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flashcards ni mang inamo > SHOULDER AND ELBOW . > Flashcards

SHOULDER AND ELBOW . Flashcards

1
Q

● 20 muscles
● 3 bony articulations
● 3 soft tissue moving surface (functional joints)
● Permit the greatest mobility of any joint area found in the
body

A

Shoulder Complex

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2
Q

How many hand placements

A

16,000

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3
Q

only bony attachment of UE to
trunk

A

Sternoclavicular joint

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4
Q

○ Manubrium
○ Right and left clavicles
○ Right and left scapulae
● Incomplete girdle (does not have bony connection
posteriorly)

A

Shoulder Girdle

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5
Q

● Clavicular facet
● Sternal/jugular notch
● Facets for attachment
of the first ribs

A

Manubrium

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6
Q

● Clavicular facet
● Sternal/jugular notch
● Facets for attachment
of the first ribs

A

Manubrium

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7
Q

● Lateral strut to the
scapula and the
humerus.
● This increases
glenohumeral mobility
to permit greater
motion in reaching and
climbing activities.

A

Clavicle

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8
Q

● a flat,
triangular-shaped
bone
● 3 sides and 3 angles
● sits against the
posterior thorax.
● Lies on the posterior
ribs
● Conforms to the
upper thorax
● Does not lie in a
pure frontal plane

A

Scapula

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9
Q

Inferior angle of scapula

A

T7

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10
Q

Scapular spine

A

T3

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11
Q

● Dense fibrous
connective tissue rim
that surrounds the
glenoid fossa.
● Increase joint
congruence.

A

Glenoid Labrum

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12
Q

● Tilted 5° upward relative
to the scapular vertebral
border.
● Teardrop or pear-shaped
appearance
● Orientation: lateral,
superior, and anterior
direction (LAS)
● (Concave)

A

Glenoid Fossa

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13
Q

Head of humerus
○ Convex
○ 1/3 to ½ sphere
○ Orientation: medial,
superior, posterior
(PMS)

A

Humerus

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14
Q

Angle of inclination

A

humeral head is angled at
135° to the long axis of
the humeral shaft

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15
Q

Angle of torsion

A

30°

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16
Q

Resting position of the humeral head in posterior rotation
relative to the distal condyles of the humerus allows the
head to be aligned in the scapular plane while
maintaining proper elbow joint alignment; this relative
position of posterior rotation =

A

Retroversion

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17
Q

through which the LH
of biceps runs from
its proximal insertion
on the supraglenoid
tubercle.

A

Bicipital groove

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18
Q

● Circumferential area on the
proximal humerus.
● Distal to the bicipital groove
● Common site for humeral
fractures, especially in the
elderly, when a fall occurs and
the individual lands on an
outstretched arm.

A

Surgical Neck

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19
Q

are the result of
sternoclavicular and acromioclavicular joint movements.

A

Scapulothoracic motions

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20
Q

responsible for the majority
of the scapular movement.

A

Sternoclavicular joint

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21
Q

provides minimal movement
and acts more as a fine tuner of scapular motion than
a producer of its motion

A

Acromioclavicular joint

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22
Q

● The only joint that acts as
a strut to connect the
upper extremity directly
with the axial skeleton.
● Medial end of the clavicle
connects with the
manubrium of the
sternum and the medial
first rib.

A

Sternoclavicular Joint

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23
Q

● Plane synovial joint
● 3 DOF
○ Elevation/Depression
○ Abduction/Adduction
○ UR/DR
● Medial margin of the
acromion and the lateral
end of the clavicle
● Lined with fibrocartilage

A

Acromioclavicular Joint

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24
Q

● no bony articulations
● False joint/pseudo joint/functional joint
● Separating the scapula from the thorax are soft tissue
structures, including a large subscapular bursa.

A

Scapulothoracic Joint

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25
Q

● Shoulder joint
● Ball-and-socket
● 3 DOF
● Little bony stability
○ Convex: Humeral
head (PMS)
○ Concave: Glenoid
fossa (small/shallow)
(LAS)
● Labrum
○ From neck of glenoid
○ To anatomic neck of
humerus
● 10 to 15 mL
● Axillary pouch

A

Glenohumeral Joint

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26
Q

● Ligaments and tendons blend with and reinforce the
glenohumeral joint capsule for added stability.
○ Coracohumeral ligament
○ Superior, Middle, Inferior GH ligament

A

Capsular Reinforcement

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27
Q

coracoid process of the
scapula → greater and
lesser tubercles of the
humerus
● where it forms a tunnel
for the tendon of the
long head of the biceps
brachii.

A

Coracohumeral Ligament

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28
Q

● Capsular ligaments
● From the glenoid and its
labrum, form capsular
thickenings, and attach to
the humeral neck and
lesser tubercle

A

Superior, Middle and Inferior GH
Ligaments

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29
Q

Support the dependent
(hanging down) arm and
limit lateral rotation in the
lower ranges of
abduction

A

Coracohumeral, Superior and Middle GH
Ligaments

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30
Q

● Forms a hammock-like
sling with anterior and
posterior bands around
the lower portion of the
humeral head and is part
of the axillary pouch.
● Main stabilizer of the
abducted shoulder

A

Inferior Glenohumeral Ligament

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31
Q

● anterior acromion →
lateral coracoid process
● osteoligamentous arch
● roof of the glenohumeral
joint

A

Coracoacromial Arch

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32
Q

● Contains:
○ supraspinatus muscle
and tendon,
○ long head of the
biceps tendon
○ subacromial bursa
○ superior capsule

A

Subacromial Space

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33
Q

● Area under the
coracoacromial
● Formed by the neck of
the scapula, the acromion
process, the rigid
coracoacromial ligament,
and the coracoid process

A

Supraspinatus Outlet

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34
Q

● A bursa reduces friction
between two structures.
● 8 bursae within the
shoulder area
○ Subacromial bursa

A

Bursae

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35
Q

● Scapular plane
glenohumeral abduction
● Occurs 30° to 40°
anterior to the frontal
plane

A

Scaption

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36
Q

● LH of biceps tendon
● Retained by the
coracohumeral ligament
and by the transverse
humeral ligament

A

Bicipital Groove

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37
Q

● They found that the early phase of abduction was
individually variable.

A

Scapulohumeral Rhythm

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38
Q

This early stage of motion was termed the “setting
phase.” After about ____ of abduction, a ___ ratio occurred:
For every 2° of glenohumeral motion, 1° occurred at the
scapulothoracic joint.

A

30°; 2:1

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39
Q

Primary scapular protractor
● “saw muscle”
● lowest five digitations is the strongest portion of the
muscle
● XXX: Medial winging of the scapula

A

Serratus Anterior

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40
Q

● superficial muscle of the neck
and upper back
● “Shawl” muscle or “musculus
cucullaris”
● Full abduction with scapular rot:
All fibers
○ Mid = ret
○ Upper and Lower = upward
rot.
● XXX: Lateral winging of the
scapula
○ Elevation is limited to 120
degrees (only by GH)

A

Trapezius

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41
Q

● connect the scapula with the vertebral column lie under the
trapezi
● XXX: scapula in protracted position
● scapula positioned farther laterally from the thoracic
spinous processes
● than the normal 6 cm from the thoracic spinous processes.

A

Rhomboid Major and Minor

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42
Q

● located anteriorly on the upper chest by the pectoralis
major.
● XXX: Weakness of this muscle results in reduced
strength during scapular depression and downward
rotation of the scapula against resistance.

A

Pectoralis Minor

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43
Q

An elevator of the scapula, an action it shares with
the upper trapezius and with the rhomboids.
● Elevation + DR
● XXX: reduced ability to elevate and downwardly
rotate the scapula.

A

Levator Scapulae

44
Q

provide glenohumeral stability as well as
glenohumeral motion.

A

Rotator Cuff

45
Q

● located above the spine of the scapula.
● capable of performing the total motion of abduction
without the assistance of the deltoid.

A

Supraspinatus

46
Q

External rotators of the shoulder

A

Infraspinatus and Teres Minor

47
Q

@ infraspiIatus fossa

A

InfraspinaItus

48
Q

@ lateral border of the scapula

A

Teres minor

49
Q

● located on the anterior scapula.
● IR = primary medial rotation function
● But can also flex, extend, adduct, or abduct the
glenohumeral joint

A

Subscapularis

50
Q

● Lies distal to the teres minor on the lateral scapula
border
● The teres major acts in most pulling activities when the
shoulder is extended or adducted against resistance.

A

Teres Major

51
Q

● A large, superficial muscle consisting of three parts: anterior,
middle, and posterior.
● The muscle covers the glenohumeral joint on all sides
except in the inferior
● Axillary region
● Comprises 40% of the mass of the scapulohumeral muscles

A

Deltoid

52
Q

● This muscle is the broadest muscle of the low back and
the lateral thoracic region
● If the arms are stabilized, as in pushing down on crutch
handles or in a seated press down, the distal attachment
aids to lift the pelvis.

A

Latissimus Dorsi

53
Q

● Large muscle of the chest
● Two parts
○ Clavicular
○ Sternocostal

A

Pectoralis Major

54
Q

Parts of Brchial Plexus

A

● Roots
● Trunks
● Divisions
● Cords
● Branches
Remember: “RoTonDa CuBao”

55
Q

● 3 individual joints
● Surrounded by 1 capsule
● Humeroulnar joint + humeroradial joint = “elbow joint”
● Proximal radioulnar joint (PRUJ)

A

Elbow Complex

56
Q

holds
the head of radius in proper
relation to the ulna and
humerus

A

Annular ligament

57
Q

connects
the radius and ulna, running
from the lateral side of the
ulnar tuberosity to the
radius slightly below the
radial tuberosity

A

Oblique cord

58
Q

Branches of the Brachial Plexus

A

● Musculocutaneous
● Radial
● Median

59
Q

Pathological conditions of the
Elbow and FA region (Acute):

A

● Fracture
● Strain
● Sprain
● Distraction injuries

60
Q

Pathological conditions of the
Elbow and FA region (Chronic):

A

● Overuse
● Repetitive microtrauma

61
Q

● Congruent
● Bones possesses notches, ridges, grooves that fit like
jigsaw puzzle pieces
● Stability and Function

A

Elbow Complex

62
Q

● The proximal articulating bone of the elbow, a long bone with several distinct
markings on its distal end, some of which are
palpable.

A

Humerus

63
Q

● Attachment site for
○ primary forearm pronator (pronator teres)
○ major stabilizing ligament (the ulnar collateral
ligament)
○ most of the wrist and finger flexor muscles

A

Medial epicondyle

64
Q

● Attachment site for
○ wrist and finger/thumb extensors
○ forearm supinator.

A

Lateral epicondyle

65
Q

landmark that is
palpable between
the lateral head of
the triceps
posteriorly and the
brachioradialis
muscle anteriorly

A

Lateral supracondylar
ridge

66
Q

Providing a deep and stable articulating surface for the
superior ulna when the elbow is in full extension

A

Olecranon fossa

67
Q

is the more
integral articulating bony
partner with the humerus
at the elbow, forming the
humeroulnar joint

A

Ulna

68
Q

The distinctive posterior prominence of the superior ulna
and is the most posterior portion of the elbow when the
joint is flexed.

A

Olecranon process

69
Q

● The concave ulnar trochlear
notch articulates with the
more proximal humeral
trochlea to form the medial
elbow joint.
● Also known as the semilunar
notch.

A

Trochlear notch

70
Q

This large articulating
ulnar surface is divided in
the center by a prominent
trochlear or longitudinal
ridge that articulates with
the trochlear groove of its
humeral companion

A

Trochlear and longitudinal ridge

71
Q

● , an attachment
site for a primary elbow
flexor muscle, the brachialis.
● Radial notch articulates with
the radius to form the
proximal radioulnar joint

A

Ulnar tuberosity

72
Q

● contributes to proximal
forearm function, it plays a
more important role at the
distal radioulnar joint and
at the wrist.

A

Radius

73
Q

is located just
distal to the humeral lateral condyle.

A

Head of Radius

74
Q

The superior surface of the radial head has a deep
concave fovea, which articulates with the round convex
head of the humeral capitulum to form the humeroradial
joint.

A

Fovea

75
Q

● Just distal to the radial head on the anterior radial
neck .
● is the attachment site for the
biceps brachii

A

Radial tuberosity

76
Q

● Ginglymus
● Uniaxial hinge joint
● 1 DOF
● Flexion and extension in sagittal plane around the
frontal axis

A

Elbow

77
Q

located in the olecranon
fossa, buffering the
locking of the elbow when
it moves into full
extension.

A

Olecranon bursa and fossa

78
Q

● Since the joint axis is not
perpendicular to the
shaft of the humerus,
the forearm alignment
angles laterally in
relation to the shaft of
the humerus in the
anatomical position.
● Cubital angle

A

Carrying angle

79
Q

Angle of Carryin angle

A

15°

80
Q

Male (Magee)

A

5 to 10 degrees

81
Q

Female (Magee)

A

10 to 15 degrees

82
Q

Cubitus valgu

A

More than 15 degrees

83
Q

Cubitus varus:

A

Less than 5 to 10 degrees

84
Q

BOUNDARIES:
● Laterally: Brachioradialis muscle
● Medially: Pronator teres
● Base: Formed by an imaginary line
drawn between the two epicondyles
of the humerus.
● Floor: Formed by the supinator
muscle laterally and the brachialis
muscle medially.
● Roof: Formed by skin and fascia and
is reinforced by the bicipital
aponeurosis.

CONTENTS:
● Median nerve
● Bifurcation of the brachial
artery into the ulnar and
radial arteries
● Tendon of biceps
● Radial nerve

A

Cubital Fossa

85
Q

● Quite large and comprised
of three distinct parts:
○ Anterior
○ Posterior
○ Transverse.

A

Medial (Ulnar) collateral ligament
(MCL)

86
Q

● It stabilizes the elbow against excessive valgus forces to
restrict the forearm from excessive lateral displacement
on the arm.
the primary stabilizer of the elbow; damage to
it may result in an unstable elbow joint. .

A

Medial (Ulnar) collateral ligament
(MCL)

87
Q

● a fan-shaped structure.
● Like the MCL, also has
three parts; these segments
extend from the humeral lateral
epicondyle to the annular
ligament surrounding the radial
head and to the ulna’s olecranon
process.

● This ligament stabilizes the elbow against excessive varus
forces
● Prevents humeroulnar subluxation
● Stabilizes the humeroradial joint
● Assists the annular ligament in stabilizing the radial head
against the ulna.

A

Lateral (Radial) collateral ligament
(LCL)

88
Q

A large bursa lies between
the olecranon an

A

Olecranon Bursae

89
Q

● PRUJ
● DRUJ
● Pronation/Supination
● 1 DOF
● Transverse plane, vertical axis

A

Radioulnar articulation

90
Q

● Located between
radius and ulna.
● This thick membrane
reinforces both
radioulnar joints
without restricting
pronation or
supination motions

A

Interosseous membrane

91
Q

has firm, fibrous connections to the
ulna, attaching to it on either side of the radial notch,
anchoring firmly around the radial head and neck.

A

Annular ligament

92
Q

is
quite short but strong,
arising from the ulna just
inferior to the radial notch
and attaching to the
medial surface of the
radial neck.

A

Quadrate ligament

93
Q

Major stabilizer of the proximal radioulnar joint during full
supination

A

Anterior portion of the quadrate
ligament

94
Q

● Weaker
● Stabilizes full pronation

A

Posterior portion of the quadrate
ligament

95
Q

● A flat band of fascia on the
ventral forearm running from the
inferior aspect of the ulna’s radial
notch to just below the ulna’s
radial tuberosity.
● Its fibers run perpendicular to
those of the interosseous
membrane and become taut in
full supination, providing
additional stability to the

A

Oblique cord

96
Q

● “workhorse”
● Large work capacity due to a large cross section
area.
● Largest of all of the elbow flexors.
● It crosses only the humeroulnar joint.

A

Brachialis

97
Q

● A fusiform-shaped muscle with two heads located
on the anterior arm.
● Functionally, is selectively recruited
when the task requires elbow flexion with forearm
supination such as in carrying a loaded tray or
bringing a spoon to the mouth.

● Greatest moment arm at 90° to 110° of flexion.
● Large cross section
● Beyond 100° of flexion or when the elbow is close
to full extension, the contractile force becomes
more translatory.
● This translatory force provides

A

Biceps brachii

98
Q

is a weak elbow flexor,
predominantly contributing to flexion when the
forearm is pronated.

A

Pronator Teres

99
Q

● Extends the elbow regardless of forearm position
● Its greatest extension force is exerted in midrange at 70° to 90°
of elbow flexion.
● Acts concentrically to extend the elbow.
● Acts eccentrically as a major elbow stabilizer during elbow
flexion.
● Powerful stabilizer of the upper extremity during any functional
closed-chain activity.

A

Triceps brachii

100
Q

● a small muscle located deep, adjacent
to the joint, blending close to the fibers of the
humeroulnar joint capsule.
● Contracts during elbow extension to tighten the loose
posterior elbow capsule
● Perhaps helping to prevent pinching of the capsule
folds as the olecranon locks into the olecranon fossa

A

Anconeus

101
Q

● is able to supply adequate force when
○ supination occurs slowly
○ the resistance is light
○ the elbow is extended
● The only muscle whose sole action is forearm supination.
● Always recruited for forearm supination, regardless of the
speed or load.
● Acts alone during slow supination or when the elbow is
extended.

A

Supinator

102
Q

Aids supination from pronation to midposition with the
elbow in flexion, but its action is quite weak.

A

Brachioradialis

103
Q

● Primarily a forearm pronator.
● It runs rather close to the axis of the elbow joint so that it
has a poor moment arm for elbow flexion
● This muscle supplies added force to elbow flexion only
when there is a significant resistance or a heavy load.

A

Pronator Teres

104
Q

● This one-joint muscle performs forearm pronation
regardless of elbow position.
● Acts as a dynamic stabilizer of the distal radioulnar joint

A

Pronator Quadratus

105
Q

● Injuries to the brachial plexus affect movements and cutaneous
sensations in the upper limb
● Disease, stretching, and wounds in the lateral cervical region
(posterior triangle) of the neck or in the axilla may produce
brachial plexus injuries.
● Signs and symptoms depend on the part of the plexus involved.

A

Brachial Nerve Palsy

106
Q

cranial portion

A

Rhomboid minor

107
Q

caudal portion

A

Rhomboid major

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