Kinesiology Exam 4 [Shoulder, Elbow, And Forearm]

Front 1

what four joints are included in the shoulder complex?

Back 1

(1) sternoclavicular
(2) acromioclavicular
(3) glenohumeral
(4) scapulothoracic

Front 2

the scapular plane is __-__º anterior to the frontal plane

Back 2

30-40

Front 3

another name for arm elevation in the scapular plane

Back 3

scaption

Front 4

this movement allows the naturally retroverted humeral head to fit more directly into the glenoid

Back 4

scaption

Front 5

during scaption, what muscle fibers become oriented for the best mechanical advantage?

Back 5

supraspinatus

Front 6

what 6 motions occur at the scapulothoracic joint?

Back 6

(1) upward/downward rotation
(2) anterior/posterior tilting
(3) internal/external rotation
(4) abduction and adduction
(5) elevation/depression
(6) winging (ABNORMAL)

Front 7

what joint do upward and downward rotation occur at?

Back 7

AC

Front 8

movement of the scapula in which the inferior angle moves laterally and the glenoid fossa rotates cranially; aka lateral rotation

Back 8

upward rotation

Front 9

movement of the scapula in which the inferior angle moves medially and the glenoid rotates caudally; aka medial rotation

Back 9

downward rotation

Front 10

a movement in which the scapula translates along the ribcage in a cranial direction

Back 10

elevation

Front 11

a movement in which the scapula translates along the ribcage in a caudal direction

Back 11

depression

Front 12

the scapula translates medially along the rib cage toward the vertebral column; this movement often occurs with external rotation

Back 12

adduction

Front 13

what other movement does scapular adduction usually occur with?

Back 13

external rotation

Front 14

the scapula translates laterally along the rib cage away from the vertebral column; this movement often occurs with internal rotation

Back 14

abduction

Front 15

what other movement does scapular abduction usually occur with?

Back 15

internal rotation

Front 16

what is the axis for internal and external rotation of the scapula?

Back 16

vertical

Front 17

these motions occur about an axis parallel to the scapular spine at the AC joint

Back 17

anterior/posterior tilt

Front 18

movement in which the coracoid moves anteriorly and caudally while inferior angle moves posteriorly and cranially

Back 18

anterior tilt

Front 19

movement in which the coracoid moves posteriorly and cranially while the inferior angle moves anterior and caudally

Back 19

posterior tilt

Front 20

rotation of the scapula about a vertical axis at the AC joint, in which the lateral border of the scapula moves anteromedialy and the vertebral border moves posterolaterally so that the costal surface faces more towrad the midline of the body

Back 20

internal rotation

Front 21

movement of the scapula in which the lateral border of the scapula moves posterolaterally and the vertebral border moves anteromedially so the costal surface faces more away from the midline of the body

Back 21

external rotation

Front 22

abnormal movement of the scapula about a vertical axis; in which the vertebral border moves in a posterior and lateral direction away from the ribcage

Back 22

winging

Front 23

winging occurs via excess of what scapular motion?

Back 23

internal rotation

Front 24

what type of joint is the sternoclavicular joint?

Back 24

saddle

Front 25

this joint is the medial end of the clavicle corresponding with the sternum

Back 25

sternoclavicular joint

Front 26

is the clavicle convex or concave along the longitudinal axis?

Back 26

convex

Front 27

is the clavicle convex or concave along the transverse axis?

Back 27

concave

Front 28

this structure at the sternoclavicular joint attaches to the clavicle, costocartilage, and 1st rib, and stabilizes and increases the joint surface area while also absorbing force

Back 28

articular disc

Front 29

what three structures does the articular disc of the sternoclavicular joint attach to?

Back 29

(1) clavicle
(2) costocartilage
(3) 1st rib

Front 30

this ligament of the SC joint runs from the clavicle to the first rib

Back 30

costoclavicular

Front 31

these two ligaments of the SC joint run from the clavicle to the manubrium of the sternum

Back 31

anterior and posterior sternoclavicular

Front 32

this ligament of the SC joint joins the clavicular heads

Back 32

interclavicular

Front 33

what three movements cause the costoclavicular ligament to be taut?

Back 33

(1) elevation
(2) protraction
(3) retraction

Front 34

what movements do the anterior and posterior sternoclavicular ligaments prevent?

Back 34

anterior and posterior dislocation

Front 35

the interclavicular ligament provides stability to the __ aspect of the SC joint

Back 35

superior

Front 36

during arm elevation, the clavicle at the SC joint does what three motions?

Back 36

(1) rotates posteriorly along a long axis
(2) retracts
(3) elevates

Front 37

this movement occurs when the lateral or distal end of the clavicle moves posterior

Back 37

retraction

Front 38

how many degrees of elevation occurs at the SC joint?

Back 38

45º

Front 39

how many degrees of depression occurs at the SC joint?

Back 39

10º

Front 40

how many degrees of protraction occurs at the SC joint?

Back 40

15-30º

Front 41

how many degrees of retraction occurs at the SC joint?

Back 41

15-30º

Front 42

how many degrees of rotation occurs at the SC joint?

Back 42

40-50º

Front 43

what is the axis for clavicular elevation and depression?

Back 43

anterior-posterior

Front 44

what is the axis for clavicular protraction and retraction?

Back 44

vertical

Front 45

what is the axis for rotation of the clavicle?

Back 45

longitudinal

Front 46

for protraction and retraction at the SC joint, a __ clavicle is articulating on a __ sternum

Back 46

concave, convex

Front 47

for elevation and depression at the SC joint, a __ clavicle is articulating on the __ sternum

Back 47

convex, concave

Front 48

what three motions are occurring when the arm is elevating from 0-120º?

Back 48

(1) flexion
(2) abduction
(3) scaption

Front 49

what movement contributes the most during arm elevation at the SC joint?

Back 49

posterior axial rotation

Front 50

what is the predominate motion that occurs at the SC joint during arm movement?

Back 50

posterior axial rotation of the clavicle

Front 51

clavicular retraction occurs greatest with what humeral movement?

Back 51

abduction

Front 52

what is the order of clavicular retraction movement?

Back 52

humeral abduction>scapular plane abduction>flexion

Front 53

clavicular elevation occurs greatest with what motion?

Back 53

abduction

Front 54

during clavicular posterior axial rotation, what two movements does the scapula do?

Back 54

upward rotation and posterior tilt

Front 55

during clavicular elevation, what two movements does the scapula do?

Back 55

upward rotation and anterior tilt

Front 56

the clavicle is retracted approximately __º from the frontal plane in normal alignment

Back 56

20

Front 57

this joint is the articulation of the acromion process with the lateral end of the clavicle

Back 57

acromoclavicular joint

Front 58

what three things provide stability to the acromioclavicular joint?

Back 58

(1) capsule
(2) acromioclavicular ligament
(3) coracoacromial ligaments

Front 59

this ligament runs from the acromion to the distal end of the clavicle; both superior and inferior

Back 59

acromioclavicular

Front 60

what does the acromioclavicular ligament prevent?

Back 60

separation of the clavicle and acromion

Front 61

these ligaments run from the inferior surface of the clavicle to the coronoid process (do not cross the joint)

Back 61

coracoclavicular (trapezoid and conoid)

Front 62

what three movements occur at the AC joint (movement of the scapula relative to the clavicle)

Back 62

(1) upward/downward rotation
(2) internal/external rotation
(3) tilting/tipping

Front 63

these motions at the AC joint occur about an axis oriented in an anterior posterior direction, perpendicular to the scapular plane

Back 63

upward and downward rotation

Front 64

these movements at the AC joint occur at a vertical axis from the scapula to the clavicle

Back 64

internal and external rotation

Front 65

in this movement at the AC joint, the medial border of the scapula pivots away fro the thorax and the glenoid will turn more anterior

Back 65

internal rotation

Front 66

in this movement at the AC joint, the medial border of the scapla moves toward the posterior thorax and the glenoid faces laterally

Back 66

external rotation

Front 67

what is the axis for anterior and posterior tipping at the AC joint?

Back 67

medial to lateral

Front 68

at the AC joint during arm elevation, what seems to be the predominate motion of the scapula relative to the clavicle?

Back 68

posterior tilting (19º)

Front 69

what is the progression of AC joint motion during arm elevation?

Back 69

posterior tilt>upward rotation>internal rotation

Front 70

which AC joint ligament's tautness causes the clavicle to be pulled into posterior axial rotation, allowing further upward rotation of the scapula?

Back 70

coracoclavicular

Front 71

this joint is not a true joint, and movements that occur here are a result of movements at the SC and AC joints

Back 71

scapulothoracic joint

Front 72

what is the ratio of scapulohumeral rhythm?

Back 72

2:1

Front 73

this phase of the scapulohumeral rhythm describes the initial scapular motion during arm elevation

Back 73

setting phase

Front 74

what is the degree of motion in the setting phase of abduction?

Back 74

30º

Front 75

what is the degree of motion in the setting phase of flexion?

Back 75

60º

Front 76

what three things are important to consider with scapular upward rotation?

Back 76

(1) glenoid position
(2) length-tension relationship of the deltoid and supraspinatus
(3) subacromial space volume

Front 77

what two motions does the scapula do as the arm is elevating?

Back 77

upward rotation and posterior tilt

Front 78

during humeral abduction, the scapula appears to do what motion?

Back 78

external rotation

Front 79

during humeral flexion, what does the scapula do?

Back 79

it may internally rotate but by end range slight external rotation should be achieved

Front 80

this motion at the scapulothoracic joint is primarily achieved from posterior axial rotation of the clavicle at the SC joint and upward rotation of the scapula relative to the clavicle at the AC joint

Back 80

upward rotation

Front 81

this motion at the scapulothoracic joint is primarily from posterior tilt of the scapula relative to the clavicle at the AC joint

Back 81

posterior tlt

Front 82

this motion at the scapulothoracic joint is from clavicular retraction at the SC joint and external rotation at the AC joint (scapula relative to the clavicle)

Back 82

external rotation

Front 83

the scapula upwardly rotates __-__º with full arm elevation

Back 83

50-60º

Front 84

at end range of arm elevation, the acromion should be level with what vertebrae?

Back 84

C6-C7

Front 85

the scapula remains approximately __ inches from the spine during motion

Back 85

3

Front 86

at the end range of shoulder flexion, the scapular orientation should be __-__º anterior to the frontal plane

Back 86

10-20

Front 87

at the end range of shoulder flexion, the scapular orientation should be __-__ posterior tilt

Back 87

5-10

Front 88

normal scapular posture is about __º of anterior tilt

Back 88

9

Front 89

what vertebrae does the scapula rest between?

Back 89

T2-T7

Front 90

a forward head and rounded shoulder causes greater range of what three movements during shoulder flexion?

Back 90

(1) internal rotation
(2) anterior tilt
(3) upward rotation

Front 91

in what three directions is the humeral head directed at the glenohumeral joint?

Back 91

(1) medial
(2) posterior
(3) tilted upward

Front 92

in what two directions is the glenoid fossa directed at rest?

Back 92

(1) lateral
(2) upward at a 5º tilt

Front 93

the lack of what scapular motion can cause instability at the glenohumeral joint?

Back 93

upward rotation

Front 94

elevation of the arm pulls what part of the capsule of the GH joint taut?

Back 94

inferior

Front 95

what is the closed pack position of the GH joint?

Back 95

maximum abduction with lateral rotation

Front 96

what part of the GH capsule is tensed with full internal rotation?

Back 96

posterior

Front 97

what part of the GH capsule is tensed with full external rotation?

Back 97

anterior

Front 98

what is the normal capsular pattern of restriction at the glenohumeral joint (what motions are restricted and in what order)?

Back 98

external rotation limited>abduction>internal rotation>/= flexion

Front 99

what GH ligament is taut with full adduction?

Back 99

superior

Front 100

what GH joint ligament is taut with external rotation?

Back 100

middle

Front 101

what GH joint ligament is taut with abduction?

Back 101

inferior

Front 102

what part of the inferior GH ligament is taut with external rotation?

Back 102

anterior band

Front 103

what part of the inferior GH ligament is taut with internal rotation?

Back 103

posterior band

Front 104

which GH ligament is a main stabilizer of the shoulder?

Back 104

inferior band

Front 105

this ligament runs from the coracoid process to the greater tubercle of the humerus

Back 105

coracohumeral ligament

Front 106

what four motions cause the coracohumeral ligament to become taut?

Back 106

(1) lateral rotation
(2) flexion
(3) extension
(4) adduction

Front 107

what two things does the coracohumeral ligament restrict?

Back 107

(1) posterior glide
(2) inferior displacement

Front 108

this ligament runs from the coracoid to the acromial process and prevents superior dislocation and may provide protectio to the subdeltoid bursae and supraspinatus tendon

Back 108

coracoacromial ligament

Front 109

what are the four static factors that contribute to glenohumeral stability?

Back 109

(1) capsule, ligaments, and labrum
(2) negative intraarticular pressure
(3) joint geometry-glenoid tilted 5º
(4) rotator cuff muscle bulk and stiffness

Front 110

what is the dynamic factor that contributes to GH joint stability?

Back 110

rotator cuff muscle contraction (increased compression and ligaments are tightened with motion)

Front 111

how many degrees of flexion occur at the GH joint?

Back 111

120º

Front 112

how many degrees of extension occur at the GH joint?

Back 112

55º

Front 113

how many degrees of abduction occur at the GH joint?

Back 113

120º

Front 114

how many degrees of horizontal adduction occur at the GH joint?

Back 114

45º

Front 115

how many degrees of internal rotation with the arm abducted occur at the GH joint?

Back 115

70º

Front 116

how many degrees of external rotation with the arm abducted occur at the GH joint?

Back 116

90º

Front 117

how many degrees of external rotation with the arm at the side occur at the GH joint?

Back 117

70º

Front 118

what direction are the roll and slide for GH joint abduction?

Back 118

superior roll, inferior glide

Front 119

what can a lack of inferior glide during GH joint abduction cause?

Back 119

impingement of the structures in the subacromial space

Front 120

during external rotation at the GH joint with the arm at the side, what are the directions of the roll and glide?

Back 120

posterior roll, anterior glide

Front 121

during internal rotation at the GH joint with the arm at the side, what are the directions of the roll and glide?

Back 121

anterior roll, posterior glide

Front 122

spinning of the humeral head in the glenoid occurs when the axis of motion is __ to the joint surface

Back 122

perpendicular

Front 123

in what two instances does spinning of the humeral head on the glenoid occur?

Back 123

(1) humeral flexion
(2) humeral IR/ER with the arm at 90º abduction

Front 124

in what two instances does the roll and glide occur in opposite ways at the GH joint?

Back 124

(1) humeral abduction
(2) humeral IR/ER with the arm at the side

Front 125

to increase humeral external rotation with the arm at the side, what type of mobilization would you want to do?

Back 125

anterior glide

Front 126

what is the weakest region of the GH joint?

Back 126

inferior

Front 127

in what region/direction would you most easily sublux the humeral head?

Back 127

anterior/inferior

Front 128

what is often an indication of insufficient upward rotation of the scapula during arm elevation?

Back 128

the inferior angle of the scapula does not reach the midaxillary line

Front 129

what does it mean when there is greater flexion with the arm in medial rotation (as compared to the other arm)?

Back 129

the GH joint has developed greater flexibility to compensate for a lack of scapular upward rotation

Front 130

what are the five axioscapular muscles (from scapula to thorax)?

Back 130

(1) serratus anterior
(2) trapezius
(3) rhomboids
(4) levator scapulae
(5) pectoralis minor

Front 131

what are the 6 scapulohumeral muscles?

Back 131

(1) deltoid
(2) supraspinatus
(3) infraspinatus
(4) subscapularis
(5) teres major
(6) teres minor

Front 132

what are the two axiohumeral muscles (from thorax to humerus)?

Back 132

(1) latissimus dorsi
(2) pectoralis major

Front 133

this muscle's capability for scapular upward rotation and posterior tilt is the best of all the scapular muscles

Back 133

serratus anterior

Front 134

this muscle pulls the scapula forward on the thorax, and can externally rotate the scapula; also stabilizes it against the ribs

Back 134

serratus anterior

Front 135

how many divisions are there of the serratus anterior muscle?

Back 135

3 (upper, middle, lower)

Front 136

what division of the serratus anterior muscle is responsible for anchoring the scapula on the thorax and can ER and provide a slight UR force?

Back 136

upper

Front 137

which portion of the serratus anterior has moderate ER and UR capability?

Back 137

middle

Front 138

which portion of the serratus anterior stabilizes and moves the scpula; has 2x the UR moment arm vs the other muscles, and is also the best moment arm for posterior tilt?

Back 138

lower

Front 139

what muscle retracts and elevates the clavicle by acting at the SC joint?

Back 139

upper trap

Front 140

what two motions does the upper trap do at the SC joint?

Back 140

retraction and elevation of the clavicle

Front 141

both the middle and the lower trapezius act at what joint?

Back 141

AC joint

Front 142

what two motions does the middle trapezius do?

Back 142

scapular adduction and external rotation

Front 143

what four motions does the lower trapezius do?

Back 143

(1) external rotation (2x ability of middle)
(2) upward rotation
(3) minimal posterior tilt
(4) scapular depression

Front 144

what are the two actions that the trapezius has on the cervical spine?

Back 144

(1) extension
(2) rotation of vertebrae to contralateral side

Front 145

what two muscles form the force couple for scapular upward rotation?

Back 145

trapezius and serratus anterior

Front 146

what two motions appear to be decreased in patients with impingement syndrome?

Back 146

scapular upward rotation and posterior tilt

Front 147

if someone does not have appropriate scapular upward rotation, what motions would you advice them to avoid repeating?

Back 147

flexion and abduction of the shoulder

Front 148

appropriate upward rotation is necessary to maintain the correct length tension relationship of what muscle to prevent excessive shortening?

Back 148

deltoid

Front 149

what four motions do the rhomboids do?

Back 149

(1) scapular ER
(2) scapular adduction
(3) scapular elevation
(4) scapular downward rotation

Front 150

what muscle is a prime stabilizer of the scapula during humeral motions with the arms below 90º?

Back 150

rhomboids

Front 151

what five motions does the levator scapulae do?

Back 151

(1) scapular ER
(2) scapular downward rotation
(3) scapular elevation
(4) scapular adduction
(5) slight scapular anterior tilt

Front 152

what two motions of the scapula are decreased with cervical flexion (50º)?

Back 152

upward rotation and posterior tilt

Front 153

shortness or stiffness of what three muscles will limit scapular upward rotation?

Back 153

(1) latissimus dorsi
(2) rhomboids
(3) levator scapulae

Front 154

lengthening of the pectoralis minor occurs when the arm is elevated into what two positions?

Back 154

(1) flexion
(2) scaption

Front 155

subjects with short pectorals minors had greater __ __ during humeral elevation

Back 155

anterior tilt

Front 156

this muscle group acts to abduct the humerus

Back 156

deltoids

Front 157

what two motions does the anterior deltoid do?

Back 157

(1) humeral IR
(2) horizontal adduction

Front 158

what motion does the middle deltoid do?

Back 158

(1) humeral abduction

Front 159

what two motions does the posterior deltoid do?

Back 159

(1) humeral ER
(2) horizontal abduction

Front 160

what muscle has a larger moment arm at the beginning range of humeral abduction?

Back 160

supraspinatus

Front 161

what muscle acts to compress the humeral head into the glenoid, providing dynamic stability to the GH joint?

Back 161

supraspinatus

Front 162

contraction of the supraspinatus, infraspinatus, and subscapularis exert an __ force on the humeral head to offset superior migration

Back 162

inferior

Front 163

at what point of the range does the rotator cuff provide active tension to the GH joint?

Back 163

midrange

Front 164

at what point of the range does the rotator cuff provide passive tension to the GH joint?

Back 164

at rest and extreme joint positions

Front 165

loss of function of the rotator cuff muscles may result in __ movement of the humeral head becuase of the dominant pull of the deltoid

Back 165

superior

Front 166

given a patient with humeral superior glide and rotator cuff weakness, would you prefer to have the patient exercise with the arm moving into flexion or abduction?

Back 166

flexion (because less of the deltoid is working, causing less superior glide and compression)

Front 167

is the empty can or full can exercise preferred to exercise the supraspinatus?

Back 167

full can (decreases chance of impingement)

Front 168

the humerus needs to be in what position in order to use the biceps tendon to create a downward force on the humeral head?

Back 168

external rotation

Front 169

the rupture of this tendon removes the physical restraint to the humeral superor glide as well as the loss of active function

Back 169

supraspinatus

Front 170

the painful arc of motion between 60 and 120º is associated with rupture of what muscle tendon?

Back 170

supraspinatus

Front 171

what five muscles are humeral internal rotators?

Back 171

(1) subscapularis
(2) teres major
(3) latissimus dorsi
(4) pectoralis major
(5) anterior deltoid

Front 172

which of the humeral internal rotators attaches closest to the axis of motion and is therefore the best controller of motion?

Back 172

subscapularis

Front 173

what is the largest of the rotator cuff muscles, and the weakness of it contributes to anterior GH joint laxity?

Back 173

subscapularis

Front 174

contraction of what four muscles can internally rotate the scapula?

Back 174

(1) infraspinatus
(2) teres minor
(3) teres major
(4) posterior deltoid

Front 175

what three muscles oppose scapular IR?

Back 175

(1) rhomboids
(2) trapezius
(3) serratus anterior

Front 176

shortness of the posterior scapulohumeral muscles may pull the scapula into what position during arm elevation?

Back 176

upward rotation

Front 177

at rest, shortness of the supraspinatus/deltoid results in what two motions?

Back 177

humeral abduction and/or scpaular downward rotation (maybe some depression as well)

Front 178

with the arm in flexion, the long head of the biceps acted as an __ rotator

Back 178

internal

Front 179

with the arm in abduction, the long head of the biceps acted as an __ rotator

Back 179

external

Front 180

these two muscles, by virtue of their humeral insertion, can pull the scapula forward on the thorax and into internal rotation

Back 180

pec major and lats

Front 181

what are the four primary muscles involved in shoulder extension/adduction?

Back 181

(1) latissimus dorsi
(2) pectoralis major
(3) teres major
(4) posterior deltoid

Front 182

what muscles stabilize shoulder extension/adduction?

Back 182

rhomboids, rotator cuff

Front 183

contraction of the pectoralis major pull the humerus in what direction?

Back 183

anterior

Front 184

humeral impairments may be more noticeable during what arm motion?

Back 184

abduction

Front 185

what two possible contributing factors of muscle are there for decreased scapular upward rotation?

Back 185

(1) decreased performance of upward rotators
(2) short/stiff or dominant downward rotators

Front 186

what two possible contributing factors of muscle are there for decreased scapular elevation?

Back 186

(1) deficiency of elevation forces (long elevators)
(2) short/stiff or dominant depressors

Front 187

what two possible contributing factors of muscle are there for scapular winging/tilting?

Back 187

(1) deficient scapulothoracic muscle timing
(2) excessive activity in the pectoralis minor and scapulohumeral mucsles

Front 188

what are two possible contributing factors for excessive humeral superior glide?

Back 188

(1) weakness of the rotator cuff (deltoid more dominant)
(2) capsular restriction

Front 189

what are two possible contributing factors for excessive humeral anterior glide?

Back 189

(1) deficiency of anterior structures (such as subscapularis weakness or laxity of anterior capsule)
(2) dominance of posterior structures (posterior deltoid, short/stiff posterior capsule and muscles)

Front 190

what stage of the tennis serve ends with the ball release from the left hand, has low forces, and there are no extremes of joint position here?

Back 190

stage 1-wind up

Front 191

what stage of the tennis serve is a gradual build up of power in the LEs greater than the UEs, and the shoulder moves into abduction and ER?

Back 191

stage 2-early cocking

Front 192

what stage of the tennis serve is a gradual build up of power, and full abduction and ER of the shoulder; need both static and dynamic stability, and there is an extreme of joint positions

Back 192

stage 2-late cocking phase

Front 193

what stage of the tennis serve is a release of power, starts when arm moves toward IR and ends with ball contact; requires power from shoulder IR, triceps, wrist flexors ?

Back 193

stage 3-acceleration

Front 194

what stage of the tennis serve is primarily eccentric muscle activity to decelerate the arm, and stress to posterior GHJ structures occurs, which may lead to stiffness/shortness posteriorly?

Back 194

follow through

Front 195

what phase of the baseball pitch is when there is flexion of the stride leg, flexion of extremities, and ends when the ball is removed from the glove?

Back 195

stage 1-windup

Front 196

what phase of the baseball throw is when the shoulder is is abduction, horizontal abduction, and external rotation?

Back 196

phase 2-early cocking

Front 197

what phase of the baseball throw starts with the contact of the stride foot with the ground; arm moves into maximal ER while staying abducted, and the trunk rotates forward?

Back 197

phase 3-late cocking

Front 198

what stage of the baseball pitch starts as soon as the arm moves toward IR from ER and ends with the ball release, and is a high velocity movement?

Back 198

phase 4-acceleration

Front 199

what stage of the baseball pitch is when deceleration of the arm occurs, dissipating forces; requires the posterior cuff, especially the teres minor and the subscapularis is also active to control humeral head; high distraction forces

Back 199

phase 5-follow through

Front 200

athletes, especially those that throw, often have increased range into what motion?

Back 200

humeral external rotation

Front 201

the __ capsule gets repetitive microtrauma during the follow through or deceleration phase of throwing sports, causing a posterior contracture

Back 201

posterior

Front 202

what type of joint is the elbow joint?

Back 202

compound synovial joint
hinge joint

Front 203

what are the two components of the TRUE elbow joint?

Back 203

(1) humeroulnar joint
(2) humeroradial joint

Front 204

what type of joint is the humeroulnar joint?

Back 204

true hinge or modified hinge

Front 205

what type of joint is the humeroradial joint?

Back 205

arthrodial or gliding joint

Front 206

which direction is the axis of the elbow joint and what does it run through medially and laterally?

Back 206

medial to lateral; through epicondyle medially and capitulum laterally

Front 207

pulley shaped articular surface of distal humerus with a central groove

Back 207

trochlea

Front 208

anterior 1/2 of sphere at distal end of humerus that lies lateral to the trochlea

Back 208

capitulum

Front 209

the trochlea lies in front of the shaft of the humerus at a __º angle

Back 209

45

Front 210

the contact of the coronoid process with the humerus occurs only when the two bones are almost __

Back 210

parallel

Front 211

the boney structure of the trochlea of the humerus accounts for the __ __; the groover is vertical anteriorly but angled obliquely

Back 211

carrying angle

Front 212

is the medial or lateral lip of the trochlea increased in depth?

Back 212

medial

Front 213

what is the normal range of carrying angle?

Back 213

2-26º

Front 214

what is the functional consequence of the carrying angle?

Back 214

in full elbow extension the forearm is at an angle with the upper arm

Front 215

is the carrying angle greater in women or men?

Back 215

women

Front 216

what are three things that can alter the normal carrying (valgus) angle?

Back 216

(1) muscle pull
(2) laxity of ligaments
(3) bony or articular changes

Front 217

stiff wrist or finger __ may increase valgus forces at the elbow

Back 217

extensors

Front 218

a torn ___ ligament may increase elbow valgus

Back 218

MCL

Front 219

the trochlea is __ superior to inferior and __ medial to lateral

Back 219

concave; convex

Front 220

the head of the radius is __ proximally for flexion and extension

Back 220

concave

Front 221

the head of the radius articulates with the __ of the humerus

Back 221

capitulum

Front 222

the humeroradial joint functions during what two motions?

Back 222

(1) flexion/extension
(2) pronation/supination

Front 223

the radius migrates proximally during forearm __

Back 223

pronation

Front 224

what are the two joints that are contained within the elbow joint capsule?

Back 224

true elbow joint (humeroradial and humeroulnar)
proximal radioulnar joint

Front 225

what are the three muscles that the elbow joint capsule is closely related to?

Back 225

(1) brachialis
(2) triceps
(3) anconeus

Front 226

these two ligaments are thickenings of the elbow joint capsule medially and laterally; they function to prevent sidways movements and to keep the articular surfaces together

Back 226

collateral ligaments

Front 227

this band of the lateral collateral ligament is taut throughout flexion and extension

Back 227

anterior band

Front 228

this band of the lateral collateral ligament is from the latearl epicondyle to the supinator tubercle, and is the PRIMARY restraint to varus stress

Back 228

inferior band (lateral ulnar collateral ligament)

Front 229

what does varus instability manifest as clinically (from an injury to the LUCL)?

Back 229

posterolateral rotary instability

Front 230

the lateral collateral ligament complex is intimately blended with the origin of what two muscles?

Back 230

supinator and ECRB

Front 231

the lateral collateral ligament complex helps to reinforce what joint within the true elbow joint?

Back 231

humeroradial joint

Front 232

how many bands are there in the medial collateral ligament?

Back 232

3 (anterior, posterior, oblique)

Front 233

this band of the MCL is the primary stabilizer of the elbow to valgus stress from 20-120º

Back 233

anterior

Front 234

this part of the anterior band of the MCL is taut with elbow extension

Back 234

anterior

Front 235

this part of the anterior band of the MCL is taut with elbow flexion

Back 235

posterior

Front 236

this band of the MCL helps restrain valgus forces at 120º of flexion, and is taut with flexion

Back 236

posterior

Front 237

what are four activities that could cause valgus forces at the elbow, putting a strain on the MCL (especially the anterior band)?

Back 237

(1) tennis serve
(2) baseball pitch
(3) resisted shouler medial rotation
(4) resisted shoulder horizontal adduction

Front 238

the MCL is closely related to what three structures?

Back 238

(1) triceps
(2) FCU
(3) ulnar nerve

Front 239

the cubital tunnel is formed by what two structures on the lateral side of the ulnar nerve?

Back 239

elbow joint and MCL

Front 240

the cubital tunnel is formed by what structure on the medial side of the ulnar nerve?

Back 240

fibrous aponeurosis between the two heads of the FCU

Front 241

what nerve runs through the cubital tunnel?

Back 241

ulnar nerve

Front 242

the cubital tunnel decreases in size by __% as you flex your elbow, which increases the pressure on the ulnar nerve

Back 242

55

Front 243

what is the normal range of active elbow flexion?

Back 243

145º

Front 244

what is the normal range of passive elbow flexion?

Back 244

160º

Front 245

what are five things that can limit the passive flexion range of motion of the elbow joint?

Back 245

(1) radius impacting radial fossa
(2) coronoid process on the coronoid fossa
(3) tension of the posterior capsule
(4) passive tension of extensor muscles and skin
(5) posterior fibers of MCL

Front 246

what is the normal range of extension of the elbow joint?

Back 246

0 to -5º

Front 247

hyperextension of the elbow joint is often due to what?

Back 247

a short olecranon

Front 248

what are three things that can limit the active and passive extension range of motion at the elbow joint?

Back 248

(1)olecranon on olecranon fossa
(2) anterior capsule and ligament
(3) flexor muscles and skin

Front 249

what are four things that forced elbow extension can result in?

Back 249

(1) fracture of olecranon
(2) torn anterior capsule
(3) posterior dislocation of forearm bones relative to humerus
(4) bruise or tear of brachial artery or median nerve

Front 250

most activities of daily living can be accomplished with what range of elbow flexion?

Back 250

30-130º

Front 251

most activities of daily living can be accomplished with how many degrees of forearm pronation and supination?

Back 251

50º

Front 252

in the capsule pattern of the elbow joint, what motion is lost the most?

Back 252

flexion lost more than extension

Front 253

what are the three positions in the close packed position of the elbow joint?

Back 253

(1) ulnohumeral extension (olecranon in fossa)
(2) radiohumeral flexion
(3) proximal radioulnar supination

Front 254

this motion of the ulnohumeral joint is accompanied by slight internal rotation of the ulna

Back 254

pronation

Front 255

this motion of the ulnohumeral joint is accompanied by slight external rotation of the ulna

Back 255

supination

Front 256

what is the direction of the slide at the ulnohumeral joint during flexion?

Back 256

anterior

Front 257

what is the direction of the slide at the ulnohumeral joint during extension?

Back 257

posterior

Front 258

what is the direction of the slide at the ulnohumeral joint during varus angulation?

Back 258

lateral

Front 259

what is the direction of the slide at the ulnohumeral joint during valgus angulation?

Back 259

medial

Front 260

is the proximal radioulnar joint synovial or not?

Back 260

yes

Front 261

forearm pronation and supination involves these two joints that are mechanically linked

Back 261

proximal and distal radioulnar joints

Front 262

what type of joint are the proximal and distal RU joints?

Back 262

pivot

Front 263

the long axis of the radius is displaced laterally during what movement?

Back 263

pronation

Front 264

is the radial head longer in diameter from A to P or M to L?

Back 264

anterior to posterior

Front 265

with excessive __ to the forearm, the head of the radius can dislocate distally through the fibrosseous ring or annular ligament

Back 265

traction

Front 266

this ligament of the proximal RU joint is strengthened by the anterior fibers of the LCL and MCL; it attaches to the anterior and posterior margins of the radial notch of the ulna

Back 266

annular ligament

Front 267

this ligament of the RU joint is a fibrous band attached to the inferior border of the radial notch and to the neck of the radius; it limits rotation of hte radius in the fibrosseous ring (limits pronation and supination)

Back 267

quadrate ligament

Front 268

what is the normal range of forearm pronation?

Back 268

75º

Front 269

what is the normal range of forearm supination?

Back 269

85º

Front 270

the ROM of forearm pronation and supination is best assessed with the arm in what position?

Back 270

adducted

Front 271

what movement of the forearm increases the contact of the radius on the capitulum?

Back 271

pronation, elbow flexion

Front 272

what movement of the forearm decreases the contact of the radius on the capitulum?

Back 272

supination

Front 273

what does the longitudinal axis of the forearm run from?

Back 273

the head of the radius to the head of the ulna

Front 274

what is the direction of the roll and slide of the radius during pronation at the proximal radioulnar joint?

Back 274

anterior roll, posterior slide

Front 275

what is the direction of the roll and slide of the radius at the proximal RU joint during supination?

Back 275

posterior roll, anterior slide

Front 276

the movement of the radius on the capitulum is primarily __ during forearm pronation/supination

Back 276

spinning

Front 277

clinically, what type of glide of the radial head is occasionally seen during contraction of the biceps in patients with laxity of the annular ligament?

Back 277

anterior

Front 278

what type of joint is the middle RU joint?

Back 278

synarthroses (non-synovial)
NO CAPSULE

Front 279

at the middle RU joint, this is a structure that is the site of muscle attachments; the fibers transfer forces and keep the radius and ulna in proper relationship with one another

Back 279

interosseous membrane

Front 280

the interosseous membrane is least taut with the forearm in what position?

Back 280

pronated with traction

Front 281

what is the order of force transmission from the interosseous ligament?

Back 281

hand to radius via the interosseous membrane to the ulna to the humerus

Front 282

this ligament of the middle RU joint is taut during supination and helps to check it

Back 282

oblique cord

Front 283

the radius is __ anteriorly and medially, allowing it to move over the ulna during pronation (increasing pronation ROM)

Back 283

concave

Front 284

what type of joint is the distal RU joint?

Back 284

pivot

Front 285

does it have its own capsule or is it included in the wrist joint capsule?

Back 285

its own capsule

Front 286

what is the close packed position of the distal RU joint?

Back 286

in neutral rotation or 5º supination

Front 287

the function of this structure at the distal RU joint is to bind the radius and the ulna together; provides dual articular surfaces and separates the radioulnar joint for the radiocarpal joint

Back 287

articular disc

Front 288

the articular disc of the distal RU joint is on maximum stretch in what position?

Back 288

neutral rotation

Front 289

what are the three intrinsic stabilizers of the distal RU joint?

Back 289

(1) joint capsule
(2) ligaments
(3) TFCC

Front 290

what are the four ligaments that stabilize the distal RU joint?

Back 290

(1) ulholunate ligament
(2) ulnotriquetral ligament
(3) dorsal olblique bundle
(4) palmar and dorsal RU ligaments

Front 291

what are the two ligaments that are contained within the TFCC?

Back 291

ulnolunate and ulnotriquetral

Front 292

these ligaments of the distal RU joint help limit both pronation and supination

Back 292

dorsal and palmar radioulnar ligaments

Front 293

what are the two mucsles that stabilize the distal RU joint?

Back 293

(1) pronator quadratus
(2) tendon of the ECU

Front 294

the cylindrical head of the ulna is __ at the distal RU joint

Back 294

convex

Front 295

the ulnar notch on the radius is __ at the distal RU joint

Back 295

concave

Front 296

what are six possible things that could limit forearm pronation?

Back 296

(1) impact of radius on ulna
(2) dorsal and palmar RU ligament tautness
(3) TFCC
(4) quadrate ligament
(5) short muscles (supinator, biceps, ECRL)
(6) decreased accessory ulnohumeral joint motions

Front 297

what are three muscles whose shortness can cause limited pronation range?

Back 297

supinator
biceps
ECRL (only if wrist flexed)

Front 298

what are six things that could limit forearm supination?

Back 298

(1) oblique cord
(2) anterior and dorsal RU ligament tautness
(3) TFCC
(4) interosseous membrane
(5) quadrate ligament
(6) muscle shortness

Front 299

what are two muscles whose shortness can cause limited supination range?

Back 299

pronators
finger flexors (if fingers extended)

Front 300

clinically, forearm (supination, pronation) is restricted more often

Back 300

supination

Front 301

after injury, the forearm is immobilized in a position of forearm __

Back 301

pronation

Front 302

what is the axis of motion for forearm rotation with the forearm resting on the table?

Back 302

through small finger and medial edge of ulna

Front 303

with is the main movement during forearm rotation?

Back 303

rotational displacement of the lower end of the radius about the ulna

Front 304

during everyday movements, the axis of rotation for forearm rotation coincides with what?

Back 304

the axis of the hand (3rd MC)

Front 305

during pronation, what are the direction of the roll and slide of the radius on the ulna at the distal RU joint?

Back 305

anterior roll, anterior slide

Front 306

during supination, what are the direction of the roll and slide of the radius on the ulna at the distal RU joint?

Back 306

posterior roll, posterior slide

Front 307

what are the three muscles that may be the best at valgus motions of the elbow?

Back 307

ECRL
EDC
ECU

Front 308

what are the two mucles that may be the best at varus motions of the elbow?

Back 308

FDS
FCR

Front 309

as a whole, which forearm muscles are more powerful, flexors or extensors?

Back 309

flexors

Front 310

what are the thre eprimary muscles of elbow flexion?

Back 310

(1) biceps
(2) brachialis
(3) brachioradialis

Front 311

the flexors produce maximal torque with the elbow flexed to __º

Back 311

90º

Front 312

the sole function of this muscle is elbow flexion; it does not pronate or supinate, and it has a large volume and PCSA so it can generate a lot of force

Back 312

brachialis

Front 313

what two nerves innervate the brachialis muscle?

Back 313

musculocutaneous and radial

Front 314

the brachialis and biceps create compressive forces at the elbow when they contract, so they may help increase __ stability when the LCL is deficient

Back 314

varus

Front 315

this muscle flexes the elbow and supinates the forearm, and is most active during flexion with the arm supinated

Back 315

biceps

Front 316

what nerve innervates the biceps?

Back 316

musculocutaneous

Front 317

the function of this part of this muscle MAY play a role in restricting anterior and superior translation of the humeral head

Back 317

long head of the biceps

Front 318

this muscle plays an important role in deceleration of the forearm during throwing; its pull on the glenoid labrum can cause labral injuries

Back 318

biceps

Front 319

during elbow flexion, this muscle extends the shoulder, acting as a synergist to allow the biceps to function at a longer length and generate more force

Back 319

posterior deltoid

Front 320

during resisted elbow flexion exercises, the scapular muscles have to stabilize the scapula to prevent the biceps from causing the scapula to go into what motion?

Back 320

anterior tilt

Front 321

this muscle flexes the elbow, and with resistance, it assists with forearm pronation and supination; it is increased in activity with faster movements and with forearm semipronated

Back 321

brachioradialis

Front 322

what nerve innervates the brachioradialis?

Back 322

radial

Front 323

what are three accessory flexors of the elbow?

Back 323

(1) FCR
(2) pronator teres
(3) ECRL

Front 324

the ECRL is the best at accessory flexing the elbow when the forearm is in what position?

Back 324

pronated

Front 325

the FCR acts as an accessory elbow flexor at elbow angles of __º or more

Back 325

50

Front 326

this elbow extensor has the largest volume and PCSA of all the muscles at the elbow; with pushing motions, you get elongation of the muscle over one joint and shortening over another joint

Back 326

triceps

Front 327

what head of the triceps adducts and extends the shoulder, as well as extending the elbow?

Back 327

long head

Front 328

what head of the triceps is most active ulness resistance is applied; it is the workhorse of the extensors

Back 328

medial head

Front 329

the best moment arm for the triceps for elbow extension is at or near what position?

Back 329

full extension

Front 330

the triceps produces maximal torque at __º of elbow flexion

Back 330

90

Front 331

compressive forces by the triceps can increase __ stability in LCL insufficiency

Back 331

varus

Front 332

this muscle is a deep extension from the medial head of the triceps that inserts into the capsule posterirly and helps pull the capsule taut during elbow extension

Back 332

articularis cubiti

Front 333

during pushing open a door, this muscle acts as a synergist with the triceps or a neutralizer flexing the shoulder during elbow extension to maintain the length of the triceps

Back 333

anterior deltoid

Front 334

this muscle extends the elbow and is recruited first for low level extensor force; it stabilizes the humeroulnar joint during elbow extension and forearm rotation motions

Back 334

anconeus

Front 335

what nerve innervates the triceps and anconeus?

Back 335

radial

Front 336

what two muscles are accessory extensors of the elbow?

Back 336

FCU and ECU

Front 337

what three muscles increased valgus stability at the elbow via compressive forces?

Back 337

biceps
brachialis
triceps

Front 338

the triceps exert greater compressive forces with the elbow in what position?

Back 338

flexed

Front 339

the biceps and the brachialis exert greater compressive forces with the elbow in what position?

Back 339

extended

Front 340

what two muscles increase valgus stability via producing a varus force secondary to the angle of pull?

Back 340

FCU
FDS

Front 341

what three muscles increase varus stability at the elbow via compressive forces?

Back 341

biceps
brachialis
triceps

Front 342

during elbow flexion/extension exercises, forearm __ is the most stable position

Back 342

pronation

Front 343

during elbow flexion/extension exercises, avoid __ loaded positions or humeral __ and __

Back 343

varus
medial rotation and abduction

Front 344

this muscle supinates the forearm; it is usually recruited before the biceps for isolated low power supination; under all conditions, but is a weaker supinator than the biceps

Back 344

supinator

Front 345

the fiber direction of this muscle may help to stabilize the head of the radius posteriorly (helps prevent anterior movement)

Back 345

supinator

Front 346

weakness of what muscle interferes with feeding oneself?

Back 346

supinator

Front 347

what innervates the supinator muscle?

Back 347

radial nerve

Front 348

what muscle that flexes the elbow is also a powerful supinator?

Back 348

biceps brachii

Front 349

what are four acessory supinators?

Back 349

finger and wrist extensors, EPL, EI

Front 350

what muscle supinates the forearm from pronation (rotates the forearm to neutral regardless if forearm is pronated or supinated)?

Back 350

brachioradialis

Front 351

this muscle pronates the forearm and assist with elbow flexion; weaknes interferes with turning a door knob, using a knife, unscrewing, and is most active during high-powered activities

Back 351

pronator teres

Front 352

what nerve innervates the pronator teres?

Back 352

median

Front 353

this muscle is the primary pronator of the forearm, and helps stabilize the distal RU joint

Back 353

pronator quadratus

Front 354

what nerve innervates the pronator quadratus?

Back 354

median

Front 355

what three muscles assist in pronation?

Back 355

FCR
palmaris longus
brachioradialis

Front 356

what forearm muscles are stronger, supinators or pronators?

Back 356

supinators

Front 357

what forearm motion can be more easily compensated for, pronation or supination?

Back 357

pronation

Front 358

this muscle may help conteract the pull of the biceps on the radius during elbow flexion

Back 358

supinator

Front 359

the functional position of the forearm is best between what two positions?

Back 359

neutral and semipronation

Front 360

it is easier to lose ROM of what forearm movement, supination or pronation?

Back 360

supination

Front 361

this muscle could be underused in elbow problems

Back 361

supinator

Front 362

this DSM is when there are increased tensile forces at the medial elbow and compressive forces ont he lateral elbow

Back 362

valgus

Front 363

this DSM is when there is increased compressive and tensile forces on the ulnar nerve in the cubital tunnel

Back 363

elbow flexion syndrome

Front 364

this DSM is when there is increased compressive forces ont he lateral elbow and increased tensile forces on the medial elbow

Back 364

increased carrying angle

Front 365

a lesion at this nerve would cause you to lose function of the biceps and brachialis; marked decreased elbow flexion torque, and you may lose passive supination ROM since the forearm wil tend to pronate

Back 365

musculocutaneous

Front 366

lesion to this nerve will cause you to lose the pronator teres, but you will have minimal flexor torque deficit; may tend to lose forearm pronation ROM due to unbalanced biceps action (supinate as you flex)

Back 366

median

Front 367

what are four structures that resist longitudinal traction forces at the elbow?

Back 367

(1) medial and lateral ligaments
(2) muscles (any arising from medial and lateral epicondyles, triceps)
(3) annular ligament (traction on radius)
(4) interosseous membrane

Front 368

this structure prevents distal movement of the radius relative to the ulna during longitudinal traction

Back 368

interosseous membrane

Front 369

this muscle may counteract the pull of the biceps on the radius with the elbow at 90º of flexion (if the annular ligament is injured)

Back 369

supinator

Front 370

impacting forces may result in fractures of what two structures in the forearm?

Back 370

radial head
coronoid process

Front 371

impacting forces may result in dislocation in what direction of the elbow joint?

Back 371

posterior