Upper Extremity

Vocabulary-style flashcards covering major anatomy, joints, planes, exam techniques, and common tests for the upper extremity as presented in the lecture notes.

Sagittal Plane Movement

mainly flexion and extension

Transverse Plane Movement

rotational or twisting

Frontal (Coronal) Plane Movement

abduction and adduction

Synovial Joint

freely moveable

contains articular cartilage, synovial membrane, and synovial fluid

Types of Synovial Joint

ball-and-socket

hinge

condylar

Spheroidal (Ball-and-Socket) Joint

allowing flexion/extension, abduction/adduction, and rotation

Hinge Joint

allowing flexion and extension

Condylar Joint

permitting two planes of movement (patella, TMJ)

Cartilaginous Joint

slightly moveable

bony surfaces separated by fibrocartilaginous discs

bone surface covered with hyaline cartilage

Fibrous Joint

immoveable

bones held together by fibrous tissue and cartilage

Bursae

Synovial sacs that reduce friction and allow muscles/tendons to glide over each other

Intraarticular Structures

Joint capsule

articular cartilage

synovial fluid

intraarticular ligaments

Extraarticular Structures

Periarticular ligaments

tendons

bursae

muscle

fascia

nerves

non-articular bones

skin surrounding a joint

Shoulder Girdle Joints

glenohumeral

sternoclavicular

acromioclavicular

Shoulder Girdle Bones

humerus

clavicle

scapula

Glenohumeral Joint

ball-and-socket between the humeral head and the glenoid fossa

Sternoclavicular Joint

Joint between the clavicle and the sternum.

Acromioclavicular Joint

Joint between the acromion of the scapula and the clavicle.

Shoulder Stabilizers (Dynamic)

Rotator cuff muscles

biceps brachii

latissimus dorsi

pectoralis major

Shoulder Stabilizers (Static)

labrum

articular capsule

glenohumeral ligaments

Primary Shoulder Muscle Groups

scapulohumeral

axioscapular

axiohumeral

Scapulohumeral muscles

rotator cuff: supraspinatus, infraspinatus, teres minor, subscapularis

Supraspinatus action

abduction

scaption

Infraspinatus action

external rotation

Teres minor action

external rotation

Subscapularis action

internal rotation

Axioscapular muscles

attach scapula to trunk

trapezius, rhomboids, serratus anterior, levator scapulae

Trapezius action

elevate, depress, retract shoulder girdle

extend and laterally flex head and neck

Rhomboids action

retract and downwardly rotate shoulder girdle

Serratus anterior action

scapular protraction and upward rotation of shoulder girdle

Levator scapulae

elevates scapula

Axiohumeral muscles

attach humerus to trunk

pectoralis major, pectoralis minor, latissimus dorsi

Pectoralis major action

adduct and medially rotate humerus

draw scapula anterior and inferior

Pectoralis minor action

stabilize scapula by drawing it inferior and anterior against thoracic wall

Latissimus dorsi action

extend, adduct, medially rotate humerus

Elbow

formed by radius, ulna, and humerus

hinge joint

Median Nerve

sensation to the thumb, index, middle, and half of the ring finger

Ulnar Nerve

sensation to the half of 4th and whole 5th digits

Radial Nerve

sensation to lateral dorsal surface of hand and dorsal surface of digits 1-4 (only bottom ½ for 2-4)

Acute Pain

less than 3-6 months

Chronic Pain

longer than 3-6 months or more than 1 month past expected healing duration

Full MSK ROS

myalgias

arthralgias

joint swelling

joint redness

joint tenderness

popping, locking, catching, clicking

weakness

decreased ROM

joint stiffness

warmth

deformity

back pain

neck pain

Bone pain description

deep or dull (as it heals)

intense or sharp (right after injury)

Muscle pain description

crampy

Pain worse in the morning

rheumatic disease

tendonitis

Pain worse in evening

osteoarthritis

Proximal weakness of LE

trouble walking and crossing knees/legs

Proximal weakness of UE

trouble brushing hair and lifting objects

Distal weakness of LE

trouble doing calf raises or jumping

Distal weakness of UE

trouble turning doorknobs or buttoning a shirt

Order of MSK physical exam

inspection

palpation

ROM

strength testing

neurovascular

special tests

Inspection

looking for erythema, ecchymosis, swelling, and deformity

make sure to compare sides

Palpation

feel bony, ligamentous, and soft tissue landmarks

Muscle strength grade 0

no evidence of muscle contraction

Muscle strength grade 1

evidence of slight contractility with no joint motion

Muscle strength grade 2

active movement with gravity eliminated

Muscle strength grade 3

active movement against gravity with no resistance

Muscle strength grade 4

active movement against gravity with some resistance

Muscle strength grade 5

complete, normal power against gravity and resistance

Normal capillary refill

less than 2 seconds

Pulse grade 0

no palpable pulse

pulse is absent

Pulse grade 1+

diminished

weaker than expected

Pulse grade 2+

brisk

easily identified (normal)

Pulse grade 3+

bounding

Atrophy of supraspinatus and infraspinatus

rotator cuff tear

Winging of scapula

weakness of trapezius or serratus anterior

injury to long thoracic nerve

Palpation of biceps tendon and bicipital groove

thumb on coracoid and fingers on humerus

feel halfway between coracoid and greater tubercle

Palpation of supraspinatus

under acromion and muscle belly above scapular spine

Palpation of infraspinatus

posterior to supraspinatus and muscle belly below scapular spine

Shoulder ROM

flexion and extension

abduction and adduction

internal and external rotation

Shoulder strength test

flexion and extension

adduction and abduction

internal and external rotation

Elbow ROM

flexion and extension

pronation and supination

Elbow strength test

flexion and extension

pronation and supination

Wrist ROM

flexion and extension

radial and ulnar deviation

Thumb ROM

flexion

extension

abduction

adduction

opposition

Wrist strength test

flexion and extension