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What are the 4 bones and joints of the shoulder?
- Sternum, Clavicle, Humerus, Scapula
- Scapulothoracic (not a true joint!)
Compare the Sternoclavicular & Acromioclavicular joints? Which is more likely to fracture, which is more likely to dislocate?
- Sternoclavicular will fracture, very strong connections, many ligaments
- Acromioclavicular will dislocate, much more movement here
The movement of the Scapulothoracic joint is closely tied to which other joints and why?
- Sternoclavicular & Acromioclavicular
- They are the only bony attachments to the axial skeleton
What are the motions of the scapula?
- Elevation & Depression
- Protraction & Retraction
- Upward & Downward Rotation
Scapulohumeral Rhythm: how do we get to 180 degrees?
- 120= glenohumeral
- 60= scpulothoracic
Proximal Stabilizers & where they start and end
- Levator Scapulae
- Serratus Anterior
- Pectoralis Major
- Lattisimus Dorsi
- start: ribs & spine
- end: clavicle & scpula
Distal Mobilizers & where they start and end where?
- Deltoids: anterior, middle, posterior
- start: clavicle & scapula
- end: humerus
Name the prime movers (shoulder muscles) for
- Flexion: Anteriod deltoid & Pec major
- Extension: Posterior deltoid & Lats
- AD: Lats & Pec major
- AB: Middle deltoid
- Horizontal AD: Anterior deltoid & Pecs
- Horizontal AB: Posterior deltoid & Lats
- External Rotation: Posterior deltoid
- Internal Rotation: Lats & Anterior deltoids
What prime movers are involved in doing a push up?
- Anterior deltoid
- Pec Major
What prime movers are involved in reaching to a high shelf in front of you?
What prime movers are involved in reaching into your back pocket?
What prime movers are involved in reaching to the opposite shoulder across the body?
What prime movers are involved in touching the top of your head to wash your hair?
- Middle deltoid
- Anterior deltoid
What prime movers are involved in pushing up from armrests of a chair?
What prime movers are involved in when lowering down from a pull-up
- primary innervation to entire upper extremity
What muscle causes scapular winging?
Rotator Cuff: role and components
- Stabilizes the humeral head!
- Supraspinatus (AB) -most common injury tear (used when reaching back in car to lift backpack to the front)
- Infraspinatus (Ext Ro)
- Teres Minor (Ext Ro)
- Subscapularis (Int Ro)
what are the actions of the sternocleidomastoid & scalenes? Unilateral, Bilateral?
Name the bones and joints of the hand
You can do it!
What are the three major joints in the wrist?
What three bones makes up the main joint?
- Radiocarpal: radius, scaphoid, lunate
- Midcarpal: horizontal, separating distal carpals from proximal carpals
- Intercarpal: vertical, between carpals
How many carpals are there and how are they arranged?
- 8 carpals
- Distal: Here Comes The Thumb
- Proximal: So Long To Pinky
What are the motions of the wrist?
- flexion, extension
- ulnar/radial deviation
- **Slide & Roll
The Scaphoid bone is more likely to fracture while the Lunate is more likely to dislocate. Why?
Scaphoid bone is directly in front of the radius, more force translates to it.
What are the advantages and disadvantages of having a multi-joint operation in the carpals/wrist?
- Advantages: minimal motion at each joint, but large motion overall, collectively they have a large range, but have STABILITY. STABILITY over mobility
- Disadvantages: misalignment: if is one gets out of line, it will push the others (like teeth). Predisposed to injury at high force
What are the wrist extensors and where to they start and end?
- lateral epicondyle to anterior metacarpals!
- Extensor Carpi Radialis Longus/Brevis
- (extension and radial deviation)
- Extensor Carpi Ulnaris
- (extension and ulnar deviation)
- C6 (drinks)-radial
What is a common injury from the wrist extensors and what happens?
- Tennis elbow aka Lateral Epicondylitis
- repetitive extension of wrist at the radiocarpal joint!
What are the wrist flexors and where do they start and end?
- medial epicondyle to anterior surface of hand
- Flexor Carpi Radialis(flexion and radial deviation)
- Flexor Carpi Ulnaris(flexion and ulnar deviation)
- Palmaris Longus-not all people have this one!
- C7 (hugs)-median
Explain TENODESIS, what muscles are active and passive in GRIP & RELEASE?
- Active: wrist extensors
- Passive: finger flexors
- Active: wrist flexors
- Passive: finger extensors
Which joints are responsible for:
Radial/Palmar ABd & ADd of thumb
- Flexion/Extension: DIP, PIP, MCP, CMC
- ABduction/ADuction: MCP
- Radial/Palmar AB & AD of thumb: CMC
Why do we have arches/creases on our hands?
form=function! help us with movements, closing and opening hand.
What are the EXtrinsic finger flexors & extendor muscles of the hand
(EXtrisic=they start outside the hand in forearm)
- Flexor Digitorum Profundus (flex DIP)
- Flexor Digitorum Superficialis (flex PIP)
- Extensors:Extensor Digitorum (extend DIP & PIP)
- Extensor Digiti Minimi (extends PINKY)
- Extensor Indicis (extends index finger)
What do the EXtrinsic thumb muscles do?
- Extend thumb
- Radially ABduct thumb
- Flex IP joint of thumb
- *Extensor Pollicis longus/brevis
What are the Interossei responsible for?
- dAB: dorsal ABduction (spreading fingers)
- pAD: palmar ADduction (cupping hands)
What are the INtrinsic finger flexion & extension muscles of the hand(EXtrisic=they are contained inside the hand)
- Thenars & Hypothenars! BUTT of palm!
- Thenars (thumb)
- -flex, ABd, ADd, Oppose thumb
- Hypothenars (pinky)-flex, ABd, Oppose pinky
What makes up the Lumbricals (intrinsic)
MCP flexion & IP extension (2-5)
Finger flexion/extension are made up of annular pulleys and retinacular ligaments
What causes carpal tunnel?
when the tendons of FDP & FDS inflame and compress the Median nerve
What do the Radial, Median & Ulnar nerves control in the wrist movements?
- Radial: wrist extensors
- Median: wrist flexors, thumb opposition
- Ulnar: pinky opposition, interossei
Explain the Swan Neck & Boutonniere deformities of the fingers!
- Swan: flexion of DIP, hyperextension of PIP
- Bout: hyperextension of DIP, flexion of PIP
Differentiate the different finger and hand grasps