Presentation on theme: "Chapter 5 Functional Anatomy of the Upper Extremity"— Presentation transcript:
1 Chapter 5 Functional Anatomy of the Upper Extremity
2 Review of Anatomical Structures Shoulder girdleAn incomplete bony ring in the upper extremity formed by the two scapulae and claviclesScapulaFlat, triangular bone on the upper posterior thoraxClavicle“S”-shaped bone articulating with scapula and sternum“Collar bone”Glenoid fossaDepression in lateral superior scapulaSocket for shoulder jointGlenoid labrumRing of fibrocartilage around rim of glenoid fossaDeepens socket for shoulder joint
3 Review of Anatomical Structures (cont.) BursaFibrous, fluid-filled sac that reduces frictionLocated between bones, tendons, and other structuresSubacromial bursaBursa between acromion process and insertion of supraspinatus muscleCoracoid processCurved process arising from upper neck of scapulaOverhangs shoulder joint
4 The Shoulder Complex Sternoclavicular joint Articulation between sternum and clavicleAcromioclavicular jointArticulation between acromion process of scapula and lateral end of clavicleScapulothoracic jointPhysiological joint between the scapula and thoraxGlenohumeral jointArticulation between the head of the humerus and the glenoid fossa of the scapula
5 Movements of the Shoulder Complex DislocationRotationElevation and DepressionProtraction and RetractionHorizontal Flexion and Extension
8 Shoulder Joint Movement Characteristics Large range of motion (ROM) at shoulderExtreme ROM required by many activitiesSwimming, throwing, gymnasticsLigaments and muscles provide stabilityScapular and clavicular movements accompany any arm movementScapulohumeral rhythmMovement relationship between humerus and scapula during arm raising movements
9 Muscular Actions Review Figure 5-9 on page 148 17 muscles that contribute to scapula and shoulder joint movements are listedMajor musclesDeltoid, trapezius, rhomboids, pectoralis major, latissimus dorsi, serratus anteriorRotator cuff (4 muscles surrounding shoulder joint)Infraspinatus, supraspinatus, teres minor, subscapularis
12 Shoulder Muscle Strength Generate greatest strength in adductionAbduction used frequently in daily livingWeakest movements are internal and external rotationMuscles generate high forces within jointAlmost 90% of body weight at 90° abductionImplications?
13 Shoulder Strength & Conditioning Shoulder muscles easy to stretch and strengthenStretchingActive and passiveStrength trainingWeight training, limb/body weight exercisesRotator cuff strength and flexibility importantStabilization of jointWidely used in daily living
14 Stretching & Strengthening Exercises Review Figure 5-14 on pages 152 and 153.
15 Injury Sprain Rupture of fibers of ligament Subluxation Partial dislocationFractureBreak in bone, often clavicleEctopic calcificationHardening of organic tissue through deposit of calcium salts in areas away from the normal sitesDegenerationDeterioration of tissue
16 Injury (cont.) Bursitis Inflammation of bursa Impingement syndrome Irritation of structures above shoulder jointDue to repeated compression between greater tuberosity and acromion processSubacromial bursitisCommon from impingement syndromeBicipital tendinitisInflammation of the tendon of the biceps brachii
17 Elbow and Radioulnar Joints Radiohumeral jointArticulation between radius and humerusCapitulumEminence on distal end of lateral epicondyleArticulates with head of radius at elbowUlnar-humeral joint“Elbow”Articulation between ulna and humerusMedial and lateral epicondylesCarrying angleAngle between ulna and humerus with elbow extended10–20°
19 Elbow and Radioulnar Joints (cont.) Articulations between ulna and radiusProximal and distalPronation, supinationInterosseous membraneThin layer of tissue running between ulna and radiusMedial and lateral epicondyles
20 Elbow Movement Characteristics and Muscular Actions All 3 joints never close packed at same timeMovements limited by several factorsSoft tissue, ligaments, joint capsule, muscles24 muscles cross elbowMost of these muscles capable of multiple movementsMuscles better at some movements than others
23 Forearm Strength and Conditioning Flexor group nearly twice as strong as extensorEffectiveness of strengthening/stretching exercisesDepends on position of armLength-tension relationshipNumerous exercises
24 Stretching and Strengthening Exercises Review Figure 5-21 on page 162.
25 Injury to Forearm Overuse injuries more common than trauma Throwing, tennis serveEctopic boneBone formation away from normal siteRuptureTorn or disrupted tissueMuscleOlecranon bursitisIrritation of the olecranon bursaeCommonly caused by falling on elbow
26 Injury to Forearm (cont.) Medial tension syndrome“Pitcher’s elbow”Medial elbow pain from excessive valgus forcesMay include ligament sprain, medial epicondylitis, tendinitis, avulsion fractureOsteochondritis dissecansInflammation of bone and cartilage resulting in splitting pieces of cartilage into the joint
27 Wrist & Fingers Manipulation activities Very fine movements Many stable, yet mobile, segments
28 Joints of the Wrist Radiocarpal “Wrist” Ellipsoid joint Flexion/extension, radial/ulnar flexionDistal radioulnarUlna makes NO contact with carpalsDoes NOT participate in wrist movementsMidcarpalArticulation between two rows of carpalsIntercarpalArticulation between a pair of carpals
29 Joints of the Wrist (cont.) CarpometacarpalArticulations between carpals and metacarpalsMetacarpophalangealArticulations between metacarpals and phalangesInterphalangealArticulations between phalanges
30 Muscular Actions Most originate outside hand region Thenar eminence Mound on radial side of palm formed by intrinsic muscles acting on thumbHypothenar eminenceMound on ulnar side of palm created by intrinsic muscles acting on little finger
31 Muscular Actions (cont.) Hand flexion/extensionHand radial/ulnar flexionFinger flexion/extensionFinger abduction/adductionThumb flexion/extensionThumb abduction/adductionThumb opposition
32 Conditioning Why condition hand region? Improve grip strength Enhance wrist action for throwing, strikingPrevent injuryExercisesWrist curlsGripping exercisesStretching
33 Contributions of the Wrist & Hand Power gripPowerful hand positionMaximally flexing fingers around objectPrecision gripFine-movement hand positionMinimally flexing fingers around objectExamples:Eating with forkThrowing softballSpiking volleyballDribbling basketballChanging channel with remote control
35 Injury of the Wrist & Hand Bennett’s fractureLongitudinal fracture of base of first metacarpalMallet fingerAvulsion of finger extensor tendons at distal phalanxResult of forced flexionBoutonniere deformityStiff proximal interphalangeal articulationCaused by injury to finger extensor mechanism
36 Injury of the Wrist & Hand (cont.) Jersey fingerAvulsion of finger flexorResult of forced hyperextensionTrigger fingerSnapping during flexion and extension of fingersCreated by nodules on tendons
37 Injury of the Wrist & Hand (cont.) TenosynovitisInflammation of sheath surrounding tendonCarpal tunnel syndromePressure and constriction of median nerveCaused by repetitive actions at wrist
39 Stretching and Strengthening Exercises Review Figure 5-27 on page 172.
40 Contribution of Upper Extremity Musculature to Sports Skills or Movements Upper extremity is obviously important in:Everyday activitiesPushing up out of a chairCarrying, liftingSporting/leisure activitiesSwimming, throwing, striking (golf, volleyball)
46 Summary Questions What do the upper extremities enable us to do? What stabilizes the structures of the upper extremities?What are potential injuries to the upper extremities?What causes these injuries?How can injuries be prevented?What are some exercises for stretching and strengthening the upper extremities?