Biomechanics Mu 2010

Front 1

Qualitative?

Back 1

•Non-numerical
•Based on direct observation
•Equipment not necessary
•Focus on time and space
•Examples:
–Rotation of femur during golf swing
–Adduction of humerusduring freestyle swim

Front 2

Quantitative

Back 2

•Numerical
•Based on data collected
•Equipment necessary
•Focus on forces
•Examples:
–Stress on shoulder during baseball pitch
–Compression force on femur during landing

Front 3

Kinesiology

Back 3

–Scientific study of human movement
–Anatomical, physiological, psychological, biomechanical

Front 4

Biomechanics

Back 4

–Application of mechanics to biological systems
–More specific than kinesiology

Front 5

Kinematics

Back 5

–Examines space and time

Front 6

Kinetics

Back 6

–Examines forces

Front 7

Dextro

Back 7

–relating to, or situated to the right or on the right side of something

Front 8

Levo

Back 8

–relating to, or situated to the left or on the left side of something

Front 9

Volar

Back 9

–relating to palm of the hand or sole of the foot
•Plantar

Front 10

Types of Bones?

Back 10

•Long bones -humerus, fibula
•Short bones -carpals, tarsals
•Flat bones -skull, scapula
•Irregular bones -pelvis, ethmoid, ear ossicles
•Sesamoid bones -patella

Front 11

Endochondral bones

Back 11

–develop from hyaline cartilage
–hyaline cartilage masses at embryonic stage

Front 12

3 major classifications according to structure & movement characteristics

Back 12

–Synarthrodial
–Amphiarthrodial
–Diarthrodial

Front 13

Synarthrodial

Back 13

•immovable joints
•Suture such as Skull sutures
•Gomphosis such as teeth fitting into mandible or maxilla

Front 14

Amphiarthrodial

Back 14

•slightly movable joints
•allow a slight amount of motion to occur
–Syndesmosis
–Synchondrosis
–Symphysis

Front 15

Syndesmosis

Back 15

Two bones joined together by a strong ligament or an interosseus membrane that allows minimal movement between the bones
–Bones may or may not touch each other at the actual joint
–Ex. Coracoclavicular joint, distal tibiofibular jt.

Front 16

Synchondrosis

Back 16

Typeofjointseparatedbyhyalinecartilagethatallowsveryslightmovementbetweenthebones
–Ex.costochondraljointsoftheribswiththesternum

Front 17

Symphysis

Back 17

–Joint separated by a fibrocartilage pad that allows very slight movement between the bones
–Ex. Symphysis Pubis& intervertebral discs

Front 18

Diarthrodial Joints

Back 18

•known as synovial joints
•freely movable
•composed of sleevelike joint capsule
•secretes synovial fluid to lubricate joint cavity
•capsule thickenings form tough, nonelastic ligaments that provide additional support against abnormal movement or joint opening

Front 19

Degrees of freedom

Back 19

–motion in 1 plane = 1 degree of freedom
–motion in 2 planes = 2 degrees of freedom
–motionin3planes=3degreesoffreedom

Front 20

Diarthrodial Joints - six types?

Back 20

–Condyloid (knuckle joint)
–Enarthrodial (ball and socket)
–Sellar (saddle - only in the 1st carpometacarpal)
–Arthrodial (glinding)
–Ginglymus (hinge joint)
–Trochoid (pivot joint)

Front 21

Osteokinematic motion

Back 21

resulting motion of bones relative to 3 cardinal planes from these physiological

Front 22

Arthrokinematics

Back 22

motion between articular surfaces

Front 23

3 specific types of accessorymotion

Back 23

–Spin
–Roll
–Glide

Front 24

Isometric contraction

Back 24

Isometric contraction
– tension is developed within
muscle but joint angles remain
constant
– static contractions
– significant amount of tension may
be developed in muscle to
maintain joint angle in relatively
static or stable position
– may be used to prevent a body
segment from being moved by
external forces

Front 25

• Isotonic contraction

Back 25

developing tension to either cause or control
joint movement
– dynamic contractions
– the varying degrees of tension in muscles result in
joint angles changing
• Isotonic contractions are either concentric or
eccentric on basis of whether shortening or
lengthening occurs

Front 26

Concentric contractions

Back 26

– muscle develops tension as it
shortens
– occurs when muscle develops
enough force to overcome applied
resistance
– causes movement against gravity
or resistance
– described as being a positive
contraction
– force developed by the muscle is
greater than that of the resistance
– results in joint angle changing in
the direction of the applied
muscle force
– causes body part to move against
gravity or external forces

Front 27

Eccentric contraction (muscle action)

Back 27

– muscle lengthens under tension
– occurs when muscle gradually lessens in
tension to control the descent of
resistance
– weight or resistance overcomes muscle
contraction but not to the point that
muscle cannot control descending
movement
– controls movement with gravity or
resistance
– used to decelerate body segment movement – Some refer to this as a muscle action instead of a
contraction since the muscle is lengthening as
opposed to shortening
– described as a negative
contraction
– force developed by the muscle is
less than that of the resistance

Front 28

Kinesthesis

Back 28

conscious awareness of
position & movement of the body in space. Through proprioceptors.

Front 29

• the types of Proprioceptors specific to joints & skin?

Back 29

. Meissnerfs corpuscles
. Ruffinifs corpuscles
. Pacinian corpuscles
. Krausefs end]bulbs

Front 30

Proprioception

Back 30

– Subconscious mechanism by which body is able
to regulate posture & movement by responding
to stimuli originating in proprioceptors of the
joints, tendons, muscles, & inner ear

Front 31

• Phases of a single muscle fiber contraction
or twitch?

Back 31

– Stimulus
– Latent period
– Contraction phase
– Relaxation phase

Front 32

• the types of Proprioceptors specific to joints & skin?

Back 32

. Meissnerfs corpuscles
. Ruffinifs corpuscles
. Pacinian corpuscles
. Krausefs end]bulbs

Front 33

Proprioception

Back 33

– Subconscious mechanism by which body is able
to regulate posture & movement by responding
to stimuli originating in proprioceptors of the
joints, tendons, muscles, & inner ear

Front 34

• Phases of a single muscle fiber contraction
or twitch?

Back 34

– Stimulus
– Latent period
– Contraction phase
– Relaxation phase

Front 35

If angle is LESS than 90 degrees,
the force is a ________because its pull/ directs the bone
toward the joint axis

Back 35

stabilizing force

Front 36

If angle is GREATER than 90
degrees, the force is ________
due to its pull directing the bone
away from the joint axis

Back 36

dislocating

Front 37

Uniarticular muscles

Back 37

– Cross & act directly only on the joint that they
cross
– Ex. Brachialis

Front 38

Biarticular muscles

Back 38

cross & act on two
different joints
– Depending, biarticular muscles may contract &
cause motion at either one or both of its joints

Front 39

Multiarticular muscles

Back 39

on three or morejoints due to the line of pull between their origin & insertion crossing multiple joints

Front 40

Active insufficiency

Back 40

reached when the muscle becomes shortened to the point that it
can not generate or maintain active tension

Front 41

Passively insufficiency

Back 41

reached when the opposing muscle becomes stretched to the point where it can no longer lengthen & allow
movement

Front 42

Three major types of muscle fibers:

Back 42

Type I, IIa, IIb.

Front 43

Type I

Back 43

Contraction velocity- Slow-twitch oxidative (OS)
Contraction force-Slow
Fatigability- Fatigue resistant

Front 44

Type IIa

Back 44

Contraction velocity- Fast-twitch oxidative-glycolytic(FOG)
Contraction force - Moderately fast
Fatigability- Somewhat fatigue resistant

Front 45

Type- IIb.

Back 45

Contraction velocity- Fast-twitch glycolytic(FG)
Contraction force-Fast
Fatigability- Rapidly fatiguing

Front 46

Distal maleoli (of tibia and fibula) serve as _____ for _______to increase _____ of muscles in performing inversion & eversion actions

Back 46

pulley
posterior tendons
mechanical advantage

Front 47

lateral malleolus -posterior tendons?

Back 47

Peroneus brevis & peroneus longus

Front 48

medial malleolus -posterior tendons?

Back 48

•“Tom, Dick & Harry”
–Tibialis posterior
–Flexor digitorum longus
–Flexor hallucis longus

Front 49

Function of the tuberosity of the 5th metatarsal?

Back 49

insertion for peroneus brevis & tertius (and abductor digiti minimi)

Front 50

what is the advantage of pennate muscles?

Back 50

Force depends on the angle. The grater the angle the the lower the force transmitted to the tendon and thus the greater the higher the maximum capable force. There is a higher number of fibres compared to a fusiform muscle.

Front 51

Degrees of movement of talocrural joint?

Back 51

–50 degrees of plantar flexion
–15 to 20 degrees of dorsiflexion
–Greater range of dorsiflexion with knee flexed (reduces gastroc tension)
–Fibula rotates 3 to 5 degrees externally with ankle dorsiflexion
& 3 to 5 degrees internally during plantarflexion

Front 52

movement of subtalar & transverse tarsal joints? (degrees)

Back 52

–Inversion & eversion occurs here
–Classified as gliding or arthrodial
–Combined movement of
•20 to 30 degrees of inversion
•5 to 15 degrees of eversion

Front 53

Metatarsophalangeal joints

Back 53

–Classified as condyloid-type joints
–Great toe metatarsophalangeal (MP) joint flexes 45 degrees & extends 70 degrees
–MP joints of the four lesser toes
•40 degrees of flexion
•40 degrees of extension
•also abduct & adduct minimally

Front 54

Movement of great toe interphalangeal (IP) joint

Back 54

joint flexes from 0 degrees of full extension to 90 degrees of flexion

Front 55

Proximal interphalangeal (PIP) joints movement?

Back 55

in lesser toes flexes from 0 degrees of extension to 35 degrees of flexion

Front 56

Distal interphalangeal (DIP) joints movement?

Back 56

flexes 60 degrees & extend 30 degrees

Front 57

Excessive _____ forces injures deltoid ligament (medially) and is ___ common

Back 57

eversion
less

Front 58

Most ____ ankle sprain results from excessive ____ that causes damage to lateral ligamentous structures, primarily _____ & _____

Back 58

common
inversion
anterior talofibularligament
calcaneofibularligament

Front 59

Most common ankle sprain results from excessive inversion that causes damage to lateral ligamentousstructures, primarily anterior talofibularligament & calcaneofibularligament

Back 59

Front 60

Most common ankle sprain results from excessive inversion that causes damage to lateral ligamentousstructures, primarily anterior talofibularligament & calcaneofibularligament

Back 60

Front 61

Back 61

Excessive eversion forces injures deltoid ligament (medially) -less common

Front 62

There are two _____ arches of the foot and one _____arch

Back 62

Hint 62

longitudinal & transverse
–Medial arch -extends from calcaneus bone to talus, navicular, 3 cuneiforms, and proximal ends of 3 medial metatarsals
–Lateral longitudinal arch -extends from calcaneus to cuboid and proximal ends of 4th& 5thmetatarsals
–Long arches may be high, medium, or low

Front 63

Transverse arch location?

Back 63

Hint 63

–extends across foot from 1stmetatarsal to the 5thmetatarsal

Front 64

triceps surae includes

Back 64

gastrocnemius & soleus

Front 65

Plantar flexors

Back 65

–Gastrocnemius
–Flexor digitorum longus
–Flexor hallucis longus
–Peroneus (fibularis) longus
–Peroneus (fibularis) brevis
–Plantaris
–Soleus
–Tibialis posterior

Front 66

Plantar flexors

Back 66

Hint 66

–Gastrocnemius
–Flexor digitorum longus
–Flexor hallucis longus
–Peroneus (fibularis) longus
–Peroneus (fibularis) brevis
–Plantaris
–Soleus
–Tibialis posterior

Front 67

Ankle and foot joint evertors?

Back 67

Hint 67

–Peroneus (fibularis) longus
–Peroneus (fibularis) brevis
–Peroneus (fibularis) tertius
–Extensor digitorum longus

Front 68

Ankle & footjoint Invertors

Back 68

Hint 68

–Tibialisanterior
–Tibialisposterior
–Flexor digitorum longus (flexor of lesser toes)
–Flexor hallucis longus (flexor of great toe)

Front 69

Ankle & footjoint muscles Anteriorcompartment

Back 69

Hint 69

–Tibialisanterior
–Extensorhallucislongus
–Extensordigitorumlongus
–Peroneus(fibularis)tertius

Front 70

Ankle & footjoint muscles Lateral compartment

Back 70

Hint 70

–Peroneus (fibularis) longus
–Peroneus (fibularis) brevis

Front 71

Ankle & foot joint muscles Deep posterior compartment

Back 71

Hint 71

–Flexor digitorum longus
–Flexor hallucis longus
–Tibialis posterior

Front 72

Ankle & foot joint muscles
Superficial posterior compartment

Back 72

Hint 72

–Gastrocnemius (medial head)
–Gastrocnemius (lateral head)
–Soleus

Front 73

Ankle Dorsiflexion Agonists

Back 73

–Tibialis anterior
–Extensor digitorum longus
–Peroneus (fibularis) tertius
•Extensor hallucis longus

Front 74

Ankle Plantar Flexion
•Agonists

Back 74

–Gastrocnemius
–Soleus
•Flexor digitorum longus
•Flexor hallucis longus
•Peroneus (fibularis) longus
•Peroneus (fibularis) brevis
•Plantaris
•Tibialis posterior

Front 75

Transverse Tarsal & Subtalar Inversion
•Agonists

Back 75

–Tibialis anterior
–Tibialis posterior
•Flexor digitorum longus
•Flexor hallucis longus

Front 76

Transverse Tarsal & Subtalar Eversion
•Agonists

Back 76

–Peroneus (fibularis) longus
–Peroneus (fibularis) brevis
–Peroneus (fibularis) tertius
–Extensor digitorum longus

Front 77

Toe Flexion
•Agonists

Back 77

–Flexor hallucis longus
–Flexor digitorum longus

Front 78

Toe Extension
•Agonists

Back 78

–Extensor hallucis longus
–Extensor digitorum longus

Front 79

Talocrural joint - Axes of rotation and joint movements.

Back 79

Front 80

•Transverse tarsal joint - Axes of rotation and joint movements - pronation

Back 80

Front 81

•Transverse tarsal joint - Axes of rotation and joint movements supination

Back 81

Front 82

Axis of rotation through tibial plateu and malleoli

Back 82

Front 83

what are the associated movements during exaggerated pronation of the subtalar joint while weight bearing?

Back 83

Hip (internal rotation, flexion and adduction)
Knee (Valgus strain)
Subtalar joint (pronation and lowering of the logitiudinal arch)
Transverse tarsal joint (inversion/ supination)

Front 84

kinetics of plantar flexor muscles during gait?

Back 84

•Also supinate the subtalar or transverse tarsal joints.
•(except for peroneus longus and brevis).
•Become active right after the dorsiflexor muscles relax.
•Are active throughout most of the stance phase of gait (especially between foot-flat and toe-off).
•Act eccentrically to decelerate the forward motion (dorsiflexion) of the leg (from foot-flat to about heel off).
•Switch to a concentric activation in order to provide push off thrust (between heel-off and toe-off).

Front 85

What are the strongest plantar flexor muscles?

Back 85

•The gastrocnemius and the
soleus muscles are the strongest plantar flexors (producing 80% of the total plantarflexion torque).

Front 86

kinetics of supinator muscles of the foot/ ankle during gait?

Back 86

The tibialis posterior, flexor hallucis longus, and the flexor digitorum longus are the primary supinators.
•Tibialis posterior is the strongest supinator.
•During stance phase, the tibialis posterior is active longer than the others, and it decelerates the pronating rearfoot and assist in controlling the lowering of the medial longitudinal arch.
•Through eccentric action, the tibialis posterior also absorbs some of the impact of loading.

Front 87

The column consists of?

Back 87

33 vertebrae, 24 of which are moveable

Front 88

most mobile joint of the cervical region?

Back 88

atlas and axis

Front 89

Most highly loaded structure in the skeletal system?

Back 89

Lumbar region

Front 90

Strength and Forces at the Vertebral Joints

Back 90

•Trunk extension strengths average 210 Nm.
•Trunk flexion strengths average 150 Nm.
•Trunk lateral flexion averages 145 Nm.
•Trunk rotation strengths average 90 Nm.
•Intra-abdominal pressure, ligaments, and other structures also contribute to the net strength moments.

Front 91

Posture when sitting

Back 91

–Unsupported sitting is more strenuous on spine.
–When sitting, lumbar lordosis is reduced, and the upper body center of gravity shifts forward.
–Lumbar load is reduced in supported sitting, especially with lumbar support and a reclined

Front 92

posture when standing?

Back 92

–S-shaped spine acts as an elastic rod support.
–Erector spinae helps keep spine erect.
–When slouching, the ligaments and joint capsules maintain posture.

Front 93

•Atlantoaxial joint

Back 93

–Atlas (C1) sits on axis (C2)
–Most cervical rotation occurs here
–Trochoid or pivot-type joint
–Most mobile joint of any two vertebrae

Front 94

•Atlantooccipital joint

Back 94

–first joint
–formed by occipital condyles of skull sitting on articular fossa of the 1stvertebra
–allows capital flexion & extension

Front 95

vertebral articulations, type and movement?

Back 95

–Cumulative effect of combined movement from several vertebrae allows for substantial movements
•Minimal movement between any 2 vertebrae (except atlantoaxial joint)
–Cumulative effect of combined movement from several vertebrae allows for substantial movements
–Vertebral articulations classified as arthrodial
–Gliding-type joints due to limited gliding movements
–Gliding movement between superior & inferior articular processes of facets joints

Front 96

herniated or “slipped” disk

Back 96

–nucleus protruding through annulus resulting from substantial weakening combined with compression
–protrusion puts pressure on spinal nerve root, causing radiating pain, tingling, numbness, and/or weakness in lower extremity

Front 97

Degrees of movement - CERVICAL region

Back 97

–Flexes 45 degrees
–Extends 45 degrees
–Laterally flexes 45 degrees
–Rotate approximately 60 degrees

Front 98

Degrees of movement - LUMBAR region
(including trunk movement)

Back 98

–Flexes approximately 80 degrees
–Extends 20 to 30 degrees
–Lumbar lateral flexion to 35 degrees
–Rotation approximately 45 degrees

Front 99

•Muscles that move the head–Anterior

Back 99

•Rectus capitis anterior
•Longus capitis

Front 100

•Muscles that move the head– Posterior

Back 100

•Longissimus capitis
•Obliquus capitis superior
•Obliquus capitis inferior
•Rectus capitis posterior -major & minor
•Trapezius, superior fibers
•Splenius capitis
•Semispinalis capitis

Front 101

Muscles that move the head–Lateral

Back 101

•Rectus capitis lateralis
•Sternocleidomastoid

Front 102

•Muscles that move the head–Lateral

Back 102

•Rectus capitis lateralis
•Sternocleidomastoid

Front 103

•Musclesofthevertebralcolumn–Superficial

Back 103

•Erector spinae (sacrospinalis)
–Spinalis -cervicis, thoracis
–Longissimus -capitis, cervicis, thoracis
–Iliocostalis -cervicis, thoracis, lumborum
•Splenius cervicis

Front 104

•Musclesofthevertebralcolumn
–Deep

Back 104

•Longus colli -superior oblique, inferior oblique, vertical
•Interspinales -entire spinal column
•Intertransversales -entire spinal column
•Multifidus -entire spinal column
•Psoas minor
•Rotatores -entire spinal column
•Semispinalis -cervicis, thoracis

Front 105

•Musclesofthethorax

Back 105

–Diaphragm
–Intercostalis-external,internal
–Levatorcostarum
–Subcostales
–Scalenus-anterior,medius,posterior
–Serratusposterior-superior,inferior
–Transversusthoracis

Front 106

•Musclesoftheabdominalwall

Back 106

–Rectus abdominis
–External oblique abdominal (obliquus externus abdominis)
–Internal oblique abdominal (obliquus internus abdominis)
–Transverse abdominis (transversus abdominis)
–Quadratus lumborum

Front 107

Muscles that Move the Head

Back 107

–3 anterior vertebral muscles –longus capitis, rectus capitis anterior & rectus capitis lateralis
•All are flexors of head & upper cervical spine
•Rectus capitis lateralis
–laterally flexes head
–assists rectus capitis anterior in stabilizing atlantooccipital joint

Front 108

Muscles that Move the Head

Back 108

Hint 108

•All originate on cervical vertebrae & insert on occipital bone of skull (capitis name)
–3 anterior vertebral muscles –longus capitis, rectus capitis anterior & rectus capitis lateralis
•All are flexors of head & upper cervical spine
•Rectus capitis lateralis
–laterally flexes head
–assists rectus capitis anterior in stabilizing atlantooccipital joint

Front 109

Posterior muscles- Muscles that Move the Head

Back 109

•Rectus capitis posterior major & minor, obliquus capitis superior & inferior, and semispinalis capitis
•All are extensors of head except obliquus capitis inferior which rotates atlas
•Obliquus capitis superior assists rectus capitis lateralis in lateral flexion of head
•Rectus capitis posterior major rotates head to ipsilateral side
•Semispinalis capitis rotates head to contralateral side
•Upper trapezius extend head & rotate its to ipsilateral side

Front 110

Posterior muscles - Muscles that Move the Head

Back 110

Hint 110

•Rectus capitis posterior major & minor, obliquus capitis superior & inferior, and semispinalis capitis
•All are extensors of head except obliquus capitis inferior which rotates atlas
•Obliquus capitis superior assists rectus capitis lateralis in lateral flexion of head
•Rectus capitis posterior major rotates head to ipsilateral side
•Semispinalis capitis rotates head to contralateral side
•Upper trapezius extend head & rotate its to ipsilateral side

Front 111

muscles that extend spine and assist in rotation & lateral flexion

Back 111

Cervical area
–Longus colli muscles
•located anteriorly
•flex cervical & upper thoracic vertebrae
•Posterior
–Erector spinae group, transversospinalis group, interspinal-intertransverse group & splenius
•All run vertically parallel to spinal column

Front 112

Posterior Muscles of the Thorax

Back 112

•Scalene muscles elevate first 2 ribs to increase thoracic volume
•External intercostals further expand the chest
•Levator costarum & serratus posterior –inspiration
•Internal intercostals, transversus thoracis, & subcostales contract to force expiration

Front 113

Cervical Extension
•Agonists

Back 113

–Erector Spinae

Front 114

Cervical Lateral Flexion
•Agonists

Back 114

–Sternocleidomastoid
–Erector Spinae

Front 115

Cervical Rotation
•Agonists

Back 115

–Sternocleidomastoid

Front 116

Lumbar Flexion
•Agonists

Back 116

–Rectus abdominis
–External oblique abdominal
–Internal oblique abdominal

Front 117

Lumbar Extension
•Agonists

Back 117

–Erector spinae

Front 118

Lumbar Lateral Flexion
•Agonists

Back 118

–Erector spinae
–External oblique abdominal
–Internal oblique abdominal

Front 119

Lumbar Rotation
•Agonists

Back 119

–Rectus abdominis
–External oblique abdominal
–Internal oblique abdominal

Front 120

Where is the centre of pressure (CoP)?

Back 120

•The CoP lies between the feet and just anterior to the ankle.
•When a person stands on a force platform the CoP can be determined by measuring the weight bearing of the feet and subsequently calculating a theoretical average force between the feet.

Front 121

•Knee joint

Back 121

–largest joint in body
–very complex
–primarily a hinge joint
•Enlarged femoral condylesarticulate on enlarged tibial condyles
•Medial & lateral tibial condyles (medial & lateral tibial plateaus) -receptacles for femoral condyles
•Tibia –medial
–bears most of weight

Front 122

•Fibula

Back 122

-lateral
–serves as the attachment for knee joint structures
–does not articulate with femur or patella
–not part of knee joint

Front 123

•Patella

Back 123

–sesamoid (floating) bone
–imbedded in quadriceps & patellar tendon
–serves similar to a pulley in improving angle of pull, resulting in greater mechanical advantage in knee extension

Front 124

Gerdy’stubercle

Back 124

Iliotibialtract of tensor fasciae lataeinserts on

Front 125

“PesAnserine”

Back 125

Sartorius, gracilis, & semitendinosusinsert just below the medial condyleon upper anteromedialtibialsurface

Front 126

Collateral ligaments

Back 126

The primary function of the collateral ligaments is to limit excessive motion in the frontal plane.
A secondary function of the collateral ligaments is to limit the extremes of knee extension
In full knee extension (locked position), the MCL and posterior capsule provide resistance.
Full extension elongates the collateral ligaments by 20% (compared to the flexion).
A taut MCL is particular vulnerable to valgus stress.

Front 127

meniscus (medial and lateral) function?

Back 127

–Thicker on outside border & taper down very thin to inside border
–Can slip about slightly, but held in place by various small ligaments
–Medial meniscus -larger & more open Cappearance
–Lateral meniscus -closed Cconfiguration

Front 128

•Anterior cruciate ligament (ACL) injuries

Back 128

–one of most common serious injuries to knee
–mechanism often involves noncontact rotary forces associated with planting & cutting, hyperextension, or by violent quadriceps contraction which pulls tibia forward on femur

Front 129

•Posterior cruciate ligament (PCL) injuries

Back 129

–not often injured
–mechanism of direct contact with an opponent or playing surface

Front 130

•Tibial (medial) collateral ligament (MCL)

Back 130

–maintains medial stability by resisting valgus forces or preventing knee from being abducted
–injuries occur commonly, particularly in contact or collision sports
–mechanism of teammate or opponent may fall against lateral aspect of knee or leg causing medial opening of knee joint & stress to medial ligamentous structures

Front 131

•Synovial cavity of the knee

Back 131

–supplies knee with synovial fluid
–lies under patella and between surfaces of tibia & femur
–"capsule of the knee”

Front 132

•Infrapatellar fat pad

Back 132

–just posterior to patellar tendon
–an insertion point for synovial folds of tissue known as “plica”
•an anatomical variant that may be irritated or inflamed with injuries or overuse of the knee

Front 133

•Bursae of the knee

Back 133

–more than 10 bursae in & around knee
–some are connected to synovial cavity
–they absorb shock or prevent friction

Front 134

Knee ROM?

Back 134

•Extends to 180 degrees
(0 degrees of flexion)
•Hyperextension of 10 degrees or > not uncommon
•Flexion occurs to about 140 degrees
•With knee flexed 30 degrees or >
–internal rotation 30 degrees occurs
–external rotation 45 degrees occurs

Front 135

•Knee “screws home”, how and why?

Back 135

to fully extend due to the shape of medial femoral condyle
–As knee approaches full extension tibia must externally rotate approximately 10 degrees to achieve proper alignment of tibial & femoral condyles
–In full extension
•close congruency of articular surfaces
•no appreciable rotation of knee
–During initial flexion from full extension
•knee “unlocks” by tibia rotating internally, to a degree, from its externally rotated position to achieve flexion

Front 136

internal rotation of the knee will not occur unless the knee if flexed to _____ to >20-30 degrees or

Back 136

20-30 degrees or >

Front 137

what is the Q angle?

Back 137

–Central line of pull for entire quadriceps runs from ASIS to the center of patella
–Line of pull of patella tendon runs from center of patella to center of tibial tuberosity
–Angle formed by the intersection of these two lines at the patella is the Q angle
–Normally, angle will be 15 degrees or less for males & 20 degrees or less in females
–Generally, females have higher angles due to a wider pelvis
–Higher Q angles generally predispose people in varying degrees to a variety of potential knee problems including lateral patellar subluxation or dislocation, patellar compression syndrome, chondromalacia, and ligamentous injuries
–For people with above normal Q angles, it is particularly important to maintain high levels of strength & endurance in vastus medialis so as to counteract lateral pull of vastus lateralis

Front 138

Does external rotation of Hip alter Knee joint alignment?

Back 138

yes

Front 139

what is Genu Recurvatum

Back 139

Front 140

Knee joint muscles location
•Posterior-primarilykneeflexion

Back 140

–Bicepsfemoris
–Semimembranosus
–Semitendinosus
•Sartorius
•Gracilis
•Popliteus
•Gastrocnemius

Front 141

•Femoral nerves innervates the knee extensors (quadriceps)

Back 141

–rectus femoris
–vastus medialis
–vastus intermedius
–vastus lateralis

Front 142

•Sciatic nerve innervation –tibial division and –common peroneal

Back 142

–tibial division
•semitendinosus, semimembranosus, biceps femoris (long head)
–common peroneal (fibular) division
•biceps femoris (short head)

Front 143

•Quadriceps muscles

Back 143

-vital in jumping
–functions as a decelerator
•when decreasing speed to change direction
•when coming down from a jump
–eccentric contraction during decelerating actions
–controls slowing of movements initiated in previous phases of the sports skill

Front 144

Muscle imbalance in the knee produces _____ Tilt

Back 144

Patella

Front 145

Knee Extension
•Agonists

Back 145

–Rectus Femoris
–Vastus Lateralis
–Vastus Intermedius
–Vastus Medialis

Front 146

Knee Flexion
•Agonists

Back 146

–Biceps Femoris (Long & Short Head)
–Semitendinosus
–Semimembranosus

Front 147

Knee Internal Rotation
•Agonists

Back 147

–Semitendinosus
–Semimembranosus
–Popliteus

Front 148

Knee External Rotation
•Agonists

Back 148

–Biceps Femoris

Front 149

Knee Extension
•Agonists

Back 149

–Rectus Femoris
–Vastus Lateralis
–Vastus Intermedius
–Vastus Medialis

Front 150

Knee Flexion
•Agonists

Back 150

–Biceps Femoris (Long & Short Head)
–Semitendinosus
–Semimembranosus

Front 151

Knee Internal Rotation
•Agonists

Back 151

–Semitendinosus
–Semimembranosus
–Popliteus

Front 152

Knee External Rotation
•Agonists

Back 152

–Biceps Femoris

Front 153

Back 153

facet orientation of the ______spine.

Front 154

Facet Orientation in the T/Spine?

Back 154

in the T/Spine –60 degrees to the Horizontal plane; 20 degrees to the Coronal plane.

Front 155

Thoracic Spine: three regions?

Back 155

•Upper (T1, T2 (T3) -similar to cervical spine.

•Mid (T3-T9)= ‘functional thoracic'.

•Lower (T10-T12) –similar to lumbar spine.

Front 156

Kinematics of the Thoracic Spine: Kyphosis

Back 156

20-55º Kyphosis
Average = 45º
Kyphosis maintained in supine position and during trunk muscle contraction.

Front 157

Thoracic Spine ROM?
(Neumann p.286)

Back 157

–Flexion30-40º
–Extension20-25º
–Axial rotation 30º
–Lateral flexion 25º

Front 158

Flexion in the thoracic involves what structures?

Back 158

concentric activity of the rectus abdominis and controlledby eccentric activity of the erector spinae, multifidi, etc.
•There is a stretching/ distraction of all the posterior elements.
•Stabilised by passive (ligamentous) structures (supraspinous, interspinous, posterior longitudinal ligaments, and posterior annulus fibrosus) and muscular contractions.

Front 159

Extension in the thoracic involves which structures?

Back 159

•an osseous stabilisation formed by approximation of the inferior articular process on the inferior vertebra, and approximation of the spinous processes.
•Further stabilisation is achieved through passive stretch of anterior annulus fibrosus, and anterior longitudinal ligament.
•Eccentric contraction of rectus abdominis further controls the movement.

Front 160

Lateral flexion in the thoracic involves which structures?

Back 160

•initiated by ipsilateral contraction of erector spinae and quadratus lumborum.
•both zygapophysial facet joint surfaces slide on each other.
•On the ipsilateral side, the inferior articular process slide inferiorly, and on the contralateral side, the inferior articular process slide superiorly.
•Controlled by contralateral eccentric contraction of erector spinae, quadratus lumborum, and the ‘segmental’ muscles (multifidii / rotatores).
•Further controlled by passive ligamentous (capsular) structures (ligs. intertransversales, capsules).

Front 161

Rotation in the thoracic involves which structures?

Back 161

•Almost a pure rotation/torsion of the IV disc, with little lateral translation.
•initiated by concentric activity of ipsilateral erector spinae, ipsilateral internal obliques and contralateral external obliques.
•The ribcage is the strongest stabilising factor for all the thoracic movements, provide the strongest stabilising support (resistance to further movement).
•The multifidus muscle probably acts more like a stabilising muscle bilaterally (creates compressive force across the joint).
•Rotation is further controlled by the ligamentous structures (articular capsule, supraspinous, interspinous, and the collagen fibres of the annulus fibrosus running in that direction).

Front 162

T1,T2 function are similar to normal cervical spine function? T or F

Back 162

True

Front 163

About __ of sagittal plane _____ for each segment (occuring with _____).

Back 163

5º
rotation
flexion

Front 164

Upper Thoracic Spine _____& _____
Lateral flexion (__-__degº total segmental ROM).

Back 164

T1
T2
4-8º

Front 165

Lateral flexion is associated with ______ in ipsilateral _____rotation and contralateral ________ rotation of the upper ribs.

Back 165

coupled motion
anterior
posterior

Front 166

The ribs on the same side (side of LF) rotate _______, and those on the contralateral side rotate _____ –spinous rotates _____.

Back 166

anterior
posterior
TOWARD

Front 167

Upper Thoracic Spine (T1,T2) axial rotation ROM?

Back 167

8-12º total segmentalROM

Front 168

explain coupled motion in Upper Thoracic Spine (T1,T2).

Back 168

The coupled motion that may occur is inconsistent within and between individuals, due to the influence of muscle activity.

Front 169

Mid-thoracic Spine (___-___) is the ____mobile in __ rotation (__ total segmental ROM).

Back 169

T3-T9
most
axial
5º

Front 170

explain movement in the thoracic spine

Back 170

•Promotes lateral translation of the facets accompanied by ipsilateral translation and tilt of the vertebral body (i.e. ipsilateral flexion) posterior rotation of the ipsilateral ribs, and anterior rotation of the contralateral ribs. I.e. Spinous rotates AWAY.

Front 171

explain coupled motion in Mid-thoracic Spine (T3-T9)

Back 171

coupled motion is limited by the thin IV disc and tension in the costal ligaments.

Front 172

Rotation of the ribs occurs due to?

Back 172

tension developed in the costal ligaments during axial rotation in the mid-thoracic spine.

Front 173

Anterior sagittal rotation (and anterior translation) is limited by?

Back 173

the vertical vertebral articular facet joints.

Front 174

Sagittal rotation for each segment in Mid-thoracic Spine (T3-T9)?

Back 174

is about 5º.

Front 175

Lateral flexion in the Mid-thoracic Spine (T3-T9) is restricted by?

Back 175

approximation of the ribcage.

Front 176

Flexion in the Mid-thoracic Spine (T3-T9) is limited by?

Back 176

tension in the posterior spinal ligaments and approximation of the ribs.

Front 177

Extension in the Mid-thoracic Spine (T3-T9) is associated with _____ and limited by the bony contact of the ____ and the _______.

Back 177

posterior translation
articular processes
spinous processes

Front 178

Movement in the lower Thoracic Spine (T10-T12) is influenced by?

Back 178

the variability of the posterior elements (i.e. facet tropism) and the anatomy of the lower two ribs.

Front 179

The lower thoracics have increasing ____ plane rotation caudally (i.e. __º of total segmental ROM at T10-11, but __º on average between T8 and T12).

Back 179

sagittal
20
5

Front 180

The mobility in the ____ plane is similar to that of the upper and middle thoracic region (approx. ___º total ROM).

Back 180

coronal
6

Front 181

In lateral flexion, the segmental motions ____ caudally (from ___º at T9-10 to ___º at T11-12) –due to ___.

Back 181

increase
6
12
the lower 2 ribs

Front 182

The ___thoracic segments have a more limited segmental axial rotation (___º) compared to the ____and ______thoracic regions.

Back 182

lower
5-7
upper
mid-

Front 183

Coupled thoracic motion

Back 183

•There is a varying degree of coupled motion in the thoracic spine.
•These regional variations in movement coupling are probably due to the vertebral orientation within the kyphosis, the zygapophysial joint orientation, and the costal articulations.
•The movement of the thoraxinto right rotation is associated with posterior rotation of the ipsilateral ribs.

Front 184

Explain the compressive load on the thoracic spine.

Back 184

•The gravitational line falls anterior to the vertebral bodies, thereby increasing the axial load on the region.
•The compressive load on the thoracic spine increases caudally from 9% of body weight at T1 to 47% of body weight at T12.
•This is counter met by a progressive increase in vertebral body size, end-plate cross-sectional area, and bone content.
•About 76% of compressive load in the upper thoracic spine is transferred through the vertebral body/intervertebral (disc) complex.

Front 185

Explain intradiscal pressure in the thoracic spine.

Back 185

Hint 185

•In upright standing position, the intradiscal pressure is about 1 MPa in the middle thoracic spine (T6-7, T7-8), but only 0.9 MPa at T9-10, T10-11.
•So, due to the increased end-plate cross-sectional area, the intradiscal pressure actually decreases caudally.•The intradiscal pressure varies greatly with different positions/manoeuvres.
•Sitting upright does not alter the intradiscal pressure (from satnding upright), but lying on the side decreases the intradiscal pressure to about 0.3 MPa. Carrying weights (20 kg) increases the intradiscal pressures, but actually decreases when the person is 30º flexed (at the hips) -(opposite to the Lumbar Spine!)

Front 186

•Rib movement occurs around a _____axis, which extends from the costo-vertebral joint towards the rib tubercle.
•In the upper ribs, the axis is located at about __º to the coronal plane (___–shown right), whereas in the lower ribs the axis is oriented closer to the sagittal plane (__ –shown left).

Back 186

medio-lateral. 35. Y. X.

Front 187

Movement of the upper ribs ____the sternum and ____ the A-P diameter of the ribcage (i.e. a ‘pump-handle’).

Back 187

elevates
increases

Front 188

movement of the lower ribs has a greater influence on the ____dimensions of the ribcage (i.e. a ‘bucket-handle’).

Back 188

lateral

Front 189

Pelvic ______ increases the length of stride in running; in kicking it results in a greater distance or more speed to the kick

Back 189

rotation

Front 190

Teres ligament

Back 190

attaches from deep in acetabulum to a depression in femoral head, slightly limits adduction

Front 191

Ischiofemoral ligament

Back 191

located posteriorly, extends from ischium to trochanteric fossa of femur, limits internal rotation

Front 192

ROM hip flexion ?

Back 192

0 to 130 degrees of flexion

Front 193

What is the ROM of the hip (femoropelvic) in extension?

Back 193

Front 194

What is the ROM of Adduction and Abbduction of the femoropelvic joint?

Back 194

–0 to 35 deg of abduction
–0 to 30 deg of adduction

Front 195

what is the ROM of adduction and abbduction of the hip?

Front 196

what is the ROM of adduction and abbduction of the hip?

Back 196

Front 197

ROM of adduction and abbduction of the hip?

Back 197

–0 to 35 degrees of abduction
–0 to 30 degrees of adduction

Front 198

ROM of internal and external rotation of the hip?

Back 198

–0 to 45 degrees of internal rotation
–0 to 50 degrees of external rotation

Front 199

Motions accompanying pelvic Anterior rotation

Back 199

Lumbar Spine Motion - Extension

Right Hip Motion - Flexion

Left Hip Motion - Flexion

Front 200

Motions accompanying pelvic Posterior rotation

Back 200

Lumbar Spine Motion - Flexion

Right Hip Motion -Extension

Left Hip Motion - Extension

Front 201

Motions accompanying pelvic right lateral rotation

Back 201

Lumbar Spine Motion -Right lateral flexion

Right Hip Motion-Adduction

Left Hip Motion-Abduction

Front 202

Motions accompanying pelvic Left lateral rotation

Back 202

Lumbar Spine Motion-Left lateral flexion

Right Hip Motion-Abduction

Left Hip Motion-Adduction

Front 203

Motions accompanying pelvic-Right transverse rotation

Back 203

Lumbar Spine Motion-Left transverse rotation

Right Hip Motion-Internal rotation
Left Hip Motion-External rotation

Front 204

Motions accompanying pelvic- Left transverse rotation

Back 204

Lumbar Spine Motion-Right transverse rotation

Right Hip Motion-External rotation

Left Hip Motion-Internal rotation

Front 205

Anterior & posterior pelvic rotation plane of movement?

Back 205

–sagittal or anteroposterior plane

Front 206

•Right & left lateral pelvic rotation plane of movement?

Back 206

–lateral or frontal plane

Front 207

•Right transverse (clockwise) rotation & left transverse (counterclockwise) pelvic rotation plane of movement?

Back 207

–horizontal or transverse plane of motion

Front 208

Six two-joint muscles have one action at hip & another at knee, what are they

Back 208

biceps femoris (long head)
sartorious
gracilis
semitendinosis
semimembranosis
rectus femoris

Front 209

•Hip joint & pelvic girdle muscles
–Anterior-primarily hip flexion

Back 209

•Iliopsoas
•Pectineus
•Rectusfemoris
•Sartorius

Front 210

•Hip joint & pelvic girdle muscles–Medial -primarily hip adduction

Back 210

•Adductorbrevis
•Adductorlongus
•Adductormagnus
•Gracilis

Front 211

•Hip joint & pelvic girdle muscles–Posterior -primarily hip extension

Back 211

•Gluteusmaximus
•Bicepsfemoris
•Semitendinosus
•Semimembranosus
•Externalrotators

Front 212

•Hip joint & pelvic girdle muscles–Lateral -primarily hip abduction

Back 212

•Gluteusmedius
•Gluteusminimus
•Externalrotators
•Tensorfasciaelatae

Front 213

•Pelvic muscles acting on hip joint

Back 213

•Iliacus
•Psoas major
•Psoas minor

Front 214

•Pelvic muscles acting on hip joint
–Gluteal region -extend & rotate hip

Back 214

•Gluteus maximus
•Gluteus medius
•Gluteus minimi
•Tensor fascia latae
•Six deep external rotators -piriformis, obturator externus, obturator internus, gemellus superior, gemellus inferior, & quadratus femoris

Front 215

•Thigh -divided into 3 compartments by _____ _____.

Back 215

intermuscular septa

Front 216

–Anterior compartment –primarily knee extensors

Back 216

•Rectus femoris
•Vastus medialis
•Vastus intermedius
•Vastus lateralis
•Sartorius

Front 217

–Posterior compartment –hamstring group

Back 217

•Biceps femoris
•Semitendinosus
•Semimembranosus

Front 218

–Medial compartment –primarily adductors

Back 218

•Adductor brevis
•Adductor longus
•Adductor magnus
•Pectineus
•Gracilis

Front 219

Femoral n. innervation

Back 219

•Iliopsoas
•Rectus femoris
•Vastus medialis
•Vastus intermedius
•Vastus lateralis
•Pectineus
•Sartorius
•Sensation to anterior & lateral thigh and medial leg & foot

Front 220

Obturator nerve innervation

Back 220

•Adductor brevis
•Adductor longus
•Adductor magnus
•Gracilis
•Obturator externus
•Sensation to medial thigh

Front 221

Superior gluteal nerve innervation

Back 221

•arises from L4, L5, & S1 to innervate gluteus medius, gluteus minimus, & tensor fasciae latae

Front 222

Inferior gluteal nerve innervation

Back 222

•arises from L5, S1, & S2 to supply gluteus maximus

Front 223

Branches from sacral plexus- innervation

Back 223

•piriformis (S1, S2), gemellus superior (L5, S1, S2), gemellus inferior & obturator internus (L4, L5, S1, S2), & quadratus femoris (L4, L5, S1)

Front 224

–Sciatic nerve
•tibial division innervation

Back 224

–semitendinosus, semimembranosus, biceps femoris (long head) & adductor magnus
–sensation for posterolateral lower leg & plantar aspect of foot

Front 225

–Sciatic nerve
•common peroneal (fibular) division

Back 225

–sensation to anterolateral lower leg & dorsum of foot

Front 226

Six Deep Lateral Rotator Muscles - Hip

Back 226

Piriformis, Gemellus superior, Gemellus inferior, Obturator externus, Obturator internus, Quadratus femoris

Front 227

Hip Flexion
•Agonists

Back 227

–Psoas
–Iliacus (Iliopsoas)
–Rectus Femoris
–Pectineus
•Sartorius
•Tensor Fasciae Latae

Front 228

Hip Extension
•Agonists

Back 228

–Gluteus Maximus
–Biceps Femoris (Long Head)
–Semitendinosus
–Semimembranosus

Front 229

Hip Abduction
•Agonists

Back 229

–Gluteus Medius
•Tensor Fasciae Latae
•Gluteus Maximus
•Gluteus Minimus

Front 230

Hip Adduction
•Agonists

Back 230

–Adductor Brevis
–Adductor Longus
–Adductor Magnus
–Gracilis

Front 231

Hip Internal Rotation
•Agonists

Back 231

–Gluteus Minimus
•Gluteus Medius
•Tensor Fasciae Latae

Front 232

Hip External Rotation
•Agonists

Back 232

–Gluteus Maximus
–Six Deep External Rotators

Front 233

Gait cycle:

Back 233

From first heel contact to second heel contact with the same foot.

Front 234

Stride length

Back 234

The distance between two successive heel contacts of the same foot.

Front 235

Step length:

Back 235

The distance between two successive heel contacts of the two different feet.

Front 236

Step width:

Back 236

The lateral distance between the heel centres of two consecutive foot contacts (7-9 cm)

Front 237

Foot angle:

Back 237

The degree of “toe out” = the angle between the line of progression of the body and the long axis of the foot (7 degrees).

Front 238

Cadence =

Back 238

step rate: The number of steps per minute

Front 239

Gait speed:

Back 239

1.37 m/s (4.9 km/h)

Front 240

Step length:

Back 240

72 cm

Front 241

Stance phase:___ of gait cycle
From ____ contact to ____

Back 241

60%
heel
toe off

Front 242

Swing phase:____ of gait cycle
From ___to heel contact

Back 242

40%
toe off
heel

Front 243

Double-limb support:At ____ & ____ of gait cycle.
Decreases with increasing speed

Back 243

0-10%
50-60%

Front 244

•The subtalar joint pronates /everts ______ of gait cycle (adding flexibility to the foot).

Back 244

30-55%

Front 245

•Late during the stance, the arch rises because of _______of _____joint giving the foot rigidity.

Back 245

supination
subtalar

Front 246

•Right after heel contact, the foot _______and _____.

Back 246

plantar flexes
pronates

Front 247

•Pronation is controlled by two mechanisms: they are?

Back 247

1) the calcaneus tips into eversion (due to the ground) reaction force passing lateral to the A-P axis of rotation).
•This also pushes the head of talus medially in the horisontal plane and inferiorly in the sagittal plane.
•This motion abducts and dorsiflexes the subtalar joint (which is consistent with the definition of pronation).
2) The second mechanism is the internal rotation of tibia and fibula during early stance phase

Front 248

•At _____ the pronated (everted) subtalar joint moves into supination

Back 248

35%

Front 249

•By late stance phase, the fully _______subtalar joint and elevated and tensed ______ _____ arch converts the midfoot into a more rigid lever.

Back 249

supinated
medial longitudinal

Front 250

the “windlass effect” is?

Back 250

•During the later part of the stance phase, the midfoot and forefoot must be relatively stable and rigid in order for the foot to push off.
•The whole foot is stabilised by extrinsic and intrinsic muscles as well as ligaments and the osseous structure of the medial longitudinal arch.

Front 251

cyclic gait phases and events:

Back 251

.Initial Contact = Heel Strike (HS)
.Loading response = HS ¨ foot flat (FF)
.Midstance = FF ¨ midstance
.Terminal stance = Midstance ¨ heel off
.Pre-swing = Heel off ¨ toe off
.Initial swing = Toe off ¨ early accel.
.Midswing = Acceleration ¨ midswing
.Terminal swing = Midswing ¨ deceleration

Front 252

Sagittal Plane Kinematics:
Initial Contact (Heel Strike):

Back 252

•HIP: 25°flexion
•KNEE: 0°-5 °flexion
•ANKLE: 0°(90 °)
•Hip stabilised by extensor activity of hamstrings and gluteals.
•Knee stabilised by contraction of quads and hamstrings.
•Ankle dorsiflexors are positioning foot for initial contact.

Front 253

Sagittal Plane Kinematics:
Loading Response Phase
(Heel Strike to Foot Flat)

Back 253

.HIP: 25‹flexion
.KNEE: 0‹¨ 15‹flexion (Lowers CM)
.ANKLE: 0‹¨ 10‹plantar flexion
.Hip abductors stabilise pelvic drop in frontal plane.
.Hip extensors counteract trunk and
hip flexion.
.Quads control knee flexion providing shock absorption.
.Ankle dorsiflexors decelerate foot drop.

Front 254

Sagittal Plane Kinematics:
Midstance Phase:
(Foot Flat to midstance event)

Back 254

.HIP: 25‹flexion ¨ 0‹
.KNEE: 15‹flexion ¨ 0‹flexion
.ANKLE: 10‹plantar flexion ¨ 5‹dorsi flexion
.Hip abductors continue to minimize pelvic drop in the frontal plane.
.Quads resist knee flexion until COG passes over base of support, then quads
are silent.
.Soleus and gastroc eccentrically control
forward tibial progression.

Front 255

Sagittal Plane Kinematics:
Terminal Stance Phase:
(Midstance event to HO)

Back 255

.HIP: 0‹flexion ¨ 20‹extension
.KNEE: 0‹
.ANKLE: 5‹¨ 10‹dorsiflexion
.Brief burst from hip flexors resisting hyperextension of the hip.
.Tensor fascia latae active throughout stance to resist pelvic drop.
.Minimal to no quad or hamstring activity
.Ankle plantar flexors contribute to heel rise through passive tension.

Front 256

Sagittal Plane Kinematics:
Pre-swing Phase:
(Heel Off to Toe Off)

Back 256

.HIP: 20‹extension ¨ 0‹
.KNEE: 0‹¨ 40‹flexion
.ANKLE: 10‹dorsiflexion ¨ 20‹plantar flexion
.Flexion of the femur may be facilitated by adductor longus and rectus femoris.
.Adductors stabilize pelvis during weight shift to other foot.
.Rectus femoris may restrain rapid
passive knee flexion, otherwise quads silent.
.Passive tension in ankle plantar
.flexors facilitates knee flexion and then decreases to zero in preparation for toe off.

Front 257

Sagittal Plane Kinematics:
Pre-swing Phase:
(Heel Off to Toe Off)

Back 257

.HIP: 20‹extension ¨ 0‹
.KNEE: 0‹¨ 40‹flexion
.ANKLE: 10‹dorsiflexion ¨ 20‹plantar flexion
.Flexion of the femur may be facilitated by adductor longus and rectus femoris.
.Adductors stabilize pelvis during weight shift to other foot.
.Rectus femoris may restrain rapid
passive knee flexion, otherwise quads silent.
.Passive tension in ankle plantar
.flexors facilitates knee flexion and then decreases to zero in preparation for toe off.

Front 258

Sagittal Plane Kinematics:
Initial Swing:

Back 258

•HIP: 15 °
•KNEE: 60°
•ANKLE: 10°plantar flexion
•Hip flexors flex hip.
•Adductor longus brings leg toward midline.
•Ankle pre-tibials initiate dorsiflexion to clear toes.

Front 259

Sagittal Plane Kinematics:
Mid-Swing:

Back 259

•HIP: 25 °
•KNEE: 25°
•ANKLE: 0°
•Hip flexors and momentum flex hip.
•Hamstrings begin to decelerate knee
extension.
•Knee extension created by tibial
•forward momentum.
•Ankle pre-tibials concentrically contract to clear foot.

Front 260

Sagittal Plane Kinematics:
Terminal Swing:
(Mid-swing->deceleration)

Back 260

•HIP: 25 °
•KNEE: 0°
•ANKLE: 0°plantar flexion
•Hamstrings continue to decelerate forward
swing of leg.
•Quadriceps may contract to extend knee in
preparation for initial contact.
•Ankle pre-tibials contract to prepare foot
for initial contact.

Front 261

The path of the Center of Pressure (CoP) under the foot

Back 261

Hint 261

•At heel contact the CoP is located just lateral to the midpoint.
•It then moves progressively to the lateral midfoot region at midstance and to the medial forefoot region during heel off to toe off.
•Ends at the base of the Hallux during toe off.

Front 262

Determinants of Gait

Back 262

Pelvic Rotation –transverse plane
Lateral Pelvic Tilt –frontal plane
Knee Flexion –during stance
Ankle PF -at Toe Off
Ankle DF –at Foot strike
Gait Width –frontal plane

Front 263

the foot at Ground Contact

Back 263

Contact Made on the Lateral Border of the Heel
Foot is Supinated
Foot is Rigid

Front 264

the foot at early Stance to MidStance

Back 264

Foot is PronatedFoot is Mobile (flexible)Enhances Balance

Front 265

the foot at Late Stance to Toe-Off

Back 265

Foot is Supinated
Foot is Rigid
Enhances Propulsion

Front 266

Pronation/Supination excess or limitation can lead to?

Back 266

Too Little
–Loss of force dissipation
-Loss of Mobility
–BalanceStress Injury
Too Much
Relationship to Tibial Rotation Associated Patellar Tracking Issues
Soft-Tissue Stress

Front 267

Ground Reaction Forces in running Influenced BY?

Back 267

–Velocity
–Vertical Displacement
–Shoes
–Surface

Front 268

Ground Reaction Forces in Running influence?

Back 268

–Foot Pressures
–Joint Forces
–Joint Moments
–Impact Shock

Front 269

What Factors Influence Speed ???

Back 269

Stride LengthAnthropometric FactorsStrengthFlexibilityNeuromuscular Factors
Stride RateNeuromuscular FactorsTechnique

Front 270

Kinematics of the SI joints- inc ROM

Back 270

•Relatively small rotational and translational movements.
•0.2-2º of rotation and
•1-2mm of translation.
•Primarily in the sagittal plane.
•Nutation and counter-nutation.
•Combination of compression force on the articular surfaces and
actual slide movements between the surfaces.

Front 271

Nutation

Back 271

•Nutation = Nodding
•Sacral base = Anterior-inferior
•Sacral apex = Posterior-superior
•Flexion of
the sacrum on
the ilium

Front 272

Counter-nutation

Back 272

•The reverse motion
•Sacral base = Posterior-superior
•Sacral apex = Anterior-(inferior)
•Extension of
the sacrum on
the ilium

Front 273

SI motion in gait cycle?

Back 273

•During a gait cycle each of the SI joints goes through two full cycles of alternating flexion and extension.

Front 274

As one innominate flexes (PSIS moves posteriorly-inferiorly), the ipsilateral sacral base moves?

Back 274

anteriorly and inferiorly.

Front 275

as the other innominate extends (moves anteriorly superiorly), the sacral base on that side moves

Back 275

posteriorly-superiorly.

Front 276

during a continuous motion the sacrum performs what movement?

Back 276

an oblique and horisontal figure-of-eight, rocking movement.

Front 277

At R heel contact during gait
the R sacroiliac flexion and
the R side of the pubic
symphysis moves in which direction?

Back 277

superiorly

Front 278

The Intervertebral Disc

Back 278

•10-12 mm in height (5 cm in total).
•10-20 concentric, circumferential lamellae.
•More type II fibres centrally.
•More type I collagen fibers towards the periphery of the anulus.
•Fibres in each lamella are parallel arranged and run obliquely in a 65º angle to the sagittal plane.
•Run opposite directions
from each other.

Front 279

the endplates are the ______components of the IV disc during axial compression

Back 279

weakest

Front 280

The facet shape may be ____(upper lumbar facets) or ____ (lower lumbar facets).

Back 280

flat C-or J-curved

Front 281

The shape and orientation govern the role of facet joints in preventing

Back 281

forward displacement and rotatory dislocation of the motion segment.

Front 282

The extent of forward displacement depends on the extent to which the superior articular facets face ______.

Back 282

backwards

Front 283

The extent to which the joint can resist rotation is related to the extent to which its superior articular facets face ______.

Back 283

medially

Front 284

Combination of A-P and M-L orientation of the facets creates a maximisation of resistance in _____

Back 284

both directions.

Front 285

A C-shaped articular facet provides a greater resistance in ___displacement as opposed to a J-shaped facets. (Lumbar)

Back 285

forward

Front 286

Kinematics of the Lumbar Spine: actions

Back 286

•Axial compression
•Axial distraction
•Flexion
•Extension
•Axial rotation
•Lateral flexion
•Rotation in flexio

Front 287

axial compression with slight extension (or with some IV disc degeneration) the load is also transmitted via the ______.

Back 287

facet joints

Front 288

Flexion of the lumbar spine involves both anterior sagittal ___ and anterior _____.

Back 288

rotation
translation

Front 289

The zygapophysial joint capsules stretch about _____ during flexion.

Back 289

5-7 mm

Front 290

In lumbar flexion the vertebral bodies undergo posterior sagittal _____(extension) and a small posterior translation

Back 290

rotation
translation

Front 291

in lateral flexion (lumbar) theoretically, both facet joints will slide (in ____directions) and cause ____ strain on both sides.

Back 291

opposite
capsule

Front 292

The ROM (lumbar) increases when the lumbar spine is in a slightly flexed, seated position.

Back 292

increases

Front 293

Coupled Lumbar motion

Back 293

•Combination of 8-13º of anterior sagittal rotation and 1-3 mm of forward translation, and these movements are consistently accompanied by axial and coronal rotations of about 1º.
•Some vertical and lateral translations also occur but are of small amplitude.
•Conversely, extension involves posterior sagittal rotation and posterior translation, with some axial and coronal rotation, but little vertical and lateral translation.
•Axial rotation and lateral flexion are coupled with one another and with sagittal rotation.

Front 294

What is the Instantaneous Axis of Rotation

Back 294

The exact location of the IAR is a function of the amount of sagittal rotation and the amount of simultaneous sagittal translation that occurs during the phase of motion defined by the starting and end positions.

Front 295

what is the location of the Instantaneous Axis of Rotation (IAR)

Back 295

•In health individuals, the IAR lies close to the upper endplate and slightly posterior.
•If more anterior translation of the upper vertebra occurred then the IAR would shift anteriorly/inferiorly (and posteriorly/inferiorly if more posterior translation occurred).
•With increased rotation the IAR moves more superiorly (and inferiorly if less rotation occurred).

Front 296

•Concentric contractions

Back 296

–shortening contraction of muscles against gravity or resistance

Front 297

•Eccentric contraction

Back 297

–muscle lengthens under tension to control the joints moving with gravity or resistance

Front 298

•Quadriceps contracts _______when the body slowly lowers in a weight bearing movement through lower extremity action

Back 298

eccentrically

Front 299

Muscular Actions
•Flexion of the thigh

Back 299

–Iliopsoas (also flexes trunk)
–Rectus femoris (also extends knee)
–Sartorius
–Pectineus
–Tensor fascia latae

Front 300

Muscular Actions •Extension of the thigh

Back 300

–Hamstrings (also flexes knee)
–Gluteus maximus

Front 301

Muscular Actions•Abduction of the thigh

Back 301

–Gluteus medius
–Gluteus minimus
–Tensor fascia latae
–Piriformis

Front 302

Muscular Actions•Adduction of the thigh

Back 302

–Gracilis
–Adductors longus, brevis, and magnus
–Pectineus

Front 303

•Standing on two limbs—hip load is approximately ___ body weight (BW)

Back 303

30%

Front 304

•Standing on one limb—hip load is ____×BW

Back 304

2.5–3.0

Front 305

•Stair climbing—hip load is __BW

Back 305

3×

Front 306

•Walking—hip load is 4–7×BW
•Running—hip load is up to 10×BW
•Hip can withstand 12–15×BW

Back 306

4–7x
10×
12–15×

Front 307

•More than ____ of hip injuries occur in the soft tissue.

Back 307

60%

Front 308

The Knee Joint

Back 308

•Knee joint is a double condyloid joint.
•It has 2 degrees of freedom.
•Flexion-extension
•When flexing, there is a small but significant amount of rotation.

Front 309

Muscular Actions
•Extension of the Knee

Back 309

–Quadriceps femoris
•Rectus femoris
•Vastus intermedius
•Vastus lateralis
•Vastus medialis

Front 310

Muscular Actions
•Flexion of the Knee

Back 310

–Hamstrings
•Biceps femoris
•Semimembranosus
•Semitendinosus

Front 311

Knee _______ stronger than _____ throughout range of motion

Back 311

extensorsf
lexors

Front 312

•The foot and ankle consist of:

Back 312

–26 irregular-shaped bones
–30 synovial joints
–30 muscles
–>100 ligaments

Front 313

•Most motion of the foot occurs at 3 joints:

Back 313

–Talocrural
–Subtalar
–Midtarsal

Front 314

talocrural joint

Back 314

•The proximal joint of the foot is the talocrural joint (ankle joint).
•It is designed for stability rather than mobility.
•This consists of articulations between the tibia and talus (tibiotalar joint) and tibia and fibula (tibiofibular joint).

Front 315

SubtalarJoint

Back 315

•More distal than the talocrural joint
•Articulation between the talus and calcaneus
•Talus and calcaneus are the largest weight-bearing bones in the foot.

Front 316

MidtarsalJoint

Back 316

•Consists of two joints (calcaneocuboid and talonavicular)
•The alignment of the axes of these joints affects the mobility of the midfoot.

Front 317

•Sample forces on the ankle and foot

Back 317

–Ground forces during walking: 0.8–1.1×BW at heel strike, 0.8×BW during midstance, 1.3×BW at toe-off
–Compression at the ankle joint during walking: 3×BW at heel strike, 5×BW at toe-off
–During running: ankle forces of 9.0–13.3×BW and Achilles tendon forces of 5.3–10×BW

Front 318

There are two branches of kinetics;

Back 318

STATICS and DYNAMICS

Front 319

Kinematics

Back 319

Describes the motion of a body without reference to the forces causing it. Examines how, when, and where a body moves.

Front 320

kinematic motion movement may be LINEAR, CURVILINEAR

Back 320

LINEAR,
CURVILINEAR
angular
parabolic

Front 321

DYNAMICS

Back 321

the changes in motion brought on by unbalanced forces.

Front 322

Lever Functions

Back 322

•Magnify a force
•Increase speed and range of-motion (ROM)
•Balance torques
•Change direction of force

Front 323

First class lever

Back 323

-FAR
-When axis close to force, produces speed and ROM, when close to resistance, produces power
-About 25% of the muscles in your body operate as first class levers

Front 324

Second Class

Back 324

•ARF
•Very few occurrences in the body
•Gain resultant force (you can lift more), lose distance Force

Front 325

Third Class

Back 325

•RFA
•As much as 85% of the muscles in the body function as third class levers
•Usually produce speed at the expense of force
•Greater lever length = greater speed (ex.)

Front 326

Laws of Motion

Back 326

•Inertia
•Acceleration
•Reaction
•“A body in motion tends to stay in motion at the same speed in a straight line unless acted upon by a force;
•A body at rest tends to remain at rest unless acted upon by a force”
•English translation: unbalanced forces cause motion; Balanced forces don’t change anything

Front 327

Factors Influencing Balance

Back 327

1.Location of the center of gravity in relation to the base of support
2.Size of the base of support
3.Mass of the person
4.Height of the center of gravity
5.Traction/friction
6.Sensory perceptions

Front 328

•Sternoclavicular (SC)
–(multiaxial) arthrodial classification
–Movements

Back 328

•anteriorly 15 degrees with protraction
•posteriorly 15 degrees with retraction
•superiorly 45 degrees with elevation
•inferiorly 5 degrees with depression

Front 329

•Sternoclavicular (SC)
–Ligamentous support

Back 329

•anteriorly by the anterior SC ligament
•posteriorly by the posterior SC ligament
•costoclavicular & interclavicular ligaments provide stability against superior displacement

Front 330

•Acromioclavicular (AC) joint

Back 330

–arthrodial classification
–20-to 30-degree total gliding & rotational motion accompanying other shoulder girdle & shoulder joint motions
–supported by
•Coracoclavicular ligaments
•Superior acromioclavicular ligament
•Inferior acromioclavicular ligament
–often injured

Front 331

Joints
•Scapulothoracic

Back 331

–not a true synovial joint
–does not have regular synovial features
–movement depends on SC & AC joints which allows the scapula to move
•25-degrees abduction-adduction
•60-degrees upward-downward rotation
•55-degrees elevation-depression
–supported dynamically by its muscles
–no ligamentous support

Front 332

Without the accompanying scapula movement humerus can only be raised into approximately 90 degrees of total shoulder abduction & flexion

Back 332

90

Front 333

5 muscles primarily involved in shoulder girdle movements

Back 333

–Trapezius -upper, middle, lower
–Rhomboid -deep
–Levator scapula
–Serratus anterior
–Pectoralis minor -deep

Front 334

Scapula Abduction

Back 334

•Scapula move laterally away from spinous processes without rotation
•EX. Push-up & bench press
•Agonists
–Pectoralisminor
–Serratusanterior

Front 335

Scapula Adduction

Back 335

•Return from abduction
•Occurs with retractions
•Agonists
–Middle Trapezius
–Rhomboids

Front 336

Scapula Upward Rotation

Back 336

•Lateral & upward movement
•Agonists
–Middle Trapezius
–Lower Trapezius
–Serratus anterior

Front 337

Scapula Downward Rotation

Back 337

•Downward & Medial Movement
•Glenoid Fossa is rotated downward when downward movement of shoulder joint occurs
•EX. Lat Pulls -pulling wt. down
•Agonists
–Pectoralis Minor
–Rhomboid

Front 338

Scapula Elevation

Back 338

•Lifting scapula without rotation in anatomic position
•Shoulder Shrug
•Agonists
–LevatorScapula
–UpperTrapezius
–Rhomboid

Front 339

Scapula Depression

Back 339

•EX. Dip
•Agonists
–Lower Trapezius
–Pectoralis Minor

Front 340

5 muscles primarily involved in shoulder girdle movements

Back 340

–Trapezius -upper, middle, lower
–Rhomboid -deep
–Levator scapula
–Serratus anterior
–Pectoralis minor -deep

Front 341

Scapula Abduction

Back 341

•Scapula move laterally away from spinous processes without rotation
•EX. Push-up & bench press
•Agonists
–Pectoralisminor
–Serratusanterior

Front 342

Scapula Adduction

Back 342

•Return from abduction
•Occurs with retractions
•Agonists
–Middle Trapezius
–Rhomboids

Front 343

Scapula Upward Rotation

Back 343

•Lateral & upward movement
•Agonists
–Middle Trapezius
–Lower Trapezius
–Serratus anterior

Front 344

Scapula Downward Rotation

Back 344

•Downward & Medial Movement
•Glenoid Fossa is rotated downward when downward movement of shoulder joint occurs
•EX. Lat Pulls -pulling wt. down
•Agonists
–Pectoralis Minor
–Rhomboid

Front 345

Which scapula movement usually occur with movement of humerus?

Back 345

–Humeral flexion & abduction require scapula elevation, rotation upward, & abduction
–Humeral adduction & extension results in scapula depression, rotation downward, & adduction
–Scapula abduction occurs with humeral internal rotation & horizontal adduction
–Scapula adduction occurs with humeral external rotation & horizontal abduction

Front 346

Glenohumeral Joint type?

Back 346

•multiaxial ball-&-socket
•enarthrodial

Front 347

Glenohumeral Joint ROM?

Back 347

–90 to 95 degrees abduction
–0 degrees adduction, 75 degrees anterior to trunk
–40 to 60 degrees of extension
–90 to 100 degrees of flexion
–70 to 90 degrees of internal & external rotation
–45 degrees of horizontal abduction
–135 degrees of horizontal adduction

Front 348

•Glenohumeral internal rotation deficit (GIRD)

Back 348

–difference in internal rotation range of motion between an individual’s throwing & nonthrowing shoulders
–overhead athletes with a GIRD of greater than 20% had a higher risk of injury
–stretching exercises recommended to regain internal rotation
•improve performance
•reduce likelihood of injury

Front 349

Pairing of shoulder girdle & shoulder joint movements

Back 349

•Glenohumeral joint is paired with shoulder girdle to accomplish total shoulder range of motion
–Ex. 170 to 180 degrees of total abduction includes
•approximately 60 degrees of scapula upward rotation
•25 degrees of scapula elevation
•95 degrees of glenohumeral abduction
•Scapulohumeral rhythm
–Not necessarily sequential actions, but synergistic relationship
–Generally accepted ratio is 2 to 1 or for every 2 degrees of glenohumeral motion, there is 1 degree of scapula motion
–May vary within and between individuals

Front 350

•Intrinsic glenohumeral muscles

Back 350

–Originate on scapula & clavicle
–Deltoid, Coracobrachialis, Teres major
–Rotator cuff group
•subscapularis, supraspinatus, infraspinatus, & teres minor

Front 351

•Extrinsic glenohumeral muscles

Back 351

–latissimus dorsi & pectoralis major

Front 352

Muscles
•Anterior

Back 352

–Pectoralismajor
–Coracobrachialis
–Subscapularis

Front 353

Muscles
•Superior

Back 353

–Deltoid
–Supraspinatus

Front 354

Muscles• Posterior

Back 354

– Latissimus dorsi
– Teres major
– Infraspinatus
– Teres minor

Front 355

Lateral pectoral nerve arising from

Back 355

C5, C6, & C7
–Pectoralis major (clavicular head)

Front 356

•Medial pectoral nerve arising from

Back 356

C8 & T1
–Pectoralis major (sternal head)

Front 357

•Thoracodorsal nerve arising from

Back 357

C6, C7, & C8
–Latissimus dorsi

Front 358

•Axillary nerve branching from

Back 358

C5 & C6
–Deltoid
–Teres minor
–Sensation to lateral patch of skin over deltoid region of arm

Front 359

•Upper subscapular nerves arising from

Back 359

C5 & C6
–Subscapularis

Front 360

•Lower subscapular nerve arising from

Back 360

C5 & C6
–Subscapularis
–Teres major

Front 361

•Suprascapula nerve originating from C5 & C6

Back 361

–Supraspinatus
–Infraspinatus

Front 362

•Musculotaneous nerve branching from

Back 362

C5, C6, & C7
–Coracobrachialis
–Sensation to radial aspect of forearm

Front 363

Glenohumeral Flexion
•Agonists

Back 363

–Anterior Deltoid
–Upper Pectoralis Major

Front 364

Glenohumeral Extension
•Agonists

Back 364

–Teres Major
–Latissimus Dorsi
–Lower Pectoralis Major

Front 365

Glenohumeral Abduction
•Agonists

Back 365

–Deltoid
–Supraspinatus
–Upper Pectoralis Major

Front 366

Glenohumeral Adduction

Back 366

•Agonists
–Latissimus Dorsi
–Teres Major
–Lower Pectoralis Major
•EX. Lat. Pull -pull down weights

Front 367

Glenohumeral Internal Rotation
•Agonists

Back 367

–Latissimus Dorsi
–Teres Major
–Subscapularis
–Pectoralis Major
•All attach anteromedially on humerus

Front 368

Glenohumeral External Rotation
•Agonists

Back 368

–Infraspinatus
–Teres Minor
•Both attach posteriorly on greater tubercle

Front 369

Glenohumeral Horizontal Abduction
•Agonists

Back 369

–Posterior Deltoid
–Middle Deltoid
–Infraspinatus
–Teres Minor

Front 370

Glenohumeral Horizontal Adduction
•Agonists

Back 370

–Anterior Deltoid
–Pectoralis Major
–Coracobrachialis

Front 371

Glenohumeral Diagonal Abduction
•Agonists

Back 371

–Posterior Deltoid
–Infraspinatus
–Teres Minor
–Triceps Brachii (Long Head)

Front 372

Glenohumeral Diagonal Adduction
•Agonists -both low & high

Back 372

–Anterior Deltoid
–Coracobrachialis
–Biceps Brachii (short head)
–Pectoralis Major -Upper & Lower

Front 373

Shoulder complex Four joints?

Back 373

Four joints
1. The scapulothoracic “joint”
2. The sternoclavicular joint
3. The acromioclavicular joint
4. The glenohumeral joint

Front 374

Movements of the SC joint

Back 374

•Elevation (45º)
•Depression (10º)
•Protraction (15-30º)
•Retraction (15-30º)
•Axial rotation (40-50º)

Front 375

Stabilizing tissues of the AC joint:

Back 375

-Superior and inferior AC joint capsular ligaments
-Deltoid and upper trapezius
-Coracoclavicular ligament
-Articular disc

Front 376

Movements of the AC joint:

Back 376

Sagittal plane rotation adjustments (10-30º)

Front 377

Movements of the scapulothoracic joint

Back 377

-Elevation (superior slide)
-Depression (inferior slide)
-Protraction (anterior-lateral slide)
-Retraction (medial slide)
-Upward rotation (inferior angle rotates supero-laterally)
-Downward rotation (inferior angle rotates infero-medially)

Front 378

Stabilizing tissues of the GH joint:

Back 378

•Rotator cuff muscles
•GH joint capsular ligaments
•Coracohumeral ligament
•Long head of biceps brachii
•Glenoid labrum

Front 379

Movements of the GH joint

Back 379

-Abduction and adduction (180º)
frontal vs. scapular plane (at 20 to 35º to the frontal plane)
-Flexion (120º) and extension (45-55º)
-Internal and external rotation
(usually associated with pro-and retraction of the scapula); (70º and 85º respectively)

Front 380

Elevators of the scapulothoracic joint

Back 380

-Upper trapezius (through postural support by maintaining shoulder in position)
-Levator scapulae-Rhomboids

Front 381

Depressors of the scapulothoracic joint

Back 381

-Lower trapezius
-Latissimus dorsi
-Pectoralis minor
-Subclavius(by depressionof the clavicle)

Front 382

Protractors of the scapulothoracic joint

Back 382

-Serratus anterior

Front 383

Retractors of the scapulothoracic joint

Back 383

-Middle trapezius
-Rhomboids
-Lower Trapezius and Rhomboids also haveRotary functions.

Front 384

Abductors of the GH joint

Back 384

-Anterior and middle deltoid
-Supraspinatus
-Coracobrachialis (arm elevation through flexion eg. Abduction in the scapular plane)
-Biceps (long head) (as for Coracobrachialis)

Front 385

Upward rotation of the scapulothoracic joint

Back 385

Combination of muscles:-Deltoid (as whole)
-Serratus anterior-Trapezius (all parts)

Front 386

Upward rotation of the scapulothoracic joint

Back 386

The lower fibers of serratus and upper and lower fibers of trapezius form a force couple that upwardly rotates the scapula.
The serratus anterior is the most effective upward rotator.
The serratus anterior muscle has gradual increase in amplitude throughout the entire ROM of abduction.

Front 387

Upward rotation of the scapulothoracic joint

Back 387

The supraspinatus is the primary initiatorof early abduction in association with upper trapezius which is especially active during this initiation, and then continues a gradual increase in activity (throughout abduction).
The upper trapezius elevates the clavicle during early phase while the lower trapezius is more actively performing scapular rotation during the late phase.

Front 388

A weakserratus anterior muscle leads to:

Back 388

-Retraction of scapula (scapular winging).
-Shoulder impingement (due to limited upward rotation of the scapula causing reduced space between subacromial space.

Front 389

A paralysisof serratus anterior

Back 389

(damage to long thoracic nerve):-Significant disruption in normal shoulder motion as the person cannot elevate the arm above 90º of abduction.

Front 390

Internal rotation of the GH joint

Back 390

-Subscapularis
-Pectoralis major
-Latissimus dorsi
-Teres major
-and Anterior deltoid
Produce 1.75 times greater isometric torque than the external rotators.

Front 391

External rotation of the shoulder

Back 391

Supraspinatus (assists when GH is between neutral and full external rotation)
-Infraspinatus
-Teres minor(SIT!)-Posterior deltoid
Produce the smallest isometric torque of any muscle group at the shoulder

Front 392

Adduction and extension of the shoulder

Back 392

-Sternocostal head of the pectoralis major
-Latissimus dorsi-Teres major-Long head of triceps-Posterior deltoid-Infraspinatus-Teres minor

Front 393

what is the angular orientation of the articulations of the shoulder?

Back 393

Front 394

Rotation of C1 and C2?

Back 394

C1 10deg - C2 12deg

Front 395

Elbow joint type?

Back 395

•Ginglymus or hinge-type joint•Allows only flexion & extension
•2 interrelated joints
–humeroulnar joint
–radiohumeral joints

Front 396

As elbow flexes ___ degrees or more, its bony stability is unlocked, allowing for more side-to-side laxity

Back 396

20

Front 397

Stability in ___ is more dependent on the lateral (radial collateral ligament) & the ____ or (ulnar collateral ligament)

Back 397

flexion
medial

Front 398

•Ulnar collateral ligament is critical in providing ____ support

Back 398

medial

Front 399

Elbow movement ROM

Back 399

0 degrees of extension to 145 to 150 degrees of flexion

Front 400

•Radioulnar joint

Back 400

–Trochoid or pivot-type joint
–Radial head rotates around at proximal ulna
–Distal radius rotates around distal ulna
–Annular ligament maintains radial head in its joint

Front 401

•Radioulnar joint

Back 401

–Supinate 80 to 90 degrees from neutral
–Pronate 70 to 90 degrees from neutral

Front 402

•Synergy between glenohumeral, elbow, & radioulnar joint muscles

Back 402

–As the radioulnar joint goes through its ROM, glenohumeral & elbow muscles contract to stabilize or assist in the effectiveness of movement at the radioulnar joints
–Ex. when tightening a screw with a screwdriver which involves radioulnar supination, we tend to externally rotate & flex the glenohumeral & elbow joints, respectfully

Front 403

• Elbow flexors

Back 403

– Biceps brachii
– Brachialis
– Brachioradialis
– Weak assistance
from Pronator teres

Front 404

• Elbow extensor

Back 404

– Triceps brachii
– Anconeus provides
assistance

Front 405

•Radioulnar pronators

Back 405

–Pronator teres
–Pronator quadratus
–Brachioradialis

Front 406

•Radioulnar supinators

Back 406

–Biceps brachii
–Supinator muscle
–Brachioradialis

Front 407

•“Tennis elbow"

Back 407

common problem usually involving extensor digitorum muscle near its origin on lateral epicondyle
–known lateral epicondylitis
–associated with gripping & lifting activities

Front 408

golfer's elbow

Back 408

•Medial epicondylitis
–somewhat less common
–associated with medial wrist flexor & pronator group near their origin on medial epicondyle
–Both conditions involve muscles which cross elbow but act primarily on wrist & hand

Front 409

Forearm Muscles• Anterior
– Primarily flexion & pronation

Back 409

• Biceps brachii
• Brachialis
• Brachioradialis
• Pronator teres
• Pronator quadratus

Front 410

Upper arm Muscles• Posterior

Back 410

– Primarily
extension &
supination
• Triceps brachii
• Anconeus
• Supinator

Front 411

•Radial nerve -originates from

Back 411

C5, C6, C7, & C8
–Triceps brachii
–Brachioradialis
–Supinator (posterior interosseous nerve)
–Anconeus
–Sensation to posterolateral arm, forearm, & hand

Front 412

•Median nerve -derived from

Back 412

C6 & C7
–Pronator teres
–Pronator quadratus (anterior interosseus nerve)
–Sensation to palmar aspect of hand & first three phalanges, palmar aspect of radial side of fourth finger, dorsal aspect of index & long fingers

Front 413

•Musculotaneous nerve -branches from

Back 413

C5 & C6
–Biceps brachii
–Brachialis

Front 414

Elbow flexors

Back 414

Front 415

Elbow Flexion
•Ex. Biceps curl
•Agonists

Back 415

–Biceps brachii
–Brachialis
–Brachioradialis

Front 416

Elbow Extension
•EX. Push-up
•Agonists

Back 416

–Triceps brachii
•Anconeus

Front 417

Radioulnar Pronation
•Agonists

Back 417

–Pronator teres
–Pronator quadratus
–Brachioradialis

Front 418

Radioulnar Supination
•Ex. Tightening a screw
•Agonists

Back 418

–Biceps brachii
–Supinator muscle
–Brachioradialis

Front 419

The Wrist & Hand •Relate functional anatomy to joint actions

Back 419

–flexion, extension, abduction ieradial deviation, & adduction ieulnardeviation of wrist & hand
–29 bones
–More than 25 joints
–More than 30 muscles
•18 are intrinsic

Front 420

• Carpal bones form a three-sided arch what are some structural components?

Back 420

– concave on palmar side
– bony arch is spanned by transverse carpal
& volar carpal ligaments
– creates the carpal
tunnel
– frequently a source of
problems known as
carpal tunnel syndrome

Front 421

•Wrist joint movement?

Back 421

–condyloid-type joint
–allows flexion, extension, abduction, & adduction
–motion occurs primarily between distal radius & proximal carpal row (scaphoid, lunate, & triquetrum)

Front 422

•Wrist joint ROM?

Back 422

–70 to 90 degrees of flexion
–65 to 85 degrees of extension
–15 to 25 degrees of abduction ieradial deviation
–25 to 40 degrees of adduction ieulnardeviation

Front 423

•Each finger has 3 joints ROM?

Back 423

–Metacarpophalangeal (MCP) joints
•Condyloid
•0 to 40 degrees of extension
•85 to 100 degrees of flexion
–Proximal interphalangeal (PIP) joints
•Ginglymus
•Full extension to 90 to 120 degrees of flexion
–Distal interphalangeal(DIP) joints
•Ginglymus
•Flex 80 to 90 degrees from full extension

Front 424

•Thumb has 2 joints, ROM?

Back 424

–Metacarpophalangeal (MCP) joint
•Full extension into 40 to 90 degrees of flexion
•Ginglymus–Interphalangeal (IP) joint
•Flex 80 to 90 degrees
•Ginglymus–Carpometacarpal (CMC) joint of thumb
•Unique saddle-type joint
•50 to 70 degrees of abduction
•Flex 15 to 45 degrees & extend 0 to 20 degrees

Front 425

Extrinsic muscles of wrist & hand grouped according to function & location
•6 muscles move wrist but not fingers & thumb?

Back 425

–3 wrist flexors
•flexor carpi radialis
•flexor carpi ulnaris
•palmaris longus
–3 wrist extensors
•extensor carpi radialis longus
•extensor carpi radialis brevis
•extensor carpi ulnaris

Front 426

•3 muscles primary flexors of phalanges

Back 426

–Also involved in wrist joint actions
–Generally weaker in their wrist actions
–Flexors
•Flexor digitorum superficialis
•Flexor digitorum profundus
•Flexor pollicis longus (thumb flexor)

Front 427

wrist Muscles–Extensors

Back 427

•Extensor digitorum
•Extensor indicis
•Extensor digiti minimi
•Extensor pollicis longus (thumb extensor)
•Extensor pollicis brevis (thumb extensor)

Front 428

–Abductor of thumb & wrist

Back 428

Abductor pollicis longus

Front 429

•_____ nerve & all ____ tendons except ____ & ___ pass through carpal tunnel

Back 429

Median
flexor
flexor carpi ulnaris
palmaris longus

Front 430

•Wrist abductors

Back 430

also radial deviation
–Generally cross wrist joint anterolaterally& posterolaterallyto insert on radial side of hand
•Flexor carpiradialis
•Extensor carpiradialislongus
•Extensor carpiradialisbrevis
•Abductor pollicislongus
•Extensor pollicislongus
•Extensor pollicisbrevis

Front 431

•Wrist adductors

Back 431

also ulnardeviation
–cross wrist joint anteromedially& posteromediallyto insert on ulnarside of hand
•Flexor carpiulnaris
•Extensor carpiulnaris

Front 432

•Intrinsic hand muscles have origins & insertions on bones of hand
–Radial side -four muscles of thumb

Back 432

•opponens pollicis
•abductor pollicis brevis
•flexor pollicis brevis
•adductor pollicis

Front 433

•Intrinsic hand muscles have origins & insertions on bones of hand–Ulnar side -three muscles of little finger

Back 433

•opponens digiti minimi
•abductor digiti minimi
•flexor digiti minimi brevis

Front 434

•Intrinsic hand muscles

Back 434

•4 lumbricals
•3 palmar interossei
•4 dorsal interossei

Front 435

Muscles•Anteromedially at elbow & forearm and anterior at hand

Back 435

–Primarily wrist flexion
•Flexor carpi radialis
•Flexor carpi ulnaris
•Palmaris longus

Front 436

Muscles •Anteromedially at elbow & forearm and anterior at hand

Back 436

–Primarily wrist & phalangeal flexion
•Flexor digitorum superficialis
•Flexor digitorum profundus
•Flexor pollicis longus

Front 437

Muscles
•Posterolaterally at elbow & forearm and posterior at hand

Back 437

–Primarily wrist extension
•Extensor carpi radialis longus
•Extensor carpi radialis brevis
•Extensor carpi ulnaris

Front 438

Nerves
•Radial nerve from

Back 438

C6, C7, & C8
–Extensor carpi radialis brevis
–Extensor carpi radialis longus

Front 439

•Posterior interosseous nerve from radial nerve

Back 439

C6, C7, & C8
–Extensor carpi ulnaris
–Extensor digitorum
–Extensor digiti minimi
–Abductor pollicis longus
–Extensor pollicis longus
–Extensor pollicis brevis
–Extensor indicis

Front 440

•Median nerve -arising from

Back 440

C6, C7, C8, & T1
–Flexor carpi radialis
–Palmaris longus
–Flexor digitorum superficialis

Front 441

•Anterior interossseous nerve from median nerve

Back 441

–Flexor digitorum profundus for index & long finger
–Flexor pollicis longus
–Intrinsic muscles
•abductor pollicis brevis, flexor pollicis brevis (superficial head), opponens pollicis, and 1st& 2ndlumbrical

Front 442

Nerves
•Ulnar nerve -branching from

Back 442

C8 & T1
–Flexor digitorum profundus for 4th& 5thfingers
–Flexor carpi ulnaris
–Remaining intrinsic muscles
•flexor pollicis brevis (deep head), adductor pollicis, palmar interossei, dorsal interossei, 3rd& 4thlumbrical, opponens digiti minimi, abductor digiti minimi, & flexor digiti minimi brevis
–Sensation to ulnar side of hand, ulnar one-half of ring finger & entire little finger

Front 443

Intrinsic Muscles of the Hand
•Thenar eminence -muscular pad on palmar surface of 1stmetacarpal

Back 443

–abductor pollicis brevis
–opponens pollicis
–flexor pollicis brevis
–adductor pollicis

Front 444

Intrinsic Muscles of the Hand
•Hypothenar eminence -muscular pad that forms ulnar border on palmar surface

Back 444

–abductor digiti minimi
–flexor digiti minimi brevis
–opponens digiti minimi

Front 445

Intrinsic Muscles of the Hand •Intermediate muscles

Back 445

–three palmar interossei
–four dorsal interossei
–four lumbrical muscles

Front 446

Intrinsic Muscles of the Hand
•Four muscles act on CMC of thumb

Back 446

–opponens pollicis -opposition in thumb metacarpal
–abductor pollicis brevis & flexor pollicis brevis abduct thumb metacarpal
–flexor pollicis brevis flexes thumb metacarpal
–adductor pollicis adducts thumb metacarpal
–flexor pollicis brevis & adductor pollicis flex proximal phalanx of thumb

Front 447

Intrinsic Muscles of the Hand

Back 447

•Three palmar interossei
–adduct the 2nd, 4th, & 5thphalanges

•Four dorsal interossei
–flex & abduct index, middle, & ring proximal phalanxes
–assist with extension of middle & distal phalanxes of index, middle, & ring fingers

•Third dorsal interossei
–adducts middle finger

•Four lumbricales
–flex index, middle, ring, & little proximal phalanxes
–extend middle & distal phalanxes of index, middle, ring, & little fingers.

Front 448

Intrinsic Muscles of the Hand•Three muscles act on little finger

Back 448

–opponens digiti minimi causes opposition of little finger metacarpal
–abductor digiti minimi abducts 5thmetacarpal
–flexor digiti minimi brevis flexes 5thmetacarpal

Front 449

Wrist Flexion
•Agonists

Back 449

–Flexor carpi radialis
–Flexor carpi ulnaris
–Palmaris longus
–Flexor digitorum superficialis
–Flexor digitorum profundus
–Flexor pollicis longus

Front 450

Wrist Extension
•Agonists

Back 450

–Extensor carpi radialis longus
–Extensor carpi radialis brevis
–Extensor carpi ulnaris
–Extensor digitorum
–Extensor indicis
–Extensor digiti minimi
–Extensor pollicis longus
–Extensor pollicis brevis

Front 451

Wrist Abduction ieulnardeviation
•Agonists

Back 451

–Flexor carpi radialis
–Extensor carpi radialis longus
–Extensor carpi radialis brevis
–Abductor pollicis longus
–Extensor pollicis longus
–Extensor pollicis brevis

Front 452

Wrist Adduction ieradial deviation
•Agonists

Back 452

•Flexor carpi ulnaris
•Extensor carpi ulnaris

Front 453

Phalangeal Flexion
•Agonists

Back 453

–Flexor digitorum superficialis
–Flexor digitorum profundus
–Flexor pollicis longus

Front 454

Phalangeal Extension
•Agonists

Back 454

–Extensor digitorum
–Extensor indicis
–Extensor digiti minimi
–Extensor pollicis longus
–Extensor pollicis brevis

Front 455

Wrist: The every day functional ROM

Back 455

10º flexion,
35º extension,
10º radial deviation,
15º ulnar deviation.
Optimal every-day (functional) hand/wrist position:
10-15 degrees extension and
10 degrees ulnar deviation.

Front 456

The wrist is a double-joint system:
Occurring both the ____ and the ___ joints (predominantly capitate)

Back 456

radiocarpal
midcarpal

Front 457

Midcarpal joint has ___axes of rotation, both through _____.

Back 457

2
head of capitate

Front 458

The ___ and head of the ___ both translate palmar with dorsal rotation (extension).

Back 458

Lunate
capitate

Front 459

A total of ___degrees of extension is achieved by minimal rotation of each carpal bone.

Back 459

60

Front 460

Full extension elongates the palmar ____ligament, palmar capsule and wrist/finger______ muscles. (i.e. Act as stabilizers and creates the close-packed position of the wrist).

Back 460

radiocarpal
flexor
The wrist flexion is similar to extension but in reverse fashion.
The wrist is not very stable in flexion.

Front 461

•Rotation (ulnar deviation) occurs as the _____ rotates ulnarly and slides radially on the ____ and _____and vice versa for radial deviation

Back 461

capitate
lunate & scaphoid
•Scaphoid, lunate, and triquetrum slide/roll radially and ulnarly

Front 462

•The proximal carpal row slightly ______during ulnar deviation (scaphoid in ____º ____) –FUNCTIONAL position of the wrist.

Back 462

extends
20º extension

Front 463

Rotational collapse of wrist

Back 463

The mobile proximal row of carpal bodies is intercalated between two rigid structures (the forearm and the distal row of carpal bones) and is thus prone to a rotational collapse in a zig-zag fashion when compressed from both ends.

Front 464

•The strongest wrist flexors are

Back 464

flexor digitorum profundus and superficialis.

Front 465

•The strongest wrist extensors

Back 465

the extensor carpi ulnaris and the extensor digitorum.

Front 466

Primary wrist extensor muscles:

Back 466

•Extensor carpi radialis longus
•Extensor carpi radialis brevis
•Extensor carpi ulnaris

Front 467

Secondary wrist extensor muscles:

Back 467

•Extensor digitorum
•Extensor indicis
•Extensor digiti minimi
•Extensor policis longus

Front 468

Primary wrist flexor muscles:

Back 468

•Flexor carpi radialis
•Flexor carpi ulnaris
•Palmaris longus

Front 469

Secondary wrist flexor muscles:

Back 469

•Flexor digitorum profundus
•Flexor digitorum superficialis
•Flexor policis longus

Front 470

Radial deviators of the wrist:

Back 470

•Extensor carpi radialis longus
•Extensor carpi radialis brevis
•Extensor carpi ulnaris
•Extensor policis brevis
•Flexor carpi radialis
•Abductor policis longus
•Flexor policis longus

Front 471

Ulnar deviators of the wrist:

Back 471

•Extensor carpi ulnaris
•Flexor carpi ulnaris

Front 472

Maximum grip strength is obtained with approximately ___ degrees wrist extension.

Back 472

30

Front 473

Palmar surface is concave with three integrated arch systems: They are?

Back 473

2 transverse (Proximal and Digital) + 1 longitudinal

Front 474

•Thumb is rotated __degrees medially (internally) relative to the other digits.

Back 474

90

Front 475

Kinematics of the Thumb

Back 475

•Abduction and adduction
•Flexion and extension
•Opposition and reposition (combination of the two other planes of motion).

Front 476

OPPOSITION of theThumb - Motion is divided into two phases:

Back 476

In phase one, the thumb metacarpal abducts. In phase two, the abducted metacarpal flexes and medially rotates across the palm towards the little finger

Front 477

Zig-zag deformity of the fingers
Swan-neck deformity:

Back 477

Hyperextension of PIP joint
Flexion of DIP joint

Front 478

Zig-zag deformity of the fingers: Boutonniere deformity:

Back 478

Flexion of PIP joint
Hyperextension of DIP joint

Front 479

Composition of cartilage?

Back 479

•70-85% of weight is water (65-80% of the total weight).
•Water is most concentrated near the articular surface (80%)
•Decreases in a near-linear fashion with increasing depth (65% in the deep zone).
•The fluid contains free mobile cations Na+, K+ Ca++, which greatly influence mechanical behaviours of the cartilage
•The remainder is primarily proteoglycans (PGs) and collagen type II fibers.

Front 480

mechanical behaviours of cartilage:

Back 480

•Viscoelasticity
•Bi-phasic creep response in compression
•Stress-relaxation response under compression
•Permeability of articular cartilage

Front 481

Articular cartilage has only a limited capacity for repair and regeneration, and if subjected to an abnormal range of stresses can quickly undergo total failure.
It is hypothesised that the following biomechanical factors relates to failure progression:

Back 481

1. The magnitude of the imposed stress
2. The total number of sustained peaks
3. The changes in the intrinsic molecular and microscopic
structure of the collagen-PG matrix
4. The changes in the intrinsic mechanical property of the
tissue

Front 482

Internal and External Force Effects on COG, •Objects in Flight

Back 482

–No external force
–Whole body system
–COG not effected by internal forces
–I.F. serve to change shape only

Front 483

Internal and External Force Effects on COG•Generate force against support

Back 483

–Reaction Force
–External Force
•Responsible for moving COG

Front 484

Mechanical Loads on the Body

Back 484

•Compression
•Tension
•Shear
•Stress
–Torsion
–Bending
–Combined Loads

Front 485

Effects of Loading

Back 485

Hint 485

•Load-Deformation Curve
•Yield Point or Elastic Limit
•Failure
•Repetitive vs Acute

Front 486

Newton’s Laws of Motion •First Law

Back 486

–Law of inertia
–A body will maintain a state of rest or constant velocity unless acted on by an external force that changes the state

Front 487

Newton’s Laws of Motion •Second Law

Back 487

–Law of Acceleration
–A force applied to a body causes an acceleration of that body of a magnitude proportional to the force, in the direction of the force, and inversely proportional to the body’s mass

Front 488

Newton’s Laws of Motion
•Third Law

Back 488

–Action-Reaction
–When one body exerts a force on a second, the second body exerts a reaction that is equal in magnitude and opposite in direction on the first body

Front 489

Newton’s Law of Gravitation

Back 489

•All bodies are attracted to one another with a force proportional to the product of their masses and inversely proportional to the distance between them
•Greater the mass the greater the attraction
•Further apart less attraction

Front 490

Friction

Back 490

•Force that acts at the interface of surfaces in contact
•Occurs in the direction opposite the impending motion
•Static Friction
•Maximum Static Friction
•Kinetic (Sliding) Friction

Front 491

Factors that Influence the Outcome when Two Bodies Collide

Back 491

•Elasticity of the two objects
•Direction of Impact

Front 492

Oblique Impact with Moving Bodies
•Six Variables to consider

Back 492

–Velocity of object 1
–Velocity of object 2
–Angle created by the vectors from 1 and 2
–Mass of object 1
–Mass of object 2
–Mutual coefficient of restitution

Front 493

•instantaneous velocity (v) is?

Back 493

slope (tangent) to the displacement-time curve at a particular instant

Front 494

Factors to take into account when assessing muscle strain are:

Back 494

•Low strength
•Reduced flexibility
•High risk player
•Early season
•Must-win game

Front 495

Active Motion

Back 495

•Is the movement of a joint in a specific direction through its range of motion, determined by the actionof the voluntary muscles

Front 496

Passive Motion

Back 496

•Is the movement of a joint in a specific direction through its range of motion, determined by its structural ligamentous integrity withoutvoluntary muscle activity.

Front 497

The goal of Motion Palpation MP is to assess the:

Back 497

•Quantity:How much does the joint move?
•Quality:How does the joint move through its ROM?
•Joint play:What is the quality of resistance (too much or too little)?
•End feel:At what point is the end feel encountered, what is the quality of resistance, and at what point does the motion stop?
•Symptoms:Changes in the amount or the location during assessment and motion?

Front 498

Joint Play

Back 498

•The qualitative evaluation of the joint’s resistance to movement when it is in a neutral or loose-packed position.
•It is the best opportunity to isolate the joint capsule from its periarticular muscles.
•Evaluated by a small magnitude, springing movement of the joint.
•Is the discrete, short-range movement of a joint independent of the action of voluntary muscles, determined by springing the joint in the neutral position

Front 499

End Play / End Feel

Back 499

•The qualitative assessment of the end play zone (EPZ).
•Evaluated by applying additional overpressure to the specific joint at the end range of passive movement.
•Characterised as a sense of increasing restriction towards first stop and a firmer resistance at its limits (second stop).
•Is the discrete, short-range movement of a joint independent of the action of voluntary muscles, determined by springing the joint at the limit of the passive range of motion (the end range).

Front 500

End Feel
•Capsular

Back 500

•Firm but giving
•Increasing resistance with increasing length
•Example: ext. Rotation of shoulder
•Abnormal: capsular fibrosis or adhesions leading to a capsular pattern

Front 501

End Feel•Ligamentous

Back 501

•Like capsular, but slightly firmer quality
•Example: knee extension
•Abnormal: abnormal resistance because of ligament shortening

Front 502

End Feel
•Soft tissue approximation

Back 502

•Giving / squeezing
•Results from approximation of soft tissue (painless)
•Example: Elbow flexion
•Abnormal: muscle hypertrophy, soft tissue swelling

Front 503

End Feel•Bony

Back 503

•Hard, non-giving
•Example: Elbow extension
•Abnormal: bony exostosis, articular hypertrophy

Front 504

End Feel
•Muscular

Back 504

•Firm, but giving
•Increases with elongation (not as stiff as capsular or ligamentous)
•Example: Hip flexion
•Abnormal: muscle hypertrophy or hypotrophy

Front 505

End Feel•Muscle spasm

Back 505

•Guarded, resisted by muscle contraction
•End feel cannot really be assessed
•Abnormal: protective muscle splinting as a result of joint injury/disease

Front 506

End Feel
•Interarticular

Back 506

•Bouncy, springing quality
•Abnormal: meniscal tear

Front 507

End Feel•Empty

Back 507

•Normal end feel resistance is missing, unusual give
•End feel is not encountered at normal point
•Abnormal: hypermobility or instability

Front 508

Joint cavitation (audible release)

Back 508

•ANormal joint.
•BLong axis distraction.
•CElastic recoil of capsule.
•DSudden increased volume decreases capsule tension.
•EStimulating high-threshold receptors.
•FGases coalesce into central area.

Front 509

•Bursa•Bursa

Back 509

–Fibrous, fluid-filled sac that reduces friction
–Located between bones, tendons, and other structures

Front 510

•Subacromial bursa

Back 510

–Bursa between acromion process and insertion of supraspinatus muscle

Front 511

–17 muscles that contribute to scapula and shoulder joint movements are listed

Back 511

–Major muscles
–Deltoid, trapezius, rhomboids, pectoralis major, latissimus dorsi, serratus anterior
–Rotator cuff (4 muscles surrounding shoulder joint)
¯Infraspinatus, supraspinatus, teres minor, subscapularis

Front 512

•Sprain
•Subluxation

Back 512

–Rupture of fibers of ligament

Front 513

17 muscles that contribute to scapula and shoulder joint movements are listed

Back 513

–Major muscles
–Deltoid, trapezius, rhomboids, pectoralis major, latissimus dorsi, serratus anterior
–Rotator cuff (4 muscles surrounding shoulder joint)
¯Infraspinatus, supraspinatus, teres minor, subscapularis

Front 514

•Sprain
•Subluxation
•Ectopic calcification

Back 514

–Rupture of fibers of ligament
–Partial dislocation
–Hardening of organic tissue through deposit of calcium salts in areas away from the normal sites

Front 515

•Impingement syndrome

Back 515

–Irritation of structures above shoulder joint
–Due to repeated compression between greater tuberosity and acromion process

Front 516

•Carrying angle

Back 516

–Angle between ulna and humerus with elbow extended
–10–20°

Front 517

•Osteochondritis dissecans

Back 517

–Inflammation of bone and cartilage resulting in splitting pieces of cartilage into the joint

Front 518

Carpal bone articulations

Back 518