arzene kines flashcard

3 factors of inferior subluxation

loss of tension in superior capsule, paralysis of deltoid and supraspinatus, paralysis of trapezius and serratus anterior

your patient is unable to put his arm behind his back due to significant loss of both active and passive IR. source of limitation?

contraction of the posterior capsule

depressors of the scapula

lower trap, latissimus dorsi, pec minor

superior compressor of humeral head

supraspinatus

if a patient has 60º of total arm elevation, but only 20º-30º of true GH rotation, what is most likely the cause?

RTC tear

when a screw is placed through the radial head and proximal radioulnar joint, what motion is lost?

pronation and supination

what muscle controls elbow extension

biceps, eccentrically lower objects down

carrying angle of elbow

cubital valgus = away from midline, cubital varus = toward midline, valgus stress = increase valgus elbow (abduction)

scapulothoracic joint movements

elevation and depression, retraction and protraction, downward and upward rotation, IR and ER, anterior/posterior tilt

why is the subscapularis the only muscle that can produce enough IR to get the hand all the way up the back

its only job is to internally rotate

final position of scapula when the shoulder is in full forward elevation

upward rotation, elevation, ER, retraction, posterior tilt

glenohumeral ligaments and joint capsule function

limit excessive translation of the humeral head on the glenoid and guide arthokinematics

RTC muscle function

primary dynamic stabilizers of the GH joint

5 parts of elevation of the arm

upward rotation of scapula via upper and lower traps and serratus anterior, scapular elevation via upper traps, external rotation of scapula via serratus anterior and middle/lower traps, posterior tilt via serratus anterior and help from lower traps, retraction of scapula via rhomboids and middle traps

muscles with distal attachments on ulna function

can flex or extend elbow but have no ability to pronate or supinate the forearm

muscles with distal attachment on radius function

can flex and extend elbow and also pronate or supinate the forearm

upward rotation of scapula

force couple: seratus anterior, upper traps, lower traps

humeroradial joint axial loading

during axial loading, contact between the radial head and capitulum provides and important bony resistance against valgus force

your patient has full passive ER w/ the arm at the side but is unable to produce any active ER. why?

dysfunction of the infraspinatus muscle (or suprascapular nerve)

relationship between RTC and deltoid

dysfunction of the RTC muscles due to weakness/ tear results in an decreased ability to offset the superior pull of deltoid, results in excessive superior translation of humeral head in elevation, results in increased of compression on subacromial structures under the coracoacromial arch, may result in loss of shoulder elevation

posterior compressor of humeral head

infraspinatus and teres minor

brachialis attachment to ulna

because it attaches distally to the ulna, pronation/supination had no influence on length, line of force, or moment arm

excessive separation or gaping of the medial aspect of the elbow joint w/ valgus stress indicates injury to

medial collateral ligament

elevator of scapula

upper trap, levator scapula, rhomboid major/minor

anterior compressor of humeral head

subscapularis

position of forearm to maximally stretch triceps

doesnt matter

maximally stretch biceps

extend shoulder, extend elbow, pronate forearm

inferior glenohumeral ligament complex: anterior band

limits anterior translation of the humeral head in 90º of abduction and ER

inferior glenohumeral ligament complex: axillary pouch

limits inferior translation of the humeral head with the shoulder in abduction/elevation

inferior glenohumeral ligament complex: posterior band

limits posterior translation of the humeral head with shoulder in flexion and IR

what is the prereq for training passive finger flexion via tenodesis

active wrist extension

what would you NOT do to promote passive finger flexion via tenodesis

dont stretch the finger of flexor muscles

what can you do to facilitate development of passive finger flexion via tenodesis

facilitate tightness in extrinsic finger flexor muscles

how to maximally stretch lumbricals

flex ip, extend mp

function of terminal tendon and central slip

terminal tendon = extension of DIP joint, central slip = extension of PIP joint

wrist radial deviators

ECRL and FCR function synergistically to perform radial deviation while simultaneously acting as antagonists by opposing each others extension/flexion potential

shortening/contracture of the dorsal radiocarpal ligament would limit what motion

flexion of the wrist

function of lumbricals

flex the mps and extend the ip

how should the hand be splinted/immobilized

mp joints in flexion (maintain length of collateral ligaments), ip joints in extension