OT1021 Final Output_Group 11_1OTB

The Human Body

Exploring

Clavicle

The only existing bone attachment between the upper limb and the trunk

Humerus

Proximal end

Scapula

A large triangular flat bone

BONES

Angles: lateral, superior, and inferior Borders: superior, lateral, and medial Surfaces: anterior and posterior Processes: acromion, spine, and coracoid process

SCAPULA

Spine

divides posterior surface into a small supraspinous and larger infraspinous fossa

Subscapular Fossa

(in the anterior surface) forms muscle attachments

Acromion

articulates with the acromial end of clavicle

Coracoid Process

projects anterolaterally and located superior to the glenoid fossa

Glenoid Fossa

(lateral) articulates with the head of humerus to form the glenohumeral joint

BONES

the only existing bone attachment between the upper limb and the trunk

CLAVICLE

Lateral End

acromial end of clavicle which articulates with the acromion of the scapula

Conoid Tubercle

attachment of coracoclavicular ligament

Medial End

sternal end of clavicle which mainly articulates with the manubrium of the sternum at at a lesser extent, with the first costal

Trapezoid Line

attachment of coracoclavicular ligament

BONES

HUMERUS (PROXIMAL END)

Greater Tubercle

prominent landmark that serves as an attachment site for the for rotator cuff muscles of the glenohumeral joint; lateral in position Superior facet: attachment of supraspinatus muscle Middle facet: attachment of infraspinatus muscle Inferior facet: attachment of teres minor muscle

Head

articulates with the much smaller glenoid cavity of the scapula

Anatomical Neck

located between the head and the greater and lesser tubercles laterally & located between the head and the shaft medially

Intertubercular Sulcus

separates the greater and lesser tubercles; where the tendon of the long head of the biceps brachii passes through; consists of a lateral and medial lip Lateral lip: where the pectoralis major muscle attaches on Medial lip: where the teres major muscle attaches on Posterior aspect: where the latissimus dorsi muscle attaches on

Lesser Tubercle

prominent landmark that serves as an attachment site for the for rotator cuff muscles of the glenohumeral joint; anterior in position for the attachment of the subscapularis muscle

Surgical Neck

weaker than other proximal regions of the bone; One of the sites in which the humerus is commonly fractured. The axillary nerve and the posterior circumflex humeral artery can be damaged by fractures in this region.

Shoulder Complex

Acromioclavicular Joint Ligaments

Glenohumeral Joint Ligaments

Sternoclavicular Joint Ligaments

LIGAMENTS

STERNOCLAVICULAR JOINT LIGAMENTS

Sternoclavicular

reinforce the capsule and function primarily to check anterior and posterior translatory movement of the medial end of the clavicle and prevents subluxation Anterior SC Ligaments - assist in preventing anterior subluxation Posterior SC Ligaments - assist in preventing posterior subluxation

Interclavicular

limits excessive depression of the distal clavicle and superior gliding of the medial clavicle on the manubrium and these ligaments are critical to protecting structures such as the brachial plexus and subclavian artery, which pass under the clavicle and over the first rib

Costoclavicular

limits the superiorly directed forces applied to the clavicle by the sternocleidomastoid and sternohyoid muscles and main check to clavicular elevation and to superior glide of the clavicle

LIGAMENTS

ACROMIOCLAVICULAR JOINT LIGAMENTS

Acromioclavicular

assist the capsule in opposing the articular surfaces. The superior acromioclavicular is the main ligament limiting movement caused by anterior forces applied to the distal clavicle.

Coracoclavicular

unites the clavicle and scapula and provides much of the joint’s superior and inferior stability. It is critical in preventing superior dislocation of the clavicle on the acromion and assist in the transmission of forces from the scapula to the clavicle. Trapezoid Ligament - quadrilateral in shape and is nearly horizontal in orientation Conoid Ligament - medial and slightly posterior to the trapezoid, is more triangular and vertically oriented

LIGAMENTS

GLENOHUMERAL JOINT LIGAMENTS

Glenohumeral

all portions tighten on lateral rotation of the humerus and motions involving anterior glide of the humerus Superior GH Ligament - taut in full adduction; limits inferior and anterior translation of humerus Middle GH Ligament - taut in external rotation; limits anterior translation Inferior GH Ligament Anterior - taut in abduction and ER; limits anteroinferior translation Posterior - taut in abduction and IR; limits posteroinferior translation

Coracoacromial

provides support to the head of humerus that prevents superior dislocation

Coracohumeral

limits inferior translation of the humeral head in the dependent arm position, resists humeral lateral rotation with the arm adducted, and assists in preventing superior translation of the humerus, especially when the dynamic stabilizing force of the rotator cuff muscles is impaired.

Brachial Plexus

BRACHIAL PLEXUS

Medial Pectoral Nerve

Innervates the pectoralis major and pectoralis minor

Subclavius Nerve

(from upper trunk of brachial plexus) Innervates the subclavius

Long Thoracic Nerve

Innervates the serratus anterior

Lateral Pectoral Nerve

Innervates the pectoralis major

Accessory Nerve

(spinal part) Innervates the trapezius, levator scapulae

Suprascapular Nernve

Innervates the supraspinatus, infraspinatus

Thoracodorsal Nerve

Innervates the latissimus dorsi

C3 and C4

Innervates the trapezius, levator scapulae

BRACHIAL PLEXUS

Lower Subscapular Nerve

Innervates the teres major, subscapularis

Musculocutaneous Nerve

Innervates the biceps brachii, coracobrachialis, brachialisInnervates the subclavius

Dorsal Scapular Nerve

Innervates the rhomboid minor and rhomboid major

Upper Subscapular Nerve

Innervates the subscapularis

Axillary Nerve

Innervates the deltoid, teres minor Innervates the trapezius, levator scapulae

Median Nerve

Innervates the pronator teres, flexor carpi radialis, palmaris longus

Radial Nerve

Innervates the triceps

SC Joint

GH Joint

Scapula

BIOMECHANICS

SCAPULA

Upward and Downward Rotation

Rotatory motions that tilt the glenoid fossa upward or downward

Protraction and Retraction

Translatory motions occur as the scapula slides along the ribcage away or towards the vertebral column

Elevation andDepression

Translatory motions where the scapula moves upward or downward along the ribcage

BIOMECHANICS

STERNOCLAVICULAR JOINT

Rotation of the Clavicle

- occurs as a spin between the surfaces of the clavicle and the manubriocostal facetAxis of rotation: longitudinally intersecting the joint Rotates in only one direction: posteriorly frm neutral bringing the inferior surface of the clavicle to face anteriorly Average ROM of clavicular rotation: 30-45 degrees Associated with scapular rotation, but does not have a direct relationship with it

Protraction and Retractionof the Clavicle

- occurs around the vertical axis Average ROM of protraction: 15 degrees Average ROM of Retraction: 15 degrees Associated with abduction and adduction of the scapula

Elevation and Depression of the Clavicle

- 0ccurs between a convex clavicular surface and a concave- the surface formed by manubrium and 1st CC around an anterior-posterior axis Average ROM of elevation: 45 degrees Average ROM of depression: 15 degrees The elevation and depression of the clavicle are associated with the elevation and depression of the scapula

BIOMECHANICS

GLENOHUMERAL JOINT

Arthrokinematics

Osteokinematics

Along with the upper arm's humerus, the scapulae are important bones because they support the shoulder joints. The scapula is a broad, flat, triangular bone that forms the acromion, or apex of the shoulder. It is a key location for the trapezius, deltoid, and biceps brachii muscles to attach.

The most visible component of the shoulder is the glenohumeral joint. Only this joint has a ball-and-socket design. It is located at the rounded head of the arm's humerus bone and meets the shoulder blade, which is stabilized by the rotator cuff muscles surrounding it.

The entire shoulder is scarcely attached to the rest of the skeleton. Only the clavicle is a bony connection between the skeleton and the shoulder.

Proximal Femur

strongest and longest bone in the body

Hip Bone

also known as pelvic bone

BONES

HIP BONE

Illium

largest and most superior

Ischium

located posteroinferiorly

Pubis

smallest component of the hip bone

Obturator foramen

mostly covered by a flat connective tissue membrane known as the obturator membrane

Acetabulum

articulates with the femoral head at the hip joint

Hip Joint

ball-and-socket joint formed by the articulation of the acetabulum and head of femur

BONES

PROXIMAL FEMUR

Head

articulates with the acetabulum of the pelvic bone

Neck

connects the head to the shaft of the femur

Greater Trochanter

attachment site for muscles of the hip joint

Intertrochanteric Line

connects the greater and lesser trochanter

Lesser Trochanter

attachment site for muscles of the hip joint; receives attachment of the tendons of iliopsoas muscles

Intertrochanteric Crest

contains quadrate tubercle which receives the attachment of the quadratus femoris muscle

Hip Complex

Hip Complex

Pubofemoral Ligament

Ischiofemoral Ligament

Iliofemoral Ligament

Ligamentum Teres

Hip Complex

Osteokinematics

Arthrokinematics

The term hip bone is derived from the Latin phrase "os coxae," where "os" indicates bone and "coxae" stands for hip.

The hip bones consist of three bones fused together. The ilium is superior to the pubis and ischium, which are inferomedial and inferolateral to the hip bone, respectively.

Comparatively, the male pelvic girdle is narrower and has a pubic arch angle of less than 90 degrees than the female pelvic girdle, which is relatively larger and broader with a pubic arch angle of more than 90 degrees, which is beneficial for birthing.

01

STEP ONE

Joints’ Positions/Movements (Shoulder, Elbow, Wrist, and Hand)Shoulder: Flexion Elbow: Flexion Wrist: Neutral Hand: Both hands have the four lateral fingers in flexion and the thumbs in extension.

02

STEP TWO

Joints’ Positions/Movements (Shoulder, Elbow, Wrist, and Hand)Shoulder: Flexion Elbow: Flexion Wrist: Neutral Hand: Hand is flexion, the pointing finger is extension and the rest of the finger are flexion.

03

STEP THREE

Joints’ Positions/Movements (Shoulder, Elbow, Wrist, and Hand)Shoulder: Flexion Elbow: Flexion and forearm is pronated Wrist: Flexion Hand: Lateral four fingers are in flexion while thumb is in extension

04

STEP FOUR

Joints’ Positions/Movements (Shoulder, Elbow, Wrist, and Hand)Shoulder: Flexion Elbow: Flexion and Extension (Opening Cupboard), Forearm Pronation Wrist: Flexion, Extension (Closing Cupboard) Hand: Fingers in flexion (opening cupboard; holding plate), thumb in flexion (holding plate), fingers and thumb in extension (closing cupboard)

05

STEP FIVE

Joints’ Positions/Movements (Shoulder, Elbow, Wrist, and Hand)Shoulder: Flexion Elbow: Flexion and Extension Wrist: Flexion (getting hotdogs from pan) and neutral when placing the hotdogs on the plate Hand: Flexion with middle and pointing fingers in extension

01

Occupation and Activities

Learning how to fold clothes is a life skill that can be acquired over time. It is a basic activity of daily life in the domain of occupation that can also fall under the category of social participation. This therapeutic practice can be used by an occupational therapist to assist a patient with following the instructions, recognizing similarities and differences, recognizing shapes and colors, using two hands independently, grasps, releases, and fine motor coordination. We can identify various issues in the area of occupation and anatomical landmarks for the analysis by having a basic knowledge of the concepts of anatomy and kinesiology.

02

Functional Application

Folding the clothes takes both gross motor abilities and fine motor skills, and it may involve shoulder movements such as adduction and abduction, extension, protraction, and rotation. When simply moving the cuff of the sleeve to the two sides of the shirt, it has an extension and adduction of the shoulder and flexion in the elbow. The wrist also performs flexion and extension, and the hand conducts abduction, adduction, flexion, and extension when executing the activity. While the fingers can be flexed when making actions to ensure that both sides are folded properly as well as abducted to flatten out the folds. To perform folding, the hands would pinch the material laterally. The sleeves can be held with the thumb and fingers performing tip-to-tip action.

02

Functional Application

03

Intervention to Support Occupations

Because we have a thorough understanding of anatomy and kinesiology fundamentals, we can propose a solution for clients whose performance is being hindered. We can easily target the body functions of the client. As occupational therapists, we employ some of the techniques that we use to evaluate various surface features in order to encourage and provide activities for those who are having trouble performing their occupations. Let's assume for the reasons of the functional application that our client has poor gross motor and fine motor skills, and that they experience pain when using their upper extremity excessively. In this case, we could provide them a DIY shirt folder, which would enable them to perform and adapt to daily activities.

03

Intervention to Support Occupations

Sorting & Folding Laundry. (2005). Making the DIY Shirt Folder [Image]. LAUSD, Los Angeles, CA, United States. https://achieve.lausd.net/cms/lib/CA01000043/Centricity/Domain/109/Self-Care_Independent%20Living%20-%20Home%20Activities%2005-11-20.pdf

04

Education and Advocacy

Occupational therapy greatly benefits from the study of anatomy and kinesiology. With the proper terminology and an understanding of how the body works, we can explain to our clients why they are having trouble performing their occupational duties and provide them with clear directions that will help them avoid doing the things that will make their pain worse and identify the source of their discomfort. We have the ability to help people restore their independence in all facets of their lives while also giving them the chance to comprehend their own bodies. Occupational therapists that deal with families, can also educate the client's family so they can help the client complete tasks that are appropriate for their abilities and needs. This will enable the family to engage and advocate for their loved ones who experiencing difficulty.

01

What did the group learn from this course? What were the key takeaways from this course?

Anatomy and Kinesiology serves as one of the fundamental areas of knowledge an occupational therapist must possess. Thus, it serves as the foundation of our grasp on the human body and its structures— muscles, nerves, ligaments, joints, bones, where each part originates and inserts, their movements, and how they are all connected and work together to contribute to daily function. As we went through each region of the body, we learned about the intricacy of our anatomy and its inner workings. From our head resting on our neck, the trunk covering our anatomical structures, and our upper and lower extremities, all serve a purpose in helping us carry out our daily occupations. Because of how associated all of these structures are, we realized how vulnerable the body may be; a disruption in one of these areas may affect the others related to it, but at the same time, easier to identify what needs to be done for rehabilitation.

02

How will your learnings help you in your future professional courses and our practice as an occupational therapist?

We can refer to Anatomy and Kinesiology as the "first baby step"— as professionals, we all have to start somewhere and this course served as the first step for us to be introduced to the world of Occupational Therapy. As Occupational Therapists, it is necessary to have extensive knowledge about the human body and its complexity in order to best apply our knowledge when creating treatment and rehabilitation plans appropriate to the many different cases we will encounter in the future because we understand the body's functions, structures, and all its innervations, we are able to provide the proper activities that each client needs. Especially in physical dysfunction cases, it is necessary to know where to identify important landmarks in the body, how to handle each case, and determine which structures limit an individual to perform a certain occupation. Because of this course, we are now better equipped to properly evaluate and assess what our future clients need, identify their problem areas, attend to our clients as necessary, and help enable them to restore function in their affected body parts.

THE TEAM

SOPHIA SADO

A: Shoulder Trivia C and D Website Design

BEATRIZ PUA

A: BiomechanicsB: Step 2D

ERIKA PEÑA

A: InnervationB: Step 1 D

JANNA ONG

A: LigamentsB: Step 3 D

THE TEAM

SAMANTHA TANGPUS

A: BonesB: Step 5 D

BEA SEEN

A: Hip TriviaC and D Website Design

KEZIAH SANTOS

A: MusclesB: Step 4 D

References

Benoudina, S. (2016). Normal pelvis: gender differences. Radiopaedia. Retrieved from https://radiopaedia.org/cases/normal-pelvis-gender-differences Smith, C. (2013). 3D Skeletal System: 5 Cool Facts about the Hip Bones. Visible Body. Retrieved from https://www.visiblebody.com/blog/3d-skeletal-system-5-cool-facts-about-the-hip-bones Ferreira, S. (2022). Hip bone. Kenhub. Retrieved from https://www.kenhub.com/en/library/anatomy/hip-bone Drake, R. et al. (2019, March 8). Gray’s Anatomy For Students. Elsevier. Sendic, G. (2022, July 8). Shoulder girdle. Kenhub. https://www.kenhub.com/en/library/anatomy/shoulder-girdle O’Leary, C. (2022, October 26). Humerus. Kenhub. https://www.kenhub.com/en/library/anatomy/the-humerus Crumble, L. (2022, July 19). Femur. Kenhub. https://www.kenhub.com/en/library/anatomy/femur Unicomb, L. (2021). #FactFriday: Interesting Facts about the Shoulder | General Physiotherapy. Thephysiojoint.com.au. https://www.thephysiojoint.com.au/blog/factfriday-interesting-facts-about-the-shoulder Fun Fact: Scapula – Outlander Anatomy. (2018, February 27). Outlanderanatomy.com. https://www.outlanderanatomy.com/fun-fact-scapula/#:~:text=Scapulae%20are%20extremely%20important%20bones,%2C%20deltoid%2C%20and%20biceps%20brachii. NOVAK, D. (2022). Guide to Shoulder Anatomy. Sports-Health. https://www.sports-health.com/sports-injuries/shoulder-injuries/guide-shoulder-anatomy#:~:text=The%20shoulder%20is%20made%20up,edge%20of%20the%20shoulder%20blade.