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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
Q

Muscular Force Complex of the Shoulder: Humeral Extension

A
  • With humeral extension:
    - Rhomboids
    - Levator Scapulae
    - Pectoralis Minor
  • Produce scapular downward rotation
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26
Q

Muscular Force Complex of the Shoulder: Other

A
  • 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
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27
Q

Subacromial/Subdeltoid Bursa: Palpation

A
  • Palpable by extending the GH joint to move the humeral head out from under the acromion
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28
Q

Subacromial/Subdeltoid Bursa Location

A
  • 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
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29
Q

Circulation of the Shoulder Joint: Axillary Artery Location

A
  • Palpable on the lateral wall of the inferior portion of the axilla
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30
Q

Circulation of the Shoulder Joint: Axillary Artery PT Concerns

A
  • Compression of the artery can occur when it is compressed against the humerus i.e. With crutches
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31
Q

Brachial Plexus

A
  • Originates from the cervical nerve roots

- Comprised of Trunks, Divisions, Cords, and Terminal Branches

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32
Q

Brachial Plexus Pre Trunk Branches: Long Thoracic Nerve

A
  • Long Thoracic (C5, C6, C7) Innervates the serratus anterior.
    - Can cause winging of the scapula if injured.
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33
Q

Brachial Plexus Pre Trunk Branches: Dorsal Scapular Nerve

A
  • Dorsal Scapular Nerve (C5, C6) innervates the levator scapulae and Rhomboids
    - Can cause impaired scapular retraction and downward rotation if injured
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34
Q

Brachial Plexus: Trunks

A
  • After passing over the first rib the nerve roots form three Trunks
    - Superior
    - Middle
    - Inferior
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35
Q

Brachial Plexus Superior Trunk: Suprascapular nerve

A
  • Nerve from the Superior Trunk
  • (C5, C6) Nerve roots
  • Passes beneath the Trap
  • Passes through the suprascapular notch
  • Innervates supraspinatus and infraspinatus muscles
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36
Q

Brachial Plexus Superior Trunk Suprascapular nerve: PT concerns

A
  • 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
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37
Q

Brachial Plexus: Divisions

A
  • Trunks split into three anterior and three posterior divisions beneath the clavicle
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38
Q

Brachial Plexus: Cords

A
  • Divisions split into lateral, posterior, and medial cords beneath the pectorals minor muscle
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39
Q

Brachial Plexus: Branches

A
  • Branches are formed after the pec minor
  • The branches are
    - Radial
    - Axillary
    - Ulnar
    - Median
    - Musculocutaneous
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40
Q

Brachial Plexus PT Concerns

A
  • Impingement of the brachial plexus can be caused by postural dysfunction, traumatic injury or misuse of crutches
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41
Q

Surface Anatomy and Bones of the Arm and Elbow: Humerus PT Concerns

A
  • 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
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42
Q

Surface Anatomy and Bones of the Arm and Elbow: Geriatric Humerus PT Concerns

A
  • 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
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43
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Ulnohumeral Joint Structure

A
  • 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
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44
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Ulnohumeral Joint Ligamentous Stability

A
  • Stabilized by the ulnar collateral ligament
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45
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Ulnohumeral Joint Movement

A
  • Full extension=Medial Joint Gap
  • Full flexion=Lateral Joint Gap
  • Pronation and Supination=Glides side to side
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46
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Radiohumeral Joint Structure

A
  • Between the radial head and the capitulum of the humerus

- Hinge joint, uniaxial

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47
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Radiohumeral Joint Ligamentous Stability

A
  • Radial collateral ligament provides lateral stability to the joint
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48
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Radiohumeral Joint PT Concerns

A
  • Trauma may interfere with elbow flexion and extension
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49
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint Structure

A
  • Between the proximal head of the radius and the medial portion of the proximal ulna
  • Pivot joint, uniaxial
50
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint Ligamentous Stability

A
  • Annular Ligament provides stability surrounding the head of the humerus
51
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint PT Concerns

A
  • Injury may limit the ability to control the portion of the hand
52
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Distal Radioulnar Joint Structure

A
  • Combination of the interosseous membrane and the oblique cord
53
Q

Elbow Joint: Osseous and Capsuloligamentous Components: Proximal Radioulnar Joint Stability

A
  • 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
Q

Elbow Joint: Muscular Biomechanics: Flexors

A
  • Brachialis
  • Biceps Bachii
  • Brachioradialis
55
Q

Elbow Joint: Muscular Biomechanics: Flexors: Brachialis

A
  • Brachialis=Primary Elbow Flexor

- Flexes elbow in all positions

56
Q

Elbow Joint: Muscular Biomechanics: Flexors: Biceps Brachii

A
  • Flexes the elbow in conjunction with forearm supination
  • Primarily a supinator
  • More situationally dependent on elbow flexion than the brachialis
57
Q

Elbow Joint: Muscular Biomechanics: Flexors: Brachioradialis

A
  • Elbow flexor

- Stabilizes the elbow during strong supination and pronation with strong resistance

58
Q

Elbow Joint: Muscular Biomechanics: Flexors: Other

A
  • Contributors to Flexion
    - Flexor Carpi Ulnaris
    - Pronator Teres
59
Q

Elbow Joint: Muscular Biomechanics: Extensors

A
  • Triceps Brachii

- Anconeus

60
Q

Elbow Joint: Muscular Biomechanics: Extensors: Anconeus

A
  • Aids in elbow extension

- Also provides stability during pronation and supination

61
Q

Elbow Joint: Muscular Biomechanics: Extensors: Closed Kinetic Chain

A
  • In a closed kinetic chain the pectoralis major and anterior deltoid will facilitate with elbow extension
62
Q

Elbow Joint: Muscular Biomechanics: Supination

A
  • Supinator at low loads and slow movements

- Biceps Brachii is a strong supinator at 90 degrees of flexion

63
Q

Elbow Joint: Muscular Biomechanics: Pronation

A
  • Pronator quadratus at low loads
  • Pronator Teres pronation and stabilization of flexion
  • Flexor Carpi ulnas may provide assistance to pronation
64
Q

Elbow Joint: Muscular Biomechanics: Muscular Force Complex: Pushing

A
  • Triceps extend=Concentrically

- Biceps controls= Eccentrically

65
Q

Elbow Joint: Muscular Biomechanics: Muscular Force Complex: Pulling

A
  • Biceps Brachii Flexes=Concentrically
  • Triceps Brachii Controls=Eccentrically
  • Shoulder+Triceps=Arm extension
66
Q

Elbow Joint: Muscular Biomechanics: Muscular Force Complex: Turning

A
  • Biceps Brachii Supinates

- Triceps controls flexion

67
Q

Subcutaneous Bursae Location

A
  • Tissue over the olecranon
68
Q

Subcutaneous Bursae PT Concerns

A
  • Bursa can become injured from respected excessive friction/overuse
69
Q

Subtendinous Bursa Location

A
  • Between the Triceps Brachii tendon and the olecranon
70
Q

Subtendinous Bursa PT Concerns

A
  • Bursa can become injured from repeated friction/overuse between the Triceps tendon and the olecranon
71
Q

Circulation of the Humerus: Brachial Artery

A
  • Continuation of the axillary artery
72
Q

Circulation of the Humerus: Brachial Artery Palpation

A
  • Can be palpated over the anterior region of the cubital fossa
73
Q

Circulation of the Humerus: Brachial PT concerns

A
  • 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
Q

Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Bones Proximal Row

A
  • Scaphoid
  • Lunate
  • Triquetrum
  • Pisiform
75
Q

Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Bones Distal Row

A
  • Trapezium
  • Trapezoid
  • Capitate
  • Hamate
76
Q

Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Tunnel

A
  • The carpal tunnel is covered by a flexor retinaculum that attaches to the scaphoid and trapezium
77
Q

Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Carpal Tunnel Syndrome

A
  • Compression of the median nerve by the tendons that pass under the flexor retinaculum
78
Q

Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Scaphoid Fracture

A
  • Most frequently fractured carpal bone

- Has poor blood supply and can develop avascular necrosis

79
Q

Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Thumb

A
  • The Thumb contributes to 40% of the hands function
80
Q

Surface Anatomy and Bones of the Forearm, Wrist, and Hand: Arches of the Hand

A
  • Longitudinal
  • Metacarpophalangeal Transverse
  • Carpal Transverse
81
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Distal radial Ulnar Joint

A
  • Pivot Joint, uniaxial
  • Pronation and Supination
  • Radius moves over the ulna for pronation
82
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint Structure

A
  • Ellipsoid Joint, biaxial

- Between radius and scaphoid+lunate

83
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint Ligamentous Stability

A
  • Radial Collateral Ligament=Laterally

- Triangular Fibrocartilage Complex (TFCC)=Medially

84
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint Function

A
  • Load bearing ratio of 60:40 between radius and ulna
85
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Radiocarpal Joint PT Concerns

A
  • Colle’s fracture
86
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Intercarpal Joints Ligamentous Stability

A
  • Dorsal Ligament
  • Palmar Ligament
  • Inrerosseus Ligament
87
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Midcarpal Joints Ligamentous Stability

A
  • Dorsal and Palmar Ligaments
88
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Midcarpal JointsScaphoid Function

A
  • Wrist flexion=Scaphoid functions with proximal row

- Wrist extension=Scaphoid functions with distal row

89
Q

The Wrist Joint: Osseous and Capsuloligamentous Components: Midcarpral Joints PT Concerns

A
  • 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
Q

The Wrist: Muscular Biomechanics: Grasping

A
  • Extensor carpi radialis brevis
91
Q

The Wrist: Muscular Biomechanics: Flexion and Extension Muscular Stability

A
  • Extensor carpi ulnaris
  • Extensor pollicis brevis
  • Abductor pollicis longus
92
Q

The Wrist: Muscular Biomechanics: Flexion

A
  • Flexor carpi radialis

- Flexor carpi ulnaris

93
Q

The Wrist: Muscular Biomechanics: Radial Deviation

A
  • Extensor carpi radialis longus and brevis

- Flexor carpi radialis

94
Q

The Wrist: Muscular Biomechanics: Ulnar Deviation

A
  • Flexor carpi ulnaris

- Extensor carpi ulnaris

95
Q

The Wrist: Circulation: Radial Artery Path

A
  • Through the cubital fossa

- To the radial styloid process

96
Q

The Wrist: Circulation: Ulnar Artery Path

A
  • Through the medial forearm

- Deep to the radial artery

97
Q

The Wrist: Circulation: PT Concerns

A
  • Supracondyler fracture of the elbow can cause damage to the radial artery in the cubital fossa
98
Q

The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joints

A
  • Between the distal row of the carpals and the metacarpals of the hand
  • Plane synovial joints
99
Q

The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joints Ligamentous Stability

A
  • Dorsal Ligaments
  • Palmar Ligaments
  • Interossues Ligaments
100
Q

The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joint of the Thumb

A
  • Saddle Joint

- Same ligamentous stability as other CMC joints

101
Q

The Hand: Osseous and Capsuloligamentous Components: Carpometacarpal Joints PT Concerns

A
  • CMC Joints are susceptible to sprains
102
Q

The Hand: Osseous and Capsuloligamentous Components: Intermetacarpal Joints

A
  • Formed between the second through forth metacarpal bones

- Plane joints with small amount of glide

103
Q

The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joints

A
  • Between the distal end of the metacarpal bones and proximal end of the proximal phalanx
  • Condyloid Joints
104
Q

The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joints: Ligamentous Stability

A
  • Palmar Ligaments
  • Transverse Ligaments
  • Collateral Ligaments that become tight in flexion
105
Q

The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joint of the Thumb

A
  • Can rotate and augment the function of the first CMC
106
Q

The Hand: Osseous and Capsuloligamentous Components: Metacarpal Phalangeal Joints PT Concerns

A
  • It is common for the MCP joints to fracture dislocate and sprain
107
Q

The Hand: Osseous and Capsuloligamentous Components: Interphalangeal Joints

A
  • Between the phalanxes
  • Two in each digit except the thumb has one
    Hinge joints, uniaxial
108
Q

The Hand: Osseous and Capsuloligamentous Components: Interphalangeal Joints Ligamentous Stability

A
  • Palmar Ligaments
  • Collateral Ligaments (not tight during flexion)
  • Fibrous capsule
109
Q

The Hand: Muscular Biomechanics: Four stages of Gripping

A
  • Opening the hand
  • Closing the fingers
  • Exerting force
  • Releasing the object
110
Q

The Hand: Muscular Biomechanics: Thumb Muscular Control

A
  • Four Intrinsic

- Four Extrinsic

111
Q

The Hand: Muscular Biomechanics:Extension of the MCP and IP Joints

A
  • Extensor digitorum
112
Q

The Hand: Muscular Biomechanics: Interosseous and Lumbricles

A
  • 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
Q

The Hand: Muscular Biomechanics: IP and MCP extension and CMC retroposition

A
  • Extensor Pollicis Longus
114
Q

The Hand: Muscular Biomechanics: Flexion of the MCP Joints

A
  • Flexor Digitorum Superficialis

- Flexor Digitorum Profundus

115
Q

The Hand: Muscular Biomechanics: Flexion of the PIP

A
  • When MCP is stable, Flexor Digitorum Superficialis
116
Q

The Hand: Muscular Biomechanics: Flexion of the DIP

A
  • When PIP is stable, Flexor Digitorum Profundus
117
Q

The Hand: Muscular Biomechanics: Grasping

A
  • The opponens digits minimi hollows the hand for grasping a cylindrical object
118
Q

The Hand: Muscular Biomechanics: Nerve Tissue PT Concerns: Radial Nerve

A
  • Damage effects the ability to
    - Maintain the functional wrist position
    - Release objects
119
Q

The Hand: Muscular Biomechanics: Nerve Tissue PT Concerns: Ulnar Nerve

A
  • Damage effects the ability to
    - Flexion of the digits on the ulnar side of the hand
    - Grip
120
Q

The Hand: Muscular Biomechanics: Nerve Tissue PT Concerns: Median Nerve

A
  • 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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