FABS Quiz 4

What is a SLAP tear?

Superior labrum, anterior-posterior tear

How many grades of SLAP tear are there?

4

Type I SLAP tear

degeneration, fraying w/o instability

Type II SLAP tear

detachment of superior labrum off glenoid fossa

Most common SLAP tear type?

II

Type III SLAP Tear

bucket handle, remainder firmly attached

Type IV SLAP Tear

bucket handle that extends to biceps tendon

Bicep tendon attaches where to superior labrum?

Anteriorly

What is the ratio of scapulohumeral rhythym?

2:1

Early phase (0-90) has how many degrees of motion from GHJ and STJ?

60º from GHJ and 30º from STJ

30º of STJ is made up of what?

5º of elevation at SCJ and 25º of upward rotation of ACJ

Late phase (90-180) has how many degrees of motion from GHJ and STJ?

Same amount as early phase

Posterior rotation of clavicle at SCJ results in tension of what? During what phase of shoulder abduction?

coracoclavicular ligament; late phase

What are the two proximal stabilizers?

Axioscapular and axiohumeral

What does the Axioscapular do? What are some examples?

Stabilization and rotation

ex. pec minor, levator scapular, traps, rhomboids, serratus anterior

What does the axiohumeral do? What are some examples?

Position and movement

ex. latissimus dorsi, pec. major

What is a distal mobilizer?

Scapulohumeral

What does the scapulohumeral do? What are some examples?

steering and compression

ex. All shoulder muscles, biceps brachii, corachobrachialis

Elevators of STJ

upper traps, levator scapular, rhomboids

Depressors of STJ

lower traps, lat dorsi, pec minor, subclavius

Protractors of STJ

serratus anterior

Retractors of STJ

Mid and lower traps, rhomboids

Upward rotators of STJ

upper, middler, lower traps

serratus anterior

Downward rotators of STJ

rhomboids and levator scapula

How many groups of muscles elevate the arm at GHJ?

3

What GHJ muscles elevate the arm?

Supraspinatus, deltoid, corachobracialis, biceps long head

What STJ muscles elevate the arm?

traps and serratus anterior

What other muscles elevate the arm?

SITS group

Supraspinatus function

pull humeral head into glenoid fossa

subscapularis, infraspinatus and teres minor function.

inferior directed translation force on humeral head

Infraspinatus and teres minor have what function?

lateral rotation of humeral head

Adductors and extenders of shoulders

lat dorsi, pec major, long head of triceps brachii, post. delt, infraspinatus, teres minor

Stabilizers of shoulder

SITS and rhomboids

External rotators of shoulder

infraspinatus, teres minor, post. deltoid

Elbow and forearm complex increase what?

the range of effective hand placement

Elbow and forearm complex consists of how many bones and joints?

3 bones; 4 joints

Trochlea consists of what?

groove; medial and lateral lips

First 4 features of ulna

Olecranon and coranoid process

trochlear notch

radial notch

Last 4 features of ulna

supinator crest

tuberosity

ulnar head

styloid process

What bone is the radial notch on?

ulna

First couple features of the humerus are what?

trochlea, coronoid fossa, capitulum, radial fossa

Other features of the humerus are what?

epicondyles, supracondylar ridges, olecranon fossa

Features of the radius?

Radial head, fovea, bicipital tuberosity, ulnar notch, styloid process

ulnar notch is on what bone?

Radius

What is the normal valgus angle?

15-18º

In who is the valgus angle generally larger?

females

What are some other names for valgus angle?

Carrying angle, cubital valgus

If carrying angle increases where does forearm go to?

Lateral

What stretches as valgus angle increases?

medial collateral lig

If there’s a decrease in valgus angle what kind of stress does it cause?

varus stress

What type of joint is humeroulnar?

Modified hinge

Ligaments of humerulnar joint?

Capsular ligament (anterior and posterior)

medial collateral

Parts of medial collateral ligament?

Anterior

posterior

transverse (does not resist valgus stress)

The humeroulnar joint in open chain has what type of movement?

Same roll and same slide

The humeroulnar/humeroradial joint in closed chain has what type of movement?

opposite roll and slide

In open chain during humeroulnar/Humeroradial of the elbow what is the roll and slide? What about during extension?

Anterior-anterior

Posterior-posterior

In closed chain during humeroulnar/Humeroradial of the elbow what is the roll and slide? What about during extension?

anterior roll-posterior slide

posterior roll- anterior slide

Flexion of humeroulnar has how many degrees? What type of feeling for end range?

145º

soft tissue feeling

Extension of humeroulnar has how many degrees? What type of feeling for end range?

0-5º hyperextension

bone to bone feeling

Humeroradial joint has what ligaments?

Capsular ligament (anterior and posterior)

lateral/radial collateral lig.

Parts of lateral/radial collateral lig.? what do they resist

radial part lig - resists varus stress

ulnar part lig - resists varus stress

annular lig. - resists distraction (does not cross joint line)

Closed packed position of humeroradial joint?

90º flexion and 5º supination

Extension of humeroradial.

little physical contact at rest in full extension

Flexion of humeroradial.

muscle contraction pulls concave radial head to convex capitulum

Pure flexor with greatest force.

Brachialis

Longest flexor muscle for flexion with no effect on pro./supination

brachioradialis

Flexor muscle that has advantage in supination and helps with shoulder extension

biceps

Reverse action for both joints causes what for both joints of humerulnar and humeroradial?

roll anterior and slide posterior

Reverse action of elbow flexor muscles:

hemiplegia, paralyzed trunks and lower muscles

use of the elbow flexor muscles to sit up

What muscle starts extension?

Anconeus

What helps with stability during extension?

flexor muscles (brachialis)

anterior capsule

anterior fibers of MCL

Bursae around elbow joint

Olecranon, subcutaneous of medial epicondyle, subcutaenous of lateral epicondyle

Olecranon bursae has what parts?

intratendinous olecranon

subtendinous olecranon (deepest)

subcutaneous olecranon (most superficial)

What bursae causes student elbow?

Subcutaneous olecranon

Blood supply of elbow

derived from anastomosis around elbow joint

Nerve supply of elbow

musculocutaneous, radial, ulnar

interosseous membrane anatomy

from proximal radius to distal ulna

oblique cord: ulnar tuberosity to distal bicipital tuberosity

interosseous membrane functions

Holding una and radius together

transmission of force through upper limb

What type of joint is proximal radioulnar?

pivot/trochoid

What is the closed chain of the radioulnar joints?

ulna moving on radius

What is the open chain of the radioulnar joints?

radius moving on ulna

Ligaments of proximal radioulnar joint?

annular and quadrate

What kind of joint is the distal radioulnar?

Fibrous syndesmoses (pivot motion)

Stabilizers of distal radioulnar?

ulnocarpal/triangular fibrocartilage complex

joint capsule

pronator quadratus and tendon of ECU

interosseous membrane

distal radioulnar ulna and radius

radius -concave head (ulnar notch)

ulna-convex head

Proximal radioulnar close packed position

full extension, 5º supination

Distal radioulnar close packed position

5º supination

Pronation/Supination at distal radioulnar joint causes in open chain what movement? at proximal radioulnar joint?

same direction roll and slide

spin around the axis of radius

Pronation/supination in closed chain has what effect in distal radioulnar? In proximal radioulnar?

Roll and glide in opposite directions

spinning around axis of radius

Primary supinator movement muscles are what?

supinator muscle and biceps brachii(at 90º elbow flexion)

Primary initiator of pronation?

Pronator quadratus

Provider of strength for pronation?

Pronator teres

Secondary pronator muscles are what?

flexor carpi radialis and palmaris longus

What is a strain/sprain?

injury to collateral ligaments

ex. repetitive force

Lateral epicondylitis is also known as what? What is it?

Tennis elbow; inflammation of extensor tendon at insertion at lateral epicondyle

What are some lateral epicondylitis causes?

Lack of strength, bad technique, over-training

Lateral epicondylitis effects?

painful lifting and grasping

Medial epicondylitis is also known as what? What is it caused by?

golfer’s elbow; common flexor tendon inflammation at insertion to medial epicondyle

Medial epicondylitis can refer pain to what?

forearm flexors

Medial epicondylitis differential diagnosis?

cubital tunnel syndrom