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1 Biomechanics of Human Upper Extremity Picture retrieved from http://catalog.nucleusinc.com/enlargeexhibit.php?ID=797 http://catalog.nucleusinc.com/enlargeexhibit.php?ID=797 ENT 214 Biomechanics

2 Picture retrieved from http://thestar.com.my/archives/2006/12/9/sports/Sazali.jpg

3 Retrieved from http://en.wikipedia.org/wiki/Image:Human_arm_bones_diagram.svg Sternum Manubrium

4  Sternoclavicular joint  Acromioclavicular joint  Coracoclavicular joint  Glenohumeral joint  Scapulothoracic joint Structure of the Shoulder

5 Sternoclavicular joint: modified ball and socket joint between the proximal clavicle and the manubrium of the sternum Interclavicular ligament Clavicle Sternoclavicular ligament Costoclavicular ligament Sternum Clavicle Articular disk Costal cartilage (1st rib)

6 Structure of the Shoulder Acromioclavicular joint: irregular joint between the acromion process of the scapula and the distal clavicle Coracoclavicular ligament Anterior viewPosterior view Clavicle Verterbal border Acromioclavicular joint Acromion process Coracoacromial ligament Coracoid process Glenoid fossa Axillary border Inferior angle Clavicle Scapular spine Vertebral border Inferior angle

7 Structure of the Shoulder Coracoclavicular joint: syndesmosis with the coracoid process of the scapula bound to the inferior clavicle by the coracoclavicular ligament Coracoclavicular ligament Anterior viewPosterior view Clavicle Verterbal border Acromioclavicular joint Acromion process Coracoacromial ligament Coracoid process Glenoid fossa Axillary border Inferior angle Clavicle Scapular spine Vertebral border Inferior angle

8 Structure of the Shoulder Glenohumeral joint: ball and socket joint in which the head of the humerus articulates with the glenoid fossa of the scapula Acromion process Coracohumeral ligament Long head of biceps Humerus Coracoid process Articular capsule Scapula

9 Structure of the Shoulder What is the scapulothoracic joint?  articulation between the anterior scapula and the thoracic wall

10 Bursae  A small fluid-filled sac located between movable parts of the body especially at joints  Reduce friction between layers of collagenous tissue

11 Movements of the Shoulder Complex scapulohumeral rhythm: a regular pattern of scapular rotation that accompanies and facilitates humeral abduction

12  First 30 o humeral elevation, contribution of scapula only 1/5 of glenohumeral joint  Beyond 30 o, scapula rotates 1 o for every 2 o of humerus movement  First 90 o of arm elevation, clavicle elevated 35 o to 45 o of motion at sternoclavicular joint. Movements of the Shoulder Complex

13 What muscles contribute to flexion at the glenohumeral joint?  anterior deltoid  clavicular pectoralis major  assisted by:  coracobrachialis  short head of biceps brachii

14 Retrieved from http://upload.wikimedia.org/wikipedia/commons/d/de/Gray410.png

15 Movements of the Shoulder Complex What muscles contribute to extension at the glenohumeral joint?  sternal pectoralis major  latissimus dorsi  teres major  assisted by:  long head of triceps brachii

16 Retrieved from http://upload.wikimedia.org/wikipedia/commons/d/d6/Deltoideus_posterior.PNG

17 Movements of the Shoulder Complex What muscles contribute to abduction at the glenohumeral joint?  middle deltoid  supraspinatus

18 Retrieved from http://upload.wikimedia.org/wikipedia/commons/8/8f/Gray412.png

19 Movements of the Shoulder Complex What muscles contribute to adduction at the glenohumeral joint?  latissimus dorsi  teres major  sternal pectoralis major  assisted by:  short head of biceps brachii  long head of triceps brachii

20 Movements of the Shoulder Complex What muscles contribute to medial rotation of the humerus?  subscapularis  teres major  assisted by:  pectoralis major  anterior deltoid  latissimus dorsi  short head of biceps brachii

21 Retrieved from http://upload.wikimedia.org/wikipedia/commons/f/f2/Gray411.png

22 Movements of the Shoulder Complex What muscles contribute to lateral rotation of the humerus? infraspinatus teres minor assisted by: posterior deltoid

23 Movements of the Shoulder Complex What muscles contribute to horizontal adduction of the humerus? pectoralis major anterior deltoid coracobrachialis assisted by: short head of biceps brachii

24 Movements of the Shoulder Complex What muscles contribute to horizontal abduction of the humerus?  infraspinatus  middle and posterior deltoid  teres minor  assisted by:  teres major  latissimus dorsi

25 Torque at shoulder  Torque created by weight of arm is the product of arm weight and perpendicular distance between arm’s COG and the shoulder

26 Torque at shoulder

27 Sample Problem 1  If the weight of the arm is 33 N, moment arm for the total arm segment is 30 cm, moment arm for deltoid muscle (Fm) is 3 cm.  How much force must be supplied by deltoid to maintain the arm in this position?  What is the magnitude of the joint reaction force (R)? wt

28 Common Injuries of Shoulder  Dislocation  Rotator Cuff Damage  Rotator cuff - anatomical term given to the group of muscles and their tendons that act to stabilize the shoulder  Example – supraspinatus, infraspinatus, teres minor, subscapularis muscles  Rotational Damage

29 Humeroulnar Joint Retrieved from http://upload.wikimedia.org/wikipedia/commons/9/97/Gray329.png

30 Structure of the Elbow What is the humeroulnar joint?  hinge joint in which the humeral trochlea articulates with the trochlear fossa of the ulna  considered to be the elbow joint

31

32 Structure of the Elbow What is the humeroradial joint?  gliding joint in which the capitellum of the humerus articulates with the proximal end of the radius

33 Structure of the Elbow What are the radioulnar joints?  the proximal and distal radioulnar joints are pivot joints  the middle radioulnar joint is a syndesmosis

34 Movements at the Elbow What muscles contribute to flexion at the elbow?  brachialis  biceps brachii  brachioradialis

35 Movements at the Elbow What muscles contribute to extension at the elbow?  triceps brachii  assisted by:  anconeus Retrieved from http://upload.wikimedia.org/wikipedia/commons/7/79/Musculusanconeus2.png

36 biceps fore force? be

37 Common Injuries of Elbow  Sprains and dislocation  Epicondylitis  Inflammation and sometimes microrupting of collagenous tissue at distal humerus

38 Wrist Retrieved from http://upload.wikimedia.org/wikipedia/commons/6/66/Gray334.png

39 Structure of the Wrist What are the radiocarpal joints?  condyloid articulations between the radius and the three carpal bones  these joints comprise the wrist

40 Structure of the Wrist What is the function of the retinacula at the wrist?  these fibrous bands of fascia form protective passageways through which tendons, nerves, and blood vessels pass

41 Movements at the Wrist What muscles contribute to flexion at the wrist?  flexor carpi radialis  flexor carpi ulnaris  palmaris longus  assisted by:  flexor digitorum superficialis  flexor digitorum profundus

42 Retrieved from http://upload.wikimedia.org/wikipedia/commons/5/5f/Gray418.png Retrieved from http://en.wikipedia.org/wiki/Image:Flexor-carpi-radialis.png

43 What muscles contribute to extension at the wrist?  extensor carpi radialis longus  extensor carpi radialis brevis  extensor carpi ulnaris  assisted by:  other wrist extensor muscles Movements at the Wrist

44 FINGERFINGER Retrieved from http://upload.wikimedia.org/wikipedia/commons/f/f7/X-ray_boy_hand.jpg

45 Structure of the Hand Joints What are the carpometacarpal joints?  the carpometacarpal joint of the thumb is a saddle joint  the other carpometacarpal joints are gliding joints

46 What are the intermetacarpal joints?  irregular joints between the metacarpals that share joint capsules with the carpometacarpal joints Structure of the Hand Joints

47 What are the metacarpophalangeal joints?  condyloid joints between the rounded distal heads of the metacarpals and the concave proximal ends of the phalanges  these joints form the knuckles of the hand Structure of the Hand Joints

48 What are the interphalangeal joints?  the proximal and distal interphalangeal joints of the fingers and the single interphalangeal joint of the thumb are all hinge joints Structure of the Hand Joints

49 Movements of the Hand What motions are permitted at metacarpophalangeal joints 2-5?  flexion  extension  abduction  adduction  circumduction

50 Movements of the Hand What muscles are responsible for motions of the hand?  there are nine extrinsic muscles with attachments both proximal and distal to the wrist  there are ten intrinsic muscles with both attachments distal to the wrist

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53 Common Injuries of Wrist & Hand  Fracture - boxers  Injury - golfers  Carpal tunnel syndrome  Passageway between carpal bone and flexor retinaculum  Symptom : pain, numbness along median nerve, clumsiness of finger function, atrophy of muscle

54 Summary 1. Shoulder – Structure – Movement and muscle involve – Common injuries 2. Elbow 3. Wrist 4. Hand 5. Force initiated and torque - calculation


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