Shoulder, Elbow, Forearm, Wrist, and Hand Assessment Flashcards

These flashcards cover bony palpations, soft tissue structures, goniometry norms, and manual muscle testing for the shoulder complex, wrist, hand, elbow, and forearm based on the provided lecture notes.

Suprasternal notch

The superior part of the sternum used as a landmark for shoulder palpations.

Sternoclavicular (SC) joint

The joint located immediately lateral to the suprasternal notch.

Coracoid process

A bony structure located at the deepest portion of the clavicular concavity; found by pressing laterally and posteriorly $1\text{ inch}$ inferior to the clavicle.

Acromion process of the scapula

The most lateral bony aspect of the shoulder that articulates with the distal end of the clavicle.

Acromioclavicular joint (AC joint)

The joint formed at the most lateral aspect of the clavicle.

Greater Tuberosity of humeral head

The most prominent portion lies slightly anterior; located lateral and slightly anterior to the lateral lip of the acromion.

Lesser tuberosity of humeral head

A bony structure lateral to the coracoid process that forms the medial border of the intertubercular groove.

Bicipital groove (Intertubercular groove)

A groove located $1\text{ inch}$ inferior from the anterior acromion; bordered laterally by the greater tuberosity and medially by the lesser tuberosity.

Deltoid Tuberosity

The distal attachment site of the deltoid muscle on the humeral shaft.

Spine of scapula

A bony landmark at the level of the $T3$ spinous process that separates the supraspinatus and infraspinatus muscle bellies.

Superior angle of scapula

A bony landmark located at the level of the $T1$ spinous process, deep to the upper trapezius muscle.

Inferior angle of scapula

A bony landmark at the level of the $T7$ spinous process.

Anterior fibers of the deltoid

Muscle fibers that resist shoulder horizontal adduction and flexion.

Middle fibers of the deltoid

Muscle fibers that resist shoulder abduction.

Posterior fibers of the deltoid

Muscle fibers that resist horizontal abduction and extension.

Pectoralis minor muscle

Muscle deep to the pectoralis major; palpated medial and inferior to the coracoid while the subject protracts the scapula.

Coracoacromial ligament

A ligament palpated between the anterior acromion process and the coracoid process.

Subscapularis muscle

A muscle palpated in the axilla over the anterior/lateral portion of the scapula while the subject actively internally rotates the arm.

Supraspinatus tendon

A tendon that inserts on the anterior part of the greater tuberosity and is palpated between the lateral acromion and greater tuberosity.

Upper trapezius muscle

A muscle that resists scapular elevation.

Rhomboid muscle (major & minor)

Muscles originating from $T2\text{-}T5$ (Major) and $C7\text{-}T1$ (Minor); palpated as the patient extends their arm and hand away from their back.

Anterior axillary border

Anatomical border of the axilla formed by the Pectoralis major.

Posterior axillary border

Anatomical boundary of the axilla formed by the Latissimus dorsi.

Medial axillary border

Anatomical boundary of the axilla formed by the ribs and serratus anterior.

Standardized Functional Movement Pattern One

Hand behind head; assesses shoulder elevation and external rotation, and elbow flexion and supination.

Standardized Functional Movement Pattern Two

Hand to contralateral scapula; assesses shoulder flexion, horizontal flexion, and internal rotation, and elbow flexion and pronation.

Normal Shoulder Flexion ROM

$$0\text{-}180^{\circ}$$

Normal Shoulder Extension ROM

$$0\text{-}60^{\circ}$$

Normal Shoulder Elevation (Abduction) ROM

$$0\text{-}180^{\circ}$$

Ulnar styloid process

Bony prominence at the distal end of the ulna where the $ECU$ tendon runs through a groove.

Radial styloid process

Bony prominence at the distal end of the radius.

Radial tubercle (Lister’s tubercle)

A small bony prominence on the dorsal side of the distal radius.

Scaphoid

A carpal bone located at the floor of the anatomical snuffbox on the radial side of the wrist.

Pisiform

A sesamoid bone within the tendon of the $FCU$, palpated on the palmar surface of the triquetrum.

Hook of the Hamate bone

A bone palpated by placing the thumb $IP$ joint over the pisiform and pointing the tip toward the index finger.

Proximal Carpal Row

Composed of the scaphoid, lunate, triquetrum, and pisiform.

Distal Carpal Row

Composed of the trapezium, trapezoid, capitate, and hamate.

Anatomical Snuffbox (Lateral border)

Formed by the Abductor pollicis longus ($APL$) and Extensor pollicis brevis ($EPB$) tendons.

Anatomical Snuffbox (Medial border)

Formed by the Extensor pollicis longus ($EPL$) tendon.

Carpal Tunnel Contents

Median nerve, flexor digitorum superficialis, and flexor digitorum profundus.

Tunnel of Guyon

A small tunnel distal to the wrist that the ulnar nerve and artery pass through.

Normal Wrist Flexion ROM

$$0\text{-}80^{\circ}$$

Normal Wrist Extension ROM

$$0\text{-}70^{\circ}$$

Normal Wrist Ulnar Deviation ROM

$$0\text{-}30^{\circ}$$

Normal Wrist Radial Deviation ROM

$$0\text{-}20^{\circ}$$

Radial head

Bony structure distal to the lateral epicondyle that rotates under the finger during supination and pronation.

Ulnar groove

The space palpated between the medial epicondyle and the olecranon.

Olecranon fossa of the humerus

Indentation palpated just proximal to the olecranon process with the elbow in $20\text{-}30^{\circ}$ of flexion.

Geometric Isosceles Triangle of the Elbow

formed by the lateral epicondyle, olecranon, and medial epicondyle at $90^{\circ}$ of elbow flexion.

Cubital Fossa (Lateral border)

Anatomical boundary formed by the Brachioradialis muscle.

Cubital Fossa (Medial border)

Anatomical boundary formed by the Pronator Teres muscle.

Cubital Fossa (Superior border)

Imaginary line between the epicondyles.

Normal Elbow Flexion ROM

$$0\text{-}150^{\circ}$$

Normal Forearm Pronation ROM

$$0\text{-}80^{\circ}$$

Normal Forearm Supination ROM

$$0\text{-}80^{\circ}$$

MMT Shoulder Flexion (Grades 3/5 to 5/5)

Tests the anterior deltoid and coracobrachialis muscles.

MMT Shoulder Extension (Grades 3/5 to 5/5)

Tests the latissimus dorsi, posterior deltoid, and teres major muscles.

MMT Shoulder Elevation (Abduction)

Tests the middle deltoid and supraspinatus muscles.