Normal Shoulder Movement, Kinesiology_Exam_1

What muscles are involved in Elbow Flexion (3)

1) Brachialis 2) Biceps Brachii 3) Brachioradialis

What ligaments support the elbow joint?

1. Fibrous capsule 2. Annular ligament of radius 3. Collateral (radial, ulnar, oblique)

How many bones in the human body

206

Sagittal ( anteroposterior)

>Frontal horizational > flexion and extension

Frontal (lateral)

>Sagittal horizational > abduction and adduction

What is winging of the scapula?

A winged scapula is associated with damage or a contusion to the long thoracic nerve of the shoulder and / or weakness in the Serratus Anterior muscle. If the long thoracic nerve is damaged or bruised it can cause paralysis of the serratus anterior muscle and winging of the scapular or shoulder blade. The patient will no longer be able to left their arm above their head.

The shoulder girdle has two joints, one at either end of the clavicle which are

Acromioclavicular (AC) and Sternoclavicular (SC)

Acromioclavicular joint

Acromioclavicular joint (Netter Atlas plate 406) Plane synovial joint Bones involved Acromial end of the clavicle Acromion of the scapula Ligaments that support this joint Acromioclavicular ligament Coracoclavicular ligament Conoid ligament Trapezoid ligament Action - very small movements are possible under normal conditions

Deltoid orgin include

Anterior (clavicular) middle (acromial) and posterior (scapular)

The annular ligament runs between the

Anterior and posterior edge of the radial notch on the ulna and forms a ring completely around the head of the radius

Synergist

Any muscle helping a prime mover accomplish its action is known as _________.

Epiphyses

Are covered with articular cartilage

The lateral end of the clavicle is referred to

As the acromial end and the medial end is referred to as the sternal end

Explain how the humeral head moves in the glenoid fossa during arm abduction.

As the head of the humerus moves, it rolls like a ball, moving away from the center of the glenoid fossa. If there were no muscles or ligaments attaching to the humerus around the glenoid, then the humerus would fall out of the glenoid fossa.

Explain how coordinated motion of the scapula and humerus results in full active range of shoulder abduction

As the humerus abducts, the greater tubercle hits the acromion. This limits range of motion. However, by rotating the glenoid superiorly, and externally rotating the humerus, this clears the greater tubercle as well as the acromion. This involves motion of the humerus relative to the glenoid and motion of the scapula relative to the thorax. The rotation of the scapula is accomplished by the coordinated efforts of trapezius and of serratus anterior. Trapezius both retracts and superiorly rotates the glenoid fossa. Serratus anterior both protracts the scapula and superiorly rotates the glenoid fossa. Thus, the protraction and retraction are cancelled out, and the net effect is superior rotation of the glenoid. External rotation of the humerus is accomplished by teres minor and infraspinatus, two of the rotator cuff muscles. Abduction is accomplished thanks to supraspinatus and deltoideus. They both work together throughout abduction to raise the humerus. By clearing both of these obstacles, the humerus has a large range of motion through abduction of up to 180 degrees.

Shoulder (glenohumeral) joint

Ball and socket synovial joint Bones involved Glenoid cavity of the scapula Glenoid labrum Head of the humerus Ligaments that support the articular capsule Glenohumeral ligaments (3) Coracoacromial ligament Other features of the shoulder joint include: Tendon of the long head of the biceps brachii m. Transverse humeral ligament Subdeltoid bursa Action - flexion, extension, abduction, adduction, circumduction

Name the different types of bones

Bones are classified by their shape into four groups which are long bone, short bones, flat bone, and irregular bones. Sometimes sesamoid bones, which are small, nodular bones embedded in a tendon.

The ligaments that stabilize the wrist are

Capsular , volar(palmer) radiocarpal, dorsal radiocarpal, collateral, and intercarpal ligaments

Efferent nerves (motor nerves)

Carry impulses away from the central nervous system to the muscle tissues

Afferent nerves (sensory nerves)

Carry impulses from muscle, ligaments, tendons, and other tissues to the central nervous system

Proximal

Close

Wrist (radiocarpal) joint

Condyloid synovial joint Bones involved Distal end of the radius Proximal row of carpal bones Ligaments that support the articular capsule Ulnar collateral ligament Radial collateral ligament Action - flexion, extension, abduction, adduction, circumduction

Metacarpophalangeal joints

Digits 2-5 Condyloid synovial joints Ligaments that support the articular capsule Collateral ligaments Deep transverse metacarpal ligaments Action - flexion, extension, abduction, adduction, circumduction Thumb Saddle synovial joint Action - flexion, extension; limited abduction and adduction

Carpometacarpal joints

Digits 2-5 Plane synovial joints Action - small gliding movements between carpal bones and metacarpal bones Thumb Plane synovial joint with a loose joint capsule Action - flexion, extension, abduction, adduction, circumduction

Compare/contrast the structures that provide *dynamic stability* of the shoulder vs. those that provide static stability of the shoulder

Dynamic stabilization occurs due to the rotator cuff muscles, which wrap around the head of the humerus. *Supraspinatus* attaches to the top of the greater tubercle; *infraspinatus* attaches below it on the greater tubercle; and *teres minor* inserts most inferiorly on the greater tubercle. *Subscapularis* inserts on the lesser tubercle. These muscles wrap almost completely around the head of the humerus and help to pull it back into the glenoid fossa as the arm moves in different directions. More dynamic stabilization is needed than at other joints, due to the large range of motion permitted by the shouler. Other joints have bony shapes that limit movement (for example, the elbow) or very strong ligaments that restrict movement (like the cruciate ligaments of the knee). These joints have much more limited range of motion than the shoulder, and in these two cases are basically hinge joints.

Movement of shoulder girdle include

Elevation, depression, abduction, and adduction. The scapula moves in a relative manner.

Distal

Far

The GH joint allows movement of 3 things of the humerus which are

Flexion-Extension Abduction-Adduction Rotation (Medial and Lateral)

Glenohumeral joint has the most

Freedom of any other joint in the body

Explain the sequence of muscle activation during full 0-180 degrees of arm abduction

From 0-60 degrees: - The *deltoideus* muscle and *supraspinatus* muscle will work together to move the humerus into abduction. - All the rotator cuff muscles will be active to stabilize the humeral head in the glenoid fossa. From 60-120 degrees - The *trapezius* and *serratus anterior* muscles will be active to rotate the glenoid superiorly. - The *deltoideus* muscle and *supraspinatus* muscle will work together to move the humerus into abduction. - The rotator cuff muscles will be active to stabilize the humeral head in the glenoid fossa. - At aroud 90 degrees, *infraspinatus* and *teres minor* are also active to laterally rotate the humerus to clear the greater tubercle from the acromion. From 120-180 degrees - The *deltoideus* muscle and *supraspinatus* muscle will work together to move the humerus into abduction. - The rotator cuff muscles will be active to stabilize the humeral head in the glenoid fossa. - There is also some rotation of the clavicle here.

A flat bone

Get their name from their shape. ex. head, chest, shoulder.

Articulation between the scapula and humerus is also know as

Glenohumeral (GH) joint

A long bone

Has a shaft , known as the diaphysis and two two large prominence's at either end of the diaphysis known as the epiphyses.

Elbow joint

Hinge synovial joint Bones involved Trochlea of the humerus Trochlear notch of the ulna Capitulum of the humerus Head of the radius Ligaments that support the articular capsule Ulnar collateral ligament Radial collateral ligament Action - flexion and extension

Interphalangeal joints

Hinge synovial joints Ligaments that support the articular capsule Collateral ligaments Action - flexion and extension

Deltoid insertion point is the deltoid tuberosity of the

Humerus

The acromioclavicular joint is formed between the interaction of the acromial end of the clavicle and the acromion of the scapula. What is this joint's classification?

It is a plane or gliding joint.

Compare and contrast passive versus active range of motion testing in the physical exam. Explain what is indicated about joint structure and/or function when there is limitation of active and/or passive range of motion

Look for asymmetry of the muscles or the bony landmarks. Lack of symmetry could be due to muscle atrophy, fracture of a bone, or dislocation of a joint. A problem with active range of motion could be due to muscle weakness or could be limited by pain. If due to weakness, then passive range of motion will be normal. A problem with passive range of motion could again be limited by pain. In addition, it could be caused by scarring of the ligaments, tendons, or joint capsule; bone spurs, as in osteoarthritis; dislocation of the shoulder joint; freezing of the ligaments (as can occur with immobilization). If ligaments are frozen, they will have a hard end point. Inflammation can cause thickening of the shoulder capsule and restrict range of motion both actively and passively. Fibrosis can also cause freezing of the ligaments.

Proximal radioulnar articulation

Pivot synovial joint Bones involved Head of the radius Radial notch of the ulna Ligament that supports the articulation Anular ligament Action - pronation and supination

Distal radioulnar articulation

Pivot synovial joint Bones involved Ulnar notch of the radius Head of the ulna Action - pronation and supination

Intercarpal joints

Plane synovial joints Action - small gliding movements between adjacent carpal bones

A short bone

Possess no diaphysis and are fairly symmetrical. ex. wrist and ankle

Which muscles serve as pronators?

Pronator teres Pronator quadratus Brachioradialis

What do tendon sheaths do

Protect

Sternoclavicular joint

Saddle synovial joint Bones involved Manubrium of the sternum Sternal end of the clavicle Ligaments that support the articular capsule Interclavicular ligament Costoclavicular ligament Other joint features include Articular disc Movements of clavicle permitted - anteriorly, posteriorly, superiorly, inferiorly

Compare/contrast the structures that provide dynamic stability of the shoulder vs. those that provide *static stability* of the shoulder

Static stabilization occurs due to the labrum of the glenoid, which deepends the socket and creates negative pressure. In additions, ligaments at the shoulder particularly, glenohumeral ligaments, extend from the glenoid fossa to the humerus to help hold it in place. These ligaments have limited ability to stabilize the shoulder joint, because they must be loose enough to allow full range of motion. Particularly important are the anterior ligaments. During arm abduction, the glenohumeral ligaments are taut. During arm adduction, the coraco-humeral and transverse humeral ligaments are taut.

Which muscles serve as supinators?

Supinator muscle Biceps brachii

Intermediate radioulnar articulation

Syndesmosis Bones involved Radius Ulna Ligament that supports the articulation Interosseous membrane Action - pronation and supination

The tissue found between joint space

Synovial membrane lining the joint secretes synovial fluid for lubrication and provides nutrients to joint structures

The lighter portion of the A-band is known as

The H-zone

AC joint is incomplete and without an articulation disc unlike

The SC joint

The anatomy of the long bone

The epiphyseal plate separates the diaphysis from the end points(epiphysis). Periosteum tissue covers the outside of the bone.

Trapezius originates from

The external occiptal protuberance at the skull and the spinous process of all cervical and thoracic vertebrae

The glenohumeral joint is formed via the articulation between what two surfaces? Also what is its classification?

The glenohumeral joint is formed via the articulation between the glenoid and the head of the humerus. Its classification is a ball and socket joint.

The posterior (scapular) fibers originate from

The inferior edge of the spine of the scapula

Latissimus dorsi inserts on the edge of

The intertubercular groove on the anterior aspect of the humerus

The middle (acromial) fibers originate from

The lateral edge of the acromion process of the scapula

The anterior (clavicular) fibers originate from

The lateral portion of the anterior aspect of the clavicle

I-band (isotropic band)

The light colored portion made up mostly of the protein filament actin

Prime mover (agonist)

The main muscle producing a particular movement. Known typically to be opposed by another muscle

Trapezius inserts on the spine of

The scapula and posterior surface of the clavicle

Latissimus dorsi originates from

The spinous process of the lower six thoracic and all five lumber vertebra, the posterior aspect of the illium, the lower three ribs and the inferior angle of the scapula; passes beneath the axilia (armpit)

An Irregular bone

Unable to be classified in other categories. ex. vertebra

Horizontal (transverse)

Vertical > rotation

External rotation (lateral rotation)

When the anterior (front) surface of the arm or leg rotates laterally (away from the midline of the body)

Internal rotation (medial rotation)

When the anterior surface of the arm or leg rotates medially (toward the midline of the body)

The three ligaments of the shoulder include

capsular ligament, glenohumeral and caracohumeral

Structures that are important for attachment for soft tissue include

deltoid tubercle, conoid tubercle, trapezoid line, costal tuberosity, and subclavian groove

Movements of the thumb include

extension (frontal plane) flexion (frontal plane) adduction (sagittal plane) abduction (sagittal plane) opposition

The joint found at the elbow is a hinge joint. What is the other name that is also considered to be synonymous with a hinge?

ginglymus is synonymous with hinge when performing a synovial classification of the joint at the elbow.

The scapula has many bones prominences which include

lateral and medial borders and the inferior angle at the junction of the two borders

Superior glenohumeral ligament runs between the upper surface of the

lesser tuberosity of the humerus and superior edge of the glenoid of the scapula

Extension in the wrist occurs primary from

midcarpal joints

Sternoclavicular is responsible for

movements in all directions

The sternoclavicular joint, which forms between the clavicular notch of the sternum and the clavicle is classified as what type of joint?

sellar

The scapula is considered a bone of both the

shoulder girdle and the shoulder joint

Two bones make up the structure known as the

shoulder girdle which are the clavicle and the scapula

Acromioclavicular is responsible for the

slight gliding movement between the two bones of the joint (elevating and depression)

Middle and inferior glenohumeral ligaments assist with

superior glenohumeral

Capsular ligament attaches the anatomical neck of the humerus and

the circumference of the glenoid of the scapula

A-band

the dark-colored area made up mostly of the filament myosin

A sarcomere is

the portion of a myofibril that appears between two Z lines

The six primary muscles involved in producing movement of the shoulder include

(anterior) Pectoralis minor, serratus anterior, subclavian and (posterior) levator scapulae, rhomboids and trapezius