Q4 Notes

Shoulder & GH

  • Shoulder Girdle: Comprised of Scapula, Clavicle & Articulations with the Sternum & Ribs

    • Clavicle trasnmits force between upper limb & axial skeleton- key for shoulder stability & function

    • Sternoclavicular joint is the only bony connection between the upper limb & axial skeleton

  • Upward Rotation RUle: Scapula must rotate 1* for every 2* of humeral elevation

Posterior Landmarks

Location

Superior Angle

Formed at the point where the medial and lateral borders

Spine of Scapula

Levels T3/T4

Vertebral Border

Closest to Spine

Axillary Border

Found Laterally

Inferior Angle

Level of T7

Glenoid Fossa

Articulation with Humerus

Acromion Process

Lateral Continuation of Spine

Supraspinatus Fossa

Above Spine

Infraspinatus Fossa

Below Spine

Anterior Landmarks

Location

Coracoid Process

“Crows Beak” short projection from the shoulder blade

Subscapular Fossa

broad concavity on the costal surface of scapula

Acromion Process

Articulates with Clavicle forming the Acromioclavicular Joint

Lateral Landmarks

Location

Acromion Process

Extends over GH Joint

Glenoid Fossa

Shallow, pyriform articular surface, which is located on the lateral angle of the scapula

Glenoid Labrum

Deepens Glenoid Fossa; Increases joit stability & depth for humeral head

Clavicular Landmarks

Location

Sternal End

Articulates with Sternum at Sternoclavicular Joint

Acromial End

Articulates with Acromion at Acromioclavicular Joint

Sternum Landmarks

Location

Manubrium

Superior Portion; articulates with Clavicle at Sternoclavicular Joint & first 2 ribs

Body

Central Portion

Xiphoid Process

Inferior Portion; made of cartilage in youth & ossifies with age

  • Articulations

  • Scapula Articulates with:

    • Clabicle at Acromioclavicular Joint

    • Humerus at GH Joint

    • Ribs indirectly as scapula moves over rib cage

    • Sternum at Sternoclavicular Joint by way of the Clavicle

  • Sternoclavicular Joint:

    • Shoulder Girdle to Sternum

    • Synovial joint containing a disc

    • Ligaments

      • Anterior Sternoclavicular: Enforce joint capsule

      • Posterior Sternoclavicular: Enforce joint capsule

      • Costoclavicular: Limits elevation

      • Interclavicular: Limits depression

    • Motions:

      • Elevation & Depression

      • Protraction & Retraction

      • Anterior Tilt (X Axis)

  • Acromioclavicular Articulaion

    • Connects Acromion to Clavicle

    • Ligaments:

      • Acromioclavicular: Stabilizes

      • Coracoclavicular: Suspends Scapula

        • Two Ligaments:

          • Trapezoid Portion & Coracoid Portion

          • Limits Rotation & Posterior Motion

  • Coracoacromial Ligament

    • Travels from Coracoid Process to Acromion Process

    • Creates arch over Head of Humerus

      • Supports head in upward force

Scapulothoracic Articulation

  • Not a true articulation; references motions of scapula on thoracic cage

    • Elevation

    • Depression

    • Protraction

    • Retraction

    • Upward Rotation

    • Downward Rotation

Action

Muscles

Elevation

Upper Traps, Levator Scapula, Rhomboids

Depression

Lower Traps, Serratus Anterior, Subclavius, Pectoralis Major & Minor, Latissimus

Retraction

Rhomboids & Mid Traps

Protraction

Serratus Anterior, Pectoralis Major & Minor

Upward Rotation

Traps & Serratus Anterior

Downward Rotation

Levator Scapula, Rhomboids, Pectoralis Major & Minor

Anterior Tilt

Pectoralis Minor

Muscle

Origin

Insertion

Action

Ligament (If any)

Levator Scapula

Transverse Process C1-C4

Superior Angle of Scapula

Elevates Scapula & Assists Downward Rotation

Rhomboid Minor

Spinous Process C7-T1

Vertebral Border of Scapula

Retraction, Elevation & Downward Rotation

Rhomboid Major

Spinous Process T2-T5

Lower on Vertebral Border of Scapula

Retraction, Elevation & Downward Rotation

Latissimus

Spinous Process T6-L5 & Lumbar Dorsal Fascia

Intertubercular Sulcus of Humerus

Extend Humerus, Medial Rotation of Humerus & Adduction

Trapezius (Upper)

Occiput & Ligamentum Nuchae

Lateral Clavicle & Acromion Process

Upward Rotation, Retraction, Elevation, Depression

Trapezius (Middle)

Ligamentum Nuchae & SP of Upper Thoracic

Distal Spine of Scapula & Acromion Process

Upward Rotation, Retraction, Elevation, Depression

Trapezius (Lower)

Spinous Processes as far as T12

Base of Scapular Spine

Upward Rotation, Retraction, Elevation, Depression

Serratus Anterior

Anterolateral Aspect of Ribs 1-9

Anterior of Vertebral Border of Scapula

Protraction, Upward Rotation

Subclavius

First Rib

Inferior Clavicle

Depresses Clavicle, Assists in Rotation of Clavicle

Pectoralis Minor

Anterior Aspect of Ribs 3-5

Coracoid Process of Scapula

Depression & Anterior Tilt

Pectoralis Major

Sternal Portion: Anterior Sternum & Costal Cartilage

Clavicular Portion: Medial ½ of Clavicle

Lateral Lip of Bicipital Groove

Flexes Arm. Adduction of GH, Horizontal Adduction

Elbow

Humeral Landmarks

Location

Head

Articulates with Glenoid Fosa

Anatomical Neck

Surgical Neck

Attaches Head to Shaft of Humerus

Bicipital (Intertubercular) Groove

Seperates the Greater & Lesser Tubercles; located on Anterior Aspect of Proximal Shaft

Greater Tubercle

Rounded Lateral Aspect of Proximal Humerus

Less Tubercle

Forms Medial Aspect of Proximal Humerus

Deltoid Tuberosity

Located ½ along shaft

Radial Groove

Posterior of shaft

Medial & Lateral Supracondylar Ridges

Widening of Humerus

Medial & Lateral Epicondyle

Rounded projections above the most distal portion of the humerus

Capitulum

Articulation with Radius

Trochlea

Artiulation with Ulna; more cone shaped with widest portion to medial side of humerus

Coronoid

Accomodates Codonoid Process of Ulna

Radial

Acoomodates Radial Head

Olecranon

Accomodates Oecranon Process on Posterior Elbow

  • Ulna

    • Found of medial forearm

    • Articulates with Humerus, Radius, & Wrist

    • Accomodates Flexion & Extension

Ulnar Landmarks

Location

Olecranon Process

Posterior articulation with Trochlea; Attachment site for Tricpes & Anconeus

Trochlea Notch

Articulates with Trochlea

Coronoid Process

Anterior; insertion of Brachialis

Radial Notch

Articulates with Radial Head

Ulnar Tuberosity

Located on Anterior & is attachment for Brachialis

Head

Articulates with Radius

Styloid Process

Pointed projection attachment for Brahioradialis

  • Radius

    • Latral bone of forearm; thumb side

    • Accomodates Supination & Pronation

Radial Landmarks

Location

Head

Articulates with Capitulum & Radial Notch

Radial Neck

Narrows down from head

Radial Tuberosity

Insertion of Biceps

Interosseus Space

Forms a space with ulna containing interosseous membrane

Styloid Process

Pointed Projection

Ulnar Notch

Articulation with Ulna

  • Elbow Joint

    • Articulatiob with Humerus & Ulna

    • Three Separate Articulations:

      • Humeroulnar

        • Articulation of Trochlea Notcha of the Ulna & Trochlea of the Humerus

        • Radial Collateral & Ulnar Collateral

        • Flexes & Extends

      • Humeroradial

        • Articulation between Capitulum of Humerus & Head of Radius

        • Annular Ligament

        • Allows for pivoting of radius during Supination / Pronation

      • Radioulnar

        • Proximal

          • Articulation between Head of Radius & Radial Notch

          • Annular Ligament

        • Distal

          • Articulation between Radius Ulna at Distal End

          • Stabilized by Interosseou Membrane along length of shaft

Muscle

Origin

Insertion

Action

Anconeus

Lateral Epicondyle

Lateral Olecranon

Extends Elbow

Triceps

Long Head: Infraglenoid Tubercle

Lateral Head: Posterilateral Shaft

Medial Head: Inferiomedial Shaft

Olecranon Process

Extends Elbow and Humerus

Brachioradialis

Lateral Supraconylar Ridge of Humerus

Radial Styloid Process

Flexion of Elbow

Brings Radius midway between Supination / Pronation

Brachialis

Anterior Distal Humerus

Coronoid Process

Flexion of Elbow

Biceps

Long Head: Supraglenoid Tubercle

Short Head: Coracoid Process

Radial Tuberosity

Flexion of Elbow

Supination of Forearm

Flexion of GH

Supinator

Superficial Layer: Lateral Epicondyle

Deeper Layer: Supinator Ridge of Ulna

Below Neck of Radius

Supnation

Pronator Quadratus

Anterior Distal Ulna

Distal Radius

Pronation

Pronator Teres

Medial Epicondyle

Medial Lateral Shaft of Radius

Pronates & Flexes Elbow

Hand & Wrist

  • Carpal Bones

    Mnemonic:

    • Proximal Row: “Sally Loves To Party”

    • Distal Row: “Try To Call Her”

  • Proximal Row (Anterior View)

    • Scaphoid

    • Lunate

    • Triquetrum

    • Pisiform (Sits over Triquetrum)

  • Distal Row

    • Trapezium

    • Trapezoid

    • Capitate

    • Hamate

  • Metacarpals

    • Five total

    • Each includes:

      • Base

      • Shaft

      • Head

  • Finger Digits

    • Made up of Phalanges

      • Digits 2–5: 3 phalanges (proximal, middle, distal)

      • Thumb (Digit 1): 2 phalanges (proximal, distal)

  • Wrist Articulations

    1. Radiocarpal Joint

      • Between radius & proximal row of carpal bones

      • Allows radial and ulnar deviation

    2. Intercarpal Joints

      • Between adjacent carpal bones

    3. Carpometacarpal Joints

      • Between distal carpals and bases of metacarpals

  • Additional Structures

    • Flexor Retinaculum

      • A fascia sheath covering the anterior wrist

      • Extends from pisiform & hook of hamate to scaphoid & trapezium

      • Forms the carpal tunnel

    • Extensor Retinaculum

      • Connects radius to ulnar styloid, triquetrum, and pisiform

  • Metacarpophalangeal Joint (MCP)

    • Located between metacarpals and proximal phalanges

    • A hinge joint allowing:

      • Flexion / Extension

      • Abduction / Adduction

      • Rotation