Download Upper Arm, Elbow, Forearm, Wrist

PTHY 6401 Kinesiology I: Exam 3 Study Guide
Spring 2015
Lecture Material: Upper Arm, Elbow, Forearm, Wrist (Neumann Chapters 6-7)
Lab Material: Upper Arm & Elbow Region (all lab content/skills); Forearm & Wrist Region (all lab content/skills;
but not hand-fingers lab skills)
1. LAB: Know the number & word grading system for MMT, including pluses & minuses (+/-). Assign a ms. grade
based on described performance and vice-versa.
2. LAB: Know Normal/Average ROM for the goniometric measures at the elbow, forearm, and wrist; judge ROM
values as hypo- or hypermobile.
3. LAB: Know Goniometric measurement procedures for each joint & muscle length measured (ie. position of
patient, landmarks used). Know the UE joint positions that stretch the long finger flexors (FDS-FDP) and finger
extensors (ExtDig). Understand how to analyze and determine if flexibility is impaired.
4. LAB: Know MMT procedures for each movement tested (ie. testing position for gravity resisted & eliminated,
muscle tested for each movement).
5. Describe the osteology of the elbow, forearm, and wrist; including palpable landmarks on the humerus,
radius, ulna, and carpal bones
6. Name and classify each joint of the elbow, forearm & wrist; know the structures that articulate to form each
joint; know the movements available at these joints.
7. What is the carrying angle & what values are normal vs abnormal for males & females? Understand cubitus
valgus vs cubitus varus. What are some common causes of an excessive carrying angle vs cubitus varus?
8. Explain the Convex-Concave Rule for the joints of the elbow, forearm, & wrist AND apply the Rule to describe
the association between an osteokinematic and arthrokinematic movement at two places: the proximal
radioulnar joint (pronation/supination) and the radiocarpal joint of the wrist (flex/ext and RD/UD).
Examples: For wrist flexion at the radiocarpal joint, the proximal row of carpals slide _____________
and roll ____________. The proximal carpal row slides laterally during ______________. The radial head
slides __________ and rolls _____________ during supination.
9. Describe the typical end-range limitations to movement at the elbow & forearm joints (ie. typical end-feels).
Therefore, what may typically be damaged if a joint’s ROM is forced to the point of tissue injury?
10. Describe/explain the “functional arc” of AROM concepts at the elbow (Figure 6-16) and forearm (Fig 6-27).
11. Explain the specific concentric action(s), attachments, and innervation (nerve supply) of the muscles that
move the elbow, forearm, & wrist joints.
12. List which muscles are in the Superficial and Deep muscle groups in the flexor (anterior) and extensor
(posterior) regions of the forearm.
13. Describe the specific location of and describe the role of the major ligaments that support the elbow, forearm,
& wrist joints. At the elbow, which ligament is likely to be damaged by an excessive valgus force? excessive
varus force?
14. Be able to briefly describe/recognize each of these pathologies: olecranon bursitis, med/lat epicondylitis,
common fracture sites at the wrist and forearm, dislocations of the elbow and proximal radioulnar joints, sites
of nerve entrapment in the elbow/forearm/wrist regions, carpal tunnel syndrome.
15. Describe the contents and borders of the Cubital Fossa.
16. Describe the contents and borders of the Carpal Tunnel, and the function of each of the tissues (contents) in
the carpal tunnel. Note: Over the last few years, the passage rate on this content has mysteriously been
unusually low.
17. Describe the name and general location of the major vessels and nerves in the forearm mentioned in the
notes.
18. Analyze elbow, forearm, and wrist osteokinematics AND muscles contracting during the performance of
common UE movements/exercises; describe the muscle activity occurring and describe the muscle
contractions as either isometric, concentric, or eccentric (emphasis on prime movers, not synergists).
19. Describe/determine the agonist and antagonist muscles for a given movement. (Example: What is/are the
agonist(s) & antagonist(s) for the performance of elbow extension against gravity?)
20. Neumann pg 192: Describe the unique joint and muscle activity of pronation and supination in a WB position
(eg. closed chain pronation & supination)?
21. Neumann pg 205 text: For the triceps, which factor seems to have the most influence on maximal elbow
extension torque production - - length-tension (physiologic factor) or moment arm (biomechanical factor)??
22. Neumann pgs 208-209: Describe the role of the triceps when tightening a screw (clockwise) with a manual
screwdriver (assuming vigorous push AND tightening with the R UE).
23. Neumann pgs 232-234: Explain the role of the following muscles when making a strong fist: wrist flexors,
wrist extensors, finger flexors, finger extensors.
24. Neumann pg 233, Fig 7-24: Which ms. is the most potent ulnar and radial deviator? Is it clear cut which
flexor carpi muscle is the most potent wrist flexor? Other concepts that you need to determine from this
illustration: role of the pollicis muscles; role of the FDS-FDP and Ext Digit
25. Neumann pg 236, Table 7-1: Describe the order (ascending & descending) of isometric torque output for the
wrist ms. groups. Knowledge of specific torque numbers not necessary.
26. Review all questions posed to you in the lecture notes and quizzes.
27. Read all of the Special Focus & Clinical Connection sections in Neumann chapter 6 & 7 and be prepared to
answer questions from the content of those sections (may overlap with other content on this review sheet).
a. Clinical Connection 7-1 is optional
b. Note: Performance on exam questions related to Special Focus sections is typically below 80%. This
is less likely due to the questions being hard and is more likely due to lack of attention/focus on this
content in the Neumann text.