Functional Anatomy Exam 2

Head and neck

-Contribute to motor, processing, and social interaction skills

-Essential to occupational performance

Bones of the head and neck

-Skull

-Mandible

-Hyoid

-Larynx

Mandible

-Jawbone

-Floor of the mouth

-No individual parts

Hyoid bone

-U-shaped bone

-Attachment for muscles for speech and swallowing

Oral cavity and pharynx

-2-way fucntional pathway

-Speaking, eating, breathing

-Space from mouth to soft palate

Sutures of the skull

-Synarthroses

-Unmoving joints

Temporomandibular joints

-Synovial joints

-Operate in tandem

-Have articular discs

-Many supporting ligaments

-Vital for self-feeding, hygiene, etc

Muscles of facial expression

-Integumentary muscles

-Purpose: express emotion

Muscles of mastication and speech

-Masseter

-Temporalis

-Medial and lateral pterygoids

Masseter

Elevates and protrudes mandible for speech and chewing

Temporalis

Elevates and retracts mandible for speech and chewing

Medial pterygoid

Deviates mandible to grind food

Lateral pterygoid

Deviates mandible to grind food

Extraocular muscles

-7 muscles

-Move the eye, and one elevates eyelid

TMJ elevation

The masseter, temporalis, and medial pterygoid contribute to elevation of the TMJ for activities like self-feeding, swallowing, and communicating

TMJ depression

The geniohyoid, mylohyoid, stylohyoid, digastric, and platysma muscles

TMJ protraction

The lateral pterygoid, medial pterygoid, and masseter

TMJ retraction

The temporalis and digastric muscles

Communication

-Facial expression is a powerful nonverbal form of communication

-Verbal communication: air in lungs forced between vocal folds (cords)

Laryngitis

-Inflammation of larynx

-Temporary loss of voice

Aphasia

Loss of ability to understand or express speech

Wernicke's aphasia

Loss of ability to understand spoken words

Broca's aphasia

Loss of ability to produce language

Self-feeding

-Classified as ADL in PTPF-4

-Requires postural control and visual-motor integration

Deglutition

Moving food from mouth to stomach

Dysphagia

-Impairment in swallowing

-Voluntary or involuntary mechanisms

Aspiration

Food or liquid descending beneath vocal folds and entering trachea

Oral preparatory phase

-Food mixed with saliva

-Undergoes mastication by teeth

-Bolus is formed

Oral transit phase

Tongue propels bolus posteriorly toward pharynx

Pharyngeal phase

-Bolus passes into oropharynx

-Bolus propelled downward toward esophagus

Vision input

Primary component of ADLs and IADLs

Diplopia

Double vision

Ptosis

Drooping of the eyelid

Homonymous hemianopsia

Loss of vision on the same side of each visual field

Shoulder

-Provides gross positioning and stability

-Functional connection between the trunk and upper extremity

Scapula

-Shoulder girdle

-Attachment for numerous muscles

-Positions glenoid fossa for humeral motion

Clavicle

-Links chest and upper arm

-Positions humerus laterally away from upper body

Humerus

Connects the trunk and forearm

Shoulder complex joints

-Scapulothoracic joint (pseudo)

-Sternoclavicular joint

-Acromioclavicular joint

-Glenohumeral joint

Scapulothoracic joint

-Structural classification: atypical

-Functional classification: atypical

Scapulothoracic joint movements

-Gliding (elevation, depression, abduction, adduction)

-Rotation (internal, external, upward, downward)

-Tilt (anterior, posterior)

Sternoclavicular joint

-Structural classification: saddle or ball-and-socket

-Functional classification: triaxial

Sternoclavicular joint movements

-Elevation

-Depression

-Protraction

-Retraction

-Posterior rotation

-Anterior rotation

Acromioclavicular joint or "AC" joint

-Structural classification: gliding

-Functional classification: biaxial

Acromioclavicular joint or "AC" joint movements

-Anterior/posterior gliding

-Superior/inferior gliding

Glenohumeral (shoulder) joint

-Structural classification: ball-and-socket joint

-Functional classification: triaxial

Glenohumeral (shoulder) joint movements

-Flexion

-Extension

-Abduction/adduction

-Internal rotation

-External rotation

-Horizontal abduction/adduction

Trapezius

-Stabilizes and mobilizes scapula

-Positioning of proximal upper extremity

- Functionally is 3 muscles

Levator scapulae

Elevation and downward rotation of scapula

Rhomboids

-Elevation and downward rotation of scapula

-Adduction of scapula

Serratus anterior

-Maintain position of scapula against rib cage

-Scapular winging: damage to long thoracic nerve

Pectoralis minor

Stabilizes scapula anteriorly against rib cage

Elevation

The trapezius, rhomboid major, rhomboid minor, and levator scapulae contribute to activities like lifting a bag off of the ground

Depression

The trapezius, serratus anterior, and pectoralis minor contribute to activities like pushing on the armrests of a chair to stand up

Upward rotation

The trapezius and serratus anterior contribute to upward rotation of the scapula for activities like reaching to retrieve an item from the top shelf

Downward rotation

The rhomboid major, rhomboid minor, levator scapulae, and pectoralis minor contribute to activities like reaching into your back pocket

Protraction

The serratus anterior and pectoralis minor contribute to activities like pushing a lawn mower

Retraction

The trapezius, rhomboid major, and rhomboid minor contribute to activities like pulling a lawn mower

Scapulohumeral muscles

-Rotator cuff

-Deltoid

-Teres major

-Are active when reaching, placing, or throwing

Rotator cuff muscles types

-Infraspinatus

-Teres minor

-Subscapularis

-Supraspinatus

Rotator cuff

Maintains functional integrity of GH joint

infraspinatus and teres minor

-External rotation of humerus

-Ex. reaching behind the back

Supraspinatus

Abducts humerus

Subscapularis

Internal rotation of humerus

Deltoid

-Flexion

-Abduction

-Extension

Teres major

-Adduction

-Internal rotation

Shoulder abduction

The middle deltoid and supraspinatus contribute to activities like holding a hose to water a garden

Humeral adduction

The latissimus dorsi, teres major, infraspinatus, teres minor, pectoralis major, triceps brachii, and coracobrachialis contribute to activities like carrying your books to class

Horizontal abduction of the shoulder

-Away from middle of the body

-The posterior deltoid and pectoralis major contribute to activities like pulling your seat belt across to latch

Horizontal adduction of the shoulder

The pectoralis major and anterior deltoid contribute to activities like reaching across to grab the seat belt

Shoulder flexion

The deltoid (anterior fibers), pectoralis major, biceps brachii, and coracobrachialis contribute to activities like lifting up objects

Shoulder extension

The deltoid (posterior fibers), latissimus dorsi, teres major, pectoralis major, and triceps brachii contribute to activities like painting

Shoulder external rotation

The deltoid (posterior fibers), infraspinatus, and teres minor contribute to activities like swinging a paddle when playing table tennis

Shoulder internal rotation

The deltoid (anterior fibers), latissimus dorsi, teres major, subscapularis, and pectoralis major contribute to activities like texting

Many ADLs require shoulder elevation (flexion or abduction)

-Personal hygiene

-Grooming

-Upper body dressing

-Bathing

Scapular winging

-Weakness of serratus anterior

-Impairs scapular mobility

-Interrupts functional movement of shoulder

Subluxation

-Result of instability, weakness, or paralysis

-Pull of gravity through humerus

-Painful strain of joint capsule

Subacromial impingement

Compression of the soft tissues between acromion and humeral head

Thoracic outlet syndrome (TOS)

Compression of structures

Glenohumeral subluxation

-Humeral head partially dislocates inferiorly

-Can be from hemiparesis

Rotator cuff muscles

-Active during ADLs like reaching behind back or head (upper body dressing, toileting)

-Leisure activities (throwing a ball, swinging a racket

Rotator cuff tear

-Injury usually due to forceful loading of shoulder while elevated

-Supraspinatus most commonly injured

Glenohumeral joint dislocation

-Most commonly dislocated joint in the body

-Involves damage in the labrum

-Leads to instability

Osteoarthritis

-Can significantly limit function

-Requires activity modification or adaptive equipment

Elbow and forearm: a rotating hinge

-Elbow flexion is needed for many self-care tasks, including hygiene, self-feeding, and bathing

-Elbow extension is often involved with weight-bearing through the upper extremity, such as when pushing down on the armrests of a chair to stand up

Trochlea

Articular surface for ulna

Capitellum

Articular surface between ulna and radius

Medial epicondyle

Origin for flexor muscles of forearm, wrist, and fingers

Lateral epicondyle

Origin for extensor muscles of forearm, wrist, and fingers

Medial and lateral supracondylar ridges

-Superior to epicondyles

-Trochlea more distal than capitellum

-Radius and ulna 5degrees-15 degrees of valgus relative to humerus

Coronoid fossa

Superior to trochlea

Radial fossa

Superior to capitellum

Olecranon fossa

Posterior surface proximal to trochlea

Ulna

Stable base for elbow flexion and forearm rotation

Trochlear notch

Ulnar socket that articulates with the trochea

Olecranon process

Posterior projection of ulna at the upper portion

Coronoid process

-Lower portion of trochlear

-Projects anteriorly

Radial notch of ulna

-Lateral surface of coronoid process

-Shallow articular surface for head of radius

Head of ulna

-Distal end of ulna

-Articulates with radius and intraarticular disc of wrist joint

Ulnar styloid

Distally beyond head of ulna