joints of upper extremities Flashcards
GH range of motion (Osteokinematic motions)
Flexion 180 Extension 45 Abduction: 180 Adduction 45 Medial Rotation 70 Lateral rotation 90 Horizontal adduction 45 Horizontal abduction 100
Glenohumeral joint classification
Structure: synovial
Subtype: ball and socket
Axis of rotation: multiaxial
Function diathrotic
Articular surfaces of GH
Scapula: glenoid fossa (concave) - glenoid labrum
Humerus: Humeral head (convex)
Capsular strength: weak
Ligaments of GH
Glenohumeral ligament
Coracohueral ligament
Transverse humeral ligament
Bursae of GH
Subscapular
Subdeltoid
Subacromial
Subcoracoid
Resting position of GH
55-70 abduction, 30 horizontal adduction, neutral rotation
Closed pack position of GH
Full elevation - maximum combined abduction and ext rotation
Capsular pattern of restriction of GH
Ext. Rotation > abduction >internal rotation
Joint mob of GH
Traction/distraction
Lateral distraction
Inferior glide - increase abduction,
Posterior glide - increase flexion (medial rotation, horizontal adduction)
Anterior glide - increase external rotation (extension, horizontal abduction)
Humeroulnar/humeroradial joints classification
Structure: synovial
Subtype: hinge
Axis of rotation: uniaxial
Function: diarthrotic
Range of motion of Humeroulnar/humeroradial
Flexion: 135
Extension: up to 5 (most functional activities occur between 30-130 of elbow flexion, 50 pronation, 50 supination)
Resting and closed pack position and capsular pattern of restriction of Humeroulnar
Resting: 70 flextion, 10 supination
Closed pack full extension and supination
Capsular pattern: flex > extension
Resting, closed pack position and capsular pattern for Humeroradial jt
Resting: Full extension and supination
Closed pack: 90 flexion, 5 supination
Capsular pattern: flex> extension
Articular surface of Humeroulnar and Humeroradius jt
Humerus: capitulum (radius) and Trochlea (ulnar) (both convex)
Radius: articular surface of the head (concave)
Ulna: Trochlear notch (concave)
Ligaments and bursa of Humeroulnar and humeroradial joint
Radial collateral ligament
Ulnar collateral ligament
Olecranon bursa
Weak due to excessive spread of capsule
joint mobs of Humeroulnar
Traction/distraction - increase flex/ext
Medial glide and medial gap- treating medial epicondylalgia, (elbow flexion)
Lateral glide and lateral gap - treating lateral epicondylalgia
joint mob of Humeroradial
Distraction (correcting a humeroradial joint compression positional fault) Compression Posterior glide (increasing ROM into elbow joint extension) Anterior glide (increasing ROM into elbow joint flexion)
Roximal radioulnar joint classification
Structure: synovial
Subtype: pivot
Axis: uniaxial
Function: diarthrotic
Proximal radioulnar joint ROM
Pronation 70-90
Supination: 90
Proximal raidoulnar Resting, closed pack, capsular pattern
Resting 35 flexion, 70 supination
Closed pack full supination/pronation
Capsular pattern supination = pronation
Articular surface of Proximal radioulnar
Articular circumference of Radius bone (convex)
Radial notch of the ulna (concave)
Weak, same capsule as the elbow
Ligaments of Proximal radioulnar joint
Annular ligament
Oblique cord
Interosseous membrane
Joint mob’s proximal radioulnar
Posterior glide of the proximal radius: increasing ROM of forearm pronation
Anterior glide of the proximal radius: increasing ROM of forearm supination
Distal Radioulnar joint classification
Structure - synovial
Subtype - pivot
Axis - uniaxial
Function: diarthrotic
Distal radioulnar joint ROM
Pronation 70-90
Supination 90
Distal radioulnar joint resting, closed pack, capsular pattern
Resting 10 supination
Closed pack position full supination/pronation
Capsular pattern: supination = pronation
Articular surface of distal radioulnar joint
Distal ulna (convex)
Ulnar notch of the radius (concave)
weak
Ligaments of distal radioulnar joint
Anterior radioulnar ligament
Posterior radioulnar ligament
Interosseus membrane
Important relations to Distal radioulnar joint
Anteriorly, tendons of the flexor digitorum profundus
Posteriorly the tendons of the extensor digiti minimi
how many joints in Wrist?
- Radioarpal joint, ulnomeniscotriquetral joint, Triquetrum-pisiform articulation, Midcarpal joint
Raidocarpal/Ulnomeniscotriquetral joint classification
Structure: synovial
Subtype: condyloid
Axis: biaxial
function: diarthrotic
Radiocarpal/Ulnomeniscotriquetral joint ROM
Flexion 80
Extension 70
Radial deviation 20
Ulnar deviation 30
Radiocarpal/Ulnomeniscotriquetral joint resting, closed pack, capsular pattern
Resting: slight flexion and ulnar deviation
Closed pack position: full extension
Capsular pattern: flexion = extension
Radiocarpal/ulnomeniscotriquetral joint articular surfaces
Carpals lunate and scapoid to radius + proximal surface to triquetram to ulna (convex)
Distal Radius (concave)
Distal Ulna (concave)
Weak
Radiocarpal/ulnomeniscotriquetral joint ligaments
Radial collateral ligament Ulnar collateral ligament Transverse carpal ligament Palmar radiocarpal ligaments dorsal radiocarpal ligaments Intercarpal ligaments
Radiocarpal/ulnomeniscotriquetral joint joint mobs
Distraction Dorsal glide -increase flexion, Volar glide -increase extension radial glide -increase ulnar deviation ulnar glide to increase radial deviation
Intercarpal/midcarpal joint classification
Structure: synovial
Subtype: planar
Axis: nonaxial
Function: diarthrotic
Intercarpal/midcarpal joint ROM
Flexion 80
Extension 70
Radial deviation 20
Ulnar deviation 30
Intercarpal/midcarpal joint Resting, closed pack, capsular pattern
Resting: Neutral or slight flexion and ulnar deviation
Closed pack: full extension
Capsular pattern: flexion=extension
Articular surface of intercarpal/midcarpal joint
Adjacent surfaces of carpals, capitate bone articulates with all carpals except pisiform and trapezium. Concave/convex varies depending on the specific joint
weak
Intercarpal/midcarpal joint ligaments (4)
- radial collateral ligament
- Volar radiocarpal liagament
- dorsal radiocarpal ligament
- intercarpal ligament
Intercarpal/midcarpal joint mobs
distraction dorsal glide - increase flexion volar glide - increase extension radial glide - ulnar deviation ulnar glide - increase radial deviation
carpometacarpal joint classification, range of motion
digit II to V: synovial, planar, nonaxial
Digit I ( thumb) synovial, saddle, biaxial
Function: diarthrotic
Range of motion: Digits II to V slight gliding
resting postion, closed pack position, capsular pattern of restriction of CMC
Midway between flexion and extension and slight ulnar deviation
closed pack: n/a
Capsular pattern : equal in all direction
Metacarpophalangeal joint classification, ROM
Structure: Digit II to V: synovial, condyloid, biaxial
Digit I: synovial hinge, uniaxial
Diarthrotic
ROM: Digits II to V flexion 90, Extension 45, abduction 20, adduction 10
Digit I Flexion 60
Resting position, closed pack position, capsular pattern of MCP
1 MCP jt, slight flexion, joint 2-5 slight flexion with ulnar deviation
Closed pack 1 full extension. joint 2-5 full flexion
Capsular pattern : flexion>extension
Interphalangeal joint resting, closed pack, capsular pattern
Resting position: PIP 10, flexion, DIP 30’s flexion
Closed pack position full extension
capsular pattern: flexion>extension (flexion is more limited than extension)
