functional e3

SC joint motions

elevation/depression, protraction/retraction, posterior rotation

AC joint motions

upward/downward rotation, anterior/posterior tipping, internal/external rotation

ST joint rotary motions

UROT/DROT, ATIP/PTIP, IR/ER, PRO/RET

ST joint translatory motions

ELE/DEP, ABD/ADD

serratus anterior actions

UROT, PTIP, ER

Upper trap actions

UROT in early ROM, elevates scap at SC, retraction at SC

Lower trap actions`

UROT in late ROM, depresses scap on thorax, PTIP

Middle trap actions

small UROT throughout, helps serratus with ER, adducts scap on thorax

Pec minor actions

protraction, DROT, ATIP, IR

Rhomboids actions

DROT, ADD, offset UROT from mid trap to perform scap retraction

radius and ulna structure

distal radius is sloped anteriorly + longer laterally

radiocarpal joint parts

radius, ulna, TFCC, scaphoid, lunate, triquetrum

Triangular fibrocartilaginous complex (TFCC)

moves with radius and ulna in supination, increases congruency, absorbs forces on the medial side, attachment for sheath of ECU tendon, vascular and neural

midcarpal joint

articulation between the proximal row and the distal row of carpal bones, CONVEX ON CONCAVE

Pisiform

articulates with hamate and triquetrum, attachment site for FCU and ADM, acts as a pulley

distal carpal joint

articulation between trapezoid, capitate, hamate and proximal metacarpals 2-5, CONCAVE ON CONVEX

Progression of motion

movement begins at CMC, continues through IC, progresses to RC, NO MUSCLE ATTACHMENT TO CARPAL BONES

intercarpal ligaments

scapholunate and lunotriquetral

scaphoid during RD and UD

during RD scapholunate ligament pulls scaphoid out of the way, during UD scaphoid moves back to its place

prime movers for RD

ECRL, FCR

prime movers for UD

FCU, ECU

4 and 5 CMC joints

2 rotary DoF

2 and 3 CMC joints

highly stable with minimal movement

MCP joints

2 rotary DoF, CONCAVE ON CONVEX

PIP/DIP joints

uniaxial hinge joint, CONCAVE ON CONVEX

thumb motion

FLX/EXT, ABD/ADD, OPPO

thumb flx/ext arthro

concave on convex

thumb abd/add arthro

convex on concave

main role of wrist extensors

position the wrist for activities of the fingers

gripping

most active in light grip is ECRB, more force = ECU then ECRL

maximal grip force ext angle

20-30 degrees of wrist EXT

elbow mobility role

position the hand in space

elbow functional tasks

reaching, grooming, eating

elbow stability role

acts as a stable platform for forceful tasks including the hand and forearm

cubitus valgus

increase in medial angle at elbow

cubitus varus

decrease in medial angle at elbow

elbow fibrous joint capsule

one capsule with 3 joints, loose and redundant anteriorly, blends with annular and collateral ligaments

MCL anterior band

resists valgus forces from 20-120 degrees of elbow flx

MCL posterior band

resists valgus forces greater than 90 degrees of elbow FLX

lateral collateral complex

resists varus forces, stabilizes against combined varus and supination, maintain posterior lateral rotaryb stability

posterolateral rotary instability

combined supination and axial load, disrupts lateral complex, lateral ulnar collateral weakest

annular ligament

stabilizes radial head to ulna

proximal radioulnar joint

convex radial head on concave radial notch

quadrate ligament

limits supination/pronation

oblique cord

restrains supination

distal radioulnar joint

concave ulnar notch on convex ulnar head, TFCC

dorsal radioulnar ligament

resists pronation

palmar radioulnar ligament

resists supination

interosseous membrane

keeps radius and ulna together, transfers forces from larger distal radius to larger proximal ulna

PRUJ supination arthro

anterior roll, posterior glide (PPP)

PRUJ pronation arthro

posterior roll, anterior glide

DRUJ supination arthro

anterior roll, anterior glide

DRUJ pronation arthro

posterior roll, posterior glide

pronator teres

stabilizer of HU joint, compression into humerus, involved in forecful pronation

brachialis

large CSA, workhorse, pure elbow flx

biceps brachii

potential for active insufficiency, most active with forearm in supination, active in all forearm positions when loaded, always involved in resisted supination, involved in fast unresisted supination

brachioradialis

only active with fast or loaded movement when the forearm is in neutral, helps pronate in supination and supinate in pronation

triceps brachii

potential for active insufficiency, all heads active during quick or resisted elbow ext

anconeus

stabilizer muscle of HU joint, small ext torque

pronator quadratus

involved in fast/slow and resisted/unresisted pronation, great stabilizer of DRUj

supinator

functions alone in unresisted, slow supination or fast supination with elbow extended

vertebral column functions

protect spinal cord and organs, allows for multiple planes of movement, provide stability

lordotic sections

cervical, lumbar

kyphotic sections

thoracic, sacral

nucleus pulposus info

high PG/GAG content, mostly type II collagen

annulus fibrosus info

type I collagen

vertebral end plate

fibrocartilage, helps attach Vdisc to Vbody

intervertebral disc function

force transmission (moves load to body), nutrition via diffusion of blood from vertebrae (intermittent compression)

interbody joint naming

joint is named by superior vertebrae (L1&L2=L1 facet joint)

facet joint structure

small fibromeniscal pad; highly innervated and irritable

interbody joint motions

gliding, tipping, rotation, compression, distraction

facet joint motions

up glide and down glide

anterior longitudinal ligament

resists ext

posterior longitudinal ligament

resists flx

vertebral segment

2 adjacent vertebra and associated joints/soft tissue

body to disc ratio

tall body, short disc = less movement

short body, tall disc = more movement

restraints to trunk flexion

posterior ligaments, posterior facet capsules, posterior annular fibers, posterior muscles

restraints to trunk extension

anterior ligaments, facet joint capsules, spinous processes, anterior annular fibers, anterior muscles

restraints to lateral flexion

contralateral intertransverse ligament, facet joint capsule, contralateral musculature

transverse ligament

holds dens to anterior arch of C1, prevents anterior translation during cranial flexion

subaxial cervical structure

small body, large disc, lots of motion

uncinate processes

form a saddle joint, provides stability and limits gliding

cervical kinetics

gravity flx moment, suboccipital extensors offset that

levator scap role at cervical spine

helps offset anterior shear component of gravity

thoracic structure

taller posterior aspect, slops anteriorly, small disc, large body, facets in frontal plane

thoracic spine and voerhead movement

kyphosis limits overhead reach due to tipping of the scap

lumbar spine structure

large body, large disc height, cauda equina here, facets in sagittal plane

available motion in spine (ranked)

1. cervical

2. lumbar

3. thoracic

L5/S1 articulation

higher angle = more anterior shear and compression

lumbar rotation arthro

no glide, ipsilateral gapping, contralateral compression

thoracolumbar fascia

contraction of muscles allows for compression (nutrients in NWB)

abdominal hoop

bracing improves trunk stiffness, bracing anterior also braces posterior

lumbar spine muscles

deep erector spinae cause posterior shear

hip flexor shortness

can cause an increase in lumbosacral angle = more anterior shear

sacroiliac joint structure

anterior is synovial, posterior is syndesmotic

sacroiliac joint function

very very stable, only becomes unstable in pregnancy and trauma