Final Exam- Elbow and Wrist

Question 1

Bones in the Elbow Joint

Answer 1

Humerus
Ulna
Radius

Question 2

Elbow Joint

Answer 2

A very stable joint that assists shoulder in application of force and controlling placement of hand in space

Assymetrical structure of trochlea creates angulation of ulna when extended known as the carrying angle

Question 3

Elbow ROM

Answer 3

Flexion/Extension
-145 degrees active, 160 degrees passive. need 100-140 degrees to perform ADLs

Supination/Pronation
-85 degrees supination; 70 degrees pronation. need 50 degrees supination and 50 degrees pronation to perform ADLs.

Question 4

Name the elbow flexors

Answer 4

ANTERIOR SIDE

1. Biceps Brachii
2. Brachioradialis
3. Brachialis

Flexors are almost twice as strong as the extensors making us better pullers than pushers

Question 5

Biceps Brachii

Answer 5

Mutliarticular muscle whose effectiveness is dependent on position of shoulder and radioulnar joints. Performs at 3 joints

Not effective when pronated.

MOST PROMINENT

Question 6

Brachioradialis

Answer 6

used more in rapid movements or against resistance

Question 7

Brachialis

Answer 7

Brachialis is the most effective elbow flexor.

Question 8

Name the elbow extensors

Answer 8

1. Triceps Brachii

2. Anconeus

Question 9

Triceps Brachii

Answer 9

teacher response

Question 10

Anconeus

Answer 10

teacher response

Question 11

Biceps Brachii Action

Answer 11

Elbow flexion
Proximal radioulnar supination
Shoulder flexion

Question 12

Brachioradialis

Answer 12

Elbow flexion

Some pronation and supination

Question 13

Brachialis

Answer 13

Elbow flexion

Question 14

Triceps Brachii

Answer 14

Elbow extension
Shoulder adduction
Shoulder extension

Question 15

Anconeus

Answer 15

Elbow extension

Question 16

Radio Ulnar Joints

Answer 16

SUPINATOR-always active
BICEPS BRACHII-active in rapid mvmts or against large loads
PRONATOR TERES-active in rapid mvmts or against large loads
PRONATOR QUAD-always active

Question 17

Supinator

Answer 17

Supination of the proximal radioulnar joint

Question 18

Pronator teres

Answer 18

Pronation of the proximal radioulnar joint

Question 19

Pronator Quadratus

Answer 19

Pronation of the proximal radioulnar joint

Question 20

Medial Epicondylitis

Answer 20

linked to movements containing high velocity valgus extension mechanism

large valgus torque near maximal external rotation resisted by a large varus torque generated by the soft tissue in the elbow.

Question 21

Little Leaguer’s Elbow

Answer 21

Medial Epicondylitis

• medial strain imparted during the initial forward phase of throw as hand and elbow lag behind trunk and shoulder
• curveball pitching will magnify this medial strain throughout pitch and therefore is not recommended for young pitchers

Question 22

Medial Elbow Injuries (Little Leaguers Elbow)

Answer 22

Sprain or rupture of ulnar collateral ligaments

Medial epicondylitis

Tendonitis of wrist flexors

Avulsion fractures of medial epicondyle

Osteochondritis dissecans to the capitulum (a lesion in the bone and articular cartilage) where the radial head is pushed up into the capitulum due to the compressive load developed from the valgus force

Question 23

Tennis Elbow

Answer 23

-Lateral Epicondylitis- inflammation/ microdamage to tissues on the lateral side of the humerus, 30%-40% of tennis players will develop some amount of this injury

• cause include poor technique and equipment
  e. g. off center shots and rackets strung too tightly

-the pain is exacerbated by activities involving EXTENSION of the wrist. These include lifting a suitcase, shaking hands, turning doorknobs, etc.

Question 24

The Wrist and Hand

Answer 24

Wrist- radiocarpal joint condyloid joint

ulna makes no contact with carpals but floats on disc so it does not influence wrist movement during supination/ pronation

Question 25

Midcarpal Joint

Answer 25

Radiocarpal joint is the articulate between the scaphoid and radius

The scaphoid may be one of the most important carpals because it supports the weight of the arm and transmits the forces between the hand and the forearm

Wrist ROM
flexion: 70-90 degrees need 10-15 for ADL’s
extension: 70-80 degrees need 35 degrees for ADL’s
ROM reduced when fingers are flexed

Question 26

Radial Ulnar Deviation

Answer 26

proximal row of carpals glides over distal row

ROM
radial dev. 15-20 degrees
ulnar dev. 30-40 degrees

Question 27

Carpometacarpal (CMC) Joint

Answer 27

CMC of thumb is a saddle joint that allows flexion/extension, ab-/adduction and rotation

these movement permit thumb to touch each finger (known as opposition)

opposition is very important in all gripping and prehension tasks

concave transverse arch metacarpals to facilitate gripping

Question 28

Metacarpophalangeal (MCP) Joint

Answer 28

MCP of thumb is a hinge joint allowing only flexion and extension

MCP of fingers is a condyloid joint perming flex/ext and ab-/adduction

Question 29

Wrist Extensors

Answer 29

Extensor Carpi Radialis Longus
Extensor Carpi Radialis Brevis
Extensor Digitorium
Extensor Carpi Ulnaris

Origin on lateral epicondyle
Because the extensors act on the elbow joint, elbow joint position will influence extensor output

Question 30

Wrist Flexors

Answer 30

Flexor Carpi Radialis
Palmaris Longus (Absent in 13% of population)
Flexor Carpi Ulnaris

All fusiform muscles.
Origin on medial epicondyle

Question 31

Flexor Carpi Ulnaris

Answer 31

strongest flexor
strength increased by encasing the pisiform in its tendon such that it becomes a seasmoid bone that improves the mechanical advantage of the muscle

Question 32

Radial Deviation is created by_______.

Answer 32

Radial deviation is created by the radial muscles

Flexor carpi radialis
Extensor carpi radialis longus and brevis

Question 33

Ulnar Deviation is created by______.

Answer 33

Ulnar deviation is created by the ulnar muscles

Extensor carpi ulnaris
Flexor carpi ulnaris