Biomech MS System (cont'd), Upper Extremity

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Transcript Biomech MS System (cont'd), Upper Extremity

Method of Study for This Section
• Read assigned readings of text
• Use Thompson Manual and the Dynamic Human CDROM to help review structure of bones, joints, and muscles
as necessary. This is the purpose of lab
• Complete labs conscientiously and study models of
articulated skeleton, shoulder, spine, and knee
• Lecture will only provide a selective review of structure,
muscles & movements, and movement-related issues
• For exams, review lecture notes and understanding
questions in both lecture and labs
Sh Jt & Girdle Ant Musculature
Sh Jt & Girdle Post Musculature
Upper Extremity – Chapter 7
Muscles and Movement of Shoulder Girdle
• Illustrations on next three slides
• Trapezius (large, superficial medial and sup to scapulae)
– Upper portion - elevation, upward rotation
– Middle portion - adduction, or retraction
– Lower portion - depression, upward rotation
• Rhomboids – elevation, downward rotation, adduction, or retraction
• Serratus anterior (underneath scapulae)
– abduction, upward rotation
• Pectoralis minor (underneath pectoralis major)
– downward rotation, abduction, or protraction
• Levator Scapulae (underneath upper trapezius)
– elevation, downward rotation
Elevation and Depression
Upward & Downward Rotation
Protraction & Retraction
Shoulder Joint Structure
Shoulder Joint Stabilizers
• Stabilizers and rotators - Rotator cuff muscles –
Teres minor - external rotation
Infraspinatus - external rotation
Supraspinatus - abduction
Subscapularis - internal rotation
Shoulder Joint Primary Movers
• Anterior movers – Anterior deltoid, pectoralis
• Superior movers - middle deltoid
• Posterior movers - posterior deltoid
• Inferior movers - latissimus dorsi, teres major,
lower pectoralis m.
• Force vectors of muscles (see next slide)
Shoulder Jt Muscles
Shoulder Joint Impingement Syndrome
• What is it? Pain from shoulder area resulting from impingement of
structures between humeral head, acromion, and coracromial arch. Three
– Stage I - edema and hemorrhage of subacromial structures
– Stage II - tendon fibrosis and bursal thickening
– Stage III - rotator cuff tears, biceps tendon ruptures, and bone spurs
Sh Jt Impingement (2)
• Causes?
– Primary impingement:
• Repeated movements requiring elevated and/or medially rotated
humerus, compounded by weak rotator cuff muscles, causing:
impingement of long head of biceps, supraspinatus
– Secondary Impingement:
• Decreased volume of subacromial space due to glenohumeral joint
instability, and perhaps joint capsular tightness
– Structural abnormalities:
• hooked or curved acromion, calcium deposits, bone spurs, thickened
bursa, thickened ligaments
Shoulder Jt Impingement (3)
• Treatment:
– Related to the cause - may involve
surgery, rotator cuff strengthening,
and flexibility exercises.
– Later, avoid humeral elevation and
rotation movements.
– Good website:
MMG - Patient Education
Impingement Syndrome
Elbow Joint Structure
Elbow and Wrist Joint Muscles
True Flexor - Brachialis
Flexor-Supinator - Biceps brachii
Extensor - Triceps brachii
Wrist flexors (medial epicondyle of humerus)
– Flexor carpi ulnaris and flexor carpi radialis
• Wrist extensors (lateral epicondyle of humerus)
– Extensor carpi ulnaris & extensor carpi radialis
• Force vectors of muscles on next slide
KIN 330
• Muscles of
elbow joint:
Muscles and Movements of Radioulnar Joint
• Elbow Flexion – Forearm Supination - Biceps Brachii
– Forearm Pronation - Pronator Teres
• Elbow Extension – Forearm Supination - Supinator
– Forearm Pronation -Pronator Quadratus
• Muscle force vectors on next slide
• Epicondylitis
– The most common cumulative trauma disorder (CTD), repetitive
stress injury (RSI), repetitive motion disorder (RMD), or overuse
syndrome (OS) is epicondylitis
– Epicondylitis website:
– MMG - Patient Education Cumulative Trauma Disorders TOC
Radioulnar Jt Muscles
Bones of Wrist and Hand
Carpal Tunnel Syndrome
• Background MMG - Patient Education Cumulative
Trauma Disorders TOC
Carpal tunnel includes
median nerve and
9 flexor tendons
( 4 flex dig sup,
4 flex dig prof,
1 fl pol l)
Carpal Tunnel Syndrome (cont’d)
• Symptoms
– Pain in wrist area, or referred proximally or distally
– Tingling of thumb, fingers, or palmar side of hand
– Loss of control of muscles affected by median nerve blockage
• Causes
– Enlargement of tissues within tunnel
– Decreased size of tunnel
– Extraneous tissue in tunnel
• Treatment
– Related to cause
• Website for prevention of repetitive stress injury at
computer workstations: CUergo: Neutral Posture Typing
KIN 330
Review & Homework Problems
for Chapter 7
• Review problems:
– Torque at shoulder with elbow flexed vs extended
• Fig 7-15, 7-16
– Compressive force at shoulder jt
• Fig 7-17, sample problem 1 p 197
– Elbow flexion force
• Figure 7-25, sample problem 2 p 206
• Homework – due Wed March 17
– Introductory problems, p 217: # 8,9,10
– Additional problem, p 218: #10