Upper extremity Flashcards
1
Q
upper v. lower extremity function
A
lower extremity about balance and weight bearing, upper about mobility and fine motor control
2
Q
Shoulder girdle:
1. clavicle
2. scapular landmarks
A
- anchored to sternum medially and to scapula at the acromion
- on med border sup and inf angle, sup lat border is glenoid fossa for humerus, supra and infra glenoid tubercules sup and inf to glenoid fossa, spine of scapula on post separates supraspinous fossa and infraspinous fossa, acromion process ext of spine of scapula, coracoid process on ant side point laterally, subscapular fossa on ant scapula
3
Q
4 shoulder girdle actions
A
- elevation: move scapula and rotate clavicle superiorly
- depression: move scapula and rotate clavicle inferiorly
- protraction: clavicles rotate posteriorly to bring scapulas apart
- retraction: clavicles rotate anteriorly to bring scapulas closer together
4
Q
sternoclavicular joint:
1. comp
2. articular disk
3. motion
A
- sternal end of clavicle meets manubrium of sternum
- fibrocartilage in capsule that prevents shear and compression
- facilitates shoulder girdle movements and sup/inf rotation of the scapula
5
Q
4 + 1 scapular actions
A
- superior rotation: rotate superior angles closer to the spine, occurs during elevation
- inferior rotation: rotate inferior angles closer to the spine, occurs during depression
- anterior tilt: superior angle gets closer to the thorax
- posterior tilt: inferior angle gets closer to the thorax
- winging: scapula not anchored to rib cage, if held by suboptimal muscular control scapula lift away from rib cage
6
Q
sternoclavicular joint ligaments:
1. anterior sternoclavicular ligament
2. posterior sternoclavicular ligament
3. costal-clavicular ligament
A
- connect sternum to clavicle on ant side, limits superior rotation, and retraction
- connect sternum to clavicle on post side; limits superior rotation and protraction
- connects costal cartilage of ribs 1 to the clavicle; limits elevation and sup translation of med clavicle
7
Q
acromioclavicular joint:
1. comp
2. articular disk
3. motion
4. injury
A
- articulation of acromion process and lat end of clavicle
- fibrocartilage preventing shear and compression in acromioclavicular joint capsule
- no motion, holds clavicle to scapula for shoulder girdle movements
- separated shoulder from clavicle and scapula being pulled apart
8
Q
- acromial clavicular ligament
- coracoclavicular ligaments
- coracoacromial ligament
A
- connect acromion to clavicle in place
- hold coracoid to clavicle, conoid on medial coracoid to conoid tubercle on inf clavicle, trapezoid on lat ant coracoid to trapezoid line on clavicle; limit sup translation of clavicle and depression
- does not cross joint, forms bridge b/w coracoid and acromion creates subacromial space over humerus, prevent sup translation of humerus
9
Q
trapezius (origin, insertion, motion):
1. upper fibres
2. middle fibres
3. lower fibres
A
- desc fibres, originate as nuchal lig and insert at lat clavicle for elevation
- originate from spinous processes of T1-4 and insert at acromion and spine of scapula for retraction
- asc fibres, originate at spinous process of T4-12, insert on acromion and spine of scapula for superior rotation and post tilt of scapula and depression
10
Q
- nuchal ligament
- supraspinus ligament
A
- nuchal lig is elastic broad lig from superior nuchal line extending lat from external occipital protuberance moving inf, touching each spine of cervical vertebrae before attaching to C7; limit flexion of the neck
- continuous with nuchal lig at C7 to sacrum; limit flexion of the spine
11
Q
- levator scapulae
- rhomboid major
- rhomboid minor
A
- originate at transverse process of C1-4, insert on sup angle of scapula for inf rotation of scapula
- originate at spinous process of T2-T5, insert on med border of scapula; retraction, manage winging
- originate at spinous process of C7-T1, insert on root of spine of scapula; retraction, manage winging
12
Q
- serratus anterior
- pectoralis minor
A
- originate on lat ribs 1-8 under scapula to med border of scapula; protraction by upper fibres and sup rotation of scapula by lower fibres, manage winging
- ant ribs 3-5 to med coracoid process, protraction, depression, and ant tilt of scapula, can contribute winging on inf angle > managed by lower fibres of traps
13
Q
glenohumeral joint:
1. comp
2. motion
3. glenoid labrum
A
- head of humerus (ball) on shallow socket of (pear-shaped) glenoid fossa; low bony congruency for large mobility
- sagittal flex (bring fingers to ceiling), sagittal extend (bring fingers from full flexion back to anatomical pos and beyond post), cross-flex (swing arm across body in transverse plane), cross-extend (from cross-flex to anatomical and beyond post), abduction (increase angle b/w arm and midline in frontal plane), adduction (decrease angle b/w arm and midline in frontal plane), ext rot (greater tuberosity gets closer to acromion), int rot (greater tuberosity gets closer to clavicle)
- fibrocartilage ring holding humerus in fossa
14
Q
11 humeral landmarks
A
- distal to head is anatomical neck
- greater tuberosity is protrusion post and lat to anatomical neck of humerus
- lesser tuberosity is protrusion ant to anatomical neck
- bicipital groove with lat and med lip b/w tuberosities
- surgical neck is narrow area of humeral neck before shaft, easily fractured
- deltoid tuberosity on lat humerus distal to greater tuberosity
- distal end capitulum lat rounded articular surface with radius
- distal end trochelea med rounded articular surface for ulna
- medial and lat epicondyles at base, med more prominent
- radial groove diagonal groove for radial nerve from post shaft towards capitulum
- supracondylar ridge, lat and med side
15
Q
- superior glenohumeral lig
- middle glenohumeral lig
- inferior glenohumeral complex
- common way to dislocate humerus
A
- 1:00 pos on glenoid rim to sup lesser tuberosity, limit ext rot when <45° abduction and sup translation of humerus.
- 2:00 pos on glenoid rim to lesser tuberosity to anatomical neck, limit cross ext during 45-90° abduction, sup translation of humerus
- Ant and post bands w/axillary pouch b/w, 3:00-8:00 pos to anatomic neck, limit ext rotation at >= 90° abduction, sup translation of humerus
- Abduction and ext rotation