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National Physical Therapy Examination: Musculoskeletal > Musculoskeletal: Upper Extremity Functional Anatomy > Flashcards

Musculoskeletal: Upper Extremity Functional Anatomy Flashcards

1
Q

Clavicle Structure

A
  • Part of the shoulder girdle

- Connects the upper limb to the axial skeleton

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2
Q

Clavicle Function

A
  • Transmits forces from the upper limb to the axial skeleton
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3
Q

Clavicle PT concerns

A
  • Susceptible to fracture, typically the medial two thirds or lateral one third, medial to the attachment of the coracoclavicular ligament
  • Fractures especially common in children and young adults
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4
Q

Scapula Structure

A
  • Highly mobile
  • Connects clavicle to humerus
  • Covers ribs 2 through 7
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5
Q

Sternoclavicular Joint (SC) Structure

A
  • Saddle joint
  • Synovial
  • Has an intra-articular disc
  • Sternoclavicular ligament
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6
Q

Sternoclavicular Joint (SC) PT concerns

A
  • The SC joint will typically be injured after the AC joint and clavicle
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7
Q

Acromioclavicular Joint (AC) Structure

A
  • Plane joint
  • Synovial
  • Between Lateral end of the clavicle and the acromion of the scapula
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8
Q

Coracoclavicular Ligament Structure: Two Ligaments

A
  • Comprised of the trapezoid and conoid ligaments and prevents separation of the scapula from the clavicle
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9
Q

Coracoclavicular Ligament Function

A
  • Stabilizes the AC joint and prevents upward displacement of the humeral head
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10
Q

Acromioclavicular Ligament

A
  • Covers the superior aspect of the AC joint
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11
Q

Acromioclavicular Joint (AC) PT Concerns

A
  • Injury to ligamentous structures causing a separated shoulder
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12
Q

Glenohumeral Joint (GH) Structure

A
  • Ball and Socket
  • Between head of humerus and glenoid cavity
  • Multiaxial
  • Allows for high ROM and low stability
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13
Q

Glenohumeral Joint (GH) Structure: Stability Structures

A
  • Stabilized by
    - An anterior and posterior joint capsule
    - The Glenoid Labrum
    - The long head of the biceps which is continuous with the labrum
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14
Q

Glenohumeral Joint (GH) Ligamentous Support

A
  • Superior, middle, and inferior glenohumeral ligaments act as static restraint to excessive anterior translation
  • Coracohumeral ligament provides restraint to inferior translation and external rotation of the humeral head
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15
Q

Glenohumeral Joint (GH) Tendonous Support

A
  • Rotator Cuff muscles provide support and attach into the joint capsule
  • Dynamic support by other muscles pulling the humerus down into the lower and wider portion of the glenoid cavity
  • Stability provided by the Rotator Cuff muscles
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16
Q

Scapulothoracic Articulation and Structure

A
  • Functional articulation of the between the body of the scapula and the thoracic spine/chest wall
  • NOT an anatomical joint
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17
Q

Scapulothoracic Articulation and Function

A
  • Provides dynamic stability

- Provides full ROM

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18
Q

Shoulder Biomechanics General Information

Scapulohumeral Rhythm the 2:1 Rule

A
  • 120 degrees of movement at the GH joint

- 60 degrees of movement at the scapulothoracic articulation

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19
Q

Shoulder Biomechanics General Information: Clavicle During Humeral Elevation

A
  • The clavicle will elevate at the SC joint with shoulder abduction and general humeral elevation
  • The clavicle will rotate backwards at the SC joint 45-50 degrees when the scapula upwardly rotates
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20
Q

Muscular Structures Function

A
  • Prime movers act as force couples to produce movement

- Scapular stabilizers act to control rotation and position the scapula

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21
Q

Muscular Structure Function: Rotator Cuff

A
  • Work collectively to hold the head of the humerus in the glenoid cavity during movement
  • Superior stability=SUPRAspinatus
  • Posterior stability=Infraspinatus and teres MINOR
  • Anterior stability=Subscapularis
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22
Q

Muscular Structure: Supraspinatus

A
  • Acts in combination with the deltoid for abduction movement patterns
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23
Q

Muscular Force Complex of the Shoulder: Humeral elevation in the GH joint

A
  • With humeral elevation:
    - The deltoid muscle pulls the humerus up
    - The rotator cuff pulls the humeral head down
  • To allow for smooth movement
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24
Q

Muscular Force Complex of the Shoulder: Humeral elevation at the scapulothoracic joint

A
  • With humeral elevation:

- The Trapezius+Serratus anterior produce upward rotation at the scapula

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25
Muscular Force Complex of the Shoulder: Humeral Extension
- With humeral extension: - Rhomboids - Levator Scapulae - Pectoralis Minor - Produce scapular downward rotation
26
Muscular Force Complex of the Shoulder: Other
- Serratus+Pec Minor=Scapular protraction - Rhomboids+Middle and Lower Trap=Scapular Retraction - Upper Trap+Levator Scap=Elevation of the scapula - Pec Minor and Latissimus Dorsi= Downward movement of the scapula
27
Subacromial/Subdeltoid Bursa: Palpation
- Palpable by extending the GH joint to move the humeral head out from under the acromion
28
Subacromial/Subdeltoid Bursa Location
- Located over the bicipital groove under the deltoid, separating this muscle from the rotator cuff for and allowing for free motion of the deltoid over the humerus
29
Circulation of the Shoulder Joint: Axillary Artery Location
- Palpable on the lateral wall of the inferior portion of the axilla
30
Circulation of the Shoulder Joint: Axillary Artery PT Concerns
- Compression of the artery can occur when it is compressed against the humerus i.e. With crutches
31
Brachial Plexus
- Originates from the cervical nerve roots | - Comprised of Trunks, Divisions, Cords, and Terminal Branches
32
Brachial Plexus Pre Trunk Branches: Long Thoracic Nerve
- Long Thoracic (C5, C6, C7) Innervates the serratus anterior. - Can cause winging of the scapula if injured.
33
Brachial Plexus Pre Trunk Branches: Dorsal Scapular Nerve
- Dorsal Scapular Nerve (C5, C6) innervates the levator scapulae and Rhomboids - Can cause impaired scapular retraction and downward rotation if injured
34
Brachial Plexus: Trunks
- After passing over the first rib the nerve roots form three Trunks - Superior - Middle - Inferior
35
Brachial Plexus Superior Trunk: Suprascapular nerve
- Nerve from the Superior Trunk - (C5, C6) Nerve roots - Passes beneath the Trap - Passes through the suprascapular notch - Innervates supraspinatus and infraspinatus muscles
36
Brachial Plexus Superior Trunk Suprascapular nerve: PT concerns
- Suprascapular nerve injuries can because by impingement via the superior transverse scapular ligament. - Suprscapular nerve injuries can cause decreased abduction and external rotation of the GH joint
37
Brachial Plexus: Divisions
- Trunks split into three anterior and three posterior divisions beneath the clavicle
38
Brachial Plexus: Cords
- Divisions split into lateral, posterior, and medial cords beneath the pectorals minor muscle
39
Brachial Plexus: Branches
- Branches are formed after the pec minor - The branches are - Radial - Axillary - Ulnar - Median - Musculocutaneous
40
Brachial Plexus PT Concerns
- Impingement of the brachial plexus can be caused by postural dysfunction, traumatic injury or misuse of crutches
41
Surface Anatomy and Bones of the Arm and Elbow: Humerus PT Concerns
- The surgical neck of the humerus is where the bone narrows to become the shaft and is the most frequently fractured site of the proximal humerus
42
Surface Anatomy and Bones of the Arm and Elbow: Geriatric Humerus PT Concerns
- Fractures of the humerus ae common among older adults and typically occur due to falling on the elbow - Injury to the axillary, radial and ulnar nerves is possible due to their proximity to the humerus
43
Elbow Joint: Osseous and Capsuloligamentous Components: Ulnohumeral Joint Structure
- Between Trochlear notch of the ulna and trochlea of the humerus - Hinge joint, uniaxial - Distal humerus and proximal ulna are offset 45 degrees anteriorly to allow for full ROM - Carrying angle of 10-15 degrees in men and 20-25 degrees in women
44
Elbow Joint: Osseous and Capsuloligamentous Components: Ulnohumeral Joint Ligamentous Stability
- Stabilized by the ulnar collateral ligament
45
Elbow Joint: Osseous and Capsuloligamentous Components: Ulnohumeral Joint Movement
- Full extension=Medial Joint Gap - Full flexion=Lateral Joint Gap - Pronation and Supination=Glides side to side
46
Elbow Joint: Osseous and Capsuloligamentous Components: Radiohumeral Joint Structure
- Between the radial head and the capitulum of the humerus | - Hinge joint, uniaxial
47
Elbow Joint: Osseous and Capsuloligamentous Components: Radiohumeral Joint Ligamentous Stability
- Radial collateral ligament provides lateral stability to the joint
48
Elbow Joint: Osseous and Capsuloligamentous Components: Radiohumeral Joint PT Concerns
- Trauma may interfere with elbow flexion and extension
49
Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint Structure
- Between the proximal head of the radius and the medial portion of the proximal ulna - Pivot joint, uniaxial
50
Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint Ligamentous Stability
- Annular Ligament provides stability surrounding the head of the humerus
51
Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint PT Concerns
- Injury may limit the ability to control the portion of the hand
52
Elbow Joint: Osseous and Capsuloligamentous Components: Distal Radioulnar Joint Structure
- Combination of the interosseous membrane and the oblique cord
53
Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint Stability
- The interosseous membrane stabilizes the elbow during pushing movements - The oblique cord goes proprioceptive input from the joint and resists distal displacement of the radius during pulling movements
54
Elbow Joint: Muscular Biomechanics: Flexors
- Brachialis - Biceps Bachii - Brachioradialis
55
Elbow Joint: Muscular Biomechanics: Flexors: Brachialis
- Brachialis=Primary Elbow Flexor | - Flexes elbow in all positions
56
Elbow Joint: Muscular Biomechanics: Flexors: Biceps Brachii
- Flexes the elbow in conjunction with forearm supination - Primarily a supinator - More situationally dependent on elbow flexion than the brachialis
57
Elbow Joint: Muscular Biomechanics: Flexors: Brachioradialis
- Elbow flexor | - Stabilizes the elbow during strong supination and pronation with strong resistance
58
Elbow Joint: Muscular Biomechanics: Flexors: Other
- Contributors to Flexion - Flexor Carpi Ulnaris - Pronator Teres
59
Elbow Joint: Muscular Biomechanics: Extensors
- Triceps Brachii | - Anconeus
60
Elbow Joint: Muscular Biomechanics: Extensors: Anconeus
- Aids in elbow extension | - Also provides stability during pronation and supination
61
Elbow Joint: Muscular Biomechanics: Extensors: Closed Kinetic Chain
- In a closed kinetic chain the pectoralis major and anterior deltoid will facilitate with elbow extension
62
Elbow Joint: Muscular Biomechanics: Supination
- Supinator at low loads and slow movements | - Biceps Brachii is a strong supinator at 90 degrees of flexion
63
Elbow Joint: Muscular Biomechanics: Pronation
- Pronator quadratus at low loads - Pronator Teres pronation and stabilization of flexion - Flexor Carpi ulnas may provide assistance to pronation
64
Elbow Joint: Muscular Biomechanics: Muscular Force Complex: Pushing
- Triceps extend=Concentrically | - Biceps controls= Eccentrically
65
Elbow Joint: Muscular Biomechanics: Muscular Force Complex: Pulling
- Biceps Brachii Flexes=Concentrically - Triceps Brachii Controls=Eccentrically - Shoulder+Triceps=Arm extension
66
Elbow Joint: Muscular Biomechanics: Muscular Force Complex: Turning
- Biceps Brachii Supinates | - Triceps controls flexion
67
Subcutaneous Bursae Location
- Tissue over the olecranon
68
Subcutaneous Bursae PT Concerns
- Bursa can become injured from respected excessive friction/overuse
69
Subtendinous Bursa Location
- Between the Triceps Brachii tendon and the olecranon
70
Subtendinous Bursa PT Concerns
- Bursa can become injured from repeated friction/overuse between the Triceps tendon and the olecranon
71
Circulation of the Humerus: Brachial Artery
- Continuation of the axillary artery
72
Circulation of the Humerus: Brachial Artery Palpation
- Can be palpated over the anterior region of the cubital fossa
73
Circulation of the Humerus: Brachial PT concerns
- Compression of the artery is possible along the entire course but most common near the middle of the humerus - Occlusion or laceration of the Brachial artery can result in associated ischemia of the deep flexor muscles casing Volkmann's contracture permanently shortening the deep flexor muscles
74
Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Bones Proximal Row
- Scaphoid - Lunate - Triquetrum - Pisiform
75
Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Bones Distal Row
- Trapezium - Trapezoid - Capitate - Hamate
76
Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Tunnel
- The carpal tunnel is covered by a flexor retinaculum that attaches to the scaphoid and trapezium
77
Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Tunnel Syndrome
- Compression of the median nerve by the tendons that pass under the flexor retinaculum
78
Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Scaphoid Fracture
- Most frequently fractured carpal bone | - Has poor blood supply and can develop avascular necrosis
79
Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Thumb
- The Thumb contributes to 40% of the hands function
80
Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Arches of the Hand
- Longitudinal - Metacarpophalangeal Transverse - Carpal Transverse
81
The Wrist Joint: Osseous and Capsuloligamentous Components: Distal radial Ulnar Joint
- Pivot Joint, uniaxial - Pronation and Supination - Radius moves over the ulna for pronation
82
The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint Structure
- Ellipsoid Joint, biaxial | - Between radius and scaphoid+lunate
83
The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint Ligamentous Stability
- Radial Collateral Ligament=Laterally | - Triangular Fibrocartilage Complex (TFCC)=Medially
84
The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint Function
- Load bearing ratio of 60:40 between radius and ulna
85
The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint PT Concerns
- Colle's fracture
86
The Wrist Joint: Osseous and Capsuloligamentous Components: Intercarpal Joints Ligamentous Stability
- Dorsal Ligament - Palmar Ligament - Inrerosseus Ligament
87
The Wrist Joint: Osseous and Capsuloligamentous Components: Midcarpal Joints Ligamentous Stability
- Dorsal and Palmar Ligaments
88
The Wrist Joint: Osseous and Capsuloligamentous Components: Midcarpal JointsScaphoid Function
- Wrist flexion=Scaphoid functions with proximal row | - Wrist extension=Scaphoid functions with distal row
89
The Wrist Joint: Osseous and Capsuloligamentous Components: Midcarpral Joints PT Concerns
- Fractures of the mid carpal joints - Anterior dislocation of the lunate and can compress the median nerve against the flexor retinaculum - Carpal bones heal poorly and may develop avascular necrosis
90
The Wrist: Muscular Biomechanics: Grasping
- Extensor carpi radialis brevis
91
The Wrist: Muscular Biomechanics: Flexion and Extension Muscular Stability
- Extensor carpi ulnaris - Extensor pollicis brevis - Abductor pollicis longus
92
The Wrist: Muscular Biomechanics: Flexion
- Flexor carpi radialis | - Flexor carpi ulnaris
93
The Wrist: Muscular Biomechanics: Radial Deviation
- Extensor carpi radialis longus and brevis | - Flexor carpi radialis
94
The Wrist: Muscular Biomechanics: Ulnar Deviation
- Flexor carpi ulnaris | - Extensor carpi ulnaris
95
The Wrist: Circulation: Radial Artery Path
- Through the cubital fossa | - To the radial styloid process
96
The Wrist: Circulation: Ulnar Artery Path
- Through the medial forearm | - Deep to the radial artery
97
The Wrist: Circulation: PT Concerns
- Supracondyler fracture of the elbow can cause damage to the radial artery in the cubital fossa
98
The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joints
- Between the distal row of the carpals and the metacarpals of the hand - Plane synovial joints
99
The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joints Ligamentous Stability
- Dorsal Ligaments - Palmar Ligaments - Interossues Ligaments
100
The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joint of the Thumb
- Saddle Joint | - Same ligamentous stability as other CMC joints
101
The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joints PT Concerns
- CMC Joints are susceptible to sprains
102
The Hand: Osseous and Capsuloligamentous Components: Intermetacarpal Joints
- Formed between the second through forth metacarpal bones | - Plane joints with small amount of glide
103
The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joints
- Between the distal end of the metacarpal bones and proximal end of the proximal phalanx - Condyloid Joints
104
The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joints: Ligamentous Stability
- Palmar Ligaments - Transverse Ligaments - Collateral Ligaments that become tight in flexion
105
The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joint of the Thumb
- Can rotate and augment the function of the first CMC
106
The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joints PT Concerns
- It is common for the MCP joints to fracture dislocate and sprain
107
The Hand: Osseous and Capsuloligamentous Components: Interphalangeal Joints
- Between the phalanxes - Two in each digit except the thumb has one Hinge joints, uniaxial
108
The Hand: Osseous and Capsuloligamentous Components: Interphalangeal Joints Ligamentous Stability
- Palmar Ligaments - Collateral Ligaments (not tight during flexion) - Fibrous capsule
109
The Hand: Muscular Biomechanics: Four stages of Gripping
- Opening the hand - Closing the fingers - Exerting force - Releasing the object
110
The Hand: Muscular Biomechanics: Thumb Muscular Control
- Four Intrinsic | - Four Extrinsic
111
The Hand: Muscular Biomechanics:Extension of the MCP and IP Joints
- Extensor digitorum
112
The Hand: Muscular Biomechanics: Interosseous and Lumbricles
- Place tension on the extensor expansion to allow the extensor digitorum to extend the IP joints - Aid the flexor digitorum superficialis in flexing the MCP joints and also adduct and abduct the digits
113
The Hand: Muscular Biomechanics: IP and MCP extension and CMC retroposition
- Extensor Pollicis Longus
114
The Hand: Muscular Biomechanics: Flexion of the MCP Joints
- Flexor Digitorum Superficialis | - Flexor Digitorum Profundus
115
The Hand: Muscular Biomechanics: Flexion of the PIP
- When MCP is stable, Flexor Digitorum Superficialis
116
The Hand: Muscular Biomechanics: Flexion of the DIP
- When PIP is stable, Flexor Digitorum Profundus
117
The Hand: Muscular Biomechanics: Grasping
- The opponens digits minimi hollows the hand for grasping a cylindrical object
118
The Hand: Muscular Biomechanics: Nerve Tissue PT Concerns: Radial Nerve
- Damage effects the ability to - Maintain the functional wrist position - Release objects
119
The Hand: Muscular Biomechanics: Nerve Tissue PT Concerns: Ulnar Nerve
- Damage effects the ability to - Flexion of the digits on the ulnar side of the hand - Grip
120
The Hand: Muscular Biomechanics: Nerve Tissue PT Concerns: Median Nerve
- Damage effects the ability to - Flex the digits on the radial side of the hand - Precision Grip

National Physical Therapy Examination: Musculoskeletal (30 decks)

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