Upper limb (week 2 3)


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Upper limb (week 2 3)

  1. 1. + Upper Limb1
  2. 2. +Humerus (Arm) The humerus articulates with the scapulaat the shoulder and with the radius andulna at the elbow The humerus is typically described ashaving a head, shaft, and base Many muscles attach including the deltoid,pectoralis major, teres major, latissimusdorsi, bicepsbrachii, brachialis, coracobrachialis, brachioradialis2
  3. 3. +Ant. Veiw (L) and Post. View (R).Arrow indicates radial sulcus3
  4. 4. +THE ELBOW AND RADIOULNAR JOINTSAssist shoulder to apply forceControl placement of hands in space
  5. 5. +Humerus, Ulna, & Radius1. Radiohumeral JointCondyloid• capitulum & head of radiusElbow Joint- Radiohumeral5
  6. 6. Elbow Joint- Ulnarhumeral2. Ulnarhumeral joint Articulation: ulna & humerus Flexion/extension of forearm6
  7. 7. Radioulnar Joint3. Radioulnar JointRadius and Ulna2 articulations• Distal (pivot)• Middle (syndesmoses)• Proximal (pivot)– Radial head & fossa (notch)– Neutral position• Pronation- radius crossesulna7
  8. 8. Radioulnar JointSupporting Structures• Radial collateralligament– support & rotation• Interosseous membrane– Maintains stability– Transfers force8
  9. 9. Elbow Joint Supporting Structures• Ulnar collateral ligament– Humeroulnar support• Radial collateral ligament– Humeroradial support9
  10. 10. + Elbow & Radioulnar Movements 10
  11. 11. + Musculature – Elbow24 muscles crossPA11
  12. 12. +Elbow FlexorsAnterior Biceps brachii (S) Brachialis Brachioradialis (P & S) Pronator teres (weak) Elbow flexion: effectiveness of sup/pron ↑ as elbow flexion ↑Origin Anterior surface of the humerus, specifically the distal portionInsertion Coronoid process and the tuberosity of the ulnaArtery Radial recurrent arteryNerve Musculocutaneous nerve (C5,C6)12
  13. 13. + Elbow Flexors- anteriorBiceps Brachii (S) 3 jnt muscle1= Glenohumeral joint2= ulnarhumeral joint3= radiohumeral joint contribution to flexion depends on position most effective- supinatorOrigin short head: coracoid process of the scapula.long head: supraglenoid tubercleInsertion radial tuberosity and bicipital aponeurosis into deepfascia on medial part of forearmArtery brachial arteryNerve Musculocutaneous nerve (C5–C6)Action Elbow flexion and forearm supinationAntagonist Triceps brachii13
  14. 14. +Elbow Flexors- anteriorPronator Teres weak-main action: pronatorOrigin Humeral head: Medial epicondyle of humerusUlnar head: Coranoid process of ulnaInsertion Middle of the lateral surface of the radiusArtery Ulnar artery and radial arteryNerve Median nerve14
  15. 15. +Elbow ExtensorsPosterior Triceps brachii 3 heads Very strongOrigin Long head: infraglenoid tubercle of the scapulaLateral head: above the radial sulcusMedial head: below the the radial sulcusInsertion Olecranon process of the ulnaArtery Brachial artery (profunda brachii)Nerve Radial nerve and axillary nerveAntagonist Biceps brachii15
  16. 16. + Flexor Strength Twice as strong as extensors Are we better pullers or pushers? Elbow flexion: ADLs = more neutral Strongest in semi-prone positions16
  17. 17. +Radioulnar Pronators Pronator Teres Pronator QuadratusOrigin Humeral head: Medial epicondyle of humerusUlnar head: Coranoid process of ulnaInsertion Middle of the lateral surface of the radiusArtery Ulnar artery and radial arteryNerve Median nervePronator QuadratusOrigin Medial, anterior surface of the ulnaInsertion Lateral, anterior surface of the radiusArtery Anterior interosseous arteryNerve Median nerve17
  18. 18. +Conditioning Pronators & SupinatorsPronators Loosening a screw, turning a doorSupinators Tightening a screw Throwing a curveball (extension, before release)18
  19. 19. +THE HAND AND WRISTWhich activities would it be essential to have anunderstanding of the hand & wrist?
  20. 20. +HAND The hand consists of 54 bones separated into three distinct regions: The wrist (carpals) The palm (metacarpals) The finger digits (phalanges) The eight carpal bones are the bones of the wristThey largely assist in motility and support of the hand20
  21. 21. +HAND Each hand consists of five metacarpal bones The phalanges consist of three sections: Proximal phalanges Intermediate phalanges Distal phalanges Collectively, these bones make up the structureknown as the fingers21
  22. 22. + Bones of the Hand Metacarpals (5) 1-5 base (proximal) head (distal) shaft Phalanges (14) proximal (1-5) middle (2-5) distal (1-5) base (proximal) head (distal) shaft22
  23. 23. Bones of the HandCarpals (8) Proximal row scaphoid (navicular) lunate (moon) triquetrum (triangular) pisiform (pea) Distal row trapezium trapezoid capitate (head) hamate (hook)23
  24. 24. +Bones: Radius, Scaphoid,Lunate, Triquetrum• Condyloid (2 df)– flexion/extension/hyperextension– radial deviation/flexion (abduction)– ulnar deviation/flexion (adduction)Wrist Joint24
  25. 25. + Common Origins/Attachments Wrist & finger flexors Medial epicondyle Medial condylar ridge Coronoid process Wrist & finger extensors Lateral epicondyle Lateral supracondylar ridge25
  26. 26. +WRIST MOVEMENTS26
  28. 28. +Muscles of Hand & WristMovementComplex mechanism29 bones, > 25 jnts, > 30muscles28
  29. 29. +Intrinsic vs. ExtrinsicMuscles acting at wrist & fingersOriginate outside hand (extrinsic) Enter hand as tendonsIntrinsic (originate in hand)29
  30. 30. +Names Identify Function/Location Flexor or extensor Carpi – carpals Radialis – radial side Ulnaris – ulnar side Digitorum- digits/fingers Superfiscialis – superfiscial aspect Profunda – deep Indicis – index finger Pollicis – thumb Digiti minimi – pinky/little finger30
  31. 31. +Organization of MusclesFinger MovementFinger flexors (ant) Flexor digitorum superfiscialis flex each finger ind Flexor digitorum profundus O: med epicondyleThumb flexor Flexor pollicis longusFinger extensors (post) Extensor digitorum O: lat epicondyle Extensor indicis Extensor digitorum minimiThumb extensor Extensor pollicis longus Extensor pollicis brevis both abductorsThumb abduction Abductor pollicis longus31
  32. 32. +Wrist Flexors32
  33. 33. +Wrist Flexors Curling the wrist Stabilize the wrist against resistance Snaps hand fwd spiking VB, throwing BB33
  34. 34. +Wrist Extensors34
  35. 35. +Wrist Extensors Curling the wrist Stabilize the wrist against resistance when forearm is_____________ Important in backhand (racquet sports) Draws the hand back dribbling BK, throwing BB35
  36. 36. Finger Flexion Important in grippingactivity Power grip Wrap around object Flexion all 3 finger jnts Precision grip (pinch) Limited flexion @ PIP, DIP Only 1-2 fingers36
  37. 37. + Finger Extensors 37
  38. 38. +Finger ExtensorsExtensor digitorum Only muscle involved in extension of all 4 fingers Apply manual resistance to dorsal aspect of flexed fingersthen extending38
  39. 39. +Thumb MusclesOpposition is the most important movementof the thumb: pinch, grasp, or grip an object.39