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POTH 225: BIOMECHANICS > lecture 10: elbow and forearm > Flashcards

lecture 10: elbow and forearm Flashcards

1
Q

which of the following is NOT a static GH joint stabilizer (deltoid, labrum, capsule, GH lgs)

A

deltoid

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2
Q

arm elevation in the plane of the scapula occurs why

A

beacuse the scapula sits on the curved surface of the thorax

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3
Q

what does the elbow do

A

controls the movement within the spheres (position of the arm and hand) to carry out functional activties

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4
Q

what are the movements of the elbow

A

flexion/extension
pronation/supination

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5
Q

define valgus at the elbow

A

lateral deviation of a distal segment with respect to proximal segment

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6
Q

define varus at the elvow

A

medial deviation of a distal segment with respect to proxima lsegment

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7
Q

what is normal ROM at the elbow for flexion/extension

A

flexion: 140-145
extension: 0

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8
Q

what is normal ROM for elbow for sup/pron

A

80-90

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9
Q

what is the arc of movement required for most ADLs at the elboe

A

30-130 (100 degrees) in flexion/extension
50 degrees of pronation and supination

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10
Q

what are the bones of the elvow

A

humerus
radius
ulna

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11
Q

the medial epicondyle of the hum is an attachment for what muscles

A

flexors and pronators

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12
Q

the lateral epicondule of the hum is an attachment for what muscles

A

extensors
supinators

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13
Q

the trochlea is located medially or lateral

A

medial

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14
Q

the capitellum is located medially or lateral

A

lateral

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15
Q

what part of the humerus articulates with the radius

A

capitellum

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16
Q

what bony parts lock to form stability at the elbow

A

coronoid fossa with coronoid
olecrannon fossa with olectronon

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17
Q

during flexion, what bony segments lock together

A

in flexion, coronoid with coronoid fossa anterior

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18
Q

during extension, what bony segments lock together

A

olecrannon with olecrannon fossa (posteriorly)

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19
Q

what nerve passes medially to the elbow and wh=y is that a problem

A

ulnar nrve passes medially and it can get injured/entrapped

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20
Q

cubital tunnel is located medially or laterally

A

medial

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21
Q

the distal humerus has a 30 degree anterior or posterior curve

A

anterior

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22
Q

the distal humerus has a BLANK degree anterior curve

A

30 degree

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23
Q

because of the anterior curve of the distal humerus favours movement in flexion or extension

A

flexion (greater contact area during flexio)

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24
Q

true or false: the distal humerus only has an anterior curve

A

false, also has a tilt

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25
Q

what degrees of tilt is there at the distal humerus

A

6 degrees of tilt

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26
Q

what is there 6 degrees of tilt at the distal humerus

A

beacuse of trochlea protruding

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27
Q

what are the important aspects of the proximal ulanr

A

trochlea notch
olecreannong
coronoid process

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28
Q

olecreannon locks with olecrannon fossa in flexion or extension

A

extension

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29
Q

olecreannon locks with blank in extension

A

olecreannon fossa

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30
Q

coronoid process locks with coronoid fossa fossa in flexion or extension

A

flexion

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31
Q

coronoid process locks with BLANK in flexion

A

coronoid fossa

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32
Q

what are the important aspects of the proximal radius

A

radial head
radial neck
radial tub
fovea

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33
Q

what bone is commonly fractured at the elbow

A

radius

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34
Q

what is the radial tuberosity an attachment for

A

biceps

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35
Q

the fovea of the radius articulars with what surface

A

the humerus

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36
Q

what are the joints of the elbow joint

A

humeroulnar
humeroradial
proximal radioulnar

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37
Q

what type of joint is the humeroulnar joint

A

ginglymus (hinge)

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38
Q

what are the movments of the humeroulnar joint

A

flexion/extension

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39
Q

explain the joint space of the humeroulnar jt

A

assymetrical

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40
Q

they boney shape of the humeroulnar joint favours what

A

favors flexion excursion vs extension excursion

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41
Q

what type of joint is the humeroradial joint

A

ginglymus (hinge)

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42
Q

what are the movements possible at the humeroradial jt

A

flexion/extension

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43
Q

in the humeroradial joint, there is greater contact with elbow during extension of flexion and why

A

during flexion beause of anterior rotation of humerus (distally)

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44
Q

what type of joint is the superior radioulnar

A

trocchoid (pivot)

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45
Q

what is the movements possible at the superior radioulnar joint

A

pronation/supination

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46
Q

true or false: the superior radioulnar joint has no support from bone structure-only soft tissues

A

true

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47
Q

what are the soft tissues that support the superior radioulnar jt

A

annular lig (around the radial head)
interosseus membrane

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48
Q

what is the function of the interosseus membrane

A

interosseus membrane an important static longitudinal stabilizer of the forearm (less contribution to forearm rotation)

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49
Q

the COR during flexion and extension goes where

A

oblique through the capitulum anfd trochlea

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50
Q

why is knowing the COR at the elbow important

A

for orthotic hinge alignment
hinge needs to allgin with anatomical COR
axis of orthosis needs to allign with axis of arm

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51
Q

the COR during pronation and supination

A

rotaiton about a longitudninal axis between the raidl head and the ulnar head

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52
Q

explain joint contact with an applies compressive force during extension

A

there is more humeroradial contact than humeroulnar

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53
Q

the medial trochlea extends farther where

A

distally

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54
Q

the medial aspect of trochlear notch of ulna ectrends further where

A

distally

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55
Q

true or false: there is medial deviation of ulna with respect to humerus

A

false, there is lateral

56
Q

there is lateral deviation of ulna with respect of humerus known ask what

A

carrying angle

57
Q

what is the valgus/carrying angle

A

men=women

valgus 10-15 degrees

58
Q

what are the 3 primary static constraints of the elbow

A

ulnohumeral articulation
anterior bundle of the medial collateral ligaments
lateral collateral ligaments

59
Q

what are the 4 secondary constraings

A

radiocapitellar articulation
common origin of the flexors
common origin of the extensiors
capsule

60
Q

when are the secondary elbow constaints going to be able to support

A

muscles are additional support while in tension

61
Q

radial head stabilizers with stress in waht direction

A

valgus

62
Q

olecrannon stabilizes with stress in what direction

A

valgus

63
Q

coronoid stabilies with stres on what direction

A

varus direction

64
Q

what are the 3 bundles of the MCL at the elbow

A

anterior
posterior
and tranverse

65
Q

which is the most important bundle of the medial collateral ligament

A

anterior

66
Q

what ligament is an important stabilizer at the elbow of valgus stress

A

medial colalteral

67
Q

MCL ligaments is an important stabilizer with what kind of stress

A

valgus (lateral)

68
Q

what are the bundles of the lateral collateral lig

A

lateral ulnar collateral
accessory lateral collateral
radial collateral
annular

69
Q

the LCL stabilies with what stress

A

varus (stops it from moving medially)

70
Q

the MCL deficient elbow should be rehabilitation in what postion and why

A

in supination as the medial muscles are taut generating greater passive tension enhancing medial sided stability

71
Q

the LCL deficient elbow should be rehabilitated in what position and why

A

in pronation as the lateral muscles are taut generating greater passive tension enhancing lateral sided stability

72
Q

in pitching, is there high valgus or varus stress

A

valgus

73
Q

what is the average valgus torque during pitching

A

64 NM

74
Q

when is valgus force highest during pitching

A

highest at late coking and acceleration phases

75
Q

professional pitchers have what newtons of valgus stress during pitching

A

290 of force across elbow joint

76
Q

what are the consequences of the fact that professional pitchers pitch at 290 N and ligamentous tensile strength is 260 N

A

possible rupture of ligaments.

77
Q

what are the muscles that crontol the elbow

A

flexors
extensiors
pronators
supinators

78
Q

what are the elbow flexors

A

biceps brachii
brachialis
brachioradiualis
pronator teres

79
Q

when are biceps less active

A

less active with arm in full pronation

80
Q

what ar ethe elbow extensir muscles

A

triceps brachii
anconeus

81
Q

what are the pronators and supinators

A

pronator teres
pronator quadratus

supinator
biceps

82
Q

what is the fancy name for tennis elbow

A

lateral epicondilyis

83
Q

what is the fancy name for golfers elbow

A

medial epicondylitis

84
Q

lateral epicondylitis affects what muscles

A

wrist extensors

85
Q

medial epicondylitus affecst what muscles

A

wrist flexors

86
Q

what is the cause of lateral epicondylitis and what position

A

overuse of the ECRB and EDC
resistance with arm and wrist in extension

87
Q

according to EMG, there is decreased exntsor activity in tennis for what position

A

for two handed back hand

88
Q

what are the consdierations of lateral epicondylitis and tennis

A

arm position
grip diameter
weight of item help in hand
repetition

89
Q

medial epicondylistis is overuse of what muscle

A

flexor pronator musculature

90
Q

medial epicondulitis is caused by excess what

A

excess valgus force and medial tension

91
Q

what are the considerations of medial epicondylitis in golfing

A

appropriate technique
lightweigth equipment
repetition

92
Q

which is harder to correct, lateral or medial epicondylitis

A

medial

93
Q

which muscle has the longest moment arm : biceps, brachialis, pronator teres and brachiiradialis

A

brachioradialis

94
Q

place these muslces in order of longest to shortest moment arms : biceps, brachialis
pronator teres
brachioradialis

A

brachioradlis
biceps
brachioalis
pronator teres

95
Q

the moment arms are at peaks when arm flexed between what degrees

A

100-120 degrees

96
Q

maximum isometris elbow flexion forec as peaks when

A

midrange between 75-90 degrees of flexion

97
Q

what is active insuffieciency

A

Active insufficiency is the decreased tension of a multiarticular muscle when it is shortened across one or more of its joints.

98
Q

true or false: when muscle if at shortest length, it is at strongest length

A

false, weakest

99
Q

what is the active insuffiecieny for biceps

A

shoulder flexion
elbow flexion
supination

100
Q

what are the movements of the wrist

A

flexion/extension
radial/ulnar dev
circumduction

101
Q

what is the functional axis of movement of the wrist

A

dart throw motion
“a plane in which functional oblique motion occurs, spefically from radial extension to ulnar flexion:

102
Q

why is “dart throw motion important

A

less movment of the scaphoid and lunate compared to pure flexion/extension or ulnar/radial devaltion
=good for people who may have instabilities
=safe protected ROM

103
Q

what is the common path of motion in many daily activities of the elbow

A

oblique plane of movement
dart through motion

104
Q

what is the ROM for flexion/extension at wrist

A

70-80

105
Q

what is the ROM for ulnar dev at wrist

A

30-50

106
Q

what is the ROM for radial dev at wrist

A

20-30

107
Q

what is the functional wrist ROM

A

40 degrees flexion and extension should be good

108
Q

what are the 6 biomechanical requirements of distal UE function

A

adequate flexion and extension
adequate radial and ulnar dev
adequate forearm rotation
function oblique movement
adequate ligamentous contraint (translation, rotaiton, distrcation, compression)
independant wrist and finger movement

109
Q

what are the main wrist flexors

A

flexor carpi radialus
flexor carpi ulnaris

110
Q

what are the main wrist extensors

A

ECRB ECRL
ECU

111
Q

the variable bone geometry of the wrist does what

A

accomodates movement
=multifaceted articulations accomodate movement and stability

112
Q

distal radius is inclined 15 degrees palmarly or dorsally

A

palmarly

113
Q

distal radius is inclined BLANK degrees palmarly

A

15

114
Q

distal radius is inclined 15-20 degrees ulnarly or radially

A

ulnary

115
Q

distal radius is inclined BLANK degrees ulnarly

A

15-20

116
Q

what is the most common upper extremity fracture in people over 50

A

distal radius fracture

117
Q

what is the MOI for distal radius fracture

A

fall on outstretched hand (bending and compressive force)

118
Q

what is the common fracture of the distal radius fracture

A

compressed and dispalced

119
Q

what are the important aspects of the distal ulna

A

stylod process
head of ulna

120
Q

what does distal ulna articulate with

A

TFCC

121
Q

what is the movment of the radius/ulna during pronation

A

radius crosses over ulna with anterior roll

122
Q

what is the movment of the radius/ulna during supination

A

radius uncrosses from ulna with posterior roll

123
Q

during supination, radius uncrosses from ulna with posterior or anterior roll

A

posterior

124
Q

during pronation, radius crosses over ulna with anterior or posterior roll

A

anterior

125
Q

the forearm supinates maximalyl with elbow is in what postiion

A

elbow flexed

126
Q

the forearm pronates maximalyl with elbow is in what postiion

A

elbow extended

127
Q

elbow extension increased or decreased the transmitted forces of the DRUJ and PRUJ

A

increases

128
Q

normally, what percentage of load is taken by the distal radius

A

80%

129
Q

true or false: there is normally alt of difference between radial height/ulnar variation

A

false, not a lot

130
Q

in negative ulnar variance, does more of the load get transmissted to ulna or radius

A

radius

131
Q

with 2-5 mm of ulnar variance (negative ulnar variance) explain the load transmission

A

95% load transmission via radius and 5% through ulna

132
Q

with negative ulnar variance there is increased risk for what

A

lunate injury

133
Q

explain load tranmission with positive ulnar variance

A

60% of load transmission via radius and 40% via ulna

134
Q

in positive ulnar variance, does more of the load get transmissted to ulna or radius

A

still more radius, but decreased from 80 to only 60%
ulna

135
Q

with positive ulnar variance there is increased risk for what

A

ligamentous tears

136
Q

what do u need to be cautious for distal radius fractures

A

beware of excessive hand squeezing and forceful ROM if distal radiu. does not have solid fixation

137
Q

during forearm pronation, the radius crosses the ulna or oppsite

A

radius over ulna

POTH 225: BIOMECHANICS (15 decks)

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