Lecture 3 - Elbow, Wrist, Hand - Jordan University PDF

10/19/22 Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation science Musculoskeletal Anatomy The Elbo...

10/19/22 Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation science Musculoskeletal Anatomy The Elbow, wrist, hand 1 DR. MOHAMMAD AL-WARDAT, PT, PH.D First Semester 2022-2023 Osteology Scapula Clavicle Shoulder 1. Shoulder / Pectoral girdle Scapula § Clavicle § Scapula Humerus 2. Humerus (Upper end) (Arm) 3. Humerus (Distal end) Elbow 1. Humerus (Distal end) 2. Radius/Ulna (Upper end) Forearm Wrist Ulna 1. Radius/Ulna (Distal end) Radius 2. Carpal Carpal Hand Metacarpal 1. Metacarpal 2. Phalanges Phalanges 1 10/19/22 Osteology (Humerus – Distal End) Body Shaft Deltoid tuberosity à Deltoid M. (Insertion) In Between Triceps medial head M. (origin) Brachialis M. (origin) Distal End Lateral Supracondylar ridge à Brachioradialis M. (origin) Medial Supracondylar ridge Lateral Epicondyle Ø 6 Origin à Anconeous M. à Common extensor M à Extensor carpi radialis longus & brevis M. à Extensor digitorum M. / Extensor digit minimi M. à Extensor carpi ulnaris M. Medial Epicondyle Ø 5 Origin à Pronator Teres M. (1) à Common flexor M. à Flexor carpi radialis longus M. / Palmaris longus M. à Flexor carpi ulnaris M. à Flexor digitorum superfacialis M. (1) Condyle: Lateral (Capitulum), Medial (Trochlea)/ Fossa à Radial, Coronoid Olecranon Osteology (Humerus) 2 10/19/22 Osteology (Ulna) Proximal end 2 Process à Olecranon process Articulate w Olecranon fossa (Humerus) à Coronoid process Articulate w Coronoid fossa (Humerus) 2 Notch à Radial Notch à Articulate w Radial Head à Trochlear Notch à Articulate w Trochlear 3 Origin à Pronator Teres M. (2) à Flexor pollicis longus M. (1) à Supinator M. (supinator crest) 3 Insertion à Brachialis M./ Anconeous M. (BAT) à Triceps M. (olecranon process) Shaft Interosseous border à Interosseous membrane Pronator tubercle à Pronator teres (In) 4 Origin à Flexor digitorum profundus à Abductor pollicis longus (1) à Extensor Pollicis longus & Extensor indicis M. Distal end Styloid process & Ulnar Head à Articulate with Ulnar notch Pronator Quadrant M. (origin) Osteology (Radius) Proximal end Head à Articulate w Radial notch (Ulna) & w Radial fossa (Humerus) Neck Bicipital tuberosity à Biceps M. (In) In between: Supinator M. (In) Shaft Interosseous border à Interosseous membrane Pronator tubercle à Pronator teres (In) 4 Origins à Flexor digitorum superfacialis (2) & Flexor pollicis longus (2) à Abductor pollicis longus (2) à Extensor Pollicis brevis Distal end Styloid process à Brachioradialis M (In) Ulnar Notch à Articulate w Ulnar Head Pronator Quadrant M. (In) 3 10/19/22 Osteology (Radius & Ulna) Triceps Carpal bone 2 rows à proximal à scaphoid, lunate, triquetral, pisiform (RàU) à distal à trapizum, trapizoid, capitate, hamate (RàU) Metacarpal & phalanges 5 metacarpal à thumb – little finger (1-5) à each has base – shaft – head à base articulate w distal row of carpal bones à head articulate w phalange 14 Phalanges à thumb (2), index – little finger * 3 4 10/19/22 Interosseous membran Strong membrane that unites the shafts of the radius & the ulna; it is attached to their interosseous borders Flexor & Extensor Retinaculum Strong bands of deep fascia that hold the long flexor & extensor tendons in position at the wrist. Extensor Flexor Retinaculum Retinaculum Arthrology Elbow Joint q Articulation: This occurs between the trochlea & capitulum of the humerus & trochlear notch of the ulna & the head of the radius q Ligament à medial & lateral Collateral ligamnets. 5 10/19/22 Arthrology Elbow Joint q Important Relations Ø Anteriorly: brachialis, tendon of biceps, median nerve & brachial artery Ø Posteriorly: triceps muscle, a small bursa intervening Ø Medially: Common flexor tendons, ulnar nerve passes behind medial epicondyle & crosses medial collateral ligament of joint. Ø Laterally: Common extensor tendon & supinator. 90º 90º Range of motion Arthrology Proximal RadioUlnar Joint Distal RadioUlnar Joint Between circumference of the head Between the rounded head of the of radius & annular ligament & radial ulna and the ulnar notch on the notch on the ulna radius Ligament: Strong annular ligament Ligaments: Weak anterior & posterior ligaments strengthen the capsule. 6 10/19/22 Arthrology (Wrist joint) Between end of the radius & ulna ! with the scaphoid, lunate, triquetral bones below Ligaments: Anterior & posterior ligaments / Medial and lateral ligament 15º 30-45º 80-90º 70-90º Arthrology Inter-carpal Joints Between the individual bones of the proximal row of the carpus; between the individual bones of the distal row of the carpus; the midcarpal joint, between the proximal and distal rows of carpal bones Carpometacarpal and Inter-metacarpal Joints Between the individual bones of the distal row of the carpus & metacarpal bones Metacarpo-phalangeal Joints (MP) Between the heads of the metacarpal bones and the bases of the proximal phalanges Inter-phalangeal Joints Between phalanges themselves à Proximal interphalangeal PIP à Distal interphalangeal DIP 7 10/19/22 Arthrology Range of Motion Abduction Flexion Extension Adduction 8 10/19/22 Thumb Range of motion Abduction Flexion Adduction Opposition Reposition 9