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Kines: Elbow
| Question | Answer |
|---|---|
| What muscle is the longest of all the elbow muscles? | Brachioradialis |
| What is the action of Brachioradialis? | Elbow flexion from neutral |
| When is the brachoradialis active? | During rapid flexion movements of elbow or when weight is lifted during slow flexion movements. |
| When checking specific muscles of the upper arm, how would you test the biceps brachii? | Supinate and flexion |
| When checking specific muscles of the upper arm, how would you test the brachialis? | Pronation and flexion |
| When checking specific muscles of the upper arm, how would you test the brachioradialis? | Neutral and flexion |
| What are the names of the 3 heads of the triceps? | Long, medial, & lateral |
| Which 2 heads arise from the humerus? | Medial & lateral heads |
| Where does the long head originate from? | Infraglenoid tubercle of the scapula |
| Where do all 3 heads insert? | Olecranon process via the common tendon |
| Which muscle has the largest work capacity of all elbow extensors? | Triceps |
| Where does the anconeus originate from? | Lateral epicondyle of the humerus |
| Where does the anconeus insert? | Both the olecranon process and the adjacent posterior surface of the ulna |
| What is the action of the anconeus? | Initiates and maintiains extension force |
| What is the order of firing in muscle force in the upper arm? | Anocneus, Medial head, lateral head, & long head |
| Which of the triceps muscles is similar to the brachialis of the elbow flexors? | Medial head of triceps |
| What is the "workhourse" of the triceps group? | Medial head of triceps |
| What is a more appropriate classification of the elbow joint? Why? | Modified hinge joint; because the ulna experiences slight amount of axial rotation and medial lateral motion |
| Where is the axis for flexion and extension of the elbow located? | Through the center of the trochlea and capitulum bisecting the longitudinal shaft of the humerus. |
| What is the carrying angle? | The angle formed between the humerus and the forearm where they meet at the elbow |
| What is a normal carrying angle for men? | 5 degrees |
| What is a normal carrying angle for women? | 10-15 degrees |
| What is cubitus valgus? | When carrying angle is greater than normal (more than 5 in a male, and more than 10-15 in a woman) |
| Is the AROM flexion more or less than PROM? Why? | AROM is less than PROM because of soft tissue approximation |
| What is the AROM for the elbow? | 135-145 degrees |
| What is the PROM for the elbow? | 150-160 degrees |
| Do you have more ROM when the forearm is supinated or pronated? Why? | Supinated; because the radius and ulna are parallel to one another in supination |
| When might passive insufficiency of tricpes occur at the elbow? | When the shoulder is fully flexed |
| What may limit elbow extension when shoulder is in a position of hyperextention? | Passive tension in biceps |
| What is the closed-packed position of the elbow? | Full extension |
| What position is the elbow the most stable? | Full extension |
| What binds the radius and ulna? | Interosseous membrane, promixal and distal RU joint |
| What makes up the superior radioulnar joint? | Radial notch, annular ligament, capitulum, head of radius |
| T/F: 75% of ring around radial head formed by annular ligament; 25% by radial notch. | True |
| Where is the radial notch located? | lateral aspect of proximal ulna below trochlear notch |
| Where is the annular ligament located? | Attached to the anterior and posterior edges of radial notch. Encircles radial head. |
| What is the radial notch covered with? | Cartilage |
| The internal circumference of the superior RU joint is lined with what? What is its function? | Cartilage reducing friction against the radial head during pronation and supination |
| Where does the external surface of the superior RU joint receive attachments from? | Elbow capsule, radial collateral ligament, & supinator muscle |
| What is the origin and insertion of the quadrate ligament? | Arises just below the radial notch of the ulna and attaches to the medial surface of the neck of the radius |
| What is the function of the quadrate ligament? | Lends structural support to the capsule of the proximal RU joint, limits the spin of radial head during supination and pronation |
| What makes up the Inferior (distal) RU joint? | Ulnar notch of the radius, articular disk, and head of the ulna |
| Where is the ulnar notch located? | Distal end of radius along interosseous border. |
| Is the ulnar notch concave or convex? | Concave with articular disk along inferior edge |
| How is the disk shaped and where is it located? | Shaped like a triagnle with base at radial unlar notch, apex at styloid process |
| What is the function of the inferior RU joint? | Stabilizes forearm during supination/pronation |
| What is the articular disk of the inferior RU joint also known as? | Triangluar fibrocartilage |
| Where does the lateral side of the disk of the inferior RU disk attach? | Entire rim of ulnar notch of radius |
| How is the main body of the disk shaped and oriented in the inferior RU joint? | Main body fans out horizontally into a triangular shape, with apex attaching medially into the depression on the ulnar head and adjacent styloid process |
| How are the anterior and posterior edges of the disk shaped and oriented in the inferior RU joint? | Anterior and posterior edges of the disc are continuous with the palmar (anterior) and dorsal (posterior) radioulnar joint capsular ligaments |
| What does the proximal surface of the disk along with the capsular ligaments do? | Holds the head of the ulna snugly against the ulnar notch of the radius |
| How does articulation happen at the RU joint? | Motion at one joint always accompanied by motion at the other |
| How much of the load does the radius carry through the wrist? | 80% |
| How much of the load does the ulna carry through the wrist? | 20% |
| What happens to the radial head with pronation and supination? | radial head spins within osteoligaments enclosure |
| T/F: The annular ligament fibers blend with the radial collateral ligament and serve as a portion of the supinator muscle attachment. | True |
| What is the shape and orientation of the oblique cord? | flat fascial band extending form an attachment just inferior to the radial notch on ulna below biceps tuberosity. |
| What is the interosseous membrane? | Broad thin facial sheath that attaches the medial border of radius and the lateral border of the ulna |
| How are the fibers of the IM directed? | Most fibers directed away from the radius in an oblique medial and distal direction. A few cords run perpendicular to the membrane’s main fiber direction |
| About __% of compressive force due to bearing weight through the forearm crosses the wrist between the lateral side of the carpus and the radius | 80 |
| About __% of the compression force passes across the medial side of the carpus and the ulna at the “ulnocarpal space” | 20 |
| Why is part of the proximal directed force through the radius is transferred across the membrane to the ulna? | Bc of the fiber direction of the IM |
| What limits the amount of force at the wrist to cross the elbow via the HU joint, thus limiting the amount of force required to cross the limited surface area of the HR joint? | Interosseous Membrane |
| Does the IM resist distally applied forces? | No |
| Where does holding heave objects place stress? | Entirely through the radius |
| What does the distal pull do to the IM? | Slackens the IM |
| The distal pull requires: | other tissues such as oblique cord and annular ligament to accept weight of load. Contraction of brachioradialis may help as well. |
| When is the IM under tensions? | When forearm is in neutral |
| When is the IM lax? | When forearm is pronated or supinated |
| What axis does the IM function in? | Longitudinal axis (transverse plane) |
| When are the ulna & radius parallel? | supination |
| What is the ROM for supination/pronation? | 150-170 degrees |
| T/F: Pronation and supination must occur at both joints. | True |
| T/F: Loss of motion at one joint will limit motion at the other joint. | True |
| Why is pronation limited? | bony approximation and tension in post. RU ligament and post fibers of MCL |
| Why is supination limited? | passive tension in ant RU ligament and the oblique cord |
| How do pronators produce pronation? | by exerting a pull on radius which causes its shaft and distal end to turn over the ulna. |
| T/F: Pronator quadratus a one joint muscle, is unaffected by changing positions of the elbow. | True (b/c btw radius and ulna only) |
| T/F: Full pronation maximally elongates the dorsal capsular ligament at the distal RU joint. | True |
| Distal RU joint is concave on convex or convex on concave? | Concave on convex (same) |
| Proximal RU joint is concave on convex or convex on concave? | Convex on concave (opposite) |
| Palmar capsular ligament slackens to about __% of its original length. | 70 |
| T/F: Full Pronation exposes the articular surface of the ulnar head | True |
| How do supinators act? | By pulling the shaft and distal end of the radius over the ulna |
| During supination what happens to the proximal surface of articular disk? | Remains in contact with the ulna head |
| At the end of supination what happens to the palmar capsular ligament? | Taut |
Created by:
katem_35