Week 11 Flashcards
What are the three joints of the elbow complex
humero-ulnar
radiohumeral
proximal radio-ulnar
what do proximal and distal radio-ulnar joints allow
supination
normal valgus angles
5-10 degrees males
10-15 degrees females
What reinforces humeroulna joint
collateral ligaments
Which fibres of the medial collateral ligament are strongest
anterior fibres
What function do the posterior fibres of the medial collateral ligament do
they are tensioned by flexion and valgus movements
What tensions the annular ligament
distraction of the radius and external rotation
The medial collateral ligament does what
primary stabiliser against valgus force with wrist flexors and pronators
What is the MOI for MCL of the elbow
excessive valgus force
e.g fall onto outstretched hand (FOOSH)
What does the LCL of the elbow do
primary stabiliser against varus forces
traumatic injury can rupture ligament
What does the interosseous membrane do
binds radius and ulna
-provides mechanism for transmitting force proximally through upper limb
Describe flexion and extension at the elbow
concave surface of the trochlear notch rolls and glides on convex trochlea
- full extension requires : ant dermis, flexor muscles,anterior capsule, MCL anterior fibres
- full flexion requires : posterior capsule elongation, extensor muscles, ulnar nerve, MCL posterior fibres and portions of LCL
flexion and extension at the humeroradial joint
the fovea of the radius rolls and slides over the convex capitulum
Fovea pulled firmly aanst capitulum in active flexion
NOrmal ROM - 5 hypextension to 145 flexion
for patients suffering from inflammation in the elbow, what is the postion of comfort
80 degrees flexion
-volume of air to space in joint is lowest
How might loss of extension occur
long term immobilisation facture inflammation muscle spasticity spinal injury above C5
Normal ROM for pronation and supination
75 degees pro
85 degrees sup
what is required functionally (pronation and supination
100 degree arc
requires approximately 50 degrees each direction
what nerve innervates brachialis
musculocutaneous nerve (C5, 6)
Innervation of biceps brachii
musculocutaneous (C5, 6
Brachioradialis innervation
radial nerve (C5, C6)
Pronator teres innervation
median nerve (C6, C7)
Triceps brachii innervation
Radial nerve
Anconeus innervation
radial nerve (C5, 6)
Pronator quadratus innervation
median nerve (C6, 7)
Pronator teres innervation
median nerve (C6,7)
Supinator innervation
Radial nerve (C5,6)
Which muscles flex the elbow
biceps brachii
brachialis
brachioradialis
pronator teres
Which muscles extend the elbow
triceps brachii
anconeus
What are the primary pronators of the forearm
pronator quadratus
pronator teres
secondary pronators of the forearms
flexor carpi radialis
palmaris longus
brachioradialis (supinated position)
primary supinators of the forearms
biceps brachii
supinator
secondary supinators of the forearm
radial wrist extensors
extensor pollicis longus
extensor indicis
bracioradialis (pronated positionj
which produces more torque out of the pronators and supinators
supinators (25% more)
what is lateral epicondylagia
localised pain over lateral elbow +/- forearm
sudden or gradual onset
increased by specific activities- backhand stroke, tightly gripping object, writing, shaking hand
source of symptoms for lateral epicondylagia
local -ECRB tendinopathy Radial nerve -posterior interosseous entrapment (radial tunnel syndrome) Radiohumeral joint RH bursae
Referred or secondary hyperalgesia
- cervical spine (C6 facet joints)
- Thoracic spine (autonomic contribution
Finish lecture 1
begin lecure 2
Which muscles flex the wrist
primary
- FCR
- FCU
- PL
secondary Flexor digitorum profundus Flexor digitorum superficials flex pollicis superficialis abductor pollicis longus extensor pollicis brevis
Which muscles extend the wrist
primary
ECRL
ECRB
ECU
secondary Ext digitorum extensor indicis ext digiti minimi ext pollicis longus
Radial deviator muscles
ECRL ECRB ext pollicis longus ext pollicis brevis FCR abd pollicis longus Flexor pollicis longus
Ulnar deviator muscles
ECU FCU Flex digitorum profuncdus Flex digitorum superficialis ext digitorum
Innervation of wrist muscles
dorsal side of wrist - radial nerve
Median and ulnar nerves - palmar side
What happens to grip strength in flexion
reduced
what is he 1st CMC joint
biaxial saddle joint function as a ball and socket due to lax capsule
