How many total degrees of freedom does the SC joint have?
6
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What are the osteokinematics of the AC joint?
- Upward/Downward rotation of the scapula (frontal) - Anterior/Posterior Tilt of the scapula (sagittal) - Internal/External rotation of scapula (transverse)
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SC elevation + AC downward rotation \=
Scapular Elevation
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What motions of the AC and SC joints give scapular depression?
What are the 6 kinematic principles of abduction to achieve full 180 degrees abduction of the upper extremity?
- 2:1 scapulohumeral rhythm - 60° scapular upward rotation is a result of SC and AC joint motion - Clavicle retracts at SC joint - Scapula posteriorly tilts and externally rotates - Clavicle posteriorly rotates around its axis - GH joint externally rotates
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How much abduction could occur if scapulothoracic joint could not move?
120 degrees
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What is the ratio of GH joint abduction to scapulothoracic upward rotation?
2:1 (ex. in 3 degrees of abduction, there is 2 from the GH joint and 1 from the ST)
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How many total degrees of shoulder abduction are there?
180 degrees
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The GH joint contributes how much to shoulder abduction?
120 degrees
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Scapulothoracic upward rotation contributes how much to shoulder abduction?
60 degrees
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Name the plane(s) and movements associated with the humero-ulnar joint
Sagittal. Flexion/Extension
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What joint is responsible for pronation and supination?
Distal radioulnar joint
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In supination
radius and ulna are parallel
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In pronation
radius crosses over the ulna
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True or False. Pronation and supination occurs at the elbow joint
False. Pronation and supination does NOT occur at the elbow joint
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Name the movements at the radiocarpal joint
Flexion/Extension and Ulnar/Radial Deviation
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What is the ROM for flexion and extension in the radiocarpal joint?
- Extension 60-75 degrees - Flexion 70-85 degrees
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What is the ROM for radial and ulnar deviation in the radiocarpal joint?
At the 1st carpometacarpal joint, ab/adduction occurs in the
Sagittal Plane
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At the 1st carpometacarpal joint, flexion/extension occurs in the
Frontal Plane
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What two osteokinematic motions combine to create opposition?
abduction and flexion (with medial rotation)
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What are the arthrokinematics of the GH joint for open chain abduction?
Superior roll and inferior glide of humerus
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What are the arthrokinematics of the GH joint for open chain adduction?
Inferior roll and superior glide of humerus
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What are the arthrokinematics of the GH joint for open chain flexion?
Spin of the humerus on glenoid
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What are the arthrokinematics of the GH joint for open chain extension?
Spin of the humerus on glenoid
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What are the arthrokinematics of the GH joint for open chain internal rotation?
Anterior roll and posterior glide of humerus
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What are the arthrokinematics of the GH joint for open chain external rotation?
Posterior roll and anterior glide of humerus
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What are the arthrokinematics of the SC joint for open chain elevation?
Convex articular surface rolls superiorly and simultaneously slides inferiorly on the concavity of the sternum
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What are the arthrokinematics of the SC joint for open chain retraction?
Concave articular surface of the clavicle rolls and slides posteriorly on the convex surface of the sternum
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What are the arthrokinematics of the humero-ulnar joint for open chain flexion?
Anterior roll and glide of ulna
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What are the arthrokinematics for distal radioulnar supination?
Dorsal roll and glide
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What are the arthrokinematics for distal radioulnar pronation?
Palmar roll and glide
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What are the arthrokinematics for radiocarpal open chain wrist extension?
Dorsal roll and palmar glide
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What are the arthrokinematics for radiocarpal open chain wrist flexion?
Palmar roll and dorsal glide
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What are the arthrokinematics for radial deviation?
radial roll and ulnar glide
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What are the arthrokinematics for ulnar deviation?
ulnar roll and radial glide
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In the 1st CMC, roll and glide are referred to as \____ for extension/flexion
Dorsal or palmar
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In the 1st CMC, roll and glide are referred to as \____ for ab/adduction
anterior or posterior
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What ligament has tension with adduction and inferior and anterior translation?
Superior GH ligament
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What ligament has tension with 45-60 degrees of abduction with external rotation and anterior translation
Middle GH ligament
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The superior GH ligament is located
Anterior to long head of biceps
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The middle GH ligament blends with
capsule and subscapular tendon
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What does the inferior GH ligament attach to?
labrum
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What part of the Inferior GH ligament has tension with 90 degrees abduction and full external rotation? It is also a primary restraint for anterior translation.
Anterior band
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What part of the Inferior GH ligament has tension with 90 degrees abduction and anteroposterior and inferior translation?
Axially pouch
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What part of the Inferior GH ligament has tension with 90 degrees abduction and full internal rotation?
Posterior band
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What is the primary restraint for anterior translation? This also happens to be the strongest and thickest part of the GH capsule.
Anterior band of inferior GH ligament
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Describe the labrum
It is a fibrocartilaginous ring that surrounds the glenoid and deepens the socket for the humeral head for better stability
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Passive restraint of the GH joint is provided by
Glenoid labrum and the long heads of the biceps tendon
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Because of the anatomical position of the long head of biceps....
it will provide stability, limit anterior translation, and superior migration of the humeral head.
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What provides active stabilization of the GH joint?
Muscles of the rotator cuff
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The downward force on the humeral head counteracts
excessive superior translation, especially caused by the deltoid
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True or False. The anterior fiber bundle of the MCL is the strongest and stiffest of the elbow and forearm ligaments
True
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The MCL fibers
Stabilize against valgus producing force/valgus torque and resist some longitudinal distraction.
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The anterior part of the MCL
is best at resisting valgus. it also resists during all flexion and extension ROM
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The posterior part of the MCL
Resists valgus and extreme elbow flexion
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The transverse part of the MCL
Provides limited stability of the joint
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The LCL fibers
have greater variability in form than the MCL and resist varus-producing forces