Forearm/elbow Flashcards

1
Q

the elbow is a ___________ joint

A

modified hinge

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2
Q

“carrying angle”

A

cubitus valgus

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3
Q

what makes up the carrying angle?

A

angle between long axis of humerus and long axis of forearm

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4
Q

normal cubitus valgus angle

A

15º

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5
Q

functional implication of cubitus valgus

A

ulnar nerve stretched more across medial elbow

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6
Q

what reinforces MCL?

A

prox wrist flexors and pronators

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7
Q

normal PROM of elbow

A

5-0-145

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8
Q

is a loss of flexion or extension more meaningful at the elbow?

A

flexion

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9
Q

elbow arthrokinematics

A

open chain:

concave on convex - roll and glide in same direction

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10
Q

what makes up the humeroradial joint?

A

fovea of radial head

capitulum of humerus

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11
Q

what makes up humeroulnar joint?

A

trochlear notch of ulna

trochlea of humerus

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12
Q

what makes up the prox radioulnar joint?

A

ulnar radial notch
annular ligament
radial head

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13
Q

what makes up the distal radioulnar joint?

A

ulnar notch of radius
head of ulna
articular disc

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14
Q

TFCC

A

triangular fibrocartilage complex

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15
Q

proximal part of TFCC articulates with _______ and distal part articulates with _________

A

ulnar head; carpals

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16
Q

primary stabilizer of distal radioulnar joint

A

TFCC

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17
Q

a pt comes in complaining of lateral wrist pain. what do you assume might be implicated?

A

TFCC

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18
Q

direction of axis of radioulnar joints

A

vertical

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19
Q

3 joints that can limit sup/pro

A

prox and distal radioulnar

humeroradial

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20
Q

normal ROM of pronation

A

75º

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21
Q

normal ROM of supination

A

85º

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22
Q

neutral position between supination and pronation

A

thumbs up

23
Q

how many DOF of radioulnar joints?

A

1

24
Q

how do we compensate for supination/pronation ROM limitations?

A

ER/IR

25
Q

proximal radioulnar joint arthrokinematics

A

convex radial head rotates in fibro-osseous ring on concave radial notch - ring prohibits typical arthrokin

26
Q

distal radioulnar joint arthrokinematics

A

concave radius and convex ulna - roll and glide in direction of radial head motion

27
Q

pronation/supination occur closed chain as a function of…

A

glenohumeral ER/IR

28
Q

3 elbow flexors

A
  1. biceps
  2. brachialis
  3. brachioradialis
29
Q

what elbow flexor generates the most force?

A

brachialis

30
Q

biceps is most effective with _______

A

supination

31
Q

when is brachioradialis most effective?

A

during elbow flexion with neutral forearm - esp during rapid movements

32
Q

in what orientation do triceps generate max force? why?

A

~90º bc length tension

33
Q

triceps frequently act as a _________

A

stabilizer

34
Q

elbow extension often performed with __________

A

shoulder flexion

35
Q

in a pushup, what keeps the triceps from extending the elbow AND shoulder?

A

anterior delt - opposes shoulder extension torque

36
Q

law of parsimony application to elbow extension

A

anconeus –> triceps

37
Q

law of parsimony application to supination

A

supinator –> biceps

38
Q

choose the stronger movement: supination or pronation

A

supination

39
Q

2 primary supinators

A

supinator

biceps

40
Q

4 secondary supinators

A

radial wrist extensors
EPL
ext indicis
brachioradialis (if starting from pronated position)

41
Q

what angle is biceps best able to supinate at? why?

A

90º - LoF is perpendicular to and radius

42
Q

2 primary pronators

A

pronator quadratus

pronator teres

43
Q

law of parsimony application to pronation

A

quadratus –> teres

44
Q

3 secondary pronators

A
  1. FCR
  2. palmaris longus
  3. brachioradialis (from supinated position)
45
Q

the law of parsimony states that the nervous system tends to activated _______________ for the control of a given joint action

A

the fewest muscles or muscle fibers possible

46
Q

why does the law of parsimony happen?

A

energy conservation - when bigger muscles are used, other muscles also turn on to stabilize/counteract

47
Q

tasks with low-level force demands are often accompished by…

A

uniarticular muscles

48
Q

fx of the cervical spine may result in..

A

C6 quadriplegia

49
Q

an essential component to maximizing movement efficiency in a person with paralysis

A

“muscle substitution”

50
Q

what is muscle substitution?

A

movement strategies that enable people with paraplegia to use an innervated muscle to substitute for part of the functional loss imposed by a paralyzed muscle

51
Q

people with C6 quad usually can’t use their ________

A

elbow extensors

52
Q

what muscles can “substitute” for elbow extensors?

A

clavicular head of pec major and/or anterior delt

53
Q

explain how shoulder muscles can sub for elbow extensors

A

shoulder muscles adduct and/or horizontally flexes the GH joint, pulling humerus toward midline with hand firmly fixed distally