elbow

• consists of:
• bones
• humerus
• radius
• ulna

• ligaments
• joint
• capsule

• elbow joint
• humeroulnar joint
• humeroradial joint

• forearm
• proximal radioulnar joint
• at elbow
• head of radius pivots within the radial notch of ulna

• distal radioulnar joint
• distal end of radius rotates around the distal end of ulna

• radioulnar joint:
• Uniaxial pivot joint
• pronation/supination
• radius moves around ulna

• Ulna locked in by boney shape at proximal end

anatomical position

longitudinal axes of humerus and forearm form an angle

angle tends to be greater in women than in men

angle occurs becuz distal end of humerus is not level

humerus

• 2 convex areas
• trochlea/ulna
• capitulum/radius

• Ulna-concave
• radius/concave

flexion-elbow

soft tissue appr/muscle bulk

extension-elbow

boney

forearm-supination

firm/soft tissue stretch-muscle and ligament

forearm/pronation

hard(boney)-contact betrween radius and ulnar

concave radial and ulnar slide on the humerus in same direction as the motion of the forearm

• uniaxial
• 1o freedom
• flexion/extension in sagittal plane

hinge joint

• ROM: 0o-145o
• uniaxial joint
• resting position
• 70o/,10o supination
• closed pack position(walker, walking on your hands)
• full/with supination

• capsule
• keeps laeral side of joint from separating when stressed
• attaches to humerus, radius, and ulna

• medial collateral
• provides medial stability

• lateral collateral
• provides lateral stability

• annular
• holds radius against the ulna

• broad flat membrane
• keeps radius and ulna together
• serves as a muscle attachment

• radioulnar articulations held together by:
• annular ligament
• interoseous membrane

• brachialis
• brachioradialis
• biceps
• supinator
• triceps
• anoconeus
• pronator teres
• pronator quadratus

elbow flexion

• o-distal half of humerus
• I-coronoid process & ulnar tuberosity of ulna

• two heads
• O-long-supraglenoid tub of scapula
• O-short-coracoid process scapula

I-radial tuberosity or radius

Action

• elbow flexion
• forearm supination

most effective in supination when forearm is at 90o flex

moment arm greatest at 90o

ex: cork screw. unscrews(supination) and then pulls(flexion)

• elbow flexion
• O-humerus(brachii)
• I-radius

Elbow extension

• 3 heads-
• I-Long,infrag tub scapula
• I-later-inferior,greater humerus
• I-medial,posterior humerus

O-olecranon ulna

assists elbow extension

keeps triceps from being pinched during extension

forearm pronation

• O-distal una
• I-disal radius

• O-humerus/ulna
• I-proximal radius

• anterior
• elbow flexors
• brachialis
• biceps brachii
• brachioradialis

• forearm -supinator
• biceps brachii
• supinator muscle

• posterior
• elbow extensor
• triceps

• forearm pronators
• pronator teres
• pronator quadratus

• Wrist Flexion
• flexor carpi radialis
• flexor carpi ulnaris

wrist extension

• extensor carpi radialis longus/brevis
• extensor carpi ulnaris

radial deviation

• flexor carpi radialis
• extensor carpi radialis longus

• Ulnar deviation
• extensor carpi ulnaris
• flexor carpi ulnaris

• elbow extensor
• stablizer

supinator and biceps muscles work together to:

move the radius around the ulnar to produce supination from a pronated position

• radiocarpal joint
• proximally: distal end of radius and radioulnar disk

• distally: scaphoid, lunate, triquetrum
• distal radio-ulnar joint
• synovial

• condyloid joint
• biaxial
• flexion-extension
• radial-ulnar deviation

• between 2 rows of carpal bones
• contributes to wrist motion

• irregular shape
• plane joints

• nonaxial
• gliding motion

short bones arranged in an arch

• concavity on the anterior(palmar surface)
• convexity on posterior side

arch contributes to thumb's ability to oppose

these concavities and convestities are important features to understand for splinting

• styloid process
• disal, lateral radius, attachment for collateral ligaments

• hook of the hamate-anterior surface hamate
• transverse carpal ligament attachment

• medial epicondyle
• common flexor tendon attachment

• lateral epicondyle
• common extensor tendon attachment

• suprcondylar ridge
• extensor carpi radialis longus attachment

• flexor retinaculum
• transverse carpal-(more distal) arches over the carpal bones and forms a tunnel for the flexor tendons and median nerve

the one usually cut to relieve 5x of CTS

palmar carpal-(more proximal) functions to prevent tendons on this side of the wrist from pulling away from the wrist during wrist extension

• **common proximal attachment
• wrist flexors-medial epicondyle
• wrist extensors-lateral epicondyle (most)

distal attachment for all wrist muscles is a metacarpal

names of the muscles tell their action and their side

example: flexor vs extensor, ulnaris vs radialis

carpi means wrist

• flexion
• flexor carpi radialis
• flexor carpi ulnaris

• extension
• extensor carpi radialis longus
• extensor carpi radialis brevis
• extensor carpi ulnaris

• radial deviation(combination of a flexion and an extensor)
• flexor carpi radialis
• extensor carpi radialis longus

• ulnar deviation(combination of flex/ext)
• flexor carpi ulnaris
• extensor carpi ulnaris

• posterior muscle
• radial nerve

• anterior muscles lateral aspect
• median nerve

• anterior muscles medial aspect
• ulnar nerve

shock abosrber

distal end of the upper extremity

• composed of:
• thumb
• fingers
• metacarpals
• phalanges

useful and versatile, complex

3 joints

• carpometacarpal (CMC)
• trapezium articulating with first metacarpal (MC)

• modified biaxial
• flexion/extension
• abd/add
• opposition
• ***the movements originalte from the CMC joints
• metacarpophalangeal (MCP)

interphalangeal (IP)


Biaxial because reposition is returned to anatomical position and opposition is a combo of flex, abd with accesory rotations

• fingers
• digit 2-5(little finger)

• joints
• carpometacarpal
• metacarpophalangeal-MCP
• proximal-interphalangeal-PIP
• distal interphalangeal-DIP

palm assumes a cupped position, when hand is relaxed

• arches-support the arches
• proximal carpal arch
• distal carpal arch
• longitudinal arch

• extrinsic-originate outside the hand
• proximal attachment
• proximal to the wrist
• assistive role in wrist function
• primary function at the thumb(pollcus) or fingers

• Intrinsic-all taking place in the palm of the hand
• proximal attachment at or distal to the carpals
• for fine motor control and precision movement of the hand
• function at the thumb or fingers
• can be further divided into:
• thenar
• hypothenar(below, little finger)
• palm

palmar interossei muscles-adduction, inbetween bones on palm

dorsal interossei-abduction

***optimal position of strength and precision

wrist-20 to 30

MCP and IP joints are slightly flexed

• Thumb in opposition
• maintenance of the thenar web

The act of taking hold, seizing or grasping an object for functional use

the act of taking hold, seizing or graspiong an object for functrional use

• power grasp
• cylindrical grasp
• sperical grasp
• disc grasp
• hook grasp
• lateral pinch
• 3-jaw chuck
• tripod grasp
• pincer grasp

holding hammer

usually involves a significant amount of force

most powerful grip

fingers flexed around an object in one direction, the thumb the opposite

moved about by move proximal point musculature