kin exam 3

describe the motions of the scapula

elevation and depression

protraction and retraction

upward and downward rotation (goes along with glenohumeral abduction and adduction)

anterior tilt and posterior tilt

• Describe the motions of the glenohumeral joint as well as the associated planes and axes

• Flexion, extension, hyperextension → occurs in the sagittal plane and mediolateral axis

• Abduction, adduction → occurs in the frontal plane and anteroposterior axis 

• External and internal rotation → occurs in the transverse plane and vertical/longitudinal axis

What mm are involved in the rotator cuff? What is their role?

Supraspinatus, infraspinatus, teres minor, subscapularis

work together to pull humeral head into socket and help maintain shoulder stability

Origin and insertion of pec minor

origin: anterior ribs 3-5

insertion: coracoid process

origin and insertion of pec major

origin: medial 3rd of clavicle, sternum, and cartilage of ribs 1-6

insertion: lateral edge of bicipital groove

origin and insertion of supraspinatus

origin: supraspinatus fossa

insertion: greater tubercle

origin and insertion of infraspinatus

origin: infraspinatus fossa

insertion: greater tubercle

origin and insertion of teres minor

origin: lateral border scapula

insertion: greater tubercle

origin and insertion of subscapularis

origin: subscapular fossa

insertion: lesser tubercle

origin and insertion of teres major

origin: lateral border, inferior angle

insertion: below lesser tubercle

origin and insertion of coracobrachialis

origin: coracoid process

insertion: medial surface of mid humerus

labral tears

SLAP (superior labrum, anterior posterior) tear — caused by very forceful biceps contraction (bicep tendon attaches here)

bankart tear (lower anterior quadrant) — result of shoulder dislocation (anterior, inferior direction of the dislocation causes it)

scapulohumeral rhythm

0 to 30 degrees abduction is glenohumeral motion

after 30 degrees, a 2:1 ratio (GH to scapula) → scapula begins to move with the GH joint (if this didn’t occur, humerus would run into acromion process of scapula and abduction couldn’t occur)

bone of the shoulder

scapula: acromion process, coracoid process, glenoid fossa

humerus: greater tuberosity, bicipital groove, lesser tuberosity

clavicle: sternal end (only bony attachment of the shoulder joint to the rest of the body), rest is attached by muscle

open / closed kinetic chain in shoulder

most of the upper extremity movement is open kinetic chain (except with something like a pushup) → so FOOSH creates closed kinetic chain, and joints aren’t used to that, resulting in injury

joints of the shoulder

sternoclavicular (SC) joint — only bony attachment to trunk of shoulder

scapulothoracic (ST) articulation

glenohumeral (GH) joint

acromioclavicular (AC) joint

which of the following muscles does not attach to the scapula? pec major, serratus anterior, deltoid, and trapezius

pec major

the glenohumeral joint’s primary abductor is which of the following muscles?

deltoid

is the acromioclavicular joint is located at the proximal or distal end of the clavicle?

distal

shoulder impingement is generally caused by problems with which muscle?

supraspinatus

what muscle is responsible for protraction of the scapula?

serratus anterior muscle

motion of pec minor

contributes to downward rotation and anterior tilt of the scapula

protraction and stabilization of the scapula

motion of pec major

internal rotation

triangular shape (with broad origin and narrow insertion) allows it to generate lots of power and force

motion of supraspinatus

glenohumeral abduction → important for the first 30 degrees of abduction, then deltoid takes over

motion of infraspinatus

external rotation

motion of teres minor

external rotation and adduction

motion of subscapularis

internal rotation, some adduction

motion of teres major

internal rotation and glenohumeral joint

motion of coracobrachilalis

adduction, some scapular motion with closed kinetic chain movement, horizontal adduction

origin and insertion of upper trapezius

origin: occipital bone and upper c-spine spinous processes

insertion: outer third clavicle, acromion

motion of upper trapezius

upward rotation and retraction of scapula

origin and insertion of mid trapezius

origin: spinous process C7-T3

insertion: spine of scapula

motion of mid trapezius

retraction of the scapula, upward rotation

origin and insertion of lower trapezius

origin: spinous processes mid-lower thoracic

insertion: base of scapular spine

motion of lower trapezius

upward rotation of scapula

all of the traps help with motion of upward rotation of the scapula. what is this important for?

abduction of arm

rhomoid major and minor origin and insertion

origin: C7-T5

insertion: medial border scapula

motion of rhomboid major and minor

retraction of scapula and downward rotation

anterior deltoid origin and insertion

origin: lateral 3rd of clavicle

insertion: deltoid tuberosity

mid deltoid origin and insertion

origin: acromion process

insertion: deltoid tuberosity

posterior deltoid origin and insertion

origin: spine of scapula

insertion: deltoid tuberosity

what motion is the deltoid responsible for

abduction

motion of anterior deltoid

GH flexion

motion of posterior deltoid

GH extension

levator scapulae origin and insertion

origin: transverse processes C1-4

insertion: medial border at superior angle

motion of levator scapulae

elevation of scapula; downward rotation

serratus anterior origin and insertion

origin: lateral surface of upper 8 ribs

insertion: medial scapular border, anterior side

motion of serratus anterior

protraction

latissimus dorsi origin and insertion

origin: spinous process T7-L5, posterior sacrum, iliac crest, and lower 3 ribs

insertion: inferior angle of scapula and medial floor of bicipital groove

latissimus dorsi motion

adduction; internal rotation of arm; little bit of downward rotation of scapula

elbow anatomy (bones and articulations)

distal end of humerus articulates with ulna (very stable bony attachment — hinge joint)

• trochlea with trochlear notch

radial head articulates with humeral epicondyle

• capitulum with head of radius

elbow anatomy- ligaments

ulnar collateral ligament-

• three bands: anterior (cord like), posterior (fan like), and oblique

• prevents excessive stretching in a particular direction

anular ligament- goes around radial head, attached to ulna (keeps radius from separating from ulna)

interosseous membrane- helps hold radius and ulna together

elbow/forearm motions

flexion/extension

pronation/supination

what does degrees of freedom refer to

amount of planes and axes that a joint can move in

• ex, shoulder joint can move in 3 planes and 3 axes, so it has 6 degrees of freedom

biarticular means…

muscle crosses two joints

biceps origin and insertion and motion

origin- coracoid process and supraglenoid tubercle of scapula

insertion- radial tuberosity

motion- elbow flexion, supination

brachialis origin, insertion, motion

origin- distal half anterior humerus

insertion- coronoid process and tuberosity of ulna

motion- elbow flexion

brachioradialis origin, insertion, motion

origin- lateral supracondyle ridge of humerus

insertion- lateral surface of distal end of radius

motion- supination, elbow flexion

triceps origin, insertion, motion

• Origin: infraglenoid tubercle of scapula, posterior surface of humerus superior to radial groove, and inferior to radial groove

• Insertion: olecranon process

• Motion: elbow extension, GH adduction

anconeus muscle origin, insertion, motion

• Origin: lateral epicondyle of humerus

• Insertion: lateral and inferior olecranon 

• Motion: extension

pronator quadratus origin, insertion, and motion

• Origin: distal ¼ of ulna

• Insertion: distal ¼ of radius

• Motion: pronation

muscles that originate on medial epicondyle

palmaris longus, flexor carpi ulnaris, flexor carpi radialis, pronator teres

palmaris longus origin, insertion, motion

o- medial epi

i- palmar fascia

m- wrist flexion

flexor carpi ulnaris origin, insertion, motion

o- medial epi

i- pisiform and base of 5th metacarpal

m- wrist flexion

flexor carpi radialis origin, insertion, motion

o- medial epi

i- base of 2nd and 3rd metacarpal

m- wrist flexion

pronator teres origin, insertion, motion

o- medial epi

i- lateral radius midpoint

m- pronation

flexor digitorum superficialis o, i, m

• Origin: medial epicondyle, coronoid process, anterior border of radius

• Insertion: middle phalanges 2-5

• Finger flexor

flexor digi profundus

• Origin: upper ¾ anterior ulna

• Insertion: base o distal phalanges

• Finger flexor

flexor pollicis longus

• Origin: middle ½ anterior radius

• Insertion: base of distal thumb phalanx 

• Thumb flexor

muscles that originate on lateral epicondyle

extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi

Extensor carpi radialis brevis

o- lat epi

i- base of 3rd metacarpal

m- wrist extensor

extensor carpi ulnaris

o- lat epi

i- base of 5th metacarpal

m- wrist extensor

extensor digitorum

o- lat epi

i- base of distal phalanx 2-5 fingers

m- finger extensor

extensor digiti minimi

o- lat epi

i- base of distal phalanx of 5th finger

m- finger extensor

extensor carpi radialis longus

• Origin: lateral supracondylar ridge

• Insertion: 2nd metacarpal

• Motion: wrist extensor