- 4 joints of the shoulder
- Sternoclavicular, Scapulothoracic, Glenohumeral, Acromioclavicular
- At what joint does most thumb movement occur?
- CMC
- Describe roll and slide for GH internal & external rotation
- Internal rotation: anterior roll, posterior slide; external rotation: posterior roll, anterior slide
- Describe the concept of a force couple in GH abduction.
- The deltoid and rotator cuff muscles act simultaneously to rotate the head of the humerus.
- Describe the humeroradial joint
- The radius is pulled to the humerus during muscle contraction, but there is no bony support. It is held in place by the joint capsule and soft tissue
- Describe the roll and slide of the lunate and capitate bones during wrist flexion
- The lunate slides dorsally & stretches the DRC ligament; the capitate rolls ventrally and slides dorsally
- Describe what a varus angle of the elbow would be
- Varus is the opposite of valgus. A varus angle is a 5 degree positioning of the forearm towards the body when in anatomical position
- Do males or females have a greater valgus angle of the elbow?
- Females
- Four bones that make up the Shoulder
- Sternum, Clavicle, Scapula, Proximal Humerus
- How are flexor tendon sheaths of the interphalangeal joints damaged? What is a condition of this called?
- When force is applied to a flexed finger; can lead to \"bowstringing\"
- How are \"check-rein\" ligaments of the PIP joints damaged?
- Hyperextension
- How does the bicep act as a supinator?
- Because it inserts on the radius, as the forearm is pronated, the biceps tendon wraps around the radius. Active contraction of the biceps can spin the radius sharply into supination.
- How does the pectoralis major act as both an adductor and an abductor at the GH joint?
- When the clavicular head of the pec major rises above the axis of rotation, that portion acts as an abductor
- How is the midcarpal joint divided? Which part experiences less movement?
- Medial and lateral compartments; lateral compartment has less movement
- How many degrees of freedom are at the CMC joints? Name the motions allowed
- 2 true planes of motion, kind of three; flexion/extension, abduction/adduction, opposition (aka hyperadduction, allows thumb to touch pinky)
- How many planes of motion are allowed at the AC joint, and what are they?
- 3; Upward & downward rotation, horizontal plane \"rotational adjustments\", sagittal plane \"rotational adjustments\"
- How many planes of motion are allowed at the GH joint, and what are they?
- 3; abduction/adduction, flexion/extension, internal & external rotation
- How many sesamoid bones are located inside the thumb MCP joint? What is their purpose
- 2; increase the flex force possible by increasing mechanical advantage
- How much abduction/adduction is there at the MCP joint of the thumb?
- Minimal; mostly at CMC joint
- How much compressive force does the IOM receive?
- 80 percent
- If someone obtains a rotator cuff tear, which group of muscles is often torn?
- GH external rotators, especially the infraspinatus
- In what order are the triceps bracii activated?
- Medial first because it\'s smallest, then lateral, then long
- Is force transmission through the IOM passive or active?
- Passive
- Is stabilization of the shoulder joint by the rotator cuff muscles an active or passive process?
- Active
- Name the 3 joints of the hand
- Carpometacarpal, metacarpophalangeal, interphalangeal
- Name the 3 major ligaments of the sternoclavicular joint.
- Anterior sternoclavicular, posterior sternoclavicular, costoclavicular
- Name the carpals, lateral to medial and proximal row to distal row
- Scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
- Name the elbow extensors
- Triceps brachii, anconeus
- Name the elbow flexors, and state which are most responsible for elbow flexion
- Bracialis & Biceps brachii are most responsible; also bracioradialis
- Name the elevators of the shoulder, and state which is the prime mover
- Upper trapezius (prime mover), levator scapulae, rhomboids
- Name the extensors of the fingers, and state which is the main extensor
- Extensor digitorum communis (main), extensor digiti minimi, extensor indicis, lumbricals, extensor retinaculum
- Name the extrinsic ligaments of the wrist
- Radial collateral, palmar radiocarpal, palmar ulnocarpal, dorsal radiocarpal, dorsal ulnocarpal, ulnar collateral
- Name the forearm pronators and state which is most active
- Pronator quadratus (most active), pronator teres
- Name the forearm supinators
- Supinator, biceps brachii
- Name the GH adductors/extensors, and indicate which ones are the main adductors
- Latissimus dorsi & pectoralis major are the main adductors; also included are teres major, long head of triceps, posterior deltoid, infraspinatus, and teres minor
- Name the GH external rotators
- Supraspinatus, infraspinatus, teres minor, posterior deltoid
- Name the GH flexors
- Anterior deltoid, coracobracialis, biceps brachii (long head)
- Name the GH internal rotators
- Subscapularis, anterior deltoid, teres major, latissiumus dorsi, pec major
- Name the intrinsic ligaments and their purposes
- Short: stabilizes the proximal row of carpals; long: provides transverse stability
- Name the scapulothoracic depressors
- Lower trapezius, latissimus dorsi, pectoralis minor, subclavius
- Name the scapulothoracic protractors
- Serratus anterior
- Name the scapulothoracic retractors
- Middle trapezius, rhomboids, lower trapezius
- Name the three arches of the hand
- Proximal transverse, distal transverse, longitudinal
- Name the two joints of the wrist
- Radiocarpal and metacarpal (midcarpal)
- Name the two types of flexor tendon sheaths of the interphalangeal joints. Which is less robust and gives less resistance?
- Annular (A2,A3,A4) and cruciate (C1,C2,C3); cruciate is weaker
- Name the wrist extensors
- Extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris
- Name the wrist flexors
- Flexor carpi radialis, flexor carpi ulnaris, palmaris longus
- Regarding the hand, what does A1 refer to, a flexor tendon pulley, or a flexor tendon sheath?
- Pulley
- True or false: Finger extensors may also act as wrist extensors
- True
- True or false: Finger flexors may also flex the wrist
- True
- True or False: forearm supination is weak
- False; it is very powerful
- True or false: hyperextension of the MCP joint of the thumb is not limited
- False; hyperextension is mostly due to the CMC joint of the thumb
- True or false: proximal movement of the forearm is reflected in distal movement
- True
- True or false: the larger your biceps are, the less elbow flexion you can have.
- True
- What actions are permitted at the sternoclavicular joint, and how many planes of motion are there?
- Elevation/Depression, Protraction/Retraction, Posterior rotation; 3 planes of motion
- What are the adductors of the thumb?
- Oppenens pollicis; adductor pollicis
- What are the extensors of the thumb? At which joints do the act?
- Extensor pollicis longus (all joints), extensor pollicis brevis (MCP and CMC joints)
- What are the joints of the forearm?
- Proximal radioulnar, distal radialulnar
- What are the properties of the distal transverse arch of the hand?
- Flexible; keystone is between the 2nd and 3rd MCP joints
- What are the properties of the first CMC joint (thumb)?
- Saddle joint; each articulating surface has both convex and concave components
- What are the properties of the longitudinal arch of the hand?
- Keystone is between 2nd and 3rd MCP joints
- What are the properties of the proximal transverse arch of the hand?
- Rigid; keystone is the capitate
- What are the relative ROM for each action at the sternoclavicular joint?
- More elevation than depression; about 15-30 degrees of protraction; about 45 degrees of axial (posterior) rotation
- What are the relative ROM for GH flexion/extension and GH internal/external rotation?
- Greater flexion than extension, and greater internal (medial) rotation than external (lateral) flexion
- What are the roll and slide actions during ulnar deviation?
- Proximal row slides laterally; capitate rolls medially and slides laterally
- What are the secondary actions of arm extensors and flexors? Why?
- Supination is a secondary action of extensors because they arise on the lateral epicondyle; Pronation is secondary action of flexors because they arise on medial epicondyle
- What are the three major ligaments of the AC joint?
- Superior acromioclavicular, inferior acromioclavicular, coracoclavicular.
- What are the thumb flexors? At which joints do they act?
- Flexor pollicis longus (all joints); flexor pollicis brevis (CMC, MCP joints)
- What are the two joints of the elbow?
- Humeroulnar & humeroradial
- What are the two large ligaments of the elbow?
- Medial collateral and lateral collateral
- What are the two ligaments at the proximal radialulnar joint, and what purpose do they serve?
- Annular ligament, which holds the radius against the ulna; quadrate ligament, which does not give much support, runs from radius to ulna
- What can cause annular ligament dislocation, and what population commonly sees this injury?
- Sharp pull to the hand; children
- What can happen at the elbow joint if the anterior joint capsule is loose?
- You can hyperextend your elbow
- What connective tissue is seen at the distal radioulnar joint?
- Dorsal radioulnar ligament, palmar radioulnar ligament, triangular fibrocartilage (articular disc)
- What do DIP and PIP stand for?
- DIP = distal interphalangeal
PIP = proximal interphalangeal - What does cubitis mean?
- Elbow
- What does the anconeus act to do, since it is a weak elbow extensor?
- Holds the elbow joint together
- What happens in terms of force transmission when you carry the handle of a suitcase?
- The bracioradialis actively pulls the radius to the humerus to transmit the force up the arm. This is fatiguing.
- What is an example of the length-tendon principle in the hand?
- Abduction of fingers is better when MCP joint is extended rather than flexed
- What is scapulothoracic rhythm?
- A natural kinematic rhythm or timing of GH joint abduction in the frontal plane occuring simultaneously with scapular upward rotation
- What is the abductor of the thumb?
- Abductor pollicis longus
- What is the difference between extrinsic and intrinsic finger flexion?
- Extrinsic flexion is flexing only your intercarpal joints, while intrinsic flexion flexes your MCP joint
- What is the law of parsimony?
- As force increases, small one-joint muscles are recruited first, then larger two-joint muscles are recruited second
- What is the natural position of the hand in anatomical position?
- Ulnar deviation (25 degrees) and slight anterior tilt (10 degrees)
- What is the osteology of the elbow and forearm complex?
- Distal humerus, ulna, radius
- What is the osteology of the hand?
- Metacarpals, phalanges
- What is the path that force takes in the forearm?
- Hand to radius to IOM to ulna to humerus
- What is the positioning of the glenoid fossa and the humeral head at the GH joint?
- The glenoid fossa points up, while the humeral head points up and back
