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SHF 200 - BIOMECHANICS > UPPER EXTREMITY > Flashcards

UPPER EXTREMITY Flashcards

1
Q

FUNCTIONAL ARTICULATIONS OF THE SHOULDER COMPLEX

A

Shoulder girdle has increased ROM with less compromise of stability

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2
Q

JOINTS OF THE SHOULDER

A
  1. Sterno-clavicular
  2. Acromio-clavicular
  3. Scapulo-thoracic
  4. Gleno-humeral (ball and socket)
  5. Supra-humeral/sub-acromial
  6. LH biceps and bicipital groove
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3
Q

ROLE OF LONG AND SHORT HEAD OF BICEP

A

Ant stability of GH, therefore failure of stabilisation of LHB can have damaging effects on GH and rotator cuff function
Achieved through compression of humeral head against glenoid fossa

Humeral head stability= compression of humeral head to glenoid fossa, doesn’t go into subacromial space

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4
Q

EVIDENCE THAT LONG HEAD BICEPS ENABLES GH STABILITY

A

LHB hypertrophies in pt with rotator cuff tears

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5
Q

FORCE COUPLING MECHANISM

A

Force coupling around a pivot point
2 opposing forces rotating around a pivot point
There are multiple forces at any given moment
These can be equal or unequal, depending on the function required and balance of moving elements such as muscles and balance of stabilising elements such as ligaments

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6
Q

SCAPULO-HUMERAL RHYTHM

A

Area at which scapula moves and relies on rate at which the humerus moves
Permits largest ROM of any complex in the body
The shoulder girdle increases ROM with less compromise of stability (scapula-humeral rhythm) (4 joints vs 1 joint)
Facilitate movements of the upper extremity by positioning the GH favourably

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7
Q

PHASE ONE OF ABDUCTION

A

30 humeral abduction
0-5 clavicle elevation
Minimal scapula movement medially

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8
Q

PHASE TWO OF ABDUCTION

A

Humerus 40 abduction (up to 90)
Scapula 20 lat rot
Clavicle 15 elevation

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9
Q

PHASE THREE OF ABDUCTION

A

Humerus 60 abduction + 90 lat rot
Scapula 30-40
Clavicle 30-50 post rot
15 elevation

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10
Q

COMBINED ROLL AND SLIDE PRINCIPLE

A
  • Maintains joint congruity through range of movement
  • GH is an example of convex on concave; where the moving bone (humerus) is convex and the stationary bone (scapular) is concave
  • The humerus superior rolls, whilst the scapular slides inferiorly during abduction
  • During flexion/extension, the head of the humerus spins along with accompanying upward rotation of the scapulothoracic joint. Assisted by rotation of the clavicle
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11
Q

ROLE OF THE CLAVICLE

A
  1. The clavicle is the only axial attachment for the entire upper extremity
  2. The clavicle elevates, depresses, rotates, protracts and retracts. All movements are passive accessory movements
  3. All clavicular movements are essential to position the scapular in the optimal position to accept the head of the humerus
  4. Essentially all movements of the glenohumeral joint involves some movement of the clavicle around the pivot point of the sternoclavicular joint
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12
Q

ROLE OF CAROCOID PROCESS

A

Ant anchor of scapula- e.g., pec minor, corocobrachialis, short head of bicep

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13
Q

ROLE OF THE LONG AND SHORT HEADS OF BICEPS IN HUMERAL HEAD STABILITY

A
  • Provides anterior stability to the GH, therefore failure of the stabilisation of the long head biceps can have damaging effects on the GH and rotator cuff function
  • Achieved through compression of the humeral head against glenoid fossa
  • Observations that the tendon of long head of biceps atrophies in patients with rotator cuff tears confirms that it has a role in GH stability
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14
Q

IMPORTANCE OF SUB ACROMIAL SPACE

A

Location of bicep tendon, rotator cuff and bursa
Can become pinched during some shoulder movements

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15
Q

GH MOVERS

A
  • Deltoid
  • Supraspinatus
  • Biceps brachii
  • Brachioradialis
  • Pectoralis major
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16
Q

GH STABILISING TISSUES

A
  • Capsule
  • Ligaments
  • Articular disc (AC/SC joints)
17
Q

GH STABILISING MUSCLES

A
  • Subscapularis
  • Serratus anterior
  • Latissimus
  • Coracobrachialis
  • Pectoralis minor
18
Q

IDENTIFY THE CAUSE OF PAINFUL AND WEAK SHOULDER

A

Rotator cuff related shoulder P
Subacromial impingement syndrome
SLAP lesion

19
Q

IDENTIFY THE CAUSE OF PAINFUL AND STIFF SHOULDER

A

Adhesive capsulitis
OA (bony remodelling) of GH, AC

20
Q

IDENTIFY THE CAUSE OF PAINFUL AND UNSTABLE SHOULDER

A

Dislocations
Repeated dislocations

21
Q

ELBOW TORQUES

A

Flexion torques are 70% greater than extension torque
Torque forces needed for bicep curl are 70% greater than an ext push down
Flex torque with supination is 20% greater than with pronation
Brachioradialis in mid prone inc power of flexion

22
Q

ELBOW LEVERS

A

3rd class lever- during flexion
Effort= muscle (at point of insertion)
Load= weight of body and additional resistance
Fulcrum= Jt itself

23
Q

ELBOW ROLL AND GLIDE

A

Ulnar concave
Humerus convex- two shapes make Jt more congruent
Humerus passive in both flex and ext, driven by active movement of ulnar and radius
On elbow flexion- roll and slide move in same direction

24
Q

WHAT IS THE PURPOSE OF THE INTEROSSEOUS MEMBRANE?

A
  • The interosseous membrane is a fibrous connective tissue structure that runs between the ulna and radius bones in the forearm, connecting them together
  • Its purpose is to provide stability and support to the forearm by distributing the forces from the humerus to the carpals
  • It plays a critical role in allowing the forearm bones to rotate around each other, enabling the pronation and supination of the hand
25
Q

WHAT IS SIGNIFICANT ABOUT THE STRUCTURE OF THE INTEROSSEOUS MEMBRANE?

A
  • The interosseous membrane is significant because it plays an essential role in the stability and movement of the forearm and hand
  • It provides stability and support for the radius and ulnar as well as helping to distribute the forces from the humerus to the carpals preventing damage and injury to these structures
26
Q

MECHANICS OF GRIP

A

Lumbricals allow for L-shape grip

27
Q

WRIST - ROLL AND SLIDE MECHANISM

A
  • Ulnar and radial deviation
  • The radius is the concave structure
  • The proximal carpals are the convex structures
  • Movement driven actively by carpals, and passively allowed by distal radius and ulnar
28
Q

MOVERS

A

o Biceps brachii
o Brachialis
o Brachioradialis
o Triceps brachii

29
Q

PRONATORS/SUPINATORS

A

o Supinator
o Pronator teres
o Pronator quadratus

30
Q

STABILISING TISSUES

A

o Capsule
o Ligaments
o Interosseous membrane

31
Q

WHAT IS SPECIAL ABOUT THE LUMBRICALS?

A
  • The lumbrical muscles are a set of 4 small muscles located in the palm of the hand
  • They originate from the tendons of the flexor digitorum profundus muscles in the forearm
  • Control of finger movement – responsible for flexing the metacarpophalangeal (MCP) joints while extending the interphalangeal (IP) joints of the fingers which allows for precision gripping and grasping
32
Q

EXAMPLES OF MECHANICAL PRINCIPLES IN THE ELBOW

A

Lever- 3rd class
Force- torque in pronation/supination
Roll/slide- proximal humerus-radius/ulnar roll- slide in same direction
Flexion force- 70% greater than ext, 3x bicep, 1x triceps
Stabiliser- interosseous membrane
90 pro/supination, 140-150 flex

33
Q

EXAMPLES OF MECHANICAL PRINCIPLES OF THE WRIST

A

Ulnar/radial deviation ROM- 30-45, 15
Roll and slide mechanism in radial/ulnar deviation
Movement driven by carpals, radius is passive, carpals roll and slide in different directions around pivot point of capitate
Role of lumbricals- allow for L-shaped grip, inc stability

34
Q

DESCRIBE KINEMATICS OF PRO/SUP OF THE FOREARM
COMMENT OF ROM, TYPES OF MOVEMENT, ROLL AND SLIDE CONCEPT

A

90 pro/sup
Torque force
Roll + slide mechanism- same direction- radial/ulnar/humeral
Roll + slide- radial/ulnar Jt
Stabilising effects of interosseous membrane

35
Q

DESCRIBE KINEMATICS OF FLEXION OF THE ELBOW
COMMENT ON ROM, TYPE OF MOVEMENT, ROLL AND SLIDE CONCEPT, TYPE OF LEVER

A

3rd class
120-140 flex
Humerus convex, ulnar concave
Roll + slide in same direction
Flexibility of capsule allows flex/ext

SHF 200 - BIOMECHANICS (9 decks)

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