elbow

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Author:
joyjohnson
ID:
107772
Filename:
elbow
Updated:
2011-10-23 14:53:51
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elbow
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elbow
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  1. elbow structure and motions
    • consists of:
    • bones
    • humerus
    • radius
    • ulna

    • ligaments
    • joint
    • capsule
  2. joint structure and motions
    • elbow joint
    • humeroulnar joint
    • humeroradial joint

    • forearm
    • proximal radioulnar joint
    • at elbow
    • head of radius pivots within the radial notch of ulna

    • distal radioulnar joint
    • distal end of radius rotates around the distal end of ulna

    • radioulnar joint:
    • Uniaxial pivot joint
    • pronation/supination
    • radius moves around ulna

    • Ulna locked in by boney shape at proximal end
  3. Carrying angle
    anatomical position

    longitudinal axes of humerus and forearm form an angle

    angle tends to be greater in women than in men

    angle occurs becuz distal end of humerus is not level
  4. joint shapes
    humerus

    • 2 convex areas
    • trochlea/ulna
    • capitulum/radius

    • Ulna-concave
    • radius/concave
  5. end feels
    flexion-elbow

    soft tissue appr/muscle bulk

    extension-elbow

    boney

    forearm-supination

    firm/soft tissue stretch-muscle and ligament

    forearm/pronation

    hard(boney)-contact betrween radius and ulnar
  6. Open chain
    concave radial and ulnar slide on the humerus in same direction as the motion of the forearm
  7. humeroulnar joint
    • uniaxial
    • 1o freedom
    • flexion/extension in sagittal plane

    hinge joint

    • ROM: 0o-145o
    • uniaxial joint
    • resting position
    • 70o/,10o supination
    • closed pack position(walker, walking on your hands)
    • full/with supination
  8. ligaments and other structures
    • capsule
    • keeps laeral side of joint from separating when stressed
    • attaches to humerus, radius, and ulna

    • medial collateral
    • provides medial stability

    • lateral collateral
    • provides lateral stability

    • annular
    • holds radius against the ulna
  9. interosseous membrane
    • broad flat membrane
    • keeps radius and ulna together
    • serves as a muscle attachment

    • radioulnar articulations held together by:
    • annular ligament
    • interoseous membrane
  10. ligaments
  11. muscles of elbow and forearm
    • brachialis
    • brachioradialis
    • biceps
    • supinator
    • triceps
    • anoconeus
    • pronator teres
    • pronator quadratus
  12. brachialis
    elbow flexion

    • o-distal half of humerus
    • I-coronoid process & ulnar tuberosity of ulna
  13. biceps brachii
    commonly called biceps
    • two heads
    • O-long-supraglenoid tub of scapula
    • O-short-coracoid process scapula

    I-radial tuberosity or radius

    Action

    • elbow flexion
    • forearm supination

    most effective in supination when forearm is at 90o flex

    moment arm greatest at 90o

    ex: cork screw. unscrews(supination) and then pulls(flexion)
  14. brachioradialis
    • elbow flexion
    • O-humerus(brachii)
    • I-radius
  15. triceps
    Elbow extension

    • 3 heads-
    • I-Long,infrag tub scapula
    • I-later-inferior,greater humerus
    • I-medial,posterior humerus

    O-olecranon ulna
  16. anconeus
    assists elbow extension

    keeps triceps from being pinched during extension
  17. pronator teres
    forearm pronation
  18. pronator quadratus
    • O-distal una
    • I-disal radius
  19. supinator
    • O-humerus/ulna
    • I-proximal radius
  20. summary of muscle action
    • anterior
    • elbow flexors
    • brachialis
    • biceps brachii
    • brachioradialis

    • forearm -supinator
    • biceps brachii
    • supinator muscle


    • posterior
    • elbow extensor
    • triceps

    • forearm pronators
    • pronator teres
    • pronator quadratus

    • Wrist Flexion
    • flexor carpi radialis
    • flexor carpi ulnaris

    wrist extension

    • extensor carpi radialis longus/brevis
    • extensor carpi ulnaris

    radial deviation

    • flexor carpi radialis
    • extensor carpi radialis longus

    • Ulnar deviation
    • extensor carpi ulnaris
    • flexor carpi ulnaris
  21. anconeus muscle
    • elbow extensor
    • stablizer
  22. force couple to move the radius
    supinator and biceps muscles work together to:

    move the radius around the ulnar to produce supination from a pronated position
  23. wrist joint structure
    • radiocarpal joint
    • proximally: distal end of radius and radioulnar disk

    • distally: scaphoid, lunate, triquetrum
    • distal radio-ulnar joint
    • synovial

    • condyloid joint
    • biaxial
    • flexion-extension
    • radial-ulnar deviation
  24. wrist joint
    2 joints
    radiocarpal and midcarpal
    • between 2 rows of carpal bones
    • contributes to wrist motion

    • irregular shape
    • plane joints

    • nonaxial
    • gliding motion
  25. bones and landmarks
    bones of the wrist
    short bones arranged in an arch

    • concavity on the anterior(palmar surface)
    • convexity on posterior side

    arch contributes to thumb's ability to oppose

    these concavities and convestities are important features to understand for splinting
  26. bones and landmarks
    • styloid process
    • disal, lateral radius, attachment for collateral ligaments

    • hook of the hamate-anterior surface hamate
    • transverse carpal ligament attachment
  27. bones and landmakrs
    • medial epicondyle
    • common flexor tendon attachment

    • lateral epicondyle
    • common extensor tendon attachment

    • suprcondylar ridge
    • extensor carpi radialis longus attachment
  28. ligaments and other structures
    • flexor retinaculum
    • transverse carpal-(more distal) arches over the carpal bones and forms a tunnel for the flexor tendons and median nerve

    the one usually cut to relieve 5x of CTS

    palmar carpal-(more proximal) functions to prevent tendons on this side of the wrist from pulling away from the wrist during wrist extension
  29. muscles of the wrist
    • **common proximal attachment
    • wrist flexors-medial epicondyle
    • wrist extensors-lateral epicondyle (most)

    distal attachment for all wrist muscles is a metacarpal

    names of the muscles tell their action and their side

    example: flexor vs extensor, ulnaris vs radialis

    carpi means wrist
  30. summary of WRIST muscle action
    • flexion
    • flexor carpi radialis
    • flexor carpi ulnaris

    • extension
    • extensor carpi radialis longus
    • extensor carpi radialis brevis
    • extensor carpi ulnaris

    • radial deviation(combination of a flexion and an extensor)
    • flexor carpi radialis
    • extensor carpi radialis longus

    • ulnar deviation(combination of flex/ext)
    • flexor carpi ulnaris
    • extensor carpi ulnaris
  31. summary of muscle innervation
    • posterior muscle
    • radial nerve

    • anterior muscles lateral aspect
    • median nerve

    • anterior muscles medial aspect
    • ulnar nerve
  32. articular disk
    shock abosrber
  33. the hand
    distal end of the upper extremity

    • composed of:
    • thumb
    • fingers
    • metacarpals
    • phalanges

    useful and versatile, complex
  34. joints and motions of the thumb
    3 joints

    • carpometacarpal (CMC)
    • trapezium articulating with first metacarpal (MC)

    • modified biaxial
    • flexion/extension
    • abd/add
    • opposition
    • ***the movements originalte from the CMC joints
    • metacarpophalangeal (MCP)

    interphalangeal (IP)


    Biaxial because reposition is returned to anatomical position and opposition is a combo of flex, abd with accesory rotations
  35. joints and motions fo the fingers (2-5)
    • fingers
    • digit 2-5(little finger)

    • joints
    • carpometacarpal
    • metacarpophalangeal-MCP
    • proximal-interphalangeal-PIP
    • distal interphalangeal-DIP
  36. arches of the hand
    palm assumes a cupped position, when hand is relaxed

    • arches-support the arches
    • proximal carpal arch
    • distal carpal arch
    • longitudinal arch
  37. muscles of the thumb and fingers
    • extrinsic-originate outside the hand
    • proximal attachment
    • proximal to the wrist
    • assistive role in wrist function
    • primary function at the thumb(pollcus) or fingers

    • Intrinsic-all taking place in the palm of the hand
    • proximal attachment at or distal to the carpals
    • for fine motor control and precision movement of the hand
    • function at the thumb or fingers
    • can be further divided into:
    • thenar
    • hypothenar(below, little finger)
    • palm
  38. profundus-all the way to the finger tips

    in. produces a pulley action
    palmar interossei muscles-adduction, inbetween bones on palm

    dorsal interossei-abduction
  39. Functional Position of the Hand
    ***optimal position of strength and precision

    wrist-20 to 30

    MCP and IP joints are slightly flexed

    • Thumb in opposition
    • maintenance of the thenar web
  40. Grasp-prehension
    The act of taking hold, seizing or grasping an object for functional use
  41. Grasp-prehension
    the act of taking hold, seizing or graspiong an object for functrional use
  42. Grasps
    Types of Prehension
    • power grasp
    • cylindrical grasp
    • sperical grasp
    • disc grasp
    • hook grasp
    • lateral pinch
    • 3-jaw chuck
    • tripod grasp
    • pincer grasp
  43. power grasp
    holding hammer

    usually involves a significant amount of force

    most powerful grip

    fingers flexed around an object in one direction, the thumb the opposite

    moved about by move proximal point musculature

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