Exam review 3 (All Notes)
Exam review 3 (All Notes) EXSC 322
Popular in Anatomical Kinesiology
Popular in Physical Education
This 20 page Class Notes was uploaded by Ticynn London on Monday March 28, 2016. The Class Notes belongs to EXSC 322 at Old Dominion University taught by Phil Sabatini in Spring 2016. Since its upload, it has received 53 views. For similar materials see Anatomical Kinesiology in Physical Education at Old Dominion University.
Reviews for Exam review 3 (All Notes)
So much better than office hours. Needed something I could understand, and I got it. Will be turning back to StudySoup in the future
-Ethan McLaughlin DVM
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 03/28/16
Exam 3 Review (All the Notes) The Shoulder Complex Shoulder Girdle Have four articulations: • Sternoclavicular • Acromioclavicular • Coracoclavicular • Scapulothoracic Sternoclavicular (SC) Articulation Articulation between the sternum and clavicle – Ball-and-socket joint – Freely mobile in frontal and transverse plane – Limited sagittal movement Site of most movement of shoulder girdle – Elevation: depression (shrugging shoulders, 60°) – Protraction: retraction (rowing, 30°) – Anterior: posterior rotation (raising your hand, 30-45°) Ligamentous support – Anterior sternoclavicular ligament – Posterior sternoclavicular ligament – Costoclavicular & interclavicular ligaments Anterior Posterior Acromioclavicular (AC) Articulation Articulation between the acromion process and distal end of clavicle Motion most noticeable during arm elevation (shoulder abduction) Ligamentous support – Superior acromioclavicular ligament – Inferior acromioclavicular ligament – Coracoacromial ligament Coracoclavicular (CC) Articulation Articulation between coracoid process of scapula and clavicle Assists in reinforcement of the weak AC articulation Ligamentous support – Coracoclavicular ligaments i.e., conoid & trapezoid Scapulothoracic Articulation • “articulation” between the anterior surface of the scapula (scapular fossa) and the thoracic wall – supported dynamically by muscles – no ligamentous support • acts to stabilize shoulder region during lifting (shrugging) - e.g. picking up a suitcase • facilitates overhead movements through elevation and upward rotation of the glenohumeral joint Clavicle • Roles: – Helps facilitate scapular motion – Site of muscular attachment – Provides a barrier to protect underlying structures – Acts strut to stabilize the shoulder and prevent medial displacement when the muscles contract – Prevents an inferior migration of the shoulder girdle. Scapula Primary function is to provide muscle attachment sites for shoulder muscles. Shoulder Girdle Movements Abduction (protraction) scapula moves laterally away from spinal column Adduction (retraction) scapula moves medially toward spinal column Downward rotation returning inferior angle inferomedially Upward rotation toward spinal column & glenoid fossa to turning glenoid fossa upward & moving normal position inferior angle superolaterally away from spinal column Elevation upward or superior movement Depression i.e., shrugging shoulders downward or inferior movement i.e., returning to normal position • Shoulder girdle muscles – Stabilize scapula • maintain scapula in a relatively static position during shoulder joint actions • Provide stable base for shoulder muscles to move humerus – Move shoulder girdle • enhance movement of upper extremity when shoulder goes through extreme ranges of motion • Synergy with muscles of glenohumeral joint – At the extreme ranges of motion: • Scapular muscles move shoulder girdle to position glenoid fossa • Allows humerus more mobility – Without the accompanying scapula movement humerus can only be o raised into approximately 90 of total shoulder abduction & flexion. – Synergy between scapula & shoulder joint muscles enhances movement of entire upper extremity Scapulohumeral Rhythm scapular rotation to facilitate shoulder abduction 1st 30 of abduction little scapular rotation e.g., shoulder = 30 , scapula ≈ 6 o beyond 30 o for every 2 of shoulder movement, scapula rotates 1 o 2:1 ratio Five Primary Muscle Involved in Shoulder Girdle Movement 1. levator scapulae 2. trapezius 3. rhomboids 4. serratus anterior 5. pectoralis minor Shoulder Girdle Muscles Rhomboids Rhomboids Trapezius Trapezius Levator Levator Scapulae Scapulae Trapezius Pectoralis Minor Serratus Anterior Pectoralis Minor Rhomboids Pectoralis Minor Trapezius Levator Scapulae Serratus Anterior Trapezius muscle Upper fibers: elevation upward rotation Middle fibers: elevation retraction Lower fibers: depression upward rotation retraction Levator scapulae muscle elevation downward rotation Rhomboid muscles - major & minor retraction elevation downward rotation Pectoralis Minor Muscle depression protraction downward rotation Serratus Anterior Muscle Subclavius Muscle protraction Stabilization & protection of SC joint upward rotation depression protraction Scapula Protraction (abduction) Scapula moving laterally away from spinous processes without rotation e.g., Push-up & bench press (upward phase) Agonists Scapula Retraction (adduction) Pectoralis minor Serratus anterior Scapula moving medial toward the spinous processes without rotation (i.e, return from abduction) Agonists e.g., rowing Middle trapezius Rhomboids Scapula Upward Rotation Lateral & upward movement e.g., reaching arm over head Scapula Downward Rotation Downward & Medial Movement Glenoid Fossa is rotated downward when downward movement of shoulder joint occurs Agonists e.g., lat pull downs Pectoralis minor Scapula Elevation Rhomboid Superior movement of the scapula without rotation e.g., Shoulder shrugs Agonists Rhomboid Levator scapula Upper trapezius Scapula Depression Inferior movement of the scapula without rotation Agonists Lower trapezius Pectoralis minor Shoulder Joint Glenohumeral (GH) articulation – Articulation of the humerus and glenoid fossa – Designed for mobility (Most mobile in body) – Lacks bony and ligamentous support – Shallow glenoid fossa – Half-spherical humeral head • Wide range of motion of the shoulder joint in many different planes requires a significant amount of laxity • Common to have instability problems – Rotator cuff impingement – Subluxations & dislocations • The price of mobility is reduced stability • The more mobile a joint is, the less stable it is & the more stable it is, the less mobile Stability of GH – Passive, Static stabilizers- • articular surface, glenoid labrum, joint capsule and ligaments. – Fully sealed, which provides suction and resists a dislocating force at lower loads. – Dynamic support • occurs mostly at midrange of motion and is provided by the muscles as they contract in a coordinated pattern to compress the humeral head in the glenoid cavity. – Posterior Stability • The posterior rotator cuff muscles – Anterior Stability • Subscapularis • Long head of the biceps (superior humeral head translation) – The Deltoid and the other scapulothoracic muscles position the scapula to provide maximum GH stability. Supporting structures for shoulder Glenoid fossa is ¼ - ⅓ size of humeral head Glenoid labrum – Lip of cartilage surrounding the joint – Increases width and depth of fossa – Assists in holding the humerus in place Coracohumeral ligament – Stabilizes the humerus against superior and lateral displacement Glenohumeral ligament – Stabilizes the humerus against anterior displacement – Superior – Middle – Inferior Shoulder Joint Movements Abduction Adduction superior & lateral inferior & medial movement of humerus movement of humerus away from body Extension toward body movement of humerus straight posteriorly Horizontal adduction Flexion aka - transverse flexion movement of humerus movement of humerus in straight anteriorly transverse plane toward & across chest Horizontal abduction aka - transverse extension movement of humerus in transverse plane away from chest Internal (medial) rotation movement of humerus External (lateral) rotation medially around its long axis movement of humerus laterally around its long axis away from midline toward midline Shoulder Joint Shoulder Girdle Abduction Upward rotation Adduction Downward Rotation Flexion Elevations & Upward Rotation Extension Depression & Downwards Rotation Internal Rotation Protraction External Rotation Retraction Horizontal Adduction Protraction Horizontal Abduction Retraction Glenohumeral internal rotation deficit (GIRD) – difference in internal rotation range of motion between an individual’s throwing & non throwing shoulders – overhead athletes with a GIRD of greater than 20% had a higher risk of injury – stretching exercises recommended to regain internal rotation • improve performance • reduce likelihood of injury Muscles that Attach or Cross the Glenohumeral 1. Deltoid 2. Coracobrachialis 3. Teres major 4. Subscapularis 5. Supraspinatus 6. Infraspinatus 7. Teres minor 8. latissimus dorsi 9. pectoralis major Rotator Cuff Muscles Supraspinatus Infraspinatus Teres minor Subscapularis Deltoid Coracobrachialis Muscle Posterior fibers: abduction horizontal adduction flexion extension adduction horizontal abduction external rotation Teres Major Muscle internal rotation extension adduction Latissimus dorsi’s “little helper” Only effective when rhomboids stabilize scapula Pectoralis Major Muscle Clavicular head: Sternal head: flexion (up to 60 ) o extension horizontal adduction horizontal adduction internal rotation internal rotation adduction (<90 ) o adduction abduction (>90 ) o Latissimus Dorsi Muscle adduction extension internal rotation horizontal abduction downward rotation of the scapula Glenohumeral Flexion Agonists Anterior deltoid Pectoralis major (clavicular head) Glenohumeral Extension Agonists Teres major Latissimus dorsi Pectoralis major (sternal head) Deltoid Glenohumeral Abduction Agonists Deltoid Supraspinatus Pectoralis major (clavicular head) Glenohumeral Adduction Agonists Latissimus dorsi Teres major Pectoralis major (sternal head) Glenohumeral Internal Rotation Agonists Latissimus dorsi Teres major Subscapularis Pectoralis major (sternal head) Glenohumeral External Rotation Agonists Infraspinatus Teres minor Glenohumeral Horizontal Abduction Agonists Posterior deltoid Infraspinatus Teres minor Glenohumeral Horizontal Adduction Agonists Anterior deltoid Pectoralis major Coracobrachialis Elbow Complex Distal humerus Medial epicondyle • Attachment site for: Olecranon fossa Joint capsule • Deep depression on posterior surface of distal humerus Ulnar collateral ligament Superficial flexor muscles of the forearm • Proximal to the trochlea • Olecranon process (ulna) fits into Lateral epicondyle this notch when elbow is extended • Attachment site for: Radial collateral ligament Superficial extensor muscles of the forearm Capitulum • Hemispheric shape • Situated on anterior and distal aspect of humerus • Does not extend posteriorly Trochlea • Pulley-shaped surface • 330 surface area Radial & coronoid fossae • Shallow depressions on anterior surface of distal humerus • Proximal to the capitulum and trochlea, respectively • Allow close approximation between humerus and the radius and ulna during maximum elbow flexion • (Radial Head – Radial Fossa, Coronoid Process of Ulna – Coronoid Fossa) Proximal Ulna Larger than distal end Olecranon process • Hooklike projection • Extends proximally and anteriorly Coronoid process • Superior surface forms floor of trochlear notch • Lateral aspect is a smooth oval facet, i.e., radial notch Trochlear notch • Articulates with trochlea of the humerus Radial notch • Articulates with head of the radius Smaller than distal end Radial head • Disc-shaped expansion of proximal end of the radius • Proximal end is concave (fovea) Articulates with the capitulum (Humerus) • Rim articulates with radial notch (Ulna) Elbow Joint Hinge-type joint (Uni-Axial) Allows only flexion & extension 2 interrelated joints - Humeroulnar articulation - Humeroradial articulation Elbow Ligaments Radial (lateral) and ulnar (medial) collateral ligaments: support for the sides of the joint. Annular ligament: holds the proximal radioulnar joint together Ulnohumeral Joint • The joint is a union between the trochlea on the distal end of the humerus and the trochlear notch on the ulna. • On the front of the ulna is the coronoid process which makes contact in the coronoid fossa of the humerus, limiting flexion in the terminal stages of motion • On the posterior side is the olecranon process, which makes contact with the olecranon fossa on the humerus, terminating extension. Radial Collateral Ligament • Provides lateral stability • Resists varus torques • Prevents elbow adduction • Rarely injured Ulnar Collateral Ligament • Provides medial support • Resists valgus torques • Prevent elbow abduction • Many contact sports & throwing activities place stress on medial aspect of joint, resulting in injury Proximal Radioulnar Articulation • Pivot-type joint (uni-axial) • Minimal bony support • Annular ligament maintains radial head in its joint RadioUnlar joint • As the radius crosses over the ulna in pronation, the distal end of the ulna moves laterally. • Interosseus membrane is the site for muscular attachment and ensures that the radius and ulna maintain a specific relationship to each other. Lateral Epicondylitis “Tennis Elbow” – inflammation, soreness or pain on the outside (lateral) side of the upper arm near elbow. MOI = repetitive microtrauma to insertion of wrist extensor muscles Risk Factors – Repetitive gripping & twisting – Poor or improper technique – Poor or improper equipment Medial Epicondylitis “Golfer’s Elbow” – inflammation, soreness or pain on the inside (medial) side of the upper arm near elbow. MOI = repeated forceful wrist flexion and extreme valgus torque on the elbow Medial strain – initial forward phase of throw – hand and elbow lag behind trunk and shoulder Elbow Movements Flexion movement of forearm to shoulder by bending the elbow to decrease its angle Extension movement of forearm away from shoulder by straightening the elbow to increase its angle Pronation internal rotary movement of radius on ulna that results in hand moving from palm- up to palm-down position Supination external rotary movement of radius on ulna that results in hand moving from palm- down to palm-up position Muscles of the Elbow Flexion • Biceps Brachii • Brachialis • Brachioradialis • Pronator Teres Extension • Triceps Brachii • Anconeus Supination • Biceps Brachii • Supinator • Brachioradialis Pronation • Pronator Teres • Pronator Quadratus • Brachioradialis The Wrist Complex Bones 29 bones, including radius & ulna 8 carpal bones In 2 rows of 4 bones Form wrist 5 metacarpal bones Numbered 1-5 from thumb to little finger Join the wrist bones 14 phalanges (digits) 3 for each finger accept the thumb, which has only 2 Proximal, middle, & distal – Thumb has a sesamoid bone in its flexor tendon – Other sesamoids may occur in joints of fingers – Flexor Carpi Ulnarisgains some of its power by encasing the pisiform bone and using it as a sesamoid bone to increase MA. Distal Radius Dorsal tubercle • Grooved on either side for extensor tendons • Serves as pulley to redirect the pull of extensor pollicis longis Radial styloid process Ulnar (sigmoid) notch Distal surface • Articulates with the scaphoid and lunate • Biconcave, continuous articular surface • 10-15 anterior tilt • 15-25 medial tilt • Decreases shear forces on the distal radius Distal Ulna Seat of the ulna • Articulation with radius • ⅔ - ¾ of perimeter covered with articular cartilage Ulnar styloid process Fovea • Attachment for apex of fibrocartilaginous disc Pole • U-shaped articular surface • Articulation with fibrocartilaginous disc Carpus Comprised of 8 carpal bones • Proximal row scaphoid (boat-shaped) lunate (moon-shaped) triquetrum (three-cornered) pisiform (pea-shaped) • Distal row trapezium (greater multangular) trapezoid (lesser multangular) capitate (head-shaped) hamate (hooked) Metacarpals Miniature long bones – Proximal base • Thumb: saddle-shaped facet • Long fingers have flattened facets • Little finger somewhat saddle-shape • Variations allow distinct differences in mobility of carpometacarpal (CMC) articulations – Distal head • Almost perfectly round • Articular cartilage covers anterior and distal surfaces and extends lightly on the posterior surface • Allows slight hyperextension at metacarpophalangeal (MCP) joints. Phalanges 14 phalanges in the hand – 3 in each finger, 2 in thumb – prominent central groove on head of proximal and middle phalanges – Affects the direction of flexion/extension – Fingers converge towards the base of the thumb during flexion Sesamoid Bones – Typically found in tendons of the flexor pollicis brevis and adductor pollicis – Less common in the tendons distal to the MCP joints of the fingers Distal Radioulnar Articulation • Pivot-type joint • Minimal bony support – The ulna makes no actual contact with the carpals and is separated by a fibrocartilage disc. • Joint capsule and triangular fibrocartilage complex (TFCC) provide support • TFCC Triangular fibrocartilage Dorsal radioulnar ligament Volar radioulnar ligament Ulnar collateral ligament complex Meniscus homologue • This arrangement is important so that the ulna can glide on the disc in pronation and supination while not influencing wrist or carpal movements. Triangular Fibrocartilage Complex • Triangular fibrocartilage disc – fills the space between ulna and carpus • Dorsal radioulnar ligament – tight in pronation • Volar radioulnar ligament – tight in supination • Ulnar collateral ligament complex – inserts on pisiform and base of 5 metacarpal • Meniscus homologue – soft tissue that runs from dorsal border of the radius medially to the volar surface of the medial aspect of the triquetrum Radiocarpal Joint: Articulation between the radius and proximal row of carpal bones Only scaphoid and lunate articulate directly with the radius Triquetrum articulates with distal surface of triangular fibrocartilage Joint capsule enclose all surfaces Midcarpal Joint: Junction between the proximal and distal rows of carpal bones Medial compartment Proximal concavity: scaphoid, lunate and triquetrum Distal convexity: capitate and hamate Lateral compartment Distal scaphoid, trapezium and trapezoid Ligaments main source of support Intercarpal Joints Articulations between adjacent carpal bones within each row Stabilized by joint capsule and extrinsic and intrinsic ligaments Transverse carpal ligament – Supports entire carpal arch – Taut in max pronation and supination – Carpal tunnel syndrome • Contents of carpal tunnel are compressed Joints of the Fingers Metacarpophalangeal (MCP) joints • Condyloid Proximal interphalangeal (PIP) joints • Hinge joint Distal interphalangeal (DIP) joints • Hinge joint Thumb Joint • Hinge joint • Metacarpophalangeal • The thumb determines whether a fine precision position or power position is generated. Wrist Movements • Wrist – Flexion & extension – Abduction & adduction • Fingers – Flexion & extension – MCP joints also abduct & adduct Abduction & Adduction Middle phalange is reference point to differentiate abduction & adduction Abduction: Movement of the thumb, index & middle fingers laterally toward radial side of hand Movement of the ring & little fingers medially toward ulnar side of hand Adduction: Medial movement of thumb, index & middle fingers toward ulnar side of hand Lateral movement of ring & little finger toward radial side of hand is adduction Special Movements Opposition: movement of thumb across (palmar) aspect to oppose any or all of the phalanges Reposition: movement of thumb as it returns to anatomical position from opposition with hand and/or fingers Muscle Extrinsic muscles of wrist & hand grouped according to function & location 6 muscles move wrist but not fingers & thumb – 3 wrist flexors • flexor carpi radialis • flexor carpi ulnaris • palmaris longus *Variable (13% Missing) – 3 wrist extensors • extensor carpi radialis longus • extensor carpi radialis brevis • extensor carpi ulnaris 9 muscles primary movers of phalanges – Also involved in wrist joint actions – Generally weaker in their wrist actions – Flexors • Flexor digitorum superficialis • Flexor digitorum profundus • Flexor pollicis longus (thumb flexor) – Extensors • Extensor digitorum • Extensor indicis • Extensor digiti minimi • Extensor pollicis longus (thumb extensor) • Extensor pollicis brevis (thumb extensor) – Abductor of thumb & wrist • Abductor pollicis longus Intrinsic Muscles of the Hand Thenar eminence - muscular pad on palmar surface of 1 metacarpal t Hypothenar eminence - muscular pad that forms ulnar border on palmar surface
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'