Chapter 7

The Biomechanics of
the Human Upper
Extremity

© 2007 McGraw-Hill Higher Education. All rights reserved.

 1. Explain how anatomical structure affects movement
capabilities of upper extremity articulations.
2. Identify factors influencing the relative mobility and
stability of upper extremity articulations.
3. Identify muscles that are active during specific upper
extremity movements.
4. Describe the biomechanical contributions to common
injuries of the upper extremity.

© 2007 McGraw-Hill Higher Education. All rights reserved.

 Structure of the
Shoulder

The shoulder is the most complex

joint

It includes five separate

articulations: the glenohumeral joint,

the sternoclavicular joint, the

acromioclavicular joint, the

coracoclavicular joint, and the

© 2007 McGraw-Hill Higher Education. All rights reserved. scapulothoracic joint.

 Structure of the Shoulder

Interclavicular ligament
Clavicle Clavicle

Sternoclavicular Articular
ligament disk

Costoclavicular Costal
ligament cartilage
(1st rib)
Sternum

Sternoclavicular joint: modified ball and socket

joint between the proximal clavicle and the
manubrium of the sternum
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 Structure of the Shoulder

Coracoclavicular Acromioclavicular Coracoclavicular

joint ligament
Clavicle ligament
Acromion process Clavicle

Coracoacromial Scapular
ligament spine
Verterbal
border Coracoid process Vertebra
l border
Glenoid fossa
Inferior
Axillary border angle
Anterior view Posterior view
Inferior angle

Acromioclavicular joint: irregular joint between

the acromion process of the scapula and the
distal clavicle
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 Structure of the Shoulder

Coracoclavicular Acromioclavicular Coracoclavicular

joint ligament
Clavicle ligament
Acromion process Clavicle

Coracoacromial Scapular
ligament spine
Verterbal
border Coracoid process Vertebral
border
Glenoid fossa
Inferior
Axillary border angle
Anterior view Posterior view
Inferior angle

Coraoclavicular joint: syndesmosis with the

coracoid process of the scapula bound to the
inferior clavicle by the coracoclavicular ligament
© 2007 McGraw-Hill Higher Education. All rights reserved.
 Structure of the Shoulder

Coracoid process
Acromion
process
Coracohumeral
ligament
Long head of
Scapula biceps

Humerus
Articular
capsule

Glenohumeral joint: ball and socket joint in

which the head of the humerus articulates with
the glenoid fossa of the scapula
© 2007 McGraw-Hill Higher Education. All rights reserved.
 Structure of the Shoulder

What is the scapulothoracic joint?

(articulation between the anterior scapula
and the thoracic wall)

© 2007 McGraw-Hill Higher Education. All rights reserved.

© 2007 McGraw-Hill Higher Education. All rights reserved.
 Movements of the Shoulder
Complex

scapulohumeral
rhythm: a regular
pattern of scapular
rotation that
accompanies and
facilitates humeral
abduction

© 2007 McGraw-Hill Higher Education. All rights reserved.

 Movements of the Shoulder
Complex

 Flexion at the Glenohumeral Joint

 Extension at the Glenohumeral Joint
 Abduction at the Glenohumeral Joint
 Adduction at the Glenohumeral Joint
 Medial and Lateral Rotation of the
Humerus
 Horizontal Adduction and Abduction at
the Glenohumeral Joint
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 COMMON INJURIES OF THE
SHOULDER

a. Dislocations at glenohumeral joint

b. Rotator Cuff Damage
c. Rotational Injuries (tears of muscles)
d. Subscapular Neuropathy (e.g overhead
activities)

© 2007 McGraw-Hill Higher Education. All rights reserved.

 Muscles of the Scapula

The muscles that attach to the scapula

are the levator scapula, rhomboids,
serratus anterior, pectoralis minor, and
subclavius, and the four parts of the
trapezius.

© 2007 McGraw-Hill Higher Education. All rights reserved.

© 2007 McGraw-Hill Higher Education. All rights reserved.
 Structure of the Elbow

What is the humeroulnar joint?

• hinge joint in which the humeral
trochlea articulates with the trochlear
fossa of the ulna
• considered to be the elbow joint

© 2007 McGraw-Hill Higher Education. All rights reserved.

 Structure of the Elbow

What is the humeroradial joint?

(gliding joint in which the capitellum of
the humerus articulates with the proximal
end of the radius)

© 2007 McGraw-Hill Higher Education. All rights reserved.

 Structure of the Elbow

What are the radioulnar joints?

• the proximal and distal radioulnar joints
are pivot joints
• the middle radioulnar joint is a
syndesmosis

© 2007 McGraw-Hill Higher Education. All rights reserved.

© 2007 McGraw-Hill Higher Education. All rights reserved.
© 2007 McGraw-Hill Higher Education. All rights reserved.
 Movements at the Elbow

• flexion and extension

• pronation and supination
• brachioradialis

© 2007 McGraw-Hill Higher Education. All rights reserved.

© 2007 McGraw-Hill Higher Education. All rights reserved.
 COMMON INJURIES OF THE
ELBOW

a. Sprains and dislocations

b. Overuse injuries

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 Structure of the Wrist

What are the radiocarpal joints?

• condyloid articulations between the
radius and the three carpal bones
• (these joints comprise the wrist)

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 Movements of the wrist

• Flexion
• Extension and hyperextension
• Radial and ulnar deviation

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© 2007 McGraw-Hill Higher Education. All rights reserved.
 Movements at the Wrist

What muscles contribute to flexion at the

wrist?
• flexor carpi radialis
• flexor carpi ulnaris
• palmaris longus
• assisted by:
• flexor digitorum superficialis
• flexor digitorum profundus
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© 2007 McGraw-Hill Higher Education. All rights reserved.
 Movements at the Wrist

What muscles contribute to extension at

the wrist?
• extensor carpi radialis longus
• extensor carpi radialis brevis
• extensor carpi ulnaris
• assisted by:
• other wrist extensor muscles
© 2007 McGraw-Hill Higher Education. All rights reserved.
 Structure of the Joints of the
Hand

What are the carpometacarpal joints?

• the carpometacarpal joint of the thumb
is a saddle joint
• the other carpometacarpal joints are
gliding joints

© 2007 McGraw-Hill Higher Education. All rights reserved.

 Structure of the Joints of the
Hand

What are the intermetacarpal joints?

(irregular joints between the metacarpals
that share joint capsules with the
carpometacarpal joints)

© 2007 McGraw-Hill Higher Education. All rights reserved.

 Structure of the Joints of the
Hand

What are the metacarpophalangeal

joints?
• condyloid joints between the rounded
distal heads of the metacarpals and the
concave proximal ends of the phalanges
• these joints form the knuckles of the
hand
© 2007 McGraw-Hill Higher Education. All rights reserved.
 Structure of the Joints of the
Hand

What are the interphalangeal joints?

(the proximal and distal interphalangeal
joints of the fingers and the single
interphalangeal joint of the thumb are all
hinge joints)

© 2007 McGraw-Hill Higher Education. All rights reserved.

© 2007 McGraw-Hill Higher Education. All rights reserved.
© 2007 McGraw-Hill Higher Education. All rights reserved.
© 2007 McGraw-Hill Higher Education. All rights reserved.