Kins 151 exam 2

• 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

• 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.

• 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.

• 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

• Brachialis!
• Great rotary component. Long Origin. Short insertion.
• O= Distal anterior humerus.    I= Ulnar tuberosity and coronoid process.    A= Eblow flexion

• 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

• 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.

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

• 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

• 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.

• 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.

• 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.

• 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.

Coracobrachialis, Deltoid, Tricep Brachii