102: The Upper Extremity: Osteology and Organization

Axilla

Shoulder (Glenohumeral joint)

Arm (Brachium)

Forearm (Antebrachium)

Hand

What are the 5 regions of the upper extremity?

Common action

Common innervation

Common blood supply

What are the three common functions of compartments of the upper extremity?

Where fixed end of a skeletal muscle attaches

- Most are bones

-Some are connective tissue sheaths or bands

- Typically proximal to insertion in an anatomical position

What is the origin?

Where the moveable end of a skeletal muscle attaches

What does insertion mean?

Specific movement produced by a skeletal muscle; typically moving insertion toward origin

What does action mean?

The scientific study of bones

What is osteology?

Sternum

identify the structure

Manubrium of sternum

identify the structure

right clavicle

identify the structure

left clavicle

identify the structure

Scapula

identify the structure

Humerus

identify the structure

Acromial end and sternal end

What are the two ends of the clavicle?

Acromion process

identify the structure

Glenoid fossa

identify the structure

Coracoid process

identify the structure

Subscapular fossa

identify the structure

Suprascapular notch

identify the structure

Suprascapular notch

identify the structure

Supraspinous fossa

identify the structure

Infraspinous fossa

identify the structure

Spine of the scapula

identify the structure

Where bones connect

What are joints/articulations?

Sternoclavicular joint

The clavicle articulates with the axial skeleton via which joint?

Acromioclavicular joint

The clavicle articulates with the scapula via which joint?

sternoclavicular joint

identify the joint

acromioclavicular joint

identify the joint

Conoid tubercle

identify the structure

Protect joints!

What is the function of ligaments?

Impression for costoclavicular ligament

identify the structure

Acromion process of the scapula to the distal end of the clavicle

What does the acromioclavicular ligament connect?

Extends between coracoid process and acromion process of scapula

What does the coracoacromial ligament connect?

1. Conoid ligament

2. Trapezoid ligament

These attach to the conoid tubercle and trapezoid line

What two ligaments make up the coracoclavicular ligament?

Connects the manubrium of sternum to sternal end of clavicle

What does the Sternoclavicular ligament connect?

Connects sternal end of clavicle to 1st rib at costal cartilage

What does the costoclavicular ligament connect?

First

Coraco comes (first/last)

Last

Clavicular comes (first/last)

acromioclavicular ligament

identify the structure

coracoacromial ligament

identify the structure

coracoclavicular ligament

identify the structure

conoid and trapezoid ligament

what two ligaments make up the coracoclavicular ligament?

conoid ligament

identify the structure

trapezoid ligament

identify the structure

Trapezoid line of clavicle

identify the structure

sternoclavicular ligament

identify the structure

costoclavicular ligament

identify the structure

Falling on shoulder or outstretched hand

What is the mechanism of injury for AC joint separation?

"Piano-key sign"

What is another name for AC joint separation?

acromioclavicular, coracoclavicular

in a "piano key sign" injury, what ligaments of the shoulder are torn?

clavicle

in a "piano key sign" injury, what bone is no longer attached to shoulder?

AC joint separation

What happened here?

glenohumeral joint

identify the joint

glenohumeral joint

In Scapulo-humeral Rhythm to make a 180 degree angle, the ______ does 120 degrees of the movement

Scapulothoracic joint

This joint allows movement in all directions between muscles of the scapula and the thoracic wall, increasing the mobility of the upper extremity

scapulothoracic joint

In Scapulo-humeral Rhythm to make a 180 degree angle, the ______ does 60 degrees of the movement

scapulothoracic joint

The "joint" that connects the scapula to the thoracic cage, does not use ligaments, but soft tissue

Upward

Scapular movements

Inferior angle: Lateral = (upward/downward)

Downward

Scapular movements

Inferior angle: Medial = (upward/downward)

Upward

Scapular movements

Glenoid: Faces up = (upward/downward)

Downward

Scapular movements

Glenoid: Faces down = (upward/downward)

Elevation

The scapular into the red is...

Depression

The scapular into the green is...

Protraction

The scapular into the red is...

Retraction

The scapular into the green is...

Upward rotation

The scapular into the red is...

Downward rotation

The scapular into the green is...

Physiological (bc it is between soft tissue not bones)

What type of joint is the scapulothoracic joint?

Glenohumeral joint

- Between glenoid cavity and humeral head

What joint connects the arm (humerous) to the pectoral girdle?

Ball and socket

- Adding further mobility to the upper extremity

What type of joint is the glenohumeral joint?

Flexion/Extension

Internal rotation/External rotation

Adduction/Abduction

Circumduction

What motions are allowed at the glenohumeral joint?

Decrease

- These joints need extra structures for support

An increase in mobility results in an (increase/decrease) stability

Forward

Flexion is when the arm moves

Backward

Extension is when hte arm moves

Away from the midline

Abduction is when the arm moves

Toward the midline

Adduction is when the arm moves

- Muscles that cross the axial skeleton to the humerus cross the joint anteriorly and pull arm medially for internal rotation

- Muscles cross joint posteriorly to laterally rotate humerus at glenoidhumeral joint

How do muscles cross the shoulder joint to produce each action?

Movement together where there is 180° abduction occurring at the glenohumeral and scapulothoracic joints

What is scapulohumeral rhythm?

Of the 180° movement:

- 60° occur at the scapulothoracic joint

- 120° occur at the glenohumeral joint

What degrees are each joint in the scapulohumeral rhythm?

Shoulders abduct, external/lateral rotate, extend back

What motions needed to get arm into this position?

Indirect

When motion/movement causes head of humerus to dislocate out of glenoid fossa this is (direct/indirect) dislocation of glenohumeral joint

Direct

While in abduction and lateral rotation, a force hits laterally, forcing elbow back and proximal end of humerus out anteriorly, this is (direct/indirect) dislocation of glenohumeral joint

arm flexion

identify the action

arm extension

identify the action

arm adduction

identify the action

arm abduction

identify the action

elbow flexion

identify the action

elbow extension

identify the action

elbow lateral rotation

identify the action

elbow medial rotation

identify the action

wrist flexion

identify the action

wrist extension

identify the action

wrist adduction

identify the action

wrist abduction

identify the action

finger adduction

identify the action

fingers abduction

identify the action

thumb adduction

identify the action

thumb abduction

identify the action

thumb opposition

identify the action

thumb flexion

identify the action

thumb extension

identify the action