondylar fractures
brachial
ischemic necrosis of forearm muscles
volkmann’s ischemic contracture
hitting funny bone causes :
ulnar nerve compression
should osteo/ arthro move in a _____ direction
opposite
elbow osteo and arthro move in ____ direction
same
Shoulder movement
convex _____ ____ and concave _____ ____
humeral head
concave glenoid fossa
coracoid process is on the
scapula
coronoid process is on the humerus
elbow flexion is
150
elbow flexion osteo and arthro
superior and anterior
humeroulnar joint
____ ______ _____ on _____ ____
concave olecranon process
convex trochlea
radiohumeral joint
____ ___ ____ on ____ ______
concave radial head on convex capitulum
active insufficient of elbow flexion
elbow flexion
shoulder flexion
forearm supination
mechanically advantages elbow flexion force shoulder in
extension
passive insufficiency of elbow flexion
shoulder extension
elbow extension
pronation
pronation of elbow flexion
brachialis
mechanically advantage of brachialis elbow flexion
100
elbow extension is
0
elbow extension
osteo and arthro
posterior
humeroulnar joint
____ _____ _____ on ____ _____
concave olecranon process on convex trochlea
radiohumeral joint
____ ____ ___ on ______ ______
concave radial head on convex capitulum
only what head of triceps cross shoulder
long head
all triceps heads cross posterior
elbow
mechincally advantage of elbow extension
elbow extension is from shoulder
flexion
active insufficiency of elbow extension
extension of elbow and shoulder
passive insufficiency of elbow extension
shoulder flexion elbow flexion
in supination and pronation radius always _____ and ulna is always ____
moves
stable
forearm supination is
80
proximal radioulnar joint supination
osteo-
arthro-
posterior
anterior
proximal radioulnar joint
____ ____ ____ on ___ ____ ____ of ____
convex radial head on concave radial notch of ulna
distal radioulnar joint supination
osteo
arthro
posterior
distal radioulnar joint supination
____ ____ ___ of ____ on ___ ___ ____
concave ulnar notch of radius on convex ulnar head
supinator pulls radius ______
laterally
forearm pronation is
80
proximal radioulnar joint pronation
osteo
arthro
anterior
posterior
proximal radioulnar joint pronation
____ ____ ___ on _____ ____ ____
convex radial head on concave radial notch
distal radioulnar joint pronation
osteo
arthro
anterior
distal radioulnar joint pronation
_____ _____ _____ of _____ on ____ ____ ___
concave ulnar notch of radius on convex ulnar head
elbow flexion / forearm supination natural motion
open door
eating- scooping
picking up bag
turning screw
elbow extension forearm supination prime mover
biceps brachii
elbow extension forearm pronation prime mover
triceps brachii, pronator
elbow extension forearm pronation natural motion
pushing item
unscrewing screw
pushing back
pushing up
pushing foof open
elbow extension forearm pronation prime movers
triceps brachii pronators
impingement syndrome
strengthen - supraspinatus, infraspinatus, teres minor, middle and lower trap
stretch- subscapularis, pec minor
what pushes up humerus ?
deltoids
SIT muscles put humerus in better position
forearm supination
elbow bent
elbow straight
biceps brachii
supinator
elbow flex forearm fully pronated -
pronator teres
pronator quadratus
forearm in neutral
brachioradialis
forearm fully supinated
supinator
biceps brachii
which muscles can you pronate
pronator teres and quadratus
brachialis
sliding board transfer
shoulder lifting muscles - traps, teres major=normal
latissimus dorsi, pec major =reverse action
proximal- distal
normal action
distal- proximal
reverse action
elbow contracting muscles in sliding board
_____ chain , concentrically push ___ , eccentrically lower ___
triceps brachii , anconeus
closed
concentric push up
eccentric lower down
impingement syndrome the greater tubercle and acromion ____
compress
impingement syndrome
glenohumeral can become impinged during _____ rotation
internal
____ _____ is a loss of blood supply where arteries run in _____ ______( avn )
humerus fracture
avascular necrosis
fracture of greater tuberosity of humerus affect the
supraspinatus infraspinatus and teres minor
shoulder motions that are affected with fracture of greater tubersouty of humerus
shoulder external rotation shoulder abduction stabilization of glenohumeral joint
upward rotation stabilizers
upper and lower trap
serratus anterior
posterior fracture is compression to ____ nerve
radial
stretch the extensor carpi radial is longus the elbow is placed in ____ wrist is ____
extension
flexed
stretch extensor carpi ulnaris the elbow and wrist are in _____
flexion
only muscle that flexed MCP and CMC joints of thumb
flexor pollicus longus
power grip muscle
flexor digitorum superficialis
thumb couldn’t be moved away from palm without
abductor pollicus longus
without function of extensor pollicus brevis the thumb of MCP joint remains
flexed
extensor pollicus longus is used when
clapping
depression is called the
anatomical snuffbox
point middle finger when other fingers are in fist muscle
extensor indicis muscle
extrinsic muscles have proximal attached ___ wrist and distal attachment on ___
below
hand
intrinsic muscles have proximal attached at distal ____ bones and function on ___ or fingers
carpal
thumb
loss of thumb opposition is caused by damage to ___ nerve referred to as ape hand deformity
median
most important function of hand
thumb opposition
flexion, abduction, rotation of thumb
tendons are contained by
extensor retinaculum
flexor retinaculum prevents the tendons to
pull away during wrist flexion
most common bones are fractured at wrist joint are the
scaphoid and radius
radius has the ____ process and ___ and ____ facets
styloid
medial and lateral
ulna has ___ head ___ process and _______ disc
ulnar
styloid
radioulnar
ulna does not articulate with the _____
carpals
concave base of _______ articulate with convex ____
metacarpals
carpals
convex head of _______ articulate with concave base _____
metacarpals
phalanges
____ head phalanges
convex
carpals are ____
convex
metacarpals and phalanges have a concave _____ but convex ____
base
head
radiocarpal
distal concave ____ to proximal convex ___
radius
carpals
between two carpal row joint
midcarpal
radioulnar disc articulated with
triquetrum
radioulnar disc does
shock absorption and space filler
joint capsule is made up of ____,___ ,____ ___ ___
radius
ulna
proximal carpal row
volar/ palmar is on the ___ side
anterior
dorsal is on the _____ side
posterior
medial collateral ligament limits a
valgus stress
lateral collateral ligament limits a
varus stress
flexor and extensor retinacula keeps ____ ___
tendons down
palmar ligaments are
palmar radiocarpal
ulnocarpal
flexor retincula is also used as
transversecarpoligament
Carpometcarpal joint
carpals-
metacarpals -
convex
concave
1st metacarpal- articulates with
2nd metacarpal- articulates with
3rd metacarpal- articulates with
4th and 5th metacarpal articulates with
trapezium
trapezoid
capitate
hamate
metacarpophalangeal is also known as
knuckles
Metacarpophalngeal joint
______ _____ articulates with proximal _____ ___
convex metacarpal
concave phalanx
convex ____ on concave proximal ____
metacarpal
phalanx
thumb has only 1 ___ joint
IP
metacarpophalngeal (condyloid) motions are
flexion extension
abduction adduction
interphalangeal motions are
flexion and extension
interphalangeal
heads-
bases-
convex
concave
medial and lateral facets hook on ____
carpals
convex _____ on concave/ convex _____ _ / thumb
trapezium
metacarpal 1
carpopmetacarpal CMC is concave of convex depending on what ____
plane
CMC motions
flex ext
abd add
opposition reposition.
CMC is a ___ joint
saddle
MCP is a ____ joint
condyloid
flex ext bringing thumb towards __, neutral
palm
abd add bringing thumb __ in front and straight ___back to body
up
down
opposition/ reposition is a combo of
flexion and abduction
opposition is bringing thumb to all ___
digits
metacapophalangeal and interphalangeal
concave -
convex -
base
head
wrist flexion is
90
wrist flexors are
flexor carpi radialis
flexor carpi ulnaris
palmaris longus
long finger flexors
wrist extension is
85
wrist extensors are
extensor carpi radialis longus
extensor carpi radialis brevis
extensor carpi ulnaris
long finger extensors
flexor intrinsic is ___ ____ ____ originates all on ____ epicondyle of humerus
common flexor tendon
medial
all extensors are innervated by the
radial nerve
2nd metacarpal does
4-5th metacarpal does
radial deviation
ulnar deviation
radial devation is
20
ulnar devation is
30
radial devation is
abduction
ulnar devation is
adduction
radial deviation range is smaller because ___ hit sooner less range
carpals
radial devation muscles are
flexor carpi radialis
extensor carpi radialis
ulnar devation muscles are
flexor carpi ulnaris
extensor carpi ulnaris
MCP flexion is
90
MCP extension is
45
MCP flexion muscles
lumbricals
long finger extensors
MCP extensor muscle is
long finger extensors
Flexion Lumbricals cross _____ to the MCP joint
anterior
MCP
flexion lumbricals produce ____ flexion
MCP
metacarpophalngeal is ___
interphalangeal is _____
lumbricals are most ____
anterior
posterior
active
extension lumbricals insert into extensor hood ______ to the IP joints
posterior
Extension lumbricals produce ___ and ___ extension
DIP and PIP
PIP flexion is
100
DIP flexion is
90
PIP flexion muscle
DIP flexion muscles
flexor digitorum superficials
flexor digutorum profundus
PIP DIP extension
all long finger extension
MCP abduction is
20
MCP adduction is
0
mcp abduction muscles
dorsal interossei
abductor digiti minimi
mcp adduction muscle
palmar interossei
thumb cmc flexion is
15
mcp flexion is
50-60
IP flexion is
80
flexion CMC muscles
flexor pollicis longus
flexor pollicis brevis
Extension CMC muscles
extensor pollicis longus
extensor pollicis brevis
thumb cmc abduction is
70
thumb cmc adduction is
0
cmc abduction muscles
abductor pollicis longus
abductor pollicis brevis - intrinsic
cmc adduction muscle
adductor pollicis
pollicis muscles insert on
metacarpals
abductor pollicis longus is
extrinsic and abducts ____
digits 1
snuffbox is thumb _____/ ______
digit in between tendons - scaphoid
Muscles for snuffbox:
abductor pollicis longus
extensor pollicis tendon
flexor pollicis longus is ____ flexion
phalangeal
flexor pollicis brevis is ____flexion
metacarpal
extensor pollicis longus is extension of ___ phalanx
distal
extensor pollicis brevis is extension of ____ phalanx
proximal
abductor pollicis longus is ____ abduction
abductor pollicis brevis is _____ abduction
anatomical
palmar
intrinsic muscles insert on
metacarpal
intrinsic only distal to ___
it’s in ___
wrist
hand
abductor pollicis brevis is intrinsic
lateral of _____ _ abduction of ___ _
metacarpal 1
digit 1
adductor pollicis is intrinsic
medial of ______ _ and adduction of ____ _
metacarpal 1
digit 1
opposition is strongest with ____ and ____ together. internal surface
pinky
thumb
opposition muscles are
opponents pollicis
opponents digiti minimi
long extensor extend ___ wrist continued individual digits __-___ extensor digitorum tendon with metacarpals
indicis -
pollicis -
minimi-
2nd
1st
5th
extensor hood mechanism helps maintain _____ of fingers
extension
extensor hood muscles
extensor digitorum
lumbricals
dorsal interossei
palmar interossei
extensor hood recieved __ tendon extensor ____ and extensor ___ ____
5th
indicis
digiti minimi
primary function of hand is
prehension
muscle most active in cyndlindrical grasp
flexor digitofum superficials
muscle most active in spherical grasp
dorsal interossei
thumb is a ___ nerve injury
median
__ grasp is the tightest
fist
cylinder object grasp
cylindrical grasp
fingers spread grasp ball
spherical grasp
digits 2-5 flex MCP ext IP flex
hook grasp
thumb has no role in
hook grasp
cylindrical grasp is also in ____ _____ adduction
palmar interossei
- tip of thumb tip of finger
tip prehension / pincer grip
pad of thumb or finger
palmar prehension pad to pad
pad of thumb side of finger
lateral prehension
horizontally arches
carpal rows / flexor retinaculum
metacarpal head / mcp
arch down the middle length of metacarpals
longitudinally arch
increased grip of fingers - increase power
palmar arch
abd / add with fingers flex/ ext
interossei cannot function in finger ___ because ___ insufficiency of finger ___
flexion
active
flexors
flexor digitorum superficials PIP ___
flexion
flexor digitroum profundus DIP and PIP ____
flexion
strongest between thumb and 5th fingers because both have ____ muscles
opponeus
dynamometer and tenedesis to measure wrist ___
flexion
decreased grip strength with wrist ____
flexion
functional hand position avoids hand getting ___
stiff
functional hand position
wrist extension is
ulnar devation is
finger flexion
-mcp
-pip
-dip
20
10
45
30
10
carpal tunnel anatomical region
proximal row of ___ and ___ retinaculum
carpals
flexor
carpal tunnels contains _ tendons
9
carpal tunnel tendons
4 flexor digitorum pollicis
4 flexor digitorum superficialis
1 flexor pollicis longus
symptoms of carpal tunnel
pain numbness tingling burning muscle weakness
treatment carpal tunnel
strengthen thenar muscles
stretching flexors - strengthen extensors
ice
weakness- atrophy , nerves not going through
thenar waisting
bicipital grove mucscles do what of humerus
internal rotation
scapulohumeral rhythm
___ glenohumeral
__ scapular motion after first 30
2
1
palmar arch (prox and distal horizontal and longitudinal arch) supported by
flexor retinaculum
extensor hood mechanism
ex digitorum
lumbricals
2 interossei
extensor indicis tendon / digiti minimi tendon
