SCAPULOTHORACIC JOINT 3 MUSCLES HOLD IT TOGETHER

SUBACROMIAL SPACE / SUPRAHUMERAL SPACE. TENDONS OF SUPRA

INFRA LONG HEAD OF BICEP SUBACROMIAL BURSA . GLENOHUMERAL
IMPINGEMENT. HUMERAL HEAD IMPINGES ON STRUCTURES BETWEEN
HEAD AND SUBACROMIAL SPACE. HUMERAL HEAD REPEATEDLY
HITTING ACROMION WILL CAUSE BONE SPUR.
3RD FUNCTIONAL JOINT LONG HEAD OF BICEPS WITHIN BICIPITAL
GROOVE.
MEDIAL BORDER/ VERTEBRAL BORDER OF SCAP
AXILLARY BORDER/LATERAL BORDER OF SCAP
INFERIOR ANGLE, WHICH SHOULD LINE UP WITH T7.
SUPERIOR ANGLE, WHICH SHOULD LINE UP WITH ..
SUBSCAPULAR FOSSA ORIGIN POINT FOR SUBSCAPULARIS
CORACOID PROCESS
SPINE OF SCAP. ROOT OF THE SPINE OF THE SCAPULA
SUPRASPINOUS FOSSA ORIGIN FOR SUPRASPINATUS
INFRASPINOUS FOSSA INFRASPINATUS MUSCLE.
SUPERSCAPULAR NOTCH THE SUPRASCAPULAR NERVE TRAVELS
THROUGH HERE TO INNERVATE SUPRASPINATUS AND INFRASPINATUS
ACROMION PROCESS
GLENOID FOSSA OVAL SMALLER THAN EXPECTED LINED WITH
HYALINE CARTILAGE BECAUSE IT IS THE ARTICULAR SURFACE OF THE
SYNOVIAL JOING
SUPRAGLENOID TUBERCLE LONG HEAD OF BICEPS ATTACHES
INFRAGLENOID TUBERCLE- LONG HEAD OF TRICEPS ATTACHES
CLAVICLE
S SHAPED. END CLOSE TO ACROMION ACROMION END, STERNUM SIDE
STERNUM END.
TRAPEZOID TUBERCLE TRAPEZOID LIGAMENT OF THE
CORACOCLAVICULAR LIGAMENT
CONOID TUBERCLE CONOID LIGAMENT OF THE
CORACOCLAVICULAR
HOW TO TELL FRONT FROM BACK OF HUMERUS INTERTUBERCULAR
GROOVE SHOULD BE FACING ANTERIOR.
HEAD OF HUMERUS

Greater tubercle not as it appears in book. Its larger its the whole
ridge that you can easily see on the lateral side.
Lesser tubercle just medial to the bicipital groove. subscapularis
attaches here.
Crest of the greater tubercle (dont write greater tubercle) / lateral lip
of the bicipital groove. pectoralis major attaches here
Crest of lesser tubercle medial lip of bicipital groove insertion for
teres major and latissimus dorsi.
Deltoid tuberosity. deltoid attaches here
Radial groove/musculo spiral groove.
Right above radial groove lateral head of tri attach
Right below the radial groove medial head of tri attach
medial and lateral epicondyles. epi because they are above the true
articular condyles.
Lateral supracondylar ridge Medial supracondylar ridge
Capitulum of humerus
Trochlea
Olecranon fossa of the humerus olecranon process of ulna fits into
the olecranon fossa of the humerus
Radial fossa. radial head fits into the radial fossa of the humerus
Just superior to trochlea coronoid fossa this is where the coronoid
process of the ulna fits.
Ulna
Olecranon process
Trochlear notch trochlea of humerus fits here.
Radial notch head of the radius fits into it

Coronoid process botton lip of trochlea

Head of the ulna is the projection of bone on your medial wrist.
Actually the most inferior aspect of the bone.
Just distal to that, you can feel the styloid process of the ulna.
RADIUS
-

fovea
Neck
Head of radius proximal , counterintuitive.
Insertion for biceps brachii radial tuberosity
Pointed tooth on the bottom of the radius radial styloid process
Ulnar notch ulnar head fits here.
Articular surface for scaphoid and lunate.
Listers tubercle something pollicis longus loops around listers
tubercle to change direction. you should be able to identify this

Any muscle that can produce pronation or supination must attach to

radius because the radius is the bone that actually rotates, the ulnar is
just along for the ride.
CARPAL BONES 2 rows proximal and distal . DREW THEM ON
BOARD.
Pisiform considered to be part of proximal row but it does not sit in
the row the way you think it is actually sitting on top of triquetrum.
Pisiform is a floating, sesamoid bone. Pisiform is embedded in the
tendon of flexor carpi ulnaris.
Trapezium articulates with the thumb. Rhymes.
Triquetrum 2nd metacarpal
Capitate 3rd metacarpal keystone of the wrist it holds them all
together
Hammate 4th and 5th metacarpal. Hook of hamate. In between
pisiform and hook of hamate is the guyons canal.

Metacarpals
base articulates with distal row of carpal bones. base is concave.
Shaft of metacarpal
Head of metacarpal convex.
Phalanges 14 phalanges per hand. bones of fingers 2-5 have three
phalanges. First digit has 2 phalange. Proximal phalange
Base - concave
Shaft
Tendon of flexor pollicis longus runs between the 2 sesamoid bones
and the sesamoid bones themselves are embedded in the tendon of
flexor pollicis brevis.
Head. convex.
Base concave

STERNOCLAVICULAR JOINT he goes out of his way to talk about the

importance of seeing the saddle nature of the sternoclavicular joint
disk enhances the congruency, enhances the fit. The disk fills in gaps
and fissures that would otherwise not articulate.
Elevate scapula elevate clav
Depress scap - depress clav
Retract scap retract clav
Protract scap protract clav
Clavicle cant rotate anteriorly. Only posteriorly
This rotation only occurs at end range should elevation such as flexion
or adduction or any combination of these movements.
If your clav cant rotate post you will not be able to achieve full
shoulder range of motion
Strong joints ligaments well developed. 1 Anterior and 1 posterior
sternoclavicular ligaments on each side so two and two.
Sitting on top of both sternoclavicular joints, there will be one
interclavicular ligament. It will resits excessive superior movement of
the clavicle.

Attaching from the 1st rib to the clavicle is the costoclavicular ligament
no attachment to the manubrium but it still supports the joint.
prevents excessive elevation of sternal end of the clavicle, excessive
anterior translation
ACROMIOCLAVICULAR JOINT - PLANE JOINT 3 DEGREES OF FREEDOM
ANTERIOR AND POSTERIOR TIPPING SMALL FIBROCARTILAGENOUS
DISK FOUND IN
THE SCAP MOVES SLIGHTY ANTERIOR FOLLOWING THE COUNTOUR OF
THE THORAX AND THIS IS KNOWN AS ANTERIOR TIPPING. IT OCCURS
WHEN THE SCAPULA MOVES UPWARD
WHEN THE SCAP ROTATES UP, THE GLENOHUMERAL JOINT ALSO
UPWARDLY ROTATES.
SCAPULAR INTERNAL ROTATION AND EXTERNAL ROTATION
ACROMIOCLAVICULAR LIGAMENTS FAIRLY WEAK THESE ARE THE
FIRST TO RUPTURE. AC JOINT SEPARATION
THE LIGAMENT UNTWISTS DRAWING THE SCAPULA INTO POSTERIOR
ROTATION.
GLENOHUMERAL JOINT IR/ER ABD/ADD FLEX/EXT
CIRCUMDUCTION.
3:1 RATIO OF HUMERAL HEAD SIZE TO GLENOID FOSSA SIZE WHICH
ALLOWS IT TO BE MORE MOBILE BUT WE SACRIFICE STABILITY.
GLENOID FOSSA. PIECE OF FIBROCARTILAGE ATTACHING TO RIM
GLENOID LABRUM. IT PROJECTS OUTWARD FROM THE GLENOID FOSSA
IT INCREASES SURFACE AREA FOR ARTICULATION BETWEEN
PART OF BICEP ALSO ATTACHES TO THE GLENOID LABRUM.
SUPERIOR, MIDDLE INFERIOR (REDUNDANCIES) POSTERIOR JOINT
CAPSULE. THE JOINT CAPSULE BLENDS IN WITH THE GLENOID
LABRUM. NEGATIVE PRESSURE IN JOINT CAPSULE INCREASES STABILITY
BECAUSE THE BAROMETRIC PRESSURE IS PUSHING DOWN ON IT. IF
YOU TEAR THIS LABRUM, YOU TEAR THE JOINT CAPSULE. IF YOU TEAR
THE JOINT CAPSULE THE NEGATIVE PRESSURE IS GONE AND YOU LOSE
THIS STABILITY EVEN IF IT IS REPAIRED.

SLAP TEAR WHAT DOES SLAP STAND FOR : SUPERIOR LABRUM

ANTERIOR TO POSTERIOR
INTRACAPSULAR -

INFERIOR - PREVENTS INFERIOR AND ANTERIOR.

MIDDLE GLENOHUMERAL PREVENTS ANTERIOR AND INFERIOR
MOVEMENT
FORAMEN OF WEICHBRECHT.
THE GLENOHUMERAL JOINT RELIES HEAVILY ON DYNAMIC STABILITY =
MUSCULAR STABILITY = ROTATOR CUFF MUSCLE STABILITY ALSO
RHOMBOID MAJOR, MINOR,
LOSE CONTACT BETWEEN SCAPULA AND THORAX SCAPULAR
WINGING. REDUCES YOUR ABILITY TO LIFT.
SCAP
SCAPULOTHORACIC JOINT - ELEVATION DEPRESSION PROTRACTION
AND RETRACTION = ROTATION .
WHEN YOU MOVE THE ARM YOU ORIENT THE GLENOID INTO THE
DIRECTION THAT YOUR HAND IS MOVING . REACH DOWN IT POINTS
DOWN AND THEREFORE THE SCAPULA DOWNWARDLY ROTATES.

SCAPULAR UPWARD ROTATION - UT +LT +SA MUST ALL CONTRACT AT

SAME TIME (UPPER TRAP) (LOWER TRAP) (SERRATUS ANTERIOR)
WEAKNESS OF LOWER TRAP SCAP GOES UP SCAPULAR ELEVATION.
THIS WILL PREVENT THE GLENOID TUBERCLE POINTING UP AS MUCH
AS IT NEEDS TO WHEN YOU REACH UP TO GO INTO FULL RANGE OF
MOTION.

END RANGE SHOULDER ELEVATOIN CAN ONLY OCCUR IN FULL

THORACIC TRUNK EXTENSION.
CORACOACROMIAL LIGAMENT FORMS THE ROOF OF THE
GLENOHUMERAL JOINT THE FUNCTION PREVENT THE HUMERAL
HEAD FROM TRANSLATING EXCESSIVELY ANTERIOR TO PREVENT
IMPINGEMENT.
TRANSVERSE HUMERAL LIGAMENT. RUNS ACROSS
INTERTUBERCULAR GROOVE.
ROTATOR CUFF 4 MUSCLES
SUPRASPINATIS SUPERIOR TO SPINE OF SCAP SUPRASPINOUS FOSSA
ATTACHES TO MOST INFERIOR ASPECT OF GREATER TUBERCLE.
INVOLVED WITH ALL UPWARD MOVEMENT AT THE GLENOHUMERAL
JOINT MOST IMPORTANT IN THE FIRST 30 45 DEGREES OF SHOULDER
ABDUCTION. ITS ACTIVE DURING THE WHOLE RANGE BUT MOST
IMPORTANT DURING 30-45. IF YOU TORE IT, YOU WOULDNT BE ABLE
TO LIFT IT. IF YOU BROUGHT IT UP TO 30-45 DEGREES THEN THE
DELTOID COULD BEGIN FUNCTIONING.
INFRASPINATUS INFERIOR TO SPINE OF SCAP CHIEF EXTERNAL
ROTATOR OF THE HUMERUS. MOST ACTIVE WHEN THE ARM IS AT THE
SIDE, TO BRING YOU INTO EXTERNAL ROTATION.
SUBSCAPULARIS ANTERIOR SCAPULA ONLY ROTATOR CUFF THAT
DOES NOT ATTACH TO GREATER TUBERCLE, INSTEAD IT ATTACHES TO
THE LESSER TUBERCLE. EXTERNAL INTERNAL ROTATOR OF THE ARM.
SUBSCAPULARIS TIGHTNESS, YOU SEE THE INABILITY TO STRETCH THE
ARM INTO EXTERNAL ROTAION BECAUSE YOU MOVE THE MUSCLE IN
THE OPPOSITE MOTION THAT IS PRODUCES IN ORDER TO STRETCH IT.
TERES MINOR -LATERAL BORDER ATTACHEMENT PART OF THE
SCAPULA MORE ACTIVE WHEN THE ARM IS AT 90 DEGREES.
PITCHING.
DELTOID ABDUCTION PAST 30/45 DEGREES.
FUNCTION OF INFRA, TERES MINOR, SUBSCAPULAR TO PULL
INFERIORLY ON THE HUMERAL HEAD TO CENTRALIZE IT WITHIN THE
GLENOID FOSSA
UPPER TRAP ELEVATE SCAP
MIDDLE TRAP RETRACT SCAP

SERRATUS ANTERIOR RIBS 1-8. RUNS UNDERNEATH THE SCAPULA TO

ATTACH TO THE MEDIAL BORDER OF THE SCAPULA. FUNCTION
PROTRACTION (ONLY FUNCTION YOU NEED TO KNOW
PECTORALIS MINOR ATTACHES TO CORACOID PROCESS AND RIBS 3-5.
INNERVATED. MEDIAL AND LATERAL PECTORAL NERVES INNERVATE IS
DEPRESS, RETRACT, AND GIVE DOWNWARD ROTATION.
TERES MAJOR - INFERIOR ASPECT OF SCAPULA MEDIAL LIP OF THE
BICIPITAL GROOVE. RUNS PARALELL TO LATISSIMUS DORSI.
INNERVATED BY LOWER SUBSCAPULAR NERVE. INTERNAL ROTATION.
ADDUCTION. EXTENSION. ALL OF THE HUMERUS AT THE
GLENOHUMERAL JOINT.
BICEPS BRACHII TWO HEADS. LONG HEAD AND SHORT HEAD. LONG
HEAD US ON LATERAL SIDE AND ATTACHES TO SUPRAGLENOID
TUBERCLE RADIAL TUBEROSITY (LATERAL SIDE) BICIPITAL
APONEUROSIS (MEDIAL SIDE). BICEPS CROSSES TWO JOINTS. THE
ELBOW AND SHOULDER. SHOULDER FLEXION
THE BICEP FUNCTIONS IN SHOULDER FLEXION AND ELBOW FLEXION
AND SUPINATOIN.
TRICEPS LONG HEAD LAERAL HEAD MEDIAL HEAD
LONG HEAD INFRAGLENOID TUBERCLE
MEDIAL HEAD INFERIOR TO MUSCULOSPIRAL GROOVE
LAERAL HEAD SUPERIOR TO MUSCULOSPIRAL GROOVE
ALL 3 HEADS COME TOETHER TO ATTACH TO OLECRANON PROCESS OF
ULNA. SHOULDER EXTENSION ELBOW EXTENSION. DOES NOT
MATTER WHETHER YOURE PRONATED OR SUPINATED. FUNCTIONS THE
SAME
CORACOBRACHIALIS CORACOID PROCESS - MEDIAL ASPECT OF
PROXIMAL. THIRD OF THE HUMERUS.
MUSCULOCUTANEOUS NERVE. FLEX THE SHOULDER AND ADDUCT AND
HORIZONTAL ADDUTION.
DELTOID 3 HEADS. ANTERIOR HEAD MIDDLE HEAL POSTERIOR HEAD.
LATERAL THIRD CLAV
LATERAL THIRD SPINE SCAPULA
ACROMION PROCESS
DELTOID TUBEROSITY.
CONVERGENT FIBER ORIENTATION.

EACH HEAD HAS ITS OWN FUNCTION.

ANTERIOR HEAD SHOULDER FLEXION INTERNAL ROTATION
HORIZONTAL ADDUCTION
POSTERIOR SHOULDER EXTENSION - HORIZONTAL ABDUCTOIN
AND ONE MORE THAT IS MISSING *
DURING ADDUCTION (OR ABDUCTION I COULDNT TELL WHICH HE
WAS SAYNG) ALL 3 HEADS ARE WORKING. IF ONE HEAD WASNT
WORKING THE ARM WOULD DRIFT DURING ABDUCTION
PECTORALIS MAJOR. INSERTS ONTO LATERAL LIP OF BICIPITAL
GROOVE. CLAVICULAR HEAD. STERNOCOSTAL HEAD. CONVERGENT
MUSCLE. FUNCTION - IR, ADDUCTION HORIZONTAL ADDUCTION.
INNERVATED BY THE MEDIAL AND LATERAL PECTORAL NERVE.
STERNOCOSTAL HEAD EXTENSION IF YOU ARE IN A FLEXED POSITION.
LATISSIMUS DORSIS ATTACHMENT AND FUNCTOIN EMPHASIZED.
MEDIAL SIDE OF TROCHLEA PROJECTS MORE INFERIORLY. CAUSES A
BIAS LATERALLY. THE ELBOW THEREFORE HAS A VALGUS ANGLE. IT
ALLOWS FOR THE CARRYING ANGLE WHERE OUR FOREARM CAN
SWING PASS OUR HIPS. WHEN THE MEDIAL ANGLE INCREASES
VALGUS
THE MEDIAL ANGLE DECREASES VARUS
MEDIAL COLLATERAL LIGAMENT (ULNAR COLLATERAL LIGAMENT)
RESISTS EXCESSIVE VALGUS FORCE TOMMY JOHN SURGERY REPAIRS
A TEAR OF THIS LIGAMENT
LATERAL COLLATERAL LIGAMENT RESISTS EXCESSIVE VARUS FORCE.

RADIOHUMERAL JOINT. FOVEA OF RADIAL HEAD AND THE CAPITULUM

OF THE HUMERUS. THE RADIAL HEAD AND CAPITULUM ONLY ACTUALLY
COME INTO CONTACT DURING WEIGHT BEARING.

DURING FULL ELBOW FLEXION THE HEAD WILL FIT INTO THE RADIAL
NOTCH. HE ASKED , WHEN DO THEY COME INTO CONTACT.
PROXIMAL RADIOULNAR JOINT PIVOT

DISTAL RADIOULNAR JOINT PIVOT

INTEROSSEOUS MEMBRANE FORMS SYNDESMOSIS BETWEEN ULNA
AND RADIUS. TRANSMIT FORCES FROM RADIUS TO ULNA THROUGH
INTEROSSEOUS MEMBRANE. 1 DEGREE OF FREEDOM AT BOTH JOINTS
ROTATON
ANNULAR LIGAMENT FROM RADIAL NOTCH TO RADIAL NOTCH TO
ENGULF THE HEAD OF THE RADIUS.
LINED WITH HYALINE
CARTILAGE. YOU COULD NOT SUPINATE OR PRONATE WITHOUT THE
ANNULAR LIGAMENT HOLDING THE HEAD IN PLACE AT THE PROXIMAL
RADIOULNAR JJOINT

DORSAL RADIOULNAR LIGAMENT DRAWS PICTURE FROM EACH SIDE

OF THE RADIUS, THEY COME TOGETHER TO A POINT FORMING A CONE.
PALMAR RADIOULNAR LIGAMENT
MUSCULATURE OF ARM.
BICEPS BRACHII SHOULDER FLEXION ELBOW FLEXOIN
CORACOBRACHIALIS DEEP TO SHORT HEAD OF BICEPS BRACHII ..
FLEX ADDUCT, HORIZONTAL ADDUCT.
DEEP TO BICEPS BRACHILIAS ANTERIOR ASPECT OF THE DISTAL 2/3
OF HUMERUS INSERTS ONTO ULNAR TUBEROSITY. ACTIVE DURING ALL
TYPES OF ELBOW FLEXION.
BICEPS BRACHII MORE ACTIVE WHEN SUPINATED AND THEN FLEXED.
TRICEPS BRACHII LONG LATERAL AND MEDIAL . LONG HEAD CROSSES
GLENOHUMERAL JOINT - SHOULDER EXTENSION.
ATTACHES TO THE ULNA SO WE HAVE NO PRONATION OR SUPINATION.
HAS TO ATTACH TO RADIUS TO SUPINATE OR PRONATE
ANCONEUS. MISSED ATTACHMENTS - EXTENSION BUT PRIMARILY AN
ELBOW STABILIZER.
WRIST FLEXORS ATTACH TO MEDIAL HUMERUS ALL HAVE ABILITY TO
WEAKLY FLEX ELBOW

WRIST EXTENSORS ATTACH TO LATERAL HUMERUS ALL HAVE ABILITY

TO WEAKLY FLEX ELBOW BECAUSE THEY CROSS THE HUMEROULNAR
JOINT ON THE ANTERIOR SIDE.

FLEXOR CARPI ULNARIS MEDIAL EPICONDYLE HOOK OF HAMMATE

AND BASE OF 5TH METACARPAL EMBEDDED IN ITS TENDON IS
PISIFORM. ULNAR NERVE .
FLEXION AND ULNAR DEVIATION AT THE SAME TIME.

PALMARIS LONGUS MEDIAL EPICONDYLE TENDON SUPERFICIAL TO

CARPALTUNNEL AND BLENDS WITH PALMAR APONEUROSIS. WRIST
FLEXION, VERY WEAK
ULNAR NERVE INNERVATES 1.5 MUSCLES, EVERYTHING ELSE IN THAT
AREA IS MEDIAN NERVE.

MEDIAL EPICONDYLE - INSERT INTO BASES OF 2ND AND 3RD

METACARPALS. WRIST FLEXION AND RADIAL DEVIATION.
YOU NEED TWO TO CONTRACT AT THE SAME TIME TO GET TRUE WRIST
FLEXION. FLEXOR CARPI RADIALIS, FLEXOR CARPI ULNARIS.
PRONATOR TERES MEDIAL EPICONDYLE . CROSSES THE FOREARM.
WHAT NERVE IS SEEN BETWEEN THE TWO HEADS OF PRONATOR
TERES? MEDIAN NERVE.
FLEXOR DIGITORUM SUPERFICIALIS . ALL 4 TENDONS THROUGH
CARPAL TUNNEL ATTACH TO MIDDLE PHALANGES OF DIGITS 2, 3, 4 ,5
FLEXOR DIGITORUM PROFUNDUS 4 TENDONS THROUGHT THE
CARPAL TUNNEL. DISTAL PHALANGE ATTACHMENT ULNAR AND
ANTERIOR INTEROSSEOUS NERVE OF THE MEDIAN.

UNIPENNATE MUSCLE - FLEXOR POLLICIS LONGUS LOOK FOR THE

OBLIQUE FIBERS INSERTING ONTO THE TENDON BEFORE MARKING IT
ON PRACTICAL HES GOING TO TAG IT.

USE BRACHIORADIALIS RUNNING ON THE LATERAL SIDE TO DECIDE

THAT EVERYTHING POSTERIOR TO IT IS POSTERIOR COMPARTMENT
AND EVERYTHIING ANTERIOR TO IT IS ANTERIOR COMPARTMENT. IT
ORIGINATES ON THE LATERAL EPICONDYLE AND BY THIS FACT, WE
HAVE TO CONSIDER IT AN EXTENSOR BUT IT PERFORMS FLEXION
WHICH MUSCLES PRODUCE RADIAL AND ULNAR DEVIATION ONLY?
FLEXOR CARPI ULNARIS AND EXTENSOR CARPI ULNARIS
EXTENSOR CARPI RADIALIS FLEXOR CARPI RADIALIS.
BICEP SUPINATOR WHEN THE ELBOW IS FLEXED
SUPINATOR, SUPINATOR AT ANY TIME.