Presentation on theme: "Read assigned readings of text"— Presentation transcript:
1 Method of Study for This Section (Applied Anatomy of the Musculoskeletal System) Read assigned readings of textUse the Dynamic Human CD-ROM and models and illustrations of the musculoskeletal system to help review structure of bones, joints, and muscles as necessary. This is the purpose of lab.Complete labs conscientiously and study models of articulated skeleton, shoulder, spine, and kneeLecture will only provide a selective review of structure, muscles & movements, and movement-related issuesFor exams, review lecture notes and understanding questions in both lecture and labs
2 Objectives of Upper Ext Unit Explain how anatomical structure affects movement capabilities on upper extremity articulations.Identify factors influencing the relative mobility and stability of upper extremity movementsIdentify muscles that are active during specific upper extremity movementsDescribe the biomechanical contributions, specific structures, and movement-related causes of common injuries of the upper extremity.
6 Normal Rom of Shoulder girdle Sternoclavicular jointProtraction 15 deg, retraction 15 degElevation 45 deg, depression 15 degAcromioclavicular jointAll directions deg
7 Muscles and Movement of Shoulder Girdle Illustrations on next three slidesTrapezius (large, superficial medial and sup to scapulae)Upper portion - elevation, upward rotationMiddle portion - adduction, or retractionLower portion - depression, upward rotationRhomboids -elevation, downward rotation, adduction, or retractionSerratus anterior (underneath scapulae)abduction, upward rotationPectoralis minor (underneath pectoralis major)downward rotation, abduction, or protractionLevator Scapulae (underneath upper trapezius)elevation, downward rotation
12 Normal ROM of arm movements Flexion – (arm at side is 0 deg) 180 deg, hyperextension 60 degTransverse flex (arm in front of chest is 0 deg) – 40 deg, transverse ext 90 degRotation(arm abducted, elbow bent to 90 deg, arm at right angles to trunk is 0 deg)Internal 90 deg, external 90 degAbduction 180 deg
16 Movements of Shoulder Complex Every movement of upper extremity involves either stabilizing or accommodating action of the shoulder girdle.If carrying something in arms, scapular elevators are involvedArm elevation – scapular protraction and/or upward rotation (first 30°,1/5th is scapular movement; then 1/3rd scapular movement after that)
17 Shoulder Joint Impingement Syndrome What is it? Pain from shoulder area resulting from impingement of structures between humeral head, acromion, and coracromial arch. Three stages:Stage I - edema and hemorrhage of subacromial structuresStage II - tendon fibrosis and bursal thickeningStage III - rotator cuff tears, biceps tendon ruptures, and bone spursII:III:I:
18 Causes of Sh Jt Impingement Primary impingement:Repeated movements requiring elevated and/or medially rotated humerus, compounded by weak rotator cuff muscles, causing: impingement of long head of biceps, supraspinatusSecondary Impingement:Decreased volume of subacromial space due to glenohumeral joint instability, and perhaps joint capsular tightnessStructural abnormalities:hooked or curved acromion, calcium deposits, bone spurs, thickened bursa, thickened ligaments
19 Shoulder Jt Impingement (3) Treatment:Related to the cause - may involve surgery, rotator cuff strengthening, and flexibility exercises.Later, avoid humeral elevation and rotation movements.Website for Shoulder Joint Impingement Syndrome(click on “view eorthopod”, then “shoulder”, then “impingement syndrome”)
23 Muscles and Movements of Radioulnar Joint Elbow Flexion -Forearm Supination - Biceps BrachiiForearm Pronation - Pronator TeresElbow Extension -Forearm Supination - SupinatorForearm Pronation -Pronator QuadratusMuscle force vectors on next slideEpicondylitisThe most common cumulative trauma disorder (CTD), repetitive stress injury (RSI), repetitive motion disorder (RMD), or overuse syndrome (OS) is epicondylitisEpicondylitis website (click on “view eorthopod”, then “elbow”, then “medial epicondylitis” or “lateral epicondylitis”
24 Normal ROM for forearm and wrist movements Flexion 150 degSupination degPronation degWristFlexion 80 degExtension 70 degRadial flex 20 degUlnar flex 30 deg
28 Carpal Tunnel Syndrome (cont’d) SymptomsPain in wrist area, or referred proximally or distallyTingling of thumb, fingers, or palmar side of handLoss of control of muscles affected by median nerve blockageCausesEnlargement of tissues within tunnelDecreased size of tunnelExtraneous tissue in tunnelTreatmentRelated to causeWebsite on carpal tunnel syndrome (Click on “view eorthopod”, then “hand”, then “carpal tunnel syndrome”KIN Biomechanics
29 Review & Homework Problems for Chapter 7 Review problems:Torque at shoulder with elbow flexed vs extendedFig 7-15, 7-16Compressive force at shoulder jtFig 7-17, sample problem 1 p 197Elbow flexion forceFigure 7-25, sample problem 2 p 206Homework – Due Tuesday, March 7Introductory problems, p 217: # 8,9,10Additional problem, p 218: #10
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