Unit 2 Lecture Flashcards
name the key bones/bony landmarks of the shoulder complex
- scapula
- clavicle
- sternum
- humerus
- rib cage
name the 3 joints and 1 articulation of the shoulder complex
- sternoclavicular joint
- acromioclavicular joint
- glenohumeral joint
- scapulothoracic articulation
the shoulder girdle is composed of which 2 bones?
scapula and clavicle
which joints allow for shoulder girdle motion?
SC & AC joints
how many muscles attach to the scapula, clavicle, or both to provide motion of the shoulder girdle?
5
what are the motions of the shoulder girdle?
- elevation & depression
- protraction & retraction - occurs with (abduction & adduction)
- UR & DR
- scapular tilt (occurs with hyperextension of the shoulder)
describe the scapula
- located between ribs 2-7
- spine of scapula is level with T3 and T4
describe the clavicle
- “S” shaped and connects upper extremities to axial skeleton at SC joint
- composed of sternal end, body, and acromial end
describe the sternum
- composed of 3 divisions: manubrium, body, and xiphoid process
the glenohumeral joint is composed of which 2 bones?
- composed of the scapula & humerus
the glenohumeral joint is also known as
the shoulder joint
what are the motions of the glenohumeral joint?
- flexion & extension
- abduction & adduction
- MR & LR
- horizontal abduction & horizontal adduction
is the glenohumeral joint more mobile or more stable?
more mobile
what is the sternoclavicular joint composed of?
- costoclavicular ligament - between the clavicle & rib limits clavicular elevation
- interclavicular ligament - between clavicle & sternum limits clavicular depression
- sternoclavicular ligament - connect to anterior & posterior surface of sternum provides reinforcement to clavicle
- articular disk - between clavicle & sternum shock absorption
what does the sternoclavicular joint provide direct attachment of?
the shoulder girdle to the trunk of the body
what are the motions of the sternoclavicular joint?
- elevation & depression disk & clavicle
- protraction & retraction disk & sternum
- rotation
3 degrees of freedom
is the sternoclavicular joint more mobile or more stable?
more stable/strong
describe the acromioclavicular joint
a synovial joint with a weak capsule
what are the motions of the acromioclavicular joint?
- elevation & depression
- protraction & retraction
- UR & DR
- scapular tilt
3 degrees of freedom
what is the acromioclavicular joint composed of?
- acromioclavicular ligament - around acromial end of clavicle superior & inferior support of weak capsule
- coracoacromial ligament - forms arch over head of humerus
- coracoclavicular ligament - scapula to clavicle lateral trapezoid and deeper medial conoid
scapulohumeral rhythm
- movement relationship between the shoulder girdle and shoulder joint
- 2:1 ratio
- first 30 degrees of joint elevation is pure joint motion
after that - every 2 degrees of shoulder flexion or abduction = 1 degree of upward rotation from scapula
- first 30 degrees of joint elevation is pure joint motion
define winging (associated with scapulohumeral rhythm)
the medial border of the scapula lifts off of the thoracic wall in a posterior direction (not normal)
name and describe the muscles of the shoulder girdle that participate in reversal of muscle action (origin moves to insertion)
- UPPER TRAP WITH SHOULDER GIRDLE STABILIZED - assists in extending the head & neck, lateral bending to same side, and rotating to opposite side
- LOWER TRAP WITH SHOULDER STABILIZED - assists in elevating the trunk (particularly during crutch walking)
- LEVATOR SCAPULA WITH SCAPULA STABILIZED - assists in rotating and laterally bending the neck to the same side
elevation prime movers (URL)
- upper trap
- rhomboids
- levator scapula
depression prime movers (LP)
- lower trap
- pec minor
retraction prime movers (RM)
- rhomboids
- middle trap
protraction prime movers (PmS)
- pec minor
- serratus anterior
UR prime movers (SUL)
- serratus anterior
- upper trap
- lower trap
DR prime movers (PmRL)
- pec minor
- rhomboids
- levator scapula
scapular tilt prime mover
- pec minor
name the key bones and landmarks that make up the shoulder joint
- supraspinous fossa
- infraspinous foss
- subscapular fossa
- humeral head (articulates with scapula)
- anatomical neck (groove that separates head from tubercle)
- surgical neck (just below the tubercles/where head meets body)
- greater tubercle (provides attachment for supraspinatus, infraspinatus, and teres minor)
- lesser tubercle (provides attachment for subscapularis)
- glenoid labrum (fibrocartilagenous ring that deepens the articular cavity)
what are the motions of the shoulder joint?
- flexion, extension, & hyperextension
- abduction, adduction, & circumduction
- MR & LR
- horizontal abduction & adduction
- scaption (occurs approximately 30 degrees forward of the frontal plane/most common functional activities occur in this position)
describe the PLT sandwich
- Pec major, Lats, and Teres major
– lateral lip - crest of greater tubercle provides attachment for pec major
– medial floor - crest of lesser tubercle provides attachment for latissimus dorsi & teres major
describe the shoulder joint & the ligaments involved
- shoulder joint capsule is thin-walled from the rim of the glenoid fossa to the anatomical neck
- glenohumeral ligaments - reinforce anterior capsule
- coracohumeral ligaments - from coracoid to medial side of greater tubercle strengthens the upper part of the joint capsule
^^helps to prevent dislocation of the humeral head^^
name the bursae involved with the shoulder joint
- subdeltoid bursa
- subacromial bursa
shoulder joint flexion prime movers (AC)
- anterior deltoid
- clavicular portion pec major
shoulder joint extension prime movers (SPLT)
- sternal portion pec major
- posterior deltoid
- latissimus dorsi
- teres major
hyperextension prime movers (PL)
- posterior deltoid
- latissimus dorsi
abduction prime movers (DS)
- deltoid
- supraspinatus
adduction prime movers (PLT)
- pec major
- latissimus dorsi
- teres major
horizontal abduction prime movers (TIP)
- teres minor
- infraspinatus
- posterior deltoid
horizontal adduction prime movers (AP)
- anterior deltoid
- pec major
LR prime movers (TIP too)
- teres minor
- infraspinatus
- posterior deltoid
MR prime movers (SPLAT)
- subscapularis
- pec major
- latissimus dorsi
- anterior deltoid
- teres major
what are the 3 bones involved with the elbow?
- radius
- ulna
- humerus
what are the 2 joint articulations of the elbow?
- trochlea-U humerus with ulna
- capitulum-R humerus with radius
name and describe the 3 ligaments of the elbow
-
medial/ulnar collateral ligament
- triangular
- starts from medial epicondyle of humerus & runs obliquely/diagonally to the medial sides of the coranoid process & olecranon process of ulna
-
lateral/radial collateral ligament
- triangular
- starts from lateral epicondyle of humerus & attaches to the annular ligament & lateral side of ulna
collateral ligaments reinforce capsule on the sides of the joint
-
annular ligament
- attaches anteriorly and posteriorly to radial notch of ulna & encompasses head of radius, holding it against the ulna (completely encircles/strengthens joint)
describe the 2 convex areas of the elbow
- trochlea (convex) articulates with the trochlear notch of the ulna (concave)
- capitulum (convex) articulates with the radial head (concave)
describe the elbow complex
- composed of the proximal and distal radioulnar joint
- allows for pronation & supination of the forearm
- radius moves around the ulna
define carrying angle & know the difference between men and women
- (in anatomical position) angle created by the humerus and forearm
– women: 10-15 degrees
– men: 5 degrees
define cubitus varus & excessive cubitus varus
- cubitus varus: angled more towards the midline of the body
- excessive cubitus varus: excessive amount of angle away from the midline of the body
describe the end feels of the elbows
- soft tissue approximation in flexion
- hard or bony in extension
describe the interosseous membrane of the elbow
keeps bones from separating & provides site of attachment for muscles of the forearm & wrist
elbow flexion prime movers (BBB)
- biceps brachii
- brachialis
- brachioradialis
elbow extension prime mover
- triceps
forearm supination prime movers (BS)
- biceps
- supinator
forearm pronation prime movers (PP)
- pronator teres
- pronator quadratus
which bones make up the wrist?
- radius
- ulna
what are the landmarks of the wrist?
- radial styloid process
- ulnar styloid process
- hook of hamate: attachment for transverse carpal ligament
which 2 joints make up the wrist?
-
radiocarpal joint
- synovial, condyloid joint
- biaxial joint
- distal end of radius and radioulnar disk articulates with the scaphoid, lunate, & triquetrium
-
midcarpal joint
- located between the 2 rows of carpal bones & contributes to joint motion
- irregular shape
- nonaxial joint that allows gliding
describe the carpometacarpal joint (CMC)
between the distal row of carpals (trapezium, trapezoid, capitate, hamate) & the proximal end of the metacarpals
name and describe the ligaments of the wrist
(1) Radial Collateral Ligament: runs from the radial styloid (laterally) to the lateral scaphoid and trapezium
(2) Ulnar Collateral Ligament: runs from the ulna (medially) to the pisiform/provides (mostly) medial and lateral stability
(3) Palmar Radiocarpal Ligament: thick, tough, strong/limits wrist extension
(4) Dorsal Radiocarpal Ligament: limits wrist flexion
where it limits movement is where/how it’s stretched
palmar fascia
- aka palmar asponeurosis
- thick and triangular shaped
- protection
- site of attachment for palmaris longus
what are the joint motions of the wrist?
- flexion & extension
- UD & RD
wrist flexion prime movers
- FCR
- FCU
wrist extension prime movers
- ECRL
- ECRB
- ECU
wrist RD prime movers
- ECRL
- FCR
wrist UD prime movers
- FCU
- EDU
sensory innervation of the wrist
median and radial nerves effect from the thumb to the middle of the ring finger
name & describe the 3 joints that make up the thumb?
(1) CMC (carpometacarpal)
- between carpals & metacarpals
- forms a saddle joint & allows for mobility/stability
- ROM - flexion &extension, abduction & adduction, opposition & reposition
(2) MCP (metacarpal phalange)
- between metacarpals & proximal phalanges
- ROM - flexion & extension
(3) IP (interphalangial)
- between phalanges & the thumb
- ROM - flexion & extension
name and describe the 4 joints of digits 2-5
(1) CMC
- the 5th digit has the most mobility & allows for opposition
(2) MCP
- knuckle articulation
- ROM - flexion, extension, & hyperextension, abduction
& adduction
- middle finger as reference (does not abduct)
(3) PIP (proximal interphalangial)
- between proximal & middle phalanges
- ROM - flexion & extension
(4) DIP (distal interphalangial)
- between middle & distal phalanges
- ROM - flexion & extension
describe the flexor retinaculum
- composed of 2 ligaments:
- palmar carpal ligament
- transverse carpal ligament
describe the palmar & transverse carpal ligaments
- palmar carpal ligament: proximal & superficial
- transverse carpal ligament:
- arches over the carpal bones forming a tunnel that the median nn & extrinsic tendons pass through
- job is to hold the flexor tendons in close to the wrist & prevent the carpal bones from spreading or separating
describe the extensor retinaculum
- broad, flat band on dorsum of the wrist
- holds tendons close when performing wrist extension
name the power grips
- cylindrical
- spherical
- hook
name the precision grips
- pad to pad
- pinch
- 3 jaw chuck
- tip to tip
- pad to side
- side to side
- lumbrical grip
