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Applied KINES > Lec 11 Elbow Complex > Flashcards

Lec 11 Elbow Complex Flashcards

1
Q

Joints of the elbow complex

A

humeroulnar
humeroradial
prox. and dist. radioulnar

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2
Q

Articulation of Humeroulnar

A

Trochlear notch of ulna

Trochlea of humerus

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3
Q

Articulation of Humeroradial

A

Head of radius

Capitulum of humerus

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4
Q

Elbow joint type and DOF

A

Modified hinge

1 DOF

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5
Q

Joint of elbow complex includes:

A
  • elbow and proximal radioulnar joint enclosed in a single joint capsule
  • large, loose and weak anteriorly and posteriorly
  • contains folds that can expand to allow for a full ROM
  • Fat pads
  • reinforced laterally by collateral ligaments
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6
Q

Carrying angle

A

medial portion of trochlea projects more distally than the lateral portion

  • results in valgus angulation of the forearm
  • combo of shoulder ER, elbow EX, and forearm supination
  • Fx: allows a person to carry objects away from side of thigh
  • Angle varies 8-15 degrees
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7
Q

Passive structures of elbow joint ligaments

A

medial (ulnar) collateral ligament

Lateral collateral ligament complex

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8
Q

Medial Collateral Ligament

A

anterior, posterior and transverse parts

  • stabilizes against valgus torque at elbow
  • limits extension at end ROM
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9
Q

Lateral Collateral Ligament complex

A

stabilizes against varus torque at the elbow and combined varus & supination torques

  • Lateral (radial) collateral lig
  • Lateral (ulnar) collateral lig
  • Annular ligament
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10
Q

When could extreme valgus-producing force occur?

A

when trying to catch oneself from a fall

-may result in rupture of MCL and/or compression force within the humeroradial joint

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11
Q

Is the Humeroradial articulation incongruent or congruent? What position is there no contact between the articulation?

A
  • incongruent

- no contact in full extension between surfaces

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12
Q

Osteokinematics of Humeroulnar (elbow)

A

Flexion and Extension

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13
Q

Arthrokinematics of Humeroulnar (elbow)

A

concave surface of trochlear notch on convex trochlea

  • flexion: roll anterior, slide anterior
  • extension: roll posterior, slide posterior
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14
Q

Elbow joint closed packed position

Humeroulnar and Humeroradial

A

Humeroulnar: full extension and supination
Humeroradial: 90 degrees elbow flexion and 5 degree supination

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15
Q

Elbow joint open packed position

Humeroulnar and Humeroradial

A

Humeroulnar: Flexed 70 degrees, supinated 10 degrees
Humeroradial: Full extension and supination

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16
Q

Capsular pattern of elbow joint

A

Flexion > Extension

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17
Q

Proximal & Distal Radioulnar Joint articulations and joint type

A 
Prox: 
-ulnar radial notch with head of radius
-capitulum of humerus
-annular ligament
Dist:
-Ulnar notch of radius with head of ulna
-TFCC
Type:
-uniaxial pivot joint
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18
Q

Pronation occurs as a result of ____ crossing over the ____ at proximal radioulnar joint

A

radius

ulna

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19
Q

Rotation occurs at the…

A

proximal radioulnar joint

20
Q

Slide of the concave surface of the _____ on the radius around the ulnar head at the distal radioulnar joint in OKC

A

ulnar notch

21
Q

Proximal Radioulnar Joint AK

A

Supination: lateral rotation
Pronation: medial rotation

22
Q

Proximal Radioulnar Joint Arthrokinematics

A

Rotation of the head of the radius on the ulnar radial notch within the annular ligament

23
Q

Distal Radioulnar Joint Osteokinematics

A

Supination/pronation

24
Q

Distal Radioulnar Joint Arthrokinematics

A

Concave ulnar notch of radius on convex head of the ulna
Supination: roll and slide laterally
Pronation: roll and slide medially

25
Q

What compensatory shoulder motion could help someone who is lacking in forearm pronation and/or supination to increase this forearm ROM? (this is open chain)

A

Pronation comp pattern: Shoulder IR

Supination comp pattern: Shoulder ER

26
Q

Closed chain supination & pronation

A

humerus and ulna rotate relative to a fixed radius/hand
starting position: shoulder in IR, forearm is supinated
-radius and ulna are parallel in supination
-moving into pronation requires ER of the humerus and ulna
-moving back to supinated position results in IR of humerus and ulnar relative to radius/hand

27
Q

Pronation and Supination are a result of ____ and ____ of the GH, respectively in CKC

A

ER and IR

28
Q

Motion is a result of the ____ and ____ muscles to move from supination to pronation in CKC

A

infraspinatus and pronator quadratus

29
Q

Proximal radio-ulnar joint articulation in WB/CKC, what is moving on what?

A

Annular ligament & radial notch of ulna rotate around a fixed radial head

30
Q

Proximal radio-ulnar joint NWB/OKC

A

Radial head rotates within a ring formed by the annular ligament & the radial notch of the ulna

31
Q

Distal radio-ulnar joint

WB/CKC

A

Convex ulnar head rolls and slides in opposite directions on the concave ulnar notch of the radius

32
Q

Distal radio-ulnar joint

NWB/OKC

A

Concavity of the ulnar notch of the radius rolls and slides in similar directs on the convex ulna head

33
Q

Proximal Radioulnar Joint Closed and Open packed positioning

A

Closed: 5 degree of supination
Open: 70 degree of flexion, 35 degree of supination

34
Q

Capsular pattern of Proximal radioulnar joint

A

supination=pronation

35
Q

Distal radioulnar joint closed and open packed positioning

A

Closed: 5 degree of supination
Open: 10 of supination

36
Q

Torque Generation of the Elbow Flexors:

Flexor Torque is 20-25% greater with the elbow in a ____ position compared to ____ position

A

supinated
pronated
Allows increased flexor moment arm of the biceps & brachioradialis when forearm is supinated

37
Q

Brachialis

A

“workhorse” of elbow flexors

  • large muscle volume
  • active involvement in all types of elbow flexion
38
Q

Torque generation of the elbow extensors:

Elbow extension typically combined with shoulder flexion in what activities?

A

explosive pushing activities

-position minimizes rate and amount of shortening required by triceps to extend elbow

39
Q

Torque generation of the elbow extensors:

Anterior delt

A

important synergist to counter shoulder extension potential of triceps

40
Q

What is the position for the strongest isometric coactivation of elbow flexors and extensors?
When do we use this position?

A
  • 90 degrees of elbow flexion

- position utilized for activities requiring strong, rigid elbow

41
Q

Pronation/Supination & Shoulder ER/IR OKC

A

Functionally

  • pronation associated with IR
  • supination associated with ER
  • combo allows for hand to rotate nearly 360 degrees in space
42
Q

Important to keep in mind when testing forearm pronation and supination

A

Arm held pressed to side with elbow at 90 allows to block rotation torque from humerus

43
Q

Supinator versus Biceps Brachii

A

Supinator muscle
-Generates significant EMG activity with supination at any angle
Biceps muscle
-Also a primary supinator
-Normally recruited with high power supination activities, particularly those in elbow flexion

44
Q

High-power Supination Torque:

Screwdriver example, what muscles are recruited? Co-contractors?

A
  • Biceps recruited to assist supinator and extensor pollicis longus
  • Triceps must co-contract to prevent biceps from actually flexing the elbow and shoulder during supination effort
45
Q

Law of Parsimony

A
  • States that nervous system tends to activate the fewest muscles or muscle fibers possible for the control of a given joint action
  • Goal of energy efficiency
  • Activation of large, polyarticular muscles initiated for more dynamic or highly resisted activities
46
Q

Pronator Teres vs Pronator Quadratus, which is higher power/lower power?

A
  • Lower powered activities utilize pronator quadratus

- Higher powered activities also recruit pronator teres

47
Q

Synergistic Relationship between Pronator Teres & Triceps

A

Highest EMG activation noted in pronator teres with higher powered pronation activities
Ie Unscrewing overtightened screw with R hand or just prior to release phase of pitching a baseball
Triceps acts as synergist to counter tendency of pronator teres to also flex the elbow

Applied KINES (6 decks)

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