ANTR350 - Pectoral Girdle, Upper Limb, and Limb Muscles
ANTR350 - Pectoral Girdle, Upper Limb, and Limb Muscles ANTR 350
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This 0 page Class Notes was uploaded by Jenay DeCaussin on Sunday February 7, 2016. The Class Notes belongs to ANTR 350 at Michigan State University taught by Lindsey Jenny in Winter2015. Since its upload, it has received 13 views.
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Date Created: 02/07/16
Pectoral Girdle Upper Limb Limb Joints 02052016 PECTORAL GIRDLE pectoral girdle articulates with trunk and supports the upper limbs consists of the L amp R clavicles and the L amp R scapulae attachment site for muscles moving upper limbs promotes upper limb mobility in two ways 0 scapula is not attached to axial skeleton moves freely across posterior surface of thorax permitting arm to move as well 0 shallow cavity of should joint permits wide range of upper limb movement Clavicle clavicle Sshaped bone that extends between manubrium of sternum and acromion of scapula only direct connection between pectoral girdle and axial skeleton its sternal end medial is roughly pyramidal in shape articulates with the manubrium of the sternum sternoclavicularjoint acromial end lateral is broad and attened articulates with acromion of scapula acromioclavicularjoint superior surface smooth inferior has grooves and ridges for muscle and ligament attachments conoid tubercle rough tuberosity on inferior surface of acromial end costal tuberosity inferiorly located prominence at sternal end of clavicle Clinical View o fractures easily because Sshape can t resist stress 0 sternoclavicularjoint is incredibly strong so stress will fracture the clavicle before the joint 0 curved on ends so the anterior middle usually breaks 0 posterior fracture is most serious l splinters penetrate subclavian artery and vein immediately posterior and inferior to clavicle and are primary blood vessels supplying upper limb Scapula scapula broad at triangular quotshoulder bladequot has several large projections for SA for muscle and Hg attachments spine ridge of bone on posterior aspect of the scapula acromion forms bony tip of shoulder o articulates at acromial end of clavicle o coracoid process is smaller more anterior projection triangle shape has 3 borders superior medial vertebral and lateral axillary borders 0 between borders are superior inferior and lateral angles 0 lateral angle is composed mostly of the shallow glenoid cavity glenoid fossa which articulates with the humerus infralgenoid tubercle and supraglenoid tubercle of glenoid cavity attachment sites for muscles that position shoulder and arm suprascapular notch some people have a suprascapular foramen here in superior border provides passage for suprascapular nerve has attened regions that provide attachment surfaces of some rotator cuff muscles that stabilize and move shoulder subscapular fossa broad relatively smooth anterior surface of scapula slightly concave featureless subscapularis muscles lies over it spine subdivides posterior surface of the scapular into two shallow depressions or fossae o supraspinous fossa superior o infraspinous fossa inferior UPPER LIMB composed of 30 long and short bones 1 humerus 1 radius 1 ulna 8 carpal bones 5 metacarpals 14 phalanges Humerus humerus longest and largest upper limb bone proximal end has hemispherical head that articulates with the glenoid cavity of scapula greater tubercle lateral to head forms rounded contour of shoulder lesser tubercle anteromedial smaller intertubercular sulcus between tubercles depression that contains the tendon of the long head of the biceps brachii between tubercles and head is anatomical neck indistinct groove marking location of formed epiphyseal plate surgical neck narrowing of bone immediately distal to tubercles at transition from head to shaft common fracture site shaft has rough deltoid tuberosity in middle where deltoid muscle attaches radial groove adjacent to deltoid tuberosity where radial nerve and blood vessels travel elbow joint humerus radius and ulna medial and lateral epicondyles bony side projections on distal humerus areas for muscle attachment 0 posterior is the ulnar nerve l intrinsic hand muscles distal end of humerus two smooth curved surfaces that articulate with bones of forearm o capitulum lateral articulates with radius 0 trochlea pulleyshaped medial articulates with trochlear notch of ulna distal end of humerus has 3 depressions 2 anterior 1 on posterior anterolaterally placed radial fossa l head of radius anteromedially coronoid fossa l coronoid process of ulna posterior depression olecranon fossa l olecranon of ulna Radius and Ulna parallel bones of the forearm radius is lateral proximal end of radius discshaped head l articulates with capitulum of humerus narrow neck separates radial head from radial tuberosity attachment side of biceps brachii shaft of radius curves slightly wide distal end w lateral styloid process bony projection palpated on lateral side of wrist proximal to thumb distal medial surface ulnar notch medial surface of radius articulates with distal end of ulna ulna longer medial bone of forearm o proximal end Cshaped trochlear notch interlocks with trochlea of humerus o posterosuperior aspect has prominent projection called the olecranon l articulates with olecranon fossa of humerus posterior bump of elbow o inferior lip is called the coronoid process l articulates w humerus at coronoid fossa o lateral to coronoid process is the radial notch that accommodates head of radius forms proximal radioulnarjoint proximal end of bone is tuberosity of ulna distal end of ulna shaft narrows into knoblike head that has posteromedial styloid process palpate medial side of wrist Both radius and ulna have interosseous borders that face each other connected by interosseous membrane ligament that keeps the two bones at a xed distance apart provides pivot of rotation for the forearm 0 joints that move during rotation of forearm are the proximal and distal radioulnarjoints supination palm forward radius thumb side ulna little nger side 0 Clinical View Colles Fracture o fracture of the distal radius is displaced posteriorly 0 occurs when person extends hand forearm protonated to break their fall 0 force can transmit through interosseous membrance and fracture distal ulna 0 common in adultselders w osteoporosis 0 common symptoms pain and swelling just proximal to wrist weak hand wrist is not straight on side view bent at angle like a fork Pronation requires radius to cross over ulna both bone pivot along interosseous membrane palm faces posteriorly carrying angle of the elbow bones of forearm angle laterally from elbow joint at 515 degrees to clear hips when walking larger in women Carpals Metacarpals and Phalanges bones that form the wrist and hand carpals small short bones that form the wrist arranged in two rows proximal and distal of four bones each small bones allow for multiple movements of wrist proximal row of carpals lateral l medial scaphoid lunate triquetrum and pisiform distal row of carpals lateral l medial trapezium trapezoid capitate and hamate Clinical View Scaphoid Fractures scaphoid is more commonly fractured carpal bone 0 fall on outstretched hand causes break into two pieces oonly one of two pieces maintains blood supply blood vessels torn on proximal part of scaphoid l avascular necrosis death of bone tissue in area due to inadequate blood supply may cause development of degenerative joint disease take long to head properly because of quot metacarpals bones of the palm of the hand 0 5 articulate with distal carpal bones and support the palm Roman numerals lV denote each bone metacarpal I located at base of thumb phalanges bones of the digits 0 3 phalanges in each of the 2ncl 5th ngers and only 2 in thumb pollex thumb total of 14 phalanges per hand oproximal phalanx articulates with head of a metacarpal distal phalanx bone in tip of nger 0 middle phalanx lies between not present in thumb jOINTS OF THE PECTORAL GIRDLE AND UPPER LIMBS Sternoclavicularjoint saddle joint formed by articulation between manubrium of sternum and sternal end of clavicle articular disc partitions the sternoclavicular joint into two parts creates two separate joint cavities wide range of motion 0 support and stability from bers of articular capsule anterior and posterior sternoclavicular ligaments reinforce capsule two extracapsular ligaments strengthen joint o clavicle call attaches to rst rib by wide strong costoclavicular ligament stabilizes joint prevents shoulder dislocation when shoulder is elevated o interclavicular ligament runs along sternal notch attaches to each clavicle reinforces superior regions of adjacent capsules clavicle will fracture before this joint is dislocated because it is so strong Acromioclavicularjoint plane joint between acromion and acromial end of clavicle brocartilaginous articular disc lies within joint cavity joint works with sternoclavicularjoint and glenohumeral to give upper limb full range of motion articular capsule strengthened superiorly by acromioclavicular ligament and strong coracoclavicular ligament binds clavicle to coracoid process of scapula coracoclavicular ligament is responsible for the majority of stability of joint because it prevents clavicle from losing contact with acromion o tear severe shoulder separation acromion and clavicle will notaHgn Glenohumeral Shoulder joint ballandsocket joint formed by articulation of head of humerus and the genoid cavity of the scapula permits greatest range of motion of ANY joint in the body also is the most unstable and frequently dislocated brocartilaginous genoid labrum encircles and covers genoid cavity relatively loose articular capsule attaches surgical neck of humerus coracoacromial ligament extends across space between coracoid process and the acromion large coracohumeral ligament is thickening of superior part of joint capsule coracoid process to humeral head oglenohumeral ligaments three thickenings of anterior portion of articular capsule often absent and provide minimal support transverse humeral ligament narrow sheet that extends between greater and lesser tubercles of humerus tendon of long head of biceps brachii travels in articular capsule stabilizes humeral head in joint ligaments of joint only minimally strengthen it most ofjoint strength is due to rotator cuff muscles surround it encircle joint and fuse wartcapsue o inferior portion ofjoint lacks rotator cuff weak most likely site of injury o supraspinatus infraspinatus teres minor subscapularis Bursae decrease friction where both tendons and large muscles extend across articular capsule o subacromial subcoracoid subdeltoid subscapular bursae Elbow loint hinge joint of two articulations in single articular capsule o humeroulnarjoint trochlear notch of ulna trochlea of humerus o humeroradial joint capitulum of humerus head of radius extremely stable thick artcapsule bony surfaces interlock two main supporting ligaments o radial collateral ligament stabilizes lateral surface extends head of radius between anular ligament and lateral epicondyle of humerus o ulnar collateral ligament stabilizes medial side extends from medial epicondyle of humerus to coronoid process of ulna posterior to olecranon o anular ligament surrounds neck of radius binds proximal head of radius to ulna helps hold head of radius in place allowing for rotation of the radial head against ulna for pronation and supination of forearm suspect to damage from severe impact or unusual stress children and teens prone to epicondyle dislocations and fractures due to growth at epiphyseal plates Radiocarpal Wrist joint articulation among the three proximal carpal bones scaphoid lunate and triquetrum the distal articular surface of the radius and a brocartilaginous articular disc articular disc separates ulna from the radiocarpal joint ulna isn t included in joint entire wrist complex ensheathed by an articular capsule w reinforcing broad ligaments to support and stabilize carpal bones radiocarpal joint is a condylar articulation permits exext addabd circum no rotation rotation distal and proximal radioulnarjoints additionally intercarpal articulations plane joints that permit gliding between carpal bones Clinical View Subluxation of the Head of the Radius subluxation incomplete dislocation head is pulled out of anular ligament quotpulled elbowquot quotslipped elbowquot common and almost only in children under 5 because their anular ligament is thin and head of radius is not fully formed doctor twists arm and manual treatment is instant relief jOINTS OF THE PELVIC GRIDLE AND LOWER LIMBS Hip Coxal Joint hip joint coxal joint is articulation between head of femur and the relatively deep concave acetabulum of the os coxae brocartilaginous acetabular labrum further deepens this socket extensive bony architecture l stronger more stable less mobile secured by strong articular capsule several ligaments and powerful muscles oarticular capsule extends from acetabulum of trochanters of femur enclosing both femoral head and neck retinacular bers ligamentous bers of capsule re ect around neck of femur proved addition stability of capsule o retinacular arteries branches of deep femoral artery travel through retinacular bers and supply almost all blood head and neck of femur oarticular capsule is reinforced by three spiraling intracapsular ligaments o iliofemoral ligament Yshaped ligament providing strong reinforcement of anterior region of capsule o ischiofemoral ligament spiralshaped posteriorly located o pubofemoral ligament triangular thickening of inferior o all three become taut when hip is extended so hip is most stable extended and least mobile oligament of head of femur tiny called ligamentum teres originates along the acetabulum attaches at center of head of femur doesn t provide strength but contains small artery supplying head of femur deep bony socket strong articular capsule supporting ligaments muscular padding hip joint stability movements exex abdadd rotcircum Knee Joint Sid and prov O largest most complex diarthrosis of body primarily functions as a hinge joint but is capable of slight rotation and lateral gliding when exed composed of 2 separate articulations o 1 tibiofemoral joint between condyles of femur and condyles of the tibia 2 patellofemoral joint between patella and patellar surface of femur articular capsule encloses only the medial lateral and posterior regions of knee joint doesn t cover anterior surface ofjoint quadriceps femoris muscle tendon passes over the anterior surface o patella is embedded in this tendon o patellar ligament extends beyond patella and continues its attachment on the tibial tuberosity of tibia No single unified capsule in the knee nor common joint cavity Posteriorly popliteal ligaments strengthen capsule es of joint two collateral ligaments that become taut on extension ide additional stability to the joint bular collateral ligament reinforces lateral surface ofjoint runs from femur to bula prevents hyperadduction of leg at knew tibial collateral ligament reinforces medial surface of knee joint runs femur to tibia prevents hyperabduction o attached to medial meniscus of knee joint so injury affects the medial meniscus 0 deep to articular capsule par of Cshaped brocartilage pads on condyles O of the tibia medial meniscus and lateral meniscus stabilize joint medially and laterally act as cushions between articular surfaces continuously change shape to conform to articulating surfaces as femur moves deep to articular capsule of the knee joint are two cruciate ligaments that limit the anterior and posterior movement of the femur on the tibia cross to form an X o anterior cruciate ligament ACL runs from posterior femur to anterior side of the tibia o when knee is extended l ACL pulled tight and prevents hyperextension o prevents tibia from moving too far anteriorly on femur posterior cruciate ligament PCL runs from anteroinferior femur to the posterior side of tibia o becomes taut on exion prevents hyper exion of the knee joint o prevents posterior displacement of tibia on femur quotLockindquot the Knee oat full extension tibia rotates laterally to tighten the ACL and squeeze meniscus between tibia and femur popliteus muscle contraction unlocks knee and causes slight rotation Talocrural Ankle loint oTalocrural joint ankle joint highly modi ed hinge joint permitting dorsi exion and plantar exion includes two articulations within one articular capsule o distal end of bula and lateral aspect of talus o medial and lateral malleoli of tibia and bula form extensive medial and lateral margins and prevent talus from sliding sidetoside oarticular capsule covers distal surfaces of tibia medial malleolus lateral malleolus and the talus multipart deltoid ligament bind tibia to foot on medial side prevents overextension of foot very strong rarely tears will pull off medial malleolus of tibia before rupturing multipart lateral ligament binds bula to foot on lateral side prevents overinversion not as strong and is prone to sprains and tears 0 two tibio bular ligaments anterior posterior bind tibia to bula loints of the Foot 4 synovial joints in foot intertarsal tarsometatarsal metatarsophalangeal and interphalangeal joints intertarsal joints articulations between tarsal bones where inversion and eversion occur tarsometatarsal joints articulations between tarsal and metatarsal bones plane joints that permit some twisting and limited sidetoside movement metatarsophalangeal MP joints between metatarsals and phalanges of the toes condylarjoints permit limited abdadd of toes as well as exext Clinical View Ankle Sprains sprain stretching or tearing of ligaments without fracture or dislocation result from foot twisting usually overinversion o bers of lateral ligaments stretched or torn l localized swelling tenderness anteroinferior to lateral malleolus overeversion is rare because deltoid ligament is so strong 0 Pott fracture can result take long time to heal because of poor vascularity prone to reinjury Clinical View Fracture of the Femoral Neck common and complex quotfractured hipquot 05 coxae isn t broken just the femoral neck when femoral neck breaks the pull of lower limb muscles causes the leg to rotate laterally and shorten by several inches Two types 0 intertrochanteric factures occur distally to or outside hip articular capsule extracapsuar fracture line between greater and lesser trochanters occurs in younger people 0 subcapital fractures within hip articular capsule very close to head of femur occurs in elderly people wosteoporosis results in tearing of retinacular bers and arteries and ligament causing avascular necrosis needs hip replacement surgery Clinical View Knee Ligament and Cartilage Injuries because knee is only reinforced by tendons and ligaments it is highly susceptible to injury ACL tear when leg is hyperextended ACL is weak and prone to injury o anterior drawer test pull tibia anteriorly to test for ACL injury PCL injury if leg is hyper exed or tibia is driven posteriorly on femur 0 occurs rarely because PCL is strong tested in posterior drawer test menisci prone to injury from blows to knee or general overuse of joint composed of brocartilage that cannot be regenerated so surgery is necessary unhappy triad of injuries triple injury of tibial collateral ligament medial meniscus and ACL 0 most common football injury play is clipped by lateral blow to knee leg is abducted and laterally rotated o tear to tibial collateral ligaments causes medial meniscus tear usually because they are connected arthroscopy type of conservative surgical treatment where a small incision is made in knee and an arthroscope camera light inserts in knee to avoid large incisions
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