1. + Upper Limb
1

2. +
Humerus (Arm)
 The humerus articulates with the scapula
at the shoulder and with the radius and
ulna at the elbow
 The humerus is typically described as
having a head, shaft, and base
 Many muscles attach including the deltoid,
pectoralis major, teres major, latissimus
dorsi, biceps
brachii, brachialis, coracobrachialis, brachioradi
alis
2

3. +
Ant. Veiw (L) and Post. View (R).
Arrow indicates radial sulcus
3

4. +
THE ELBOW AND RADIOULNAR JOINTS
Assist shoulder to apply force
Control placement of hands in space

5. +
Humerus, Ulna, & Radius
1. Radiohumeral Joint
Condyloid
• capitulum & head of radius
Elbow Joint- Radiohumeral
5

6. Elbow Joint- Ulnarhumeral
2. Ulnarhumeral joint
 Articulation: ulna & humerus
 Flexion/extension of forearm
6

7. Radioulnar Joint
3. Radioulnar Joint
Radius and Ulna
2 articulations
• Distal (pivot)
• Middle (syndesmoses)
• Proximal (pivot)
– Radial head & fossa (notch)
– Neutral position
• Pronation- radius crosses
ulna
7

8. Radioulnar Joint
Supporting Structures
• Radial collateral
ligament
– support & rotation
• Interosseous membrane
– Maintains stability
– Transfers force
8

9. Elbow Joint Supporting Structures
• Ulnar collateral ligament
– Humeroulnar support
• Radial collateral ligament
– Humeroradial support
9

10. + Elbow & Radioulnar Movements 10

11. + Musculature – Elbow
24 muscles cross
P
A
11

12. +
Elbow Flexors
Anterior
 Biceps brachii (S)
 Brachialis
 Brachioradialis (P & S)
 Pronator teres (weak)
 Elbow flexion: effectiveness of sup/pron ↑ as elbow flexion ↑
Origin Anterior surface of the humerus, specifically the distal portion
Insertion Coronoid process and the tuberosity of the ulna
Artery Radial recurrent artery
Nerve Musculocutaneous nerve (C5,C6)
12

13. + Elbow Flexors- anterior
Biceps Brachii (S)
 3 jnt muscle
1= Glenohumeral joint
2= ulnarhumeral joint
3= radiohumeral joint
 contribution to flexion depends on position
 most effective- supinator
Origin short head: coracoid process of the scapula.
long head: supraglenoid tubercle
Insertion radial tuberosity and bicipital aponeurosis into deep
fascia on medial part of forearm
Artery brachial artery
Nerve Musculocutaneous nerve (C5–C6)
Action Elbow flexion and forearm supination
Antagonist Triceps brachii
13

14. +
Elbow Flexors- anterior
Pronator Teres
 weak-main action: pronator
Origin Humeral head: Medial epicondyle of humerus
Ulnar head: Coranoid process of ulna
Insertion Middle of the lateral surface of the radius
Artery Ulnar artery and radial artery
Nerve Median nerve
14

15. +
Elbow Extensors
Posterior
 Triceps brachii
 3 heads
 Very strong
Origin Long head: infraglenoid tubercle of the scapula
Lateral head: above the radial sulcus
Medial head: below the the radial sulcus
Insertion Olecranon process of the ulna
Artery Brachial artery (profunda brachii)
Nerve Radial nerve and axillary nerve
Antagonist Biceps brachii
15

16. + Flexor Strength
 Twice as strong as extensors
 Are we better pullers or pushers?
 Elbow flexion:
 ADLs = more neutral
 Strongest in semi-prone positions
16

17. +
Radioulnar Pronators
 Pronator Teres
 Pronator Quadratus
Origin Humeral head: Medial epicondyle of humerus
Ulnar head: Coranoid process of ulna
Insertion Middle of the lateral surface of the radius
Artery Ulnar artery and radial artery
Nerve Median nerve
Pronator Quadratus
Origin Medial, anterior surface of the ulna
Insertion Lateral, anterior surface of the radius
Artery Anterior interosseous artery
Nerve Median nerve
17

18. +
Conditioning Pronators & Supinators
Pronators
 Loosening a screw, turning a door
Supinators
 Tightening a screw
 Throwing a curveball (extension, before release)
18

19. +THE HAND AND WRIST
Which activities would it be essential to have an
understanding of the hand & wrist?

20. +
HAND
 The hand consists of 54 bones separated into three distinct regions:
 The wrist (carpals)
 The palm (metacarpals)
 The finger digits (phalanges)
 The eight carpal bones are the bones of the wrist
They largely assist in motility and support of the hand
20

21. +
HAND
 Each hand consists of five metacarpal bones
 The phalanges consist of three sections:
 Proximal phalanges
 Intermediate phalanges
 Distal phalanges
 Collectively, these bones make up the structure
known as the fingers
21

22. + Bones of the Hand
 Metacarpals (5)
 1-5
 base (proximal)
 head (distal)
 shaft
 Phalanges (14)
 proximal (1-5)
 middle (2-5)
 distal (1-5)
 base (proximal)
 head (distal)
 shaft
22

23. Bones of the Hand
Carpals (8)
 Proximal row
 scaphoid (navicular)
 lunate (moon)
 triquetrum (triangular)
 pisiform (pea)
 Distal row
 trapezium
 trapezoid
 capitate (head)
 hamate (hook)
23

24. +
Bones: Radius, Scaphoid,
Lunate, Triquetrum
• Condyloid (2 df)
– flexion/extension/hyperextension
– radial deviation/flexion (abduction)
– ulnar deviation/flexion (adduction)
Wrist Joint
24

25. + Common Origins/Attachments
 Wrist & finger flexors
 Medial epicondyle
 Medial condylar ridge
 Coronoid process
 Wrist & finger extensors
 Lateral epicondyle
 Lateral supracondylar ridge
25

26. +
WRIST MOVEMENTS
26

27. +
HAND & FINGER MOVEMENTS
27

28. +
Muscles of Hand & Wrist
Movement
Complex mechanism
29 bones, > 25 jnts, > 30
muscles
28

29. +
Intrinsic vs. Extrinsic
Muscles acting at wrist & fingers
Originate outside hand (extrinsic)
 Enter hand as tendons
Intrinsic (originate in hand)
29

30. +
Names Identify Function/Location
 Flexor or extensor
 Carpi – carpals
 Radialis – radial side
 Ulnaris – ulnar side
 Digitorum- digits/fingers
 Superfiscialis – superfiscial aspect
 Profunda – deep
 Indicis – index finger
 Pollicis – thumb
 Digiti minimi – pinky/little finger
30

31. +
Organization of Muscles
Finger Movement
Finger flexors (ant)
 Flexor digitorum superfiscialis
 flex each finger ind
 Flexor digitorum profundus
 O: med epicondyle
Thumb flexor
 Flexor pollicis longus
Finger extensors (post)
 Extensor digitorum
 O: lat epicondyle
 Extensor indicis
 Extensor digitorum minimi
Thumb extensor
 Extensor pollicis longus
 Extensor pollicis brevis
 both abductors
Thumb abduction
 Abductor pollicis longus
31

32. +
Wrist Flexors
32

33. +
Wrist Flexors
 Curling the wrist
 Stabilize the wrist against resistance
 Snaps hand fwd
 spiking VB, throwing BB
33

34. +
Wrist Extensors
34

35. +
Wrist Extensors
 Curling the wrist
 Stabilize the wrist against resistance when forearm is
_____________
 Important in backhand (racquet sports)
 Draws the hand back
 dribbling BK, throwing BB
35

36. Finger Flexion
 Important in gripping
activity
 Power grip
 Wrap around object
 Flexion all 3 finger jnts
 Precision grip (pinch)
 Limited flexion @ PIP, DIP
 Only 1-2 fingers
36

37. + Finger Extensors 37

38. +
Finger Extensors
Extensor digitorum
 Only muscle involved in extension of all 4 fingers
 Apply manual resistance to dorsal aspect of flexed fingers
then extending
38

39. +
Thumb Muscles
Opposition is the most important movement
of the thumb: pinch, grasp, or grip an object.
39