UE Ana & Kines PDF - Upper Extremity Anatomy & Kinesiology Review

UPPER EXTREMITY - 64 bones LOWER EXTREMITY - 62 bones BONES NUMBER TYPE OF BONE Clavicle 2 long Scapula 2 flat Humerus...

UPPER EXTREMITY - 64 bones LOWER EXTREMITY - 62 bones BONES NUMBER TYPE OF BONE Clavicle 2 long Scapula 2 flat Humerus 2 long Radius 2 long Ulna 2 long Carpal Bones 16 All short except pisiform - sesamoid Metacarpals 10 long Phalanges 28 long JOINTS TYPE OF JOINT Sternoclavicular ➔ Saddle jt. (Sellar) ☆☆ Acromioclavicular ➔ Plane jt. (Gliding/ Arthrodial) ☆☆ Glenohumeral ➔ Ball & Socket (Sphroidal) Humeroulnar ➔ Hinge (Ginglymus) Humeroradial ➔ Hinge Proximal Radioulnar ➔ PIVOT (Trochoid) Distal Radioulnar ➔ PIVOT Radiocarpal ➔ Ellipsoid ☆☆ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  Midcarpals ➔ Plane 1st Carpometacarpal ➔ Saddle ☆☆ 2nd - 5th Carpometacarpal ➔ Plane Metacarpophalangeal ➔ Condyloid☆☆ Interphalangeal (DIP/ PIP) ➔ Hinge SHOULDER FLEX 0-180 EX 0-60 ABD 0-180 ER 0-90 IR 0-70 ELBOW FLEX 0-150 EX 0 FOREARM PRON 0-80 SUPINATE 0-80 CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  WRIST FLEX 0-80 EX 0-70 RD 0-20 UD 0-30 THUMB FLEX 0-15 EXT 0- 20 ABD 0-70 Composed of: ❖ 20 muscles ❖ 3 Bony Articulations ❖ 3 Functional jts. Facts about your Shoulder! The primary purpose of the shoulder is to put the hand in a position for function Stabilizes the upper extremity for hand motions, lifts and pushes objects, elevates the body, assists with forced respiratory inspirations and expirations, and even bears weight when walking crutches. Allows greatest mobility but more unstable :( The only bony attachment of the upper extremity to the trunk is at the sternoclavicular joint. Support and stabilization of the shoulder are primarily dependent on muscles and ligaments. CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 BONES Shoulder Girdle : Clavicle, Scapula and Humerus. A.Clavicle ★ Aka: Strut / Collar Bone Shape: S shape/ Long Slender Orient: medial ⅔ - convex ant. Lateral ⅓ - concave ant. Muscles Attachment: O : “ PAS” Pectoralis Major, Ant. Deltoid, SCM I : “ SUT” Subclavius & Upper Trapz MC Conditions: ★★★★ ➔ CLAVICULAR FX ; MOST COMMON AMONG ADULTS ➔ MOI : FOOSH ➔ MC PART : MIDDLE ⅓ B. SCAPULA ★ Aka : Shoulder Blade Shape : Flat Triangular Resting Position : Distance b/w spinous process -> Medial Border ❖ 5- 6 cm ❖ 2-3 finger widths. Vertebra Level: T2 -T7 ★★★ T2 - Superior Angle T3- Spine of the Scapula? T7 - Inferior Angle CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 PARTS OF YOUR SCAPULA Anterior: Subscapular Fossa Coracoid PARTS REAL NA ! A. Lateral Border ★★★ Upper ⅔ -> Origin : T-minor Loweer ⅓ -> Origin : T- major Insertion : wala hehe B. Medial Border ★★★ Origin : wala Insertion : SLR ❖ Serattus Ant. ❖ Levator Scapulae ❖ Rhomboids CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  C. Inferior Angle Origin : Latissimus Dorsi Insertion : Serratus Anterior D. Spine Origin: Post. Deltoid Insertion: Lower Trapz E. Suspraspinatus Fossa Origin : Supra F. Infraspinatus Origin : Infra G. Subscapular Fossa Origin : Subscap H. Acromion Aka: Shoulder Summit Orient: ❖ Post. ❖ Lat. ❖ Superior Types: “ FCHR” I. Flat II. Curved -> MC ★★★ III. Hooked -> MC of Impingement★★★ IV. Ruptured -> 1/10 population Origin : Middle deltoid Insertion : Middle Trapz I. CORACOID Origin : Shorthead of Biceps & Coracobrachialis ★★★ Insertion: Pectoralis Minor ★★★ J. Glenoid Fossa ★★★ Origin ❖ Superior ❖ Anterior ❖ Lateral CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 K. Supraglenoid Tub Origin: Longhead of Biceps Brachii L: Infraglenoid Fossa Origin: Long head of Triceps C. HUMERUS a. Humeral Head ➔ ⅓ of the sphere ➔ Orient: MPS b. Anatomical Neck ➔ Marks the end of GH joint c. Surgical Neck ➔ Prone to Fx. ★★★ 1. Axillary Nerve → Deltoid (Roundness of Sh) → Atrophy “ squared shoulder” 2. Post. Humeral Circumflex Artery. D. Tuberosities LOCATION PALPATION INSERTION Greater Tub. Lateral Med. ROT/ IR SIT ★★★ Lesser Tub. Medial Lat. ROT /ER Subscap ★ Guards the jt. ant. CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 E. Bicipital Groove Pass: LH of Triceps Protected By: Transverse Humeral Ligament Palpation: SH. ER Insertion: LAT TIP → Pectoralis Major FLOOR → LATS DORSI MEDLIP → TERES MAJOR F. Deltoid Tuberosity G. Spiral Groove Aka: Radial Groove Pass: Radial Nerve aka Musculospiral N. Cond: 1. Saturday night Palsy 2. Honeymoon’s Palsy Angles: 1. Angle of Inclination → Axis between humeral head/ neck & humeral shaft NORMAL : 135 DEGREES ★★★ 2. Angle of Torsion → Axis between humeral head posterior rotation NORMAL : 30 DEGREES ★★★ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 STERNOCLAVICULAR JOINT ★★★ ➔ ONLY attachment of UE to the trunk ➔ Where the shoulder Circling ➔ Saddle ( Sellar) not STELLAR SUPERO INFERIOR ( CONVEX) - OPP Elevation - inferior Depression - superior ANTEROPOST (CONCAVE) - Same Retraction - Posterior Protraction - Anterior (-) : Manubriosternal + Medial Clavicle Limit: 1. Interclavicular - Depression 2. Costoclavicular - Elevation★★★ 3. SC Ligament Ant. - Retraction Post. - Protraction Kinematics: ELEVATION/ DEPRESSION PROTRACTION/ RETRACTION Posterior Longitudinal Rotation (PLR) Aka Transverse Rotation 90 Sh. elevation - PLR ➔ COMPLETES scapular upward rotation ➔ COMPLETES shoulder elevation (flex & abd) Note : Without PLR. sh elevation will be limited to 110 degrees. NOT 90 :) ★★★ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 ACROMIOCLAVICULAR JOINT ➔ Force Transmission★★ ➔ Painful arc 170 degree to 180 degree.★★ Type of Joint: PLANE Attachment: Acromion + Lat. Clavicle 1. Acromioclavicular Ligament Superior - Inf. translation Inferior - Sup. translation 2. Coracoclavicular Ligament CONOID (mtv.com) TRAPEZOID Medial Lateral Triangular Quadrangular Vertical Horizontal Kinematics: Degrees of Freedom = 3 Upward/ Downward Rotation Ant. Post.tilt ER/ IR CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 GLENOHUMERAL JOINT ★ Shoulder (Scapula & Humerus) ★ Painful Arc : 60 degree to 120 degree Board : 90 degree to 130 degree ★ CAPSULAR PATTERN : ER AB IR Type of Joint: Ball & Socket (Spheroidal) Attachment : Glenoid Fossa (SAL) + Humeral Head (MPS) Ligaments: 1. CorACohumeral → greatly affected AD. Caps 2. GlenohumERal →ER Superior GH - @ 0- 45 abd Middle GH - @ 45 -90 abd Inf. GH - @ >90 abd ➔ MC DISLOCATION: ANTERIOR ❖ Ant - ant. Translation ❖ Post. - post. Translation ❖ Axillary Pouch - inferior Translation KINEMATICS: ➔ 3 dof a. Flex- ext b. Abd- add c. ER- IR PJM (CONVEX) OPP Flex - post Ext- Ant Abd- Inferior ER - Ant IR - Post CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 FALSE JOINT Aka : Pseudojoint/ Functional Jt. 1. Bicipital Groove P.P.P & P.L.D.T 2. Subacromial Space A.k.a : Supraspinatus Outlet ★★ / Suprahumeral Space 3. Scapulothoracic Joint IMPORTANCE OF ST MOTION: ↑ ROM ↑ Stability ↑ Length tension of Deltoid Shock absorption Allows body elevation such as crutches & seated push ups. Scapulohumeral Rhythm - After 30 degree of shoulder elevation GH: SH will have 2: 1 ratio Phases HUMERUS SCAPULA CLAVICLE I 30 ° “Setting phase” 0 °-15° elev II (30-90°) 40 ° 20° 10 °-15° Elev III (> 90°) 60° 30° PLR STATIC SHOULDER STABILITY (NULC) ★★ 1. Negative Intraarticular pressure / Atmospheric ★★ 2. Upward tilt of glenoid fossa 3. Ligament tension - ★★ few & act on limited ROM 4. Capsule - allows 1-2 cm of distraction/ traction NOT SCM ★★ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  1. FORCE COUPLE ➔ Two opposing forces create some direction of rotation. ➔ “ SALTUT” is your SCAPULAR UPWARD ROTATION Serratus Ant. - protraction Lower Trapz - retraction → depression Upper Trapz - retraction → Retraction Analogy : Revolving Door 2. GH JT. & DELTOID ★ Roundness ★ Creates ALL movements ★ Axillary N. Ant - FABIR ★★ Mid - ABD★★ Post - EXABER★★ 3. Rotator Cuff Muscles “SITS” ★★ ➔ Susprapisnatus, Infraspinatus, Teres Minor, Subscapularis ➔ Controller of GH Arthrokinematics ➔ Prevents Dislocation/ Subluxation Supraspinatus ❖ Stabilizes ❖ Upward pull of humerus ❖ Prevents Inf. Subluxation ❖ Rotates the Sh. jt. ❖ Abduction Initiator Infraspinatus ❖ ER PRIMARY ★★ Teres Minor ❖ ER Subscapularis → IR primary★★ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 Axillary Triangle : Apex: Anterior: Clavicle (Front) Posterior: Superior border of the scapula (back) Medial 1st Rib WALLS MNEMONIC: “ MRS PSLT naman ng APPS mo padalhan nalang kita sa LBC” Medial wall: 4th - 5th Ribs and Serratus Ant. Posterior wall : Subscapularis, Latissimus Dorsi, Teres major Anterior wall : Pectoralis major, Pectoralis minor , Subsclavius Lateral Wall : Biceps brachii and Coracobrachialis BASE : PLDT Anterior axillary fold : Pectoralis major Posterior axillary fold: Latissimus dorsi, teres major QUADRILATERAL SPACE S: T minor I: T. Major M: LH of Triceps L: Surgical Neck Content: Axillary Nerve CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  TRIANGULAR SPACE S: T. Minor I:T Major L:LH of Triceps Content: Scapular Circumflex A. TRIANGULAR INTERVAL S: Teres Major L:Humerus M: Long head triceps brachii MUSCLE ORIGIN INSERTION NERVE ACTION 1. Pectoralis Clavicle, Sternum Lat. Lip of Lateral Pectoral Protraction Major Upper 6th CC Bicipital Groove Medial Pectoral FADIR ★★ ★★ ★★ 2. Pectoralis 3rd, 4th, 5th Ribs Coracoid Process Medial Pectoral Elevate Ribs Minor ★★ ★★ Depress Scapula 3. Subclavius 1st CC Clavicle Nerve to Stabilize Clavicle Subsclavius 4. Serratus Upper 8th Ribs Medial border of Long thoracic Protraction, Ant ★★ the Scapula & ★★ upward rotation Aka : saw ms inferior Angle Sh. Elevation Aka: Boxer’s ms ★★ Flexion > Abd ★★ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  MUSCLES CONNECTING THE UPPER LIMB TO VERTEBRAL COLUMN MUSCLE ORIGIN INSERTION NERVE ACTION 1. Trapezius Ligamentum Upper Trapz - Spiral part of All ms. for retraction Aka: Shawl Nuchae Occiput Clavicle Accessory N. UT - ELEV Spine of C7 -T12 MT - CN 11 MT- RETRAC Acromion LT- DEP LT- Spine of ★★ ★★ the Scapula 2. Latissimus Iliac Crest, ★★ Floor of BG Thoracodorsal EXADIR dorsi Lower Ribs, ★★ ★★ ★★ ★★ Lower Thoracic Aka: Swimmer’s ms Spine, Inferior Widest Ms Angle 3. Levator Transverse Medial Border Dorsal Scapular N RETRACTION Scapulae Process (c 5)★★ ★★ 4. Rhomboid Spinous Process Medial Border Dorsal Scapular N RETRACTION Minor (c 5)★★ ★★ 5. Rhomboid Spinous Process Medial Border Dorsal Scapular N RETRACTION Major (c 5)★★ ★★ MUSCLES CONNECTING THE SCAPULA TO HUMERUS MUSCLE ORIGIN INSERTION NERVE ACTION 1. Deltoid A: Clavicle Deltoid Tub Axillary N ★★ A: FABIR M: Acromion M: Abd P: Spine P: Exaber 2. Supraspinatus Supraspinous G. Tub★★ Suprascapular N. ABD (initiator) fossa ★★ 3. Infraspinatus Infraspinatus G. Tub★★ Suprascapular N. ER ★★ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  fossa 4. Teres Minor Upper- Lat. G. Tub★★ Axillary N★★ ER ★★ Border 5. Teres Major Lower part -Lat. Medial lip of Lower Subscap EXADIR B BG ★★ ★★ 6. Subscapularis Subscapular Lesser Tub Upper Subscap IR ★★ Fossa ★★ Lower Subscap ELBOW & FOREARM I. BONES II. JOINTS III. CARRYING ANGLE IV. CUBITAL FOSSA V. CUBITAL TUNNEL VI. MUSCLE VII. OINA CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 PARTS: I. SUPRACONDYLAR RIDGE Lateral : Origin : Brachioradialis, ECRL Medial : Origin : Pronator Teres II. EPICONDYLES Lateral: Origin wrist extensors + Supinator Medial: Origin: wrist flexors + Pronator Teres Condition: ❖ Lat. Epicondylitis ★★ ➔ Aka: Tennis Elbow ➔ Aff: wrist extensors Mobile wad of three 1. Brachioradialis 2. ECRL 3. ECRB ★★ ❖ Medial Epicondylitis ➔ Aka: Golfer’s Elbow ➔ Aff: Wrist Flexors (PT pa FCR) ★★ 1. 1st Pronator Teres 2. 2nd FCR III. CAPITULUM ◆ Lateral/ Radial ➔ Avascular Necrosis → PANNER’S IV. TROCHLEA Medial/ Ulnar Articulates with Trochlear Notch “ Semilunar Notch” V. RADIAL HEAD ★ (+) Annular Ligament - prevents excessive radial distraction ★★ Cond: Nursemaid’s Elbow (Pulled Elbow) VI. RADIAL TUBEROSITY I: Biceps Brachii ★★ CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 VII. CORONOID PROCESS I: Brachialis ★★ VIII. OLECRANON PROCESS I: Triceps Brachii★★ Anconeus → Initiator of elbow Ext. IX. INTEROSSEOUS MEMBRANE ➔ Prevents proximal displacement ➔ Stability ➔ Shock absorption ➔ Muscle attachment JOINTS I. HUMERORADIAL T: Hinge A: Capitulum (Convex) + Radial (concave) L:Lateral Collateral Ligament (LCL) - limits varus ★★ K:1 dof (flex-ext) II. HUMEROULNAR T: Hinge A:Trochlea (convex) trochlear Notch (concave) L:Medial Collateral Ligament (MCL) - Limits valgus ★★ K:1 DOF (flex -ext) III. PROXIMAL RADIOULNAR JOINT (PRUT) T: Pivot A:Radial head (convex) + Radial notch (convex) L: (O SUP, Q SPIN) a. Annular Ligament → Prevents excessive radial distraction b. Oblique Cord → ↓ Supination c. Quadrate Lig → Spinning K:1 DOF (Sup - Pron) IV. DISTAL RADIOULNAR JOINT (DRUJ) T: Pivot A:Ulnar head (convex) + ulnar notch (concave) CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  L:Radioulnar Ligament 1. Radioulnar Ligament ➔ Palmar → Limits posterior translation ➔ Dorsal → limits anterior translation 2. TFCC (Triangular Fibrocartilaginous Complex) ➔ Major Stability of DRUJ K: 1 DOF (Sup- pron) SUPER ULTRA MEGA NOTES: ★★★★★★★★★★★★★★★★ 1. FLEX-EXT OF ELBOW BEST: Humeroulnar LEAST: DRUJ 2. PRONATION & SUPINATION BEST: PRUJ LEAST: Humeroulnar 3. AXIS OF MOTION PROXIMAL → RADIUS DISTAL → ULNA 4. PJM PPP ( PRUJ -PRONATION - POSTERIOR) PSA (PRUJ- SUPINATION - ANTERIOR) DPA (DRUJ -PRONATION - ANTERIOR) DSP (DRUJ-SUPINATION - POSTERIOR) CARRYING ANGLE ➔ Axis formed by the humerus & ulna ➔ Present: Elbow extension + supination ➔ Absent: Elbow Flexion (>30) + pronation NORMAL MEN → 5° - 10 ° WOMEN → 10° -15° AVE: 5 °- 15° CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 COND: < 5 ° - cubitus varus “ Gunstock Deformity > 15 ° - cubitus valgus CUBITAL FOSSA Floor ➔ Lat: Supinator ➔ Med: Brachialis Contents: “ Medial to Lateral” MEDIA AT RADIO Median N ⏐ Brachial Artery ⏐ Biceps Tendon ⏐ Radial N. ➔ Prone of entrapment of Cubital Fossa Boundaries: Sup - Imagining Line between 2 epicondyle Lat - Brachioradialis Med - Pronator Teres CUBITAL TUNNEL ➔ Between m. Epicondyle & olecranon Content: ULNAR NERVE CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  MUSCLES SPURT (MOBILITY “SHUNT” ( STABILITY) “ Par ang Urigin” “Urigin is Near” O: FAR O: NEAR I : NEAR I: FAR Ex: 1. BICEPS 1. BRACHIORADIALIS O: Lat. supracondyle BRACHIORADIALIS I: Radial Sytloid O:LH - Supraglenoid ; SH. Coracoid I:Radial Tub 2. TRICEPS O: LH of infraglenoid I: Olecranon 3. BRACHIALIS ANTERIOR ARM BICEPS BRACHIALIS BRACHIORADIALIS FA: SUPINATE ★★ FA: PRONATE FA: MIDPOSITION ★★ ➔ Strongest Supinator ➔ ★★Workhorse as ➔ Elbow flex with ➔ Multiple Joints elbow flexor chief certain cond elbow flexor (MIDPOST) SH - FLEX ➔ Loyal/ stick to 1 ➔ Supinates & ELB - FLEX ELBOW JT Pronates forearm FA - SUP “ Unbothered” MS “MIDPOSITION” Active : Any FA position ➔ Also part of wrist CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  ➔ Fast or slow extensors contraction ➔ (Posterior FA/ Lat. ➔ With/ without FA) resistance POSTERIOR ARM TRICEPS BRACHII Long Head - Prone to insufficiency Lateral Head - most muscular & strongest Medial Head - Workhouse Anconeus ★★ Initiator Small amount of force Maintains elb. ext. MUSCLE ORIGIN INSERTION N. ACTION BICEPS LH- Radial Tub ★★ Musculocutan SH- Flex Supraglenoid eous N. Elb - Flex Tub Fa- Sup SH - ★★ Coracoid Process CORACOBRAC Coracoid Medial Tub. ★★ Musculocutan Weak Flex HIALIS Process eous N. Add (SH) BRACHIALIS Anterior Coracoid Process Musculocutan Elbow Humerus ★★ eous N. Flexion CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  ONLY ★★ POSTERIOR LH - Olecranon Process Radial N. Sh. Ext 1. Triceps infraglenoid ★★ Elbow Brachii tub Ext. ★★ ★★ Lat. Head - Post. Hum Medial Head - Post. Hum WRIST & HAND BONES ★★Wrist & Hand = 29 Hand : 27 CAPALS Proximal (SLTP) 1. Scaphoid ➔ Aka.Navicula ➔ Shape: Boat ➔ Most Mobile ➔ 2nd Largest 2. Lunate ➔ Aka. Semiulnar ➔ Shape: Crescent ➔ Palpation: Loc. Distal to Lister’s Tubercle CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  3. Triquetrum ➔ Lies below the PISIFORM (not platform wtf.) ★★ 4. Pisiform ➔ Aka. Pea ➔ Smallest ➔ Only sesamoid - FCU ➔ Only 1 articulation ( triquetrum) ➔ Does not belong to RC joint ➔ Last to ossify. DISTAL (TTH) 1. Trapezium ➔ Aka. Greater Multangular ➔ Articulates with 1st Metacarpal - THUMB★★ 2. Trapezoid ➔ Aka. Lesser Multangular ➔ 2nd Smallest.★★ 3. Capitates ➔ Aka. Osmagnum ➔ Shape: head ➔ LARGEST CARPAL BONE★★ 4. Hamate ➔ Aka. Unciform ➔ Shape: Hoooked Articulation:★★★★ Capitates : 7 Scaphoid: 5 Pisiform: 1 The Rest : 1 CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 OSSIFICATION “ Come Home at 3am Let’s sing and Trim Together Pare”. 1. Capitate★★ 2. Hamate 3. Triquetrum 4. Lunate 5. Scaphoid 6. Trapezium 7. Trapezoid 8. Pisiform★★ SUPER ULTRA MEGA POWERFUL NOTES!! MC FRACTURED★★ 1. Scaphoid 2. Lunate 3. Triquetrum MC DISLOCATED★★ 1. Lunate AVASCULAR NECROSIS★★ 1. Scaphoid ➔ PREISNER’S DSE 2. Lunate ➔ KIENBOK’S DSE 3. Distal Lunate ➔ BURN DSE METACARPALS CON: FRACTURE 1. 1st MC - Rolando’s Bennetts★★ 2. 5th - Boxers/ Streetfighter ★★ PHALANGES “ Battle Line” Pollex - Thumb Strongest - 2nd Weakest - 5th CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  JOINT I. RADIOCARPAL T: Ellipsoid A: Radius + SLT L: Radiocarpal Ligament Palmar - Post Disloc Dorsal - Ant. Disloc K: 2 DOF Flext- Ext RD-UD (ABD) (ADD) RC JOINT PJM NORMAL ADL NEEDS RC- CONVEX “ SLIDE OPP” ★ FLEX- POSTERIOR Flex 80° 40° ★ EXT- ANTERIOR Ext 70° 40° ★ RD (ABD) - MEDIAL RD 20° 10° ★ UD (ADD) - LATERAL UD 30° 30° II. MIDCARPAL T: Plane / Arthrodial ; RC & MC Contributions Flexion UD > RC - 50 ° >RC - ⅔ > MC - 30° > MC - ⅓ RC> MC RC> MC Extension RD > RC - 20 ° >RC ½ > MC - 50 ° >MC ½ MC> RC RC=MC CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  III. CMC Type of Joint: PJM CONCAVE 1st - Saddle/ Sellar 2nd- 5th - Plane F → Ant. E → Post. IV. MCP ABD → Lat. ADD → Med. T: Condyloid PJM: Concave V. IP PIP - HINGE DIP - MED SOFT TISSUES (WRIST) 1. Flexor Retinaculum Aka: transverse carpal ligament Attachment: Lat: Scaphoid & Trapezium Med: Pisiform & Hook of Hamate Contents: (10) 4 tendons of FDS 4 tendons of FDD 1 Tendon of FPL Median Nerve CONDITION: CTS Median N. DORSAL/ EXTENSOR TUNNEL I. APL,EPB II. ECRL, ECRB III. EPL IV. EDC, EI V. EDM VI. ECU CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 II. Extensor Retinaculum Attachment: Lat: Distal End of Radius Med: Pisiform & HOH III. Tunnel of Guyon ➔ Formed by: PISOHAMATE LIG★★ ➔ Content: ULNAR N.★★ IV. ANATOMIC SNUFFBOX Aka: FOVEA RADIALIS Pass: Radial Artery Boundary: Lateral EPB & APL Medial : EPL FLoor: Scaphoid Bone SOFT TISSUES (FINGERS) (FLEXOR ZONE) FDP ★★ FDS★★ I. FDP Insertion ATT: MP & DP ATT: MP Only II. FDS Insertion “ no man Action: PIP & DIP “ Strong/ Fisting Hand island” “Light Hand Closure” Closure” ★ Contraindicated: FDPabebe FDStrong Flexor Tendon Repair FDSuntok III. Neck of Metacarpal IV Carpal Tunnel V Proximal to the wrist CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  II. Extensor Mechanism Swan Neck Deformity - Lateral Band Boutonniere's Deformity - Central Slip III. Anular & Cruciate Pulley ➔ Prevents Bowstringing LOCATION ★★★★★★ A5 Proximal of DP C1 - b/w A2 & A3 A4 Mid of MP C2- b/w A3 & A4 A3 Distal of PP C3- b/w A4 & A5 A2 Mid of PP A1 Metacarpal * MCP jt. Trigger Finger CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024 FOREARM : ANTERIOR Innervated by Median N. 1. Palmaris Longus 2. Pronator Teres 3. Pronator Quadratus 4. FCR 5. FPL 6. FDS 7. FDP Lateral half Innervated by Ulnar N. SUPERDUPER ULTRA MEGA FDP -> Medial Half NOTES!!!! 8. FCU ★ Palmaris Longus FOREARM : LATERAL - Wrist Extension Only Innervated by Radial N. ★ Pronator Teres - Does not flex the wrist 1. Brachioradialis - 2 degree elbow flexor 2. ECRL - “Substitute Elbow FOREARM :POSTERIOR Flexor” Innervated by Radial N. ★ Radial Deviations 1. Anconeus - FCR, ECRL, ECRB 2. Supinator ★ Ulnar Deviations 3. APL - FCU, ECU 4. EPB 5. ECRB 6. EPL 7. EDC 8. EI 9. EDM 10. ECU CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024  HAND MUSCLE MEDIAN ULNAR 1. THENAR Eminence 1. HYPOTHENAR Eminence A- Abd Pollicis Brevis A- Abd DM F- Flexor Pollicis Brevis F - Flexor DM O - Opponens Pollicis O - Opponens Digiti 2. LUMBRICALS Minimi Lateral (1st & 2nd) 2. LUMBRICALS Action: Medial 3rd - 4th ★ MCP Flexion ★★ 3. Interossei “PAD- DAB” ★★ ★ IP Flexion★★ PRIMARY ACTION: ❖ PALMAR - ABDUCTION ❖ DORSAL- ABDUCTION 4. FPB - Dually innervated 5. Adductor Pollicis ST: Prominent’s Sign. “I can do all things through Christ who strengthens me”. CARMINA P. MANALO PTRP REVIEWER FOR BOARDS DECEMBER 2024