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Know the detailed bone anatomy of the arm, forearm, and hand
- Humerus:Lateral Epicondyle, Trochlea, Media Epicondyle, Capitulum
- Radius: head, Turberosity, radial styloid process
- Ulna: Olecranon, semilunar notch, coronoid process, radial notch, Turberosity, ulnar styloid process
- Hand bones: Scaphoid, Lunate, Pisiform, Triquetral, Hamate, Capitate, Trapezoid, Trapezium
- Metacarpal 1 (thumb), Metacarpal 2,3,4,5
- Proximal phalange 1,2,3,4,5
- Middle phalange 2,3,4,5
- Distal phalange 1,2,3,4,5
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Know the muscles of humeral movement and stabilization of the shoulder, but located in the arm; origins, insertions and actions
- Movements of the Humerus:
- Adduction/Abduction/Flexion/Extension/Horizontal/Rotation/Circumduction
- Ball + socket, prone to downward dislocation
- Muscles Acting on the Humerus for shoulder stabilization (9):
1. Pec Major- O= Ant. Surface of the sternum and Ant. border of clavicle. I= Lateral lip of bicipital groove. A= Flexion, horizontal flexion(adduction), inward rotation, adduction, extension when shoulder is in a flexed position
2. Coracobrachialis O= Coracoid Process. I= Middle medial border of humerus. A= Horizontal flexion of humerus, slight flexion of humerus. Additional humeral head support counteracting the rotator cuff as a "mast muscle".
3. Deltoid O= "U" shape- Ant.- Lateral anterior clavicle. Middle- Lateral acromion process of scapula. Post- Inferior spine of scapula. I= Deltoid tuberosity of humerus. A= abduction, ant.flexion, horizontal flexion (adduction), inward rotation. Posterior extension, horizontal extension(abduction), slight outward rotation.
- 4. Lat. Dorsi O= T7-15, post. sacrum, ribs 10-12. I= Bicipital groove. A= extension, adduction, inward rotation of humerus.
- 5. Teres Major O= Inferior, medial border & inferior angle of scapula. I= Medial inferior lip of bicipital groove of humerus. A= Inward rotation, adduction, extension, stabilizer of humerus.
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SITS?
- S.I.T.S.
- 6. Supraspinatus O= Supraspinatous foss of scapula. I= Superior greater tubercle of humerus. A= Stabilizer, outward rotation, abduction upon isolation with deltoid of humerus
- 7. Infraspinatus Acts as one with Teres Minor, it's "buddy" O= Infraspinous fossa of sccapula. I= Middle greater tubercle of humerus. A= Stabilization, outward rotation, extension + horizontal extension of humerus.
- 8. Teres Minor O= Lat. Border of scapula. I= Lower gr8er tubercle. A= Stabilization, outward rotation, extension + horiztonal extension when isolated.
- 9. Subscapularis O= Subscapular fossa of scapula. I= Lesser tubercle of humerus. A= Stabilization, adduction, inward rotation, ext. of humerus when isolated.
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Know the muscles of the Elbow, origins, insertions and actions.
- Elbow is a hinge joint. Does Flexion + extension. Pivot joint. Rotation of the pivot join is called pronation and supination. Proximal and distal movement.
- Muscles (8):
- 1. Bicep Brachii O= LH- Supraglenoid tubercle. SH- Coracoid process. I= Bicipital tuberosity of radius. A= Elbow flexion and supination. Shoulder stabilization, assistor in humeral flexion.
- 2. Brachialis O= Distal anterior humerus. I= Ulnar tuberosity and coronoid process. A= Eblow flexion
- 3. Brachioradialis O= lateral condyle of humerus. I= Radius at Styloid process. A= Flexion, pronation from supination, supination from pronation.
- 4. Pronator Teres O= Medial Epicondylar Ridge of Humerus. I= Lateral wrap to lateral radius. A= Pronation, weak elbow flexion.
- 5. Pronator Quadratus Outlaw, deepest muscle, doesnt cross wrist or elbow. O= Ant. Ulna. I= Ant. Raius. A= Pronation
- 6. Tricep Brachii O= LH- infraglenoid tubercle. Lat. Head- upper posterior humerus. Med. head- Lower posterior humerus. I= Superior crest of olecranon process of ulna. A= Forearm extension at elbow, long head stabilizes the shoulder joint.
- 7. Anconeus O= Posterior lateral condyle of humerus. I= upper posterior ridge of ulna. A= initiation of extension, stabilization
- 8. Supinator O= Posterior lateral epicondyle of humerus and posterior proximal ulna. I= Lateral wrap to proximal radius. Supination! OF COURSEEE
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True Elbow Flexor?
- Brachialis!
- Great rotary component. Long Origin. Short insertion.
- O= Distal anterior humerus. I= Ulnar tuberosity and coronoid process. A= Eblow flexion
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What is the Elbow extensor initiator?
- Anconeus. its an elbow stabilizer, fan shaped fiber arrangement.
- O= Posterior lateral condyle of humerus. I= upper posterior ridge of ulna. A= initiation of extension, stabilization
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What muscles for the forearm are pronators, supinators or both?
- TWO Supinators:
- Supinator
- Bicep brachii
- TWO pronators:
- Pronator Teres
- Pronator Quadratus
- BOTH SUPINATION AND PRONATION:
- Brachioradialis will pronate and supinate back to a neutral position.
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Know the Anterior muscles of the wrist, hand, fingers origins, insertions, and actions
Pronator teres and Quadratus are the outlaws of the anterior forearm... WHy?
- At the Superficial/Intermediate Anterior
- Forearm Layer All with the same O=Med. Epicondyle and A= wrist flexion/Elbow Flexion, unless otherwise stated:
- 1. Flexor Carpi Radialis I= 2-3 Metacarpal base.
- 2. Palmaris Longus I= metacarpals.
- 3. Flexor Carpi Ulnaris I= metacarpals.
- 4. Flexor Digitorum Superficialis I= Proximal Phalanges 2-5. A= Digit flexion as well.
- Deep Anterior Forearm Layer:
- 1. Flexor Digitorum Profundus O= Ulna I= Distal Phalanges 2-5 A= Wrist flexion, finger flexion.
- 2. Flexor Pollicis Longus O= Radius/Ulna I= Distal Phalange 1 A= Wrist flexion, thumb flexion.
- 3. Pronator Quadratus O= Ulna I= Radius A= Pronation
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Know the Posterior muscles of the wrist, hand, fingers origins, insertions, and actions
- Posterior Forearm Superficial Layer, all have same O=Lateral Epicondyle and ridge:
- Ext. Carpi Radialis Longus *OUTLAW* I= #2 Metacarpal A= Wrist ext. and radial deviation.
- Ext. Car. Rad. Brev. *OUTLAW* I= #3 metacarpal A= Wrist ext. and radial deviation.
- Extensor Digitorum I= Middle and distal phalange 2-5 A= Wrist ext. + digit Ext.
- Ext. Dig. Min. I= Middle and Distal Phalange 5 A= Wrist ext. and digit ext.
- Ext. Car. Ulnaris I #5 metacarpal A= Wrist ext. + Ulnar Devation
- Posterior Forearm Deep Layer, all are medium to weak wrist extensors :( :
- Abductor pollicis long. O= Radius/Ulna I= #1 metacarpal A= #1 abduction and extension
- Ext. Poll. Brevis O=Radius I= #1 Proximal Phalange A= #1 Abduction and extension
- Ext. Poll. Longus O= Ulna I= #1 Distal Phalange A= #1 abduction and extension
- Ext. Indicis *OUTLAW* O= Ulna I= #2 middle/distal phalange A= #2 Extension
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Special features of the Thumb?
- Extension + Flexion happen on the same plane as adduction and abduction of the fingers.
- Opposable! 3 Joints:
- Carpometacarpal joint: Saddle, sloppy
- Metacarpophalangeal: Hinge-like with less motion
- Interphalangeal joint: ONly one hinge joint.
- "twirling trapezium" changes planes.
- Not covered by Palmar Aponeurosis.
- Joint Capsule thick + posteriorly and lax and thin anteriorly
- :::Controlled by 8 Muscles:::
- Intrinsic Muscles- Thenar eminence:
- Abductor Pollicis Brevis O= Scaphoid and Trapezium. I= Proximal phalange of #1 Digit(thumb) A= Abduction, Flexion, Opposition
- Flexor Pollicis Brevis O= Trapezium I= Proximal phalange of #1 digit. A= Abduction, flexion, Opposition
- Opponens Pollicis O= Trapezium I= Proximal Phalange of #1 digit + lateral border of distal metacarpal #1. A= Abduction, Flexion, Opposition
- Lies beneath thenar eminence:
- Adductor Pollicis O= Capitate, Scaphoid, 2, 3, metacarpal. I= Proximal phalange #1 A= Adduction, duh...
- Intrinsic muscles- Hypothenar Eminance:
- 1. Abductor Digiti Minimi O= Pisiform I= Proximal phalange of #5 digit A= Abduction, Flexion, Opposition
- 2. Flexor Digiti Minimi O= hamate hook I= Proximal phalange of #5 digit A= Flexion, Abduction, Opposition
- 3. Opponens Digiti Minimi O= Hamate. I= Proximal phalange of #5 digit, medial border. A= Opposition, abduction, Flexion
- 4. Palmar Interossei O= Medial Metacarpal 2, Lateral 4, 5. I= medial, Proximal phalange 2, lateral 4,5. A= Adduction to #3
- 5. Dorsal Interossei O= Medial metacarpal 1, lateral 5, medial and lateral 2, 3, 4. I= Lateral proximal phalange 2,3, medial proximal 3,4. A= Abduction away from #3
- 6. Lumbricals O= Tendinous tissue, Flexor digitorum profundus. I= Lateral proximal pahalnge 2,3,4,5 A= Flexion initiation and cupping.
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Know the muscles of the interior pelvis, superficial and deep, o and I, A
- Internal Pelvis:
- Iliacus O= Internal iliac fossa. I= Lesser Trochanter. A= Hip flexion, lordotic tendencies.
- DOES NOT CROSS SPINE, CROSSES HIP AND FUSES FIBERS WITH PSOAS MAJOR.
- Psoas Major O= Lateral bodies of T12-L5 I= Lesser Trochanter A= Hip FLexion, slight external rotation, lordotic tendencies
- CROSSES SPINE AND HIP. POWERFUL ENOUGH TO DOMINATE AT BOTH JOINTS CROSS.
- Psoas Minor O= Lateral bodies of T12-L3 I= Iliopectineal eminence.. A= Hip flexion, external rotation, lordotic tendencies.
- CROSSES SPINE ONLY. SOME FIBER FUSION WITH MAJOR.
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Know the muscles of the exterior pelvis, superficial and deep, o and I, A
- Posterior Lateral:
- GLuteus Maximus O= Posterior Gluteal Line of Ilium. I= Upper fibers- femoral gluteal line, Lower fibers- iliotibial tract to head of fibula. A= Extension, stabilization of weight line with tensor fascia latae. Outward rotation.
- Gluteus Medius O= SUperior to inferior gluteal lines. I= Greater Trochanter. A= Abduction, inward rotation.
- STABILIZES FEMORAL HEAD WHEN WEIGHT IS BEING SHIFTED BETWEEN FEET. MEDIUS AND MINIMUS ACT LIKE INFRASPINATUS AND TM OF SITS.
Gluteus Minimus O=Anterior to inferior gluteal lines. I= Greater trochanter. A=Abduction, inward rotation
- Anterior Lateral:
- Tensor Fascia Latae O= Iliac crest and anterior superior iliac spine. I= Head of fibula and lateral condyle of tibia. A= Stabilizes torso in line of hip and knee, flexes hip, internally rotates hip.
Sartorius O= Anterior superior Iliac spine I= Medial/anterior condyle and surface of tibia. A= Flexion of hip, some external rotation, likes to stabilize weight between trunk and knee.
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Know the Deep muscles of the pelvis, o and I, A
- Exterior Pelvis Deep: In order of superior to inferior.
- Piriformis
- Superior Gemelli
- Obturator Internis
- Inferior Gemelli
- Obturator Externis
- Quadratus Femoris
ALL FORM FAN SHAPE FROM FEMUR TO SACRUM AND HAVE A STABILIZING COMPONENT.
- O= Common origin lined up from superiolateral sacrum and greaer sciatic notch of ilium to ischial tuberosity.
- I=Lined up superior to inferior on common insertion; greater trochanter.
- A= COmmon action of outward hip rotation.
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Know which of the abdo muscles tilt pelvis to ribs, ribs to pelvis, rotate to same side, and rotate to opposite side.
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Identify muscles that have a special role in helping stabilize the shoulder against the pull of gravity along the long axis of the humerus.
Coracobrachialis, Deltoid, Tricep Brachii
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