Exam 4 Flashcards
what is the primary goal of elbow and FA
placement of hand
what connects on the med epicondyle
common flexors/pronators
what connects on the lat epicondyle
common extensor/supinators
describe the proximal ulna
thick
olecranon process
trochlear notch
radial notch
describe the distal ulna
articular cartilage
styloid process
what attaches to the supinator crest
LCL and sup mm
what attaches to the tuberosity of the ulna
brachialis
how is the radius positioned in supination
parallel and lateral
describe the distal end of radius
large
styloid process
describe the proximal end of radius
small
radial head
fovea
describe radial head
disc like articular cartilage
280 deg of rim
radial notch on ulna
what is the fovea on the radial head
shallow up connected to capitulum
describe the humeral-ulnar jt
FLX/EXT
stability
describe the humeroradial jt
FLX/EXT
ligaments attach to radial head and capitulum
what is the normal cubitus valgus
carrying angle
13 deg
excessive = 20-25 deg
describe the capsule/ligaments of the elbow
encompass 3 jts
multiplanar stability
describe the ant fibers of MCL
strongest
resist valgus
med epicondyle to coronoid process
stability in sagittal
describe the post fibers of MCL
posterior/med capsule
med epicondyle to olecranon
resist valgus
tight in flexion
describe the transverse fibers of the MCL
olecranon to coronoid process
articular stability
what is a WB injury to MCL
extended/valgus force
compression fx
ant capsule
med muscles at epicondyle
what is a NWB injury to MCL
repetitive valgus force (overhead athletes)
ant fibers damaged - tommy john surgery
what is the RCL
annular lig
supinator
extensor carpi radialis brevis
what is the LCL
thicker
taut at full flexion
sling for radial head
frontal/horizontal plane stability
what is a triad injury in the elbow
full outstretch supinated
elbow jt dislocation
fx radial head
fx coronoid process
what are complications of the triad injury
persistent instability
n damage
stiffness
what level of spinal injury can cause paralysis in elbow
above C5 spinal injury
what is a flexion contracture
after immobilization
ossification
inflammation
m spasticity
tricep paralysis
scarring
what is the functional arc of elbow
145-150
what are the humero-ulnar jt arthro
concave trochlear notch on convex trochlea
what fibers are taut in full elbow extension
anterior m and tissues
ant capsule
ant MCL fibers
what fibers are taut in FLX
elongation of ulanr n
post capsule and m
post MCL fibers
what are the humeroradial arthro
radius rolls and slides
cuplike fovea and capitulum
what is the fovea doing in active FLX
firmly against capitulum
how is the central band of interosseus membrane positioned
directed distally medially at 20 deg from radius
what are complications of interosseus membrane tears
proximal migration of radius
Describe the proximal radio-ulnar jt
Radial notch + annular ligament
Lined with cartilage
Attachment for radial collateral and supination m
Describe the distal radio-ulnar jt
Convex head of ulna
Shallow concavity on radius
TFC, disc, m
What is the TFC
Triangular fibrocartilage
Holds the ulna head to the notch during supination and pronation
What are the stabilizers of the distal radio-ulnar jt
TFCC, pronator quadratus, ECU, interosseus membrane
What limits supination
Pronator teres
Pronator quadratus
Flexor carpi radialis
TFCC
quadrate lig
Interosseus membrane
what limits pronation
biceps
supinator
radial wrist extensors
extensor pollicis longus
TFCC
how do the bones move during supination at the proximal and distal seg
radius and carpal bones rotate around fixed humerus and ulna
prox- radial head RT
distal- radius rolls and slides same direction
where is the axis of RT in the radio-ulnar jt
nearly parallel to the interosseus membrane
limits tension
stabilizer
what is happening in pronation in open chain activities
pronator rotates the radius around fixed ulna
what is happening in pronation in closed chain activities
the infraspinatus rotates the humerus relative to fixed scapula
ER of ulna around fixed radius
what are the elbow flexors
brachialis (MSC n)
bicep brachii (MSC n)
brachioradialis (radial n)
pronator teres (median n)
what are the elbow extensors
tricep brachii (radial n)
anconeus (radial n)
what are the FA pronators
pronator quadratus (median n)
pronator teres (median n)
what are the FA supinators
bicep brachii (MSC n)
supinator (radial n)
what is the job of the 3 heads of tricep
medial - workhorse
lateral - mod to high levels of demand
long - reserve for high performance
when does the tricep have max torque
80-90 elbow flexion
what does the tricep do in WB
stability as isometric or low velocity eccentric
when does the tricep do high velocity concentric
sports
pushing up from a chair
pushing up from door
what are the secondary supinator m
radial wrist extensors
extensor pollicis longus
extensor indicis
brachioradialis
when is the bicep recruited for supination
90 deg elbow flexion
where does the median n pass through
2 heads of pronator teres
what is an effect of median n injury
pronators are paralyzed
what are secondary pronators
flexor carpi radialis
palmaris longus
brachioradialis
what is different from carpul tunnel syndrome and pronator teres syndrome
pronator teres has pain in medial FA plus the paresthesia on palmar 3.5 digits
what is the ulna tilt
distal end of radius tilts towards ulna 25 deg
what is the palmar tilt
ulna is 10 deg more in flexion than wrist ext
what makes up the prox carpal row
scaphoid, lunate, triquetrum, and pisiform
loosely joined